Bellwether PDMP case heard

With help from Arthur Allen (@arthurallen202), Rachel Roubein (@rachel_roubein) and Mohana Ravindranath (@ravindranize)

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Quick Fix

— Bellwether PDMP case heard: We’ve got a report on the potential bellwether PDMP case, and other news from opioid data-tracking.

— HITAC preview: ONC and the Health IT Advisory Committee are slated to start their planning for 2020 in today’s committee meeting.

— In Cali: Golden State Gov. Gavin Newsom has signed new legislation boosting reimbursement for virtual care in the state.

And more. But first, the jump.

eHealth tweet of the day: Keith Humphreys @KeithNHumphreys “Next best step for prescription drug monitoring programs is making them easier to use. Integrate them with existing EMR, make the interface smooth and the response fast, let prescribers delegate the check to someone on their team, and pay them for their time.”

WEDNESDAY: Your correspondent hopes everyone spent a nice weekend, whether long or short. He himself had fun watching a matinee showing of The Laundromat — a fun little caper about money (sadly, nothing on dry cleaning. The definitive dry cleaning movie is still The Man Who Wasn’t There.) Talk autumnal film releases by email at [email protected]. Discuss movies socially at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Driving the Day

BELLWEATHER PDMP CASE — A potential landmark case concerning privacy rights for prescription data was heard Thursday in the First Circuit Court of Appeals. The case pits New Hampshire and the ACLU against the DEA. The federal law enforcement agency is seeking access to New Hampshire’s PDMP data using a subpoena, which requires a lower evidentiary bar than a search warrant.

The DEA has long been able to access PDMP data with a subpoena, despite occasional attempts by states to require a search warrant. But New Hampshire’s attempt to resist the DEA subpoena — based on state law requiring a search warrant for law enforcement access of the PDMP – comes in a new context: a recent Supreme Court decision narrowing a legal doctrine called the third-party doctrine, and requiring search warrants for law enforcement access to certain big databases.

The ACLU believes that PDMP data should also require a search warrant under this new precedent, and the organization’s lawyer, Nate Wessler, said the judges gave him a respectful reception during arguments. “The judges clearly understood there are serious privacy questions here,” he said, arguing that they often skeptically probed the federal government’s argument that patients don’t have a special expectation of privacy for their medical records.

Two of the three judges hearing the case were appointed by a Republican president. If they do decide in New Hampshire’s favor, Wessler believes approximately ten other states might try and follow their lead.

— NFL rolling out PDMP: The National Football League is rolling out a new prescription drug monitoring program, the Boston Globe reports. Football players have long been known as heavy users of opioids as a means of coping with injuries endured in a brutal game. The new league wide program is intended to track “who got what, which medication, for how long, and the reasons for that,” NFL players association medical director Thom Mayer told the Globe.

HITAC PREVIEW — We’re set for another meeting of the Health Information Technology Advisory Committee today. Topics for discussion include planning for next year’s round of meetings. One new klatch of health IT experts: a new task force to discuss recommendations on the EHR reporting program, the bete noir of every tired provider documenting the day’s work.

IN CALI, CALI — Gov. Gavin Newsom provided a boost to telemedicine Sunday when he signed a bill mandating parity in reimbursement between visits conducted virtually, and those conducted in-person. Effective January 2021, The bill was championed by the California Medical Association and opposed by health insurance groups.

Health IT Business Watch

WHAT EHR MERGERS MEAN FOR CUSTOMERS — Whether health record companies’ consolidation heightens or wrosens customer satisfaction depends on factors like company culture, a new report from KLAS concludes.

About 42 percent of customers reported a decrease in satisfaction in the year after an EHR vendor merger (like Cerner’s purchase of Siemens a few years back). And the number of customers looking to leave their vendor doubles in the year after a bad merger, KLAS found. Dissatisfied users reported frustrations with “frequent nickel-and diming, a decline in the quality of phone/web support, and stagnant product development,” KLAS found.

Still, about 40 percent reported higher satisfaction after a merger. A company might increase satisfaction by deciding not to make significant cost structure changes in the first year, and nurturing a sense of stability, the report suggests. A culture of open communication also helps. “In the absence of communication, customers are stuck creating their own stories about the company vision,” the authors wrote.

NEWS AND NOTES — Omada Health announced a partnership with Abbott Monday. The medical device firm, which manufactures a smartphone-compatible glucose monitor, will work with Omada to bring a type 2 diabetes management program to customers … Oncology startup Syapse has hired its first chief medical officer, Thomas Brown, formerly of the Swedish Cancer Institute in the Pacific Northwest. … Medical device trade association AdvaMed to launch its Center for Digital Health today.

Around the Agencies

FTC’s COMPETITION BUREAU CHIEF STEPPING DOWN — The leader of the Federal Trade Commission’s competition bureau, Bruce Hoffman, is stepping down in November, our Tech colleague Steven Overly reports. He’ll be replaced by his deputy, Ian Conner.

The commission is embroiled in a big health IT antitrust case against e-prescription network Surescripts. The agency has accused Surescripts, a dominant intermediary in relaying digital prescriptions, of abusing its position to crowd out competitors and slow innovation. Surescripts has vigorously denied the charges, and arguments on a motion to dismiss the FTC’s complaint are due to be heard November 19.

ONE CHALLENGE WITH CDC’S LUNG ILLNESS INVESTIGATION: FAX MACHINES — The CDC is investigating a mysterious vaping-related lung injury that’s led to at least 29 deaths — and is stumbling into “antiquated and fragmented” public health data collection and reporting systems.

That’s according to CDC principal deputy director Anne Schuchat’s written testimony for a House Appropriations Labor-HHS subcommittee hearing on e-cigarettes on tap this morning, where she lays out the challenges in securing timely information in a way that maintains patient privacy. “This investigation is emblematic of a challenge to all our work that requires rapid collection and analysis of public health data but is often reliant on paper-based systems and fax machines,” the testimony states.

What We're Reading

Genetic biohackers are starting to pick up some of the research establishment’s best practices, Bloomberg reports.

A Q&A with some thinkers about ethical dilemmas in health care AI in the Wall Street Journal.

And here’s a rundown of the changes to the Stark and Anti-Kickback regulations in a Health Affairs blog post.