Some say data sharing incurs patient risk

With help from Arthur Allen (@arthurallen202) and Darius Tahir (@dariustahir)

Editor’s Note: This edition of Morning eHealth is published Mondays, Wednesdays and Fridays at 10 a.m. POLITICO Pro eHealth subscribers hold exclusive early access to the newsletter each morning at 6 a.m. Learn more about POLITICO Pro’s comprehensive policy intelligence coverage, policy tools and services at politicopro.com.

Quick Fix

— Some say data sharing incurs patient risk: Health care providers worry they don’t have the resources to vet all the new health apps their patients send data to. Upcoming HHS rules might leave the responsibility in patients’ hands.

— Another study deems telemedicine abortion safe: Planned Parenthood health centers in Alaska, Idaho, Nevada, and Washington prescribed abortion medication via video chat to several hundred patients, and outcomes were comparable to those of in-person visits.

— Boehler departs CMMI: Adam Boehler, who often proclaimed his intent to “blow up fee for service,” will step down from the top spot at the Center for Medicare & Medicaid Innovation.

eHealth Tweet of the day: Sachin H. Jain, MD @sacjai: “What if—rather than ‘innovation’ in healthcare—we committed to a simpler idea: radical common sense.

Committing to ‘radical common sense’ means that we drive towards making the right thing happen—not just the expedient thing—when someone needs our help.”

IT’S FRIDAY at Morning eHealth, where your author is contemplating making a galette. Any tried-and-true recipes for a novice baker? Pies, pastries and news tips go to [email protected]. Tweet the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Driving the Day

OK, FREE UP THE DATA. THEN WHAT? — That’s the question some provider groups have as they prepare for upcoming rules making it easier for patients to access their own data. Sure, patients should be able to download their own health records, and even send it to the health app of their choosing, they say — but are patients really savvy enough to protect themselves from data mongers who want to sell or exploit their information?

“There’s going to be new apps coming online every single day,” Steven Lane, clinical informatics director of Sutter Health and a member of ONC’s HIT Advisory Committee, told POLITICO. "[M]ost patients who are using these tools don’t fully understand the privacy implications.”

HHS has been clear that providers aren’t responsible for the health data once a patient decides to send it to an app outside the health system. But some of them feel an ethical responsibility to ensure patients don’t share their data irresponsibly, and are calling for federal guidelines outlining what health apps can do with patient data and how to get consent.

Others say that perspective is paternalistic, pointing out that consumers regularly download apps outside of health care and can be trusted to protect their own privacy. Drafts of upcoming information blocking and interoperability rules from ONC and CMS suggest that HHS believes patients are responsible for their own information, Cedars-Sinai CIO Darren Dworkin said. “At the end of the day, we’re entering a brave new world in which patients will choose what they want to do with their information and how they want to share it.”

— Elsewhere in health IT policy, ONC’s Health Information Technology Advisory Committee met this week and voted to advance to ONC a set of recommendationson the second draft of TEFCA. The Trusted Exchange Framework and Common Agreement is a set of principles for more seamless health data sharing. Among the recommendations was that ONC use both “carrots and sticks” to encourage TEFCA adoption.

Technology

STUDY: TELEMEDICINE ABORTIONS JUST AS SAFE AS IN-PERSON ONES — A handful of studies have concluded that abortion medication prescribed via video chat — whether the patient is at home, in a car or at a doctor’s office — is just as safe as when it’s prescribed in person. Planned Parenthood and UCSF researchers published another such study this week, assessing more than 700 women in Alaska, Idaho, Nevada, and Washington.

Abortion rights advocates have argued that telemedicine could make it easier for patients who would otherwise have to drive what could be hundreds of miles to their nearest abortion clinic just to pick up a pill. Some clinics in some states allow patients, once they’ve submitted their ultrasounds and pre-screening, to video chat with an abortion provider either from the facility or from their homes to get the prescription. Still, telemedicine abortion is only legal in some states — patients in other states would still need to travel to the nearest state where the virtual procedure is allowable to video chat with a clinician.

— Also on telehealth, FCC commissioners this week unanimously approved a proposal for a three-year, $100 million fund supporting virtual health programs for low-income Americans, particularly in rural areas. The FCC is now seeking public comment on the proposal.

