Trump picks Marine vet, cyber expert as VA CIO

With help from Darius Tahir and Mohana Ravindranath

ANOTHER SHOE DROPS AT VA: President Donald Trump announced over the weekend his nomination of James Paul Gfrerer as assistant secretary for information and technology at the VA. We assume that Gfrerer will also be chief information officer. If confirmed he would be the first permanent CIO since Laverne Council left early in the Trump administration.

Gfrerer is a cybersecurity executive at Ernst & Young. Trained in computer science and resource strategy, he was a Marine for 20 years, including a stint as the first director of the Marine Corps Information Operations Center which runs psychological warfare training and operations. Before joining Ernst & Young in 2015, for three years he was detailed for three years to the State Department as senior security official with a focus on cyber issues.

The acting chief information officer, Camilo Sandoval, is a Trump loyalist who was sued for sexual discrimination earlier this year by one of his employees during the Trump campaign.

VA Secretary Robert Wilkie — who is to be sworn in today — has promised to make a priority of filling senior vacancies, which in addition to the CIO include his deputy and leadership of the Veterans Health Administration. Various top VA officials have quit or been fired in recent months in what some described as a “purge” by acting Secretary Peter O’Rourke.

Senate Veterans Affairs Chairman Johnny Isakson said he was pleased by the announcement, noting that the CIO oversees a number of critical projects at the VA, including the massive EHR implementation. “I look forward to meeting Mr. Gfrerer and learning more about his background and vision for accomplishing these important tasks,” Isakson said in a news release.

“Mr. Gfrerer will be inheriting a good team in OIT that will need his leadership and direction,” said Scott Blackburn, who was acting CIO until April. “As I learned, VA CIO is one of the most challenging and thankless jobs in government. Not only will EHR implementation be a monumental challenge -- he has a lot of other IT issues that will need his attention and leadership.”

… Meanwhile, HisTalk notes that the DoD’s legal justification for the $1.1 billion addition to the $4.3 billion Leidos-Cerner contract states that it had to extend Leidos’ work order to include EHR standardization since the VA had hired Cerner as its prime contractor. “Contracting with anyone else (other than Leidos) to work with Cerner would create significant redundancies, inefficiencies, and other issues,” the contract states. Allscripts and CACI challenged DoD’s sole-source selection of Leidos for the contract extension, but were rejected with the rationale that the government isn’t interested in bringing another EHR into the mix, according to the report.

Tweet of the Day: Eric Topol @EricTopol —How good is #AI for prediction in medicine? —We don’t know. All 12 papers I’ve summarized are in silico, retrospective, many w/ statistical methodologic issues, and we’ve yet to see a prospective validation study in a real world clinical environment.

Welcome to Monday Morning eHealth: The House is on vacation, the Senate is finishing up pre-recess business, and so are we — we leave on a big road trip Friday. Send recommendations for South Dakota