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Masks, gloves and other equipment are crucial as health care workers face the COVID-19 outbreak. There聽is a strategic national stockpile that the U.S. government controls 鈥� but no one knows what, beyond that stockpile, is available in the private sector.

Some hospitals have a surplus of the protective equipment and some not enough. The Centers for Disease Control and Prevention is working on a system that would track the inventory across the U.S.

The big hurdle isn鈥檛 the technology. The issue is getting hospitals comfortable sharing information about their preparedness 鈥� information that, until now, they have considered confidential.

Protective masks have become a hot commodity, even within hospitals. At Nashville General Hospital, for example, employees several weeks ago were casually approaching supply chain management director Tom Cooper and asking if they could have a box for personal use.

Cooper told them the masks were available only for 鈥渃linicians as needed, for their job duties.鈥�

And Cooper said he鈥檚 feeling more protective of the supply his hospital has on hand 鈥� especially N95 respirators. General Hospital鈥檚 distributor, Medline, already of the respirators. Cooper said he can鈥檛 get any more than his usual monthly allotment, even if he could afford it.

鈥淩ight now, we鈥檙e OK,鈥� he said. 鈥淏ut next month, what could happen?鈥�

鈥楶anic Purchasing鈥�

The CDC has tried to avoid such scarcity and the costs associated with shortages. Often, there鈥檚 plenty of disposable protective gear to go around, but it鈥檚 not always in the right places ahead of pandemics.

鈥淚t can result in 鈥榩anic purchasing,鈥欌�� said , a nurse epidemiologist with the CDC. 鈥淭his is where facilities buy as much as possible, just to be on the safe side.鈥�

Right now, public health agencies know only what鈥檚 in government stockpiles of protective gear. Health and Human Services Secretary Alex Azar told Congress in recent weeks that the government has 聽even though 300 million may be needed. (The few U.S. companies manufacturing masks say demand in recent weeks has far聽, though they are ramping up.)

The nation鈥檚 6,000 hospitals have been more of a black box 鈥� now and in earlier epidemics. In past outbreaks 鈥� of H1N1 influenza, for example 鈥� some hospitals resorted to informal supply swaps on a street corner, according to project managers with the Center for Medical Interoperability, a Nashville-based nonprofit.

Last year, before COVID-19 emerged, the center was awarded a $3 million contract with the CDC to build a system that calls for hospitals to submit information about their real-time inventory. The information typically can be pulled directly from an institution鈥檚 electronic medical record system. Using that accumulated data, the CDC should be able to use a digital dashboard to easily identify facilities with the greatest need.

鈥淚t could also, potentially, provide a tool for hospitals to request personal protective equipment from state or local health departments, stockpiles or even other hospitals that might have excess,鈥� Casey said. 鈥淲e do see this as a potential opportunity for resource sharing and having those kinds of discussions.鈥�

A storage closet in the basement of Nashville General Hospital holds rarely used protective suits. Melanie Thomas, chief information officer at the hospital, is now sharing information with the CDC about its inventory of this sort of equipment.(Blake Farmer/WPLN)

Competitive Advantage

But the prospect of sharing supplies is where the business of health care makes cooperation hard even in a crisis, said . She鈥檚 the chief information officer at Nashville General, one of the pilot sites for the CDC-sponsored project.

鈥淚t鈥檚 difficult and scary sometimes to share data and equipment, especially with your competitors,鈥� Thomas said, 鈥渂ecause you want to have the advantage.鈥�

Nashville General is the smallest of the pilot sites, which include Northwestern Memorial in Chicago and Nashville-based Community Health Systems, a for-profit chain of nearly 100 hospitals around the U.S.

Thomas acknowledged it鈥檚 easier for her taxpayer-funded hospital to grant access to its inventory system because it doesn鈥檛 have the buying power to stockpile equipment.

鈥淭hat鈥檚 never going to be our problem,鈥� she said. 鈥淲e want the shared information because we鈥檙e going to have just enough.鈥�

And when they run out, she鈥檇 like to know where to turn to get more.

A Theoretical Threat Becomes Real

The Center for Medical Interoperability started its work quietly, a few months before COVID-19 emerged. But the project managers have noticed a greater willingness to participate among major health systems now that a theoretical threat has become very real.

鈥淲e know 鈥� that their supply chains are under strain right now because these products, they come out of China,鈥� said Tommy Ragsdale, the center鈥檚 director of strategy.

China needs the disposable equipment that is manufactured there for its own use. And only a handful of companies in the U.S. still make the protective gear domestically. One聽聽for more than a billion masks.

鈥淚t has definitely created different discussions at the hospital and health system level than we were having in October or November,鈥� Ragsdale said.

The CDC has pumped an additional $600,000 into the data-sharing project, with an accelerated go-live date in May, Ragsdale said. The center plans to hold a webinar on April 1 for additional hospitals interested in participating in later phases.

At this point, the CDC said, there鈥檚 no mandate for hospitals to participate. But Ragsdale said he hopes they will see the benefit: 鈥淭his is clearly for the greater good.鈥�

This story is part of a partnership that includes , and Kaiser Health News.