The Connected Care Pilot Program would be similar to FCC’s existing $571 million Rural Health Care Program,which helps hospitals and other health care centers cover telecommunications costs. AARP, the American Telemedicine Association, and the College of Healthcare Information Management Executives have all said they support the pilot.

— In the world of opioids: Sens. Lisa Murkowski and Maggie Hassan introduced a new bill that would remove some restrictions on prescribing buprenorphine for opioid use disorder. The Mainstreaming Addiction Treatment (MAT) Act would also allow prescription via telemedicine — per a clause added by Murkowski’s staff — though her office did not clarify how that provision aligns with the Ryan Haight Act, which broadly bans the virtual prescription of controlled substances except in select cases.

— Also on opioids: RB Group, the former parent of drug company Indivior, will pay a $1.4 billion settlement to resolve allegations that it fraudulently marketed addiction treatment drug Suboxone, our colleague Arthur Allen reports.

Medicare

BOEHLER OUT, AND OTHER CMS HAPPENINGS — CMMI head and value-based care advocate Boehler is stepping down as leader of CMS’s innovation center, our colleagues Dan Diamond and Rachel Roubein report. He’s led the innovation center since April 2018, and has aggressively rolled out new payment models during his tenure. President Donald Trump announced his intent to name Boehler CEO of the United States International Development Finance Corporation; he’ll remain at CMMI during the nomination process for that position.

— Elsewhere at CMS, the agency released its 2020 home health payment rule, which includes proposals for establishing a permanent home infusion therapy benefit for 2021, which includes remote monitoring and is required under the 21st Century Cures Act, our colleague Rachel Roubein reports.

— On Medicaid, CMS is also proposing to exempt states from Obama-era requirements for monitoring and anayzing data on beneficiaries access to care, arguing that those requirements are burdensome, Dan reports. "[W]e believe mandating states to collect the specific information as described excessively constrains state freedom to administer the program in the manner that is best for the state and Medicaid beneficiaries in the state,” CMS wrote.

Public Health

BATTLING VACCINE MISINFORMATION — Public health officials are not quite sure how to keep parents from buying into conspiracies, our colleague Renuka Rayasam writes. Just 5 percent of Americans strongly disagreed with the statement that vaccines are safe in a June Wellcome Trustsurvey, but only 48 percent strongly agreed with the statement. Sixteen percent neither agreed or disagreed.

"[S]tate and local officials and their allies are turning to compelling storytellers to deliver messages on social media that vaccines are safe,” Renuka writes. “The challenge is to counter the sway of anti-vaccine messaging based on distrust of the government and pharmaceutical companies.”

Health IT Business Watch

Big tech made big inroads in health this week while Washington leaders promised to turn up the heat on the private sector. Here’s what we’re tracking:

— NHS PARTNERS WITH ALEXA TO REDUCE DEMAND: The U.K.'s National Health Service is partnering with Amazon’s voice assistant technology, Alexa, so that patients can ask Alexa for simple health advice, BBC reports. Alexa can scan NHS’s official website for answers.

— MICROSOFT WORKS WITH PROVIDENCE ST. JOSEPH ON HIGH-TECH HOSPITAL: The computing giant will transform one of Providence St. Joseph’s existing facilities in Seattle, near Microsoft’s headquarters, CNBC’s Chrissy Farr reports. Among the priorities: making a better, easier-to-use EHR.

— NEW TECH OVERSIGHT IN WASHINGTON: The Senate Judiciary Committee is forming a new task force examining online platforms, Sen. Marsha Blackburn (R-Tenn.) said at this week’s White House social media summit, per our POLITICO colleagues Margaret Harding McGill and Cristiano Lima. Blackburn also plugged her online privacy bill, the BROWSER ACT, which would allow consumers to opt in to the collection of sensitive information and opt out of the collection of non-sensitive data.

What We're Reading

— Charlie Warzel and Ash Ngu write about Google’s privacy policy for The New York Times’ Privacy Project.

— Menlo Ventures’ Greg Yap writes in Tech Crunch about the potential for more advanced blood pressure monitoring.

— John Torous, Paul Cerrato and John Halamka assess the risks and potential of mental health technology, including chatbots, in mHealth.