The Office of the Comptroller of Puerto Rico published an operational audit on the effectiveness and efficiency of the Department of Health in collecting COVID-19 case data. An operational audit is the professional, objective, and systematic examination of an entity's operations, to determine the degree of effectiveness, economy, and efficiency of the audited operations, and to formulate recommendations.
This audit is part of a multistate project promoted by the Delaware state auditor, with the assistance of the National Association of State Auditors (NASACT).
The Special Report reveals that the Department of Health was not fully effective in collecting the results of COVID-19 cases within 24 hours. From the examination performed, 27.5% of the cases reported in the BioPortal were recorded from two days to 11 months late.
This situation is attributed to the limited structure of the Office of Epidemiology and Research (OEI) and to the absence of an approved procedure for recording COVID-19 case data in the BioPortal.
In this regard, OEI has seven regional surveillance offices with an unstable and temporary structure, since its human resources are made up mostly of contract personnel. For example, the Mayagüez region has eight employees with temporary contracts, including the regional epidemiologist. In addition, prior to March 7, 2022, quick-guide-type communications had been published to register and access the BioPortal, but not an official guide approved by the Secretary of Health on the recording of COVID-19 case data.
Other external factors that affected data collection are attributed to the lack of sufficient personnel at the Department of Health during the COVID-19 surges and to the difficulties of the external sources with the processing of information in the BioPortal.
The second result of this operational audit notes that 95.6% of the cases recorded in the BioPortal by the source did not include the evidence of the laboratory test result, which is why the Department of Health could not authenticate and validate them as cases. As of May 9, 2022, 1,125 source entities were authorized to record in the BioPortal. In this regard, the Department was not efficient in verifying that the source entities completed all the information in the BioPortal and that they presented the result of the laboratory test performed.
These situations do not allow having updated and accurate information for decision-making, affect the surveillance and tracing functions, or lead to extreme measures of closures and limitations on activities to the detriment of the economy and the mental health of citizens, based on erroneous figures.
For the audited period, the Department of Health received $49,350,738 in state funds and $1,146,602,053 in federal funds.
The audited matter takes on great timely relevance in view of the impact and incidence of the pandemic at the international and local level. The Office of the Comptroller analyzed the regulations, the applicable rules, and evaluated the best practices in the collection of case data, and the reliability of the BioPortal's information, among others.
This special report covers the period from January 1, 2020 to December 31, 2021.
Special Report DA-23-16 can be obtained on our website: www.ocpr.gov.pr.
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