ONC info blocking rule marks milestone

With help from Arthur Allen (@arthurallen202) and Mohana Ravindranath (@ravindranize)

ONC INFO BLOCKING RULE MARKS MILESTONE: The Office of Management and Budget is now responsible for reviewing ONC’s long-awaited proposal clarifying what kinds of conduct constitutes information blocking. An OMB notice stating that the proposed rule was pending review was posted Tuesday morning.

The news is sure to cheer the health care sector, which had become increasingly outspoken about the lack of a rule.

The 21st Century Cures Act bans health IT vendors, hospital systems or other entities from interfering with or restricting the exchange of secure health information. The law directs ONC to define exceptions so that HHS’ Office of the Inspector General knows which practices to penalize. An amendment submitted by Sens. Sheldon Whitehouse and Bill Cassidy to the “minibus” spending bill directs HHS Secretary Alex Azar to update Congress on ONC’s rulemaking status by Nov. 1. Pros can get the story here.

E&M PROPOSAL DRAWS DOCS’ IRE: CMS’s proposal to cut paper-pushing by changing the agency’s long-standing — and almost-as-long-complained about — evaluation and management code system was supposed to be a PR coup. Instead, as our Health colleague Rachel Roubein and your correspondent report, it’s been greeted by annoyance.

Why? The structure of the rule, doctors’ groups and other analysts say, decreases the incentive to treat complex patients or to take a long time in a given visit. According to an analysisin the New England Journal of Medicine, a doctor seeing a complex patient over half an hour or more could better spend her time, financially speaking, seeing three patients quickly.

But there’s more to it — many doctors’ groups feel CMS’s rollout blindsided them, and that they didn’t have enough information to dig into the rule. The controversy has reached a high boil, with a bipartisan group of 90 House members sending a letter to CMS critiquing the rule. A group of Senators is reportedly going to send a version for its chamber.

eHealth tweet of the day: Andrey Ostrovsky, MD @AndreyOstrovsky Replying to @JoanneKenen [re: the big opioids bill] “Provisions in the bill are profoundly insufficient to incentivize the disastrous behavioral health EHR industry to become customer-centric and actually meet the needs of opioid treatment programs.”

WEDNESDAY: Someone tell your correspondent what he’s gotta to do banish all this rain. Send suggestions to repel downpours at [email protected]. Talk meteorology at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

CAVALRY COMING FOR VA?: A trio of developments could bring change to the VA on several fronts:

— Investigation?: A pair of Democratic senators — Richard Blumenthal and Sherrod Brown — have sent a letter to the Department of Veterans Affairs inspector general requesting an investigation into the allegations laid out principally in ProPublica’s expose of the “Mar-a-Lago crowd” purportedly controlling matters at the agency. (Don’t forget our colleague Arthur Allen also delved into the influence the group had over the EHR selection saga.)

— Nominees get committee stamp of approval: Tuesday, the Senate Veterans’ Affairs Committee advanced the nominations of James Gferer, slated to be the agency’s CIO; and Tamara Bonzanto, to serve as the agency’s assistant secretary of the its Office of Accountability and Whistleblower Protection.

Gferer is likely to be the more important official for IT matters, given the implementation of the $16 billion Cerner project. The committee’s ranking member, Jon Tester, said they had “challenging positions,” and urged “good communication and hard work.” They await confirmation by the full Senate.

— Booz Allen and the Cerner implementation: Booz Allen Hamilton, the giant consultant with a $750 million management contract to support the VA’s EHR modernization, is advertising for help in Spokane, Wash., home of the Mann-Grandstaff VA Medical Center — one of the four sites for the initial VA Cerner implementation over the next 18 months. Booz Allen wants someone to provide “dedicated, site-level support to assist with critical path success and to mitigate site-level issues.” The tasks include project scheduling, risk management and conducting “critical path analyses.”

The VA is leaning heavily on Booz Allen for expertise, project leader John Windom said at a hearing last week. No one on the VA team proper has experience implementing a big EHR project, he said.

NEW PULSE CHECK — WHAT’S IT LIKE TO BE A RADIOLOGIST?: In the latest episode of “Pulse Check,” our Health colleague Dan Diamond delves into the life of the American radiologist, asking whether their days are numbered: they’re stalked by the prospect of outsourcing and artificial intelligence replacing their jobs.

THE LATEST IN SENATE APPROPS: The Senate has approved, 93-7, a conference report spending package, H.R. 6157 (115), which would fund the Defense, Labor, Education and Health and Human Services departments, our colleague Jennifer Scholtes reports.

Research!America fulsomely praised the bill and its funding levels for NIH, CDC, and AHRQ, saying, “it is imperative to accelerate the critical work of federal health agencies committed to protecting the health and security of Americans.”

The American Association of Medical Colleges was also similarly pleased, citing specifically a $2 billion boost to the NIH’s budget. “This additional funding builds on significant investments in the NIH over the past three fiscal years, continuing a trend of sustained, meaningful growth,” they said.

TECH UPDATE: Omada Health is partnering with big insurer Cigna, the startup announced Tuesday. Beginning January 2019, Cigna beneficiaries can access Omada services along with the insurers’ own weight-loss and wellness offerings.

JOBS WATCH: ONC’s hiring a nurse informaticist. The office lists burden reduction for nurses, improved safety, and rulemaking related to 21st Century Cures as some of the responsibilities for a prospective hire. The individual should probably have a masters in informatics, and needs to coordinate with developers, state agencies, and others. Applications due by October 15.

WHAT WE’RE CLICKING ON:

A suite of offerings from the medical journals: in JAMA, a pair of articles discussing deep learning; and in the Health Affairs blog, a pair of posts on rolling out artificial intelligence.

A Wired article discusses AI identifying tumor mutations

A McKinsey analysis delves into the response to the opioid crisis.