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State Auditor asks IDPH for Iowans' private medical records

Auditor Rob Sand is looking into TestIowa, which is the state-run coronavirus testing program.

DES MOINES, Iowa — Iowa State Auditor Rob Sand requested medical records of Iowans from the Iowa Department of Public Health (IDPH) in order to audit the state's response to the novel coronavirus.

Sand announced Tuesday that he joined a team of "fiscal watchdogs" from 14 other states to find out how states are collecting and monitoring COVID-19 cases. 

"We expect to see similar requests from Republican and Democratic auditors across the country," Sand's spokesman Andrew Turner said in an emailed statement Wednesday. 

In an interview with Simon Conway from WHO Radio Tuesday, Sand said Iowa law allows him to look at these records, but said his office only wants coronavirus data.

"Our office is covered under HIPAA as an entity that's allowed to have private health information disclose to it," Sand said during the WHO Radio interview.

Local 5 reached out to his office for comment on the situation. 

The Auditor's office provided Local 5 the following emailed statement Wednesday when asked why their office needs Iowans' medical records:

"The medical records in question are the same ones the Governor's Test Iowa contract is providing to two private companies in Utah as well as three other state agencies. We are responsible for auditing them."

On average, IDPH said TestIowa results get reported to the state quicker than other COVID-19 tests

Sand's requests in the letter shed light on how TestIowa reports data, specifically to how the Office of the Chief Information Officer (OCIO) is involved.

In the letter, the IDPH said the OCIO provides technical support in the TestIowa reporting process, such as IT coding and data management. The OCIO created an automated process to pull test data every 30 minutes from DOMO, the agency that assists TestIowa in data collection. 

This automated process validates the records by checking for proper date formats, list values, data types and length checks, and corrects invalid birth dates. Invalid data is flagged and then sent to the IDPH via email for correction.

After validation, another automated process places the data on the IDPH SFTP server. This process takes about one minute to complete, according to the letter. 

"At no time does OCIO access the data," IDPH said in the letter. 

The letter also details why TestIowa results aren't directly sent to the IDPH

Currently, TestIowa results are sent to two private companies and one other state entity before the IDPH receives the data.

IDPH said requiring the State Hygienic Laboratory to send TestIowa results to their department at the same time as non-TestIowa results "would create a significant reporting burden" on the lab and add "tremendous inefficiencies and duplication to the current reporting structure."

In the letter, IDPH said having the State Hygienic Lab report it directly to IDPH wouldn't create any added value to the timeliness, security, efficiency or accuracy in reporting. 

The letter also said last quarter, TestIowa results were reported to the state's disease surveillance system faster than other COVID-19 test results. 

  • TestIowa reporting lag: .33 days (1/3 of 1 day)
  • State Hygienic Lab reporting lag: .52 days (1/2 of 1 day)
  • All other non-TestIowa reporting lag: .86 days (almost a full day)

"Of significance is the fact that the average for all COVID test reporting is under 24 hours from results being released, the timeframe mandated by the federal government in the CARES Act and used by other states in their response," IDPH said in the letter. "These timeframes for reporting, including the reporting for Test Iowa results, satisfy the statutory and the mandatory reporting order requirements."

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