Interoperability research shows agita

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

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Quick Fix

— Interoperability research shows agita: Some new research into interoperability shows the benefits of data-sharing aren’t as simple as just making the data available.

— New congressional proposals: Some members are out with new data privacy and AI investment plans.

— A shot of SDOH funding: Fourteen hospitals and health systems are putting down $700 million in cash to fund social determinants of health work — but questions about a lack of data and sometimes rocky implementation await.

And more. But first, the jump.

eHealth tweet of the day: Arien Malec @amalec “Thesis: progress towards nationwide #interoperability adequately explained by the behavior of large health systems that value ownership & control over ‘data follows patient-control’”

WEDENESDAY: Days are getting dark and short but Morning eHealth is trying to shed light at length. (Not too much length!) Anything we should be keeping an eye out for? Send tips to [email protected]. Discuss fall news socially at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Driving the Day

RESEARCH ROUNDUP — Some recent studies exploring interoperability agita are worth your time:

— Are patients accessing their medical records?: Not a bunch, a new study in Health Affairs concludes. Looking at a sample of 2,410 hospitals that had attested to stage 2 of meaningful use between 2014 and 2016, the researchers found that 95 percent of patients had access to their data two years after their attestation — but only 10 percent of those patients actually took a peek at that information through their patient portals.

Institutions with higher use tended to be nonprofits and major teaching hospitals, and were less likely to be rural. Hospitals located in counties with low computer and internet access were less likely to have high use.

Not only were access rates low, but they’d not increased during the years studied. “Taken together, these results suggest that the US is unlikely to achieve widespread electronic use of health information by patients without further policy action,” the authors write. Those might include increasing meaningful use requirements or targeting specific types of information use, like patients exchanging secure messages with their care team.

— Some decline, not significant, in duplicate imaging after shared records: You’d hope that sharing an EHR would lead to less duplicate imaging of a patient. A new study in the Journal of General Internal Medicine adds a definite “maybe” to that hope.

The study, which examines inter-hospital transfers before and after the implementation of a shared EHR between two Massachusetts institutions, finds a decrease in duplicate imaging — but not a significant one. Indeed, 28.2 percent of images post-transfer were duplicates, the study finds, suggesting that mere sharing is not enough to address the issue.

CONGRESSIONAL PROPOSALS — Congress unveiled some consequential proposals Tuesday:

— Data protection legislation: Two Silicon Valley Democrats, Reps. Anna Eshoo and Zoe Lofgren, unveiled legislation to safeguard consumer privacy, our POLITICO Tech colleague John Hendel reports.

The Online Privacy Act, H.R. 4978 (116), would establish the Digital Privacy Agency, a new agency that would write regulations and levy fines on par with what the FTC can issue. The sponsors envision the agency would have about 1,600 employees.

Critics, including House GOP lawmakers, see the measure as too aggressive and favor keeping the FTC as the principal regulator for tech, John writes.

Eshoo and Lofgren’s proposal is another attempt to write nationwide, comprehensive privacy legislation. California’s new law, which takes effect in the new year, has spurred interest in Congress for an analogous effort at the federal level. But the two parties are divided over several matters, including whether such a law would preempt state legislation.

— Schumer makes AI pitch: Senate Minority Leader Chuck Schumer called for a $100 billion artificial intelligence investment over five years, our Defense colleague Jacqueline Feldscher reported Tuesday. The new funds would come as part of a plan to establish a National Science Technology Foundation to do tech research.

HOSPITALS PUTTING MONEY INTO SDOH — Fourteen hospitals and health systems are investing over $700 million to improve the economic, racial and environmental disparities that can lead to poor health, our colleague Rachel Roubein reports.

The investments are aimed at boosting projects in the providers’ communities, such as financing affordable housing developments, new grocery stores in food deserts, child care centers and minority- and women-owned businesses.

Addressing social determinants of health is a catchphrase in health care these days. But health experts have cautioned that there’s little data so far on whether providing non-traditional health services keeps people healthier and saves the system money — and they say it’ll be important to analyze what works.

Indeed, some other attempts to involve non-traditional providers have foundered. CMS’ attempt to roll out the diabetes prevention program as a new benefit has reached barely any Medicare beneficiaries — only hundreds in 2018, the agency’s data suggests — and DPP providers are concerned that the agency’s pratfall could be replicated in other social determinants work.

The agency has put a lot of anti-fraud requirements on prospective providers, and not-for-profits don’t have the capital to meet them. A similar fate could meet social determinants providers if the government wades in, experts have told us.

This new initiative, coordinated by the Healthcare Anchor Network, will collect initial data, such as the number of jobs and housing units that are created. Analyzing changes in health outcomes will come later.

In the States

FLORIDA LAUNCHES PRICE TRANSPARENCY TOOL — Florida Gov. Ron DeSantis rolled out a state website intended to display the prices of 44 non-emergency health procedures. The website is reliant on claims data.

It’s the latest conservative effort to spotlight price transparency as a policy tool to solve health care — recall that CMS has delayed its rule requiring hospitals to post their prices.

But there’s little evidence consumers actually use such data when it’s available to them. For example, one study surveying employees’ use of their companies’ price transparency tools found that 40 percent knew about the technology — but only 7 percent were active users. Castlight Health, one of the top transparency companies, has had a rough ride as a public company.

— And in New York…: Legislation signed by Gov. Andrew Cuomo on Tuesday will require medical examiners and coroners to fill out the type of opioid involved in an overdose, our New York colleague Shannon Young reports.

The bill is intended to improve data collection related to the opioid crisis. Researchers and policymakers have long expressed concerns about the quality of death certificate data. For example, one November 2018 study in the American Journal of Public Health found that a majority of accidental overdose deaths in one Indiana county had an unspecificied drug as a cause; after using toxicology data, the researchers doubled the proportion of opioid-involved deaths.

Inside the Humphrey Building

UNENCRYPTED FLASH DRIVE, LAPTOP LEAD TO $3M HIPAA SETTLEMENT — The University of Rochester Medical Center has agreed to a $3 million settlement and has pledged to take corrective action following alleged HIPAA violations related to two unencrypted devices stolen from a facility. (Nota bene: your correspondent’s mom, a URMC employee, was not involved to our knowledge. Also, hi mom!)

The medical center had filed reports with OCR in 2013 and 2017 about the loss and theft of a flash drive and laptop, respectively. As the devices were unencrypted, they may have revealed protected health information.

NEW PREDICTIVE MODEL FOR KIDNEY DISEASE — Cricket Health has a new machine learning model for identifying patients at high risk for chronic kidney disease, the kidney care company said in a white paper released today. The model takes into account factors such as demographics and health care use; Cricket Health plans to work with insurers to reach out to patients’ primary care providers and specialists if they’re flagged as high-risk. The system doesn’t require any lab tests or patient involvement, according to Cricket.

LINES ARE OPEN — Registration for ONC’s 2020 Annual Meeting, to be held January 27-28, is now open.

PERSONNEL NOTES – Manatt, the law/consulting firm, has added Yarmela Pavlovic as a partner in its Health and Digital and Technology groups … Former Trump administration staffers Lance Leggitt (of the Domestic Policy Council) and Peter Urbanowicz (of HHS as chief of staff) to APCO Worldwide, per our colleagues at Influence … Venture capital firm Section 32 hires Foundation Medicine alum Steven Kafka as managing partner.

What We're Reading

CNBC profiles Jonathan Bush and his life post-athenahealth.

MedPage Today delves into an NYC-area physician suing patients over their negative Yelp reviews on his Botox service.

A doc describes life with a new EHR in STAT.

Florida police officer gets “game-changer” search warrant to go into DNA database, New York Times reports.

UnitedHealth is expanding a housing program for homeless Medicaid patients, Bloomberg reports.