State Auditor: Test Iowa Reporting System Is Flawed

A report issued Tuesday morning by State Auditor Rob Sand details the complicated, four-step reporting chain implemented by the Iowa Department of Public Health to process coronavirus test results from Test Iowa clinics, a reporting chain Sand believes to be illegal and “risky.”

The 17-page report was produced in light of concerns about reporting issues related to Test Iowa brought to the auditor’s office by state and county-level employees. Sand said his office looked at the reporting processes from all coronavirus testing sites in the state and found that Test Iowa clinics were the only ones not reporting results directly to IDPH.

Once the State Hygienic Lab processes an Iowan’s coronavirus test, instead of sending the test result directly to IDPH as required by law, Sand’s office found the test result goes to three separate entities before reaching public health officials, a reporting process he believes “is contrary to law, takes apparently pointless risks, and increases taxpayer risk of legal liabilities.”

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Gov. Kim Reynolds established the Test Iowa initiative in April through a $26 million no-bid contract between the state of Iowa and Nomi Health, Inc, following a recommendation by actor Ashton Kutcher. A website to register for drive-through coronavirus tests conducted at locations across the state was established so Iowans have access to free testing.

After the state lab processes a coronavirus test conducted at a Test Iowa site, it first reports the result to Qualtrics, a private company in Utah. Qualtrics then reports data to Domo, another Utah-based company, and Domo reports to the Iowa Office of the Chief Information Officer. The CIO office then reports the test results to IDPH.

“Each link in the chain is an area where the integrity, reliability, and timely transmission of information is put at unnecessary risk of error, equipment failure, maladministration, outright falsification, or any other cause,” the auditor’s report states.

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Given the high stakes of the pandemic, Sand felt it was necessary to inform the public about the potential problems of a lengthy reporting chain and to implore IDPH to change the Test Iowa reporting process so test results go immediately from the state lab to public health officials.

“The importance of getting this information right, from a public health aspect, is paramount,” Sand said. “We should not be taking unnecessary risks with data related to the pandemic.”

When asked about the auditor’s report during a press conference today, Gov. Kim Reynolds said the attorney general’s office “has concluded that the State Hygienic Lab procedures do follow the law, and they have an extensive letter they put together that addresses the state auditor’s issues.”

Sand said the report does not delve into whether the four-step reporting chain has led to a delay in Iowans receiving their test results, though he acknowledged there have been news reports about testing and reporting issues linked to Test Iowa.

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Last week, the Des Moines Register reported “leaked samples and an equipment malfunction” at the State Hygienic Lab damaged more than 200 coronavirus tests in mid-June, primarily from Test Iowa sites in Linn and Marshall counties. In the spring, Iowans reported receiving inconclusive results from Test Iowa sites and delayed results that, in some cases, took more than two weeks to receive.

The auditor’s report includes a May 26 letter from Sand to Dr. Michael Pentella, director of the State Hygienic Lab (SHL), outlining the ways in which Test Iowa’s reporting chain does not comply with a section of Iowa law that requires infectious disease test results to “immediately” be sent to IDPH.

“To comply with state code, the SHL must report all Test Iowa results into IDSS (Infectious Disease Surveillance System) immediately, as is done with all non-Test Iowa tests,” Sand wrote.

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In response, an IDPH attorney outlined the reporting process for a variety of coronavirus testing methods happening in the state, including Test Iowa.

“It is the Department’s position that SHL has been reporting all COVID-19 test results to IDPH in a manner which complies with state code, including the Test Iowa results.”

Other testing methods available to Iowans include local hospitals, out-of-state labs and Abbott, a diagnostic testing system provided to states by the federal government.

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Sand said he has not received an explanation from the governor’s office or IDPH as to why the reporting chain for Test Iowa has three intermediaries.

“We’ve asked the question: Why can’t it (Test Iowa results) be reported directly? Why are you routing it this way? And we’ve received no answer to it,” Sand said, “which suggests to us there is no legitimate point to do it that way.”

By Elizabeth Meyer
Posted 7/14/20

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