Management of outbreaks rely on hospitals’ health information technology (IT) to electronically share data to public health systems. Studies show that half of non-federal hospitals reported a lack of capacity to exchange information with public health agencies, placing a variable burden on institutions to meet the government mandated reporting requirements. This study aims to contrast the impact of COVID-19 reporting requirements across two New York City institutions with disparate health IT capabilities.

A retrospective, qualitative study contrasting the impact of reporting requirements on a small independent hospital (SIH) with 198 staffed beds and a large, networked hospital (LNH) with eleven campuses during the COVID-19 pandemic. Researchers conducted 51 interviews with hospital leadership, clinical directors, and infection control personnel. Interviews were transcribed and coded using qualitative analysis software.

The LNH had a 50-person analytic team that handled reporting tasks, a centralized data warehouse that was automatically updated, electronically generated reports with universal access, and limited burden of clinical staff. The SIH had no dedicated analytic team. Seventeen departments were utilized to handle reporting tasks with no centralized place to share electronic data, limited capacity to create automatically updated reports, a daily manual information gathering processes, and significant need of clinical staff to collect data. Both SIH and LNH faced challenges associated with the distribution of responsibilities and resources with pressure to report in a timely fashion. However, the burden on the SIH was so onerous that it significantly impeded routine hospital work and patient care.

The disparity in health IT capabilities highlights significant institutional inequities and variability in response during a pandemic. The findings have implications for how government and other regulatory bodies may adjust policies to equitably meet public health needs and not unfairly burden small hospitals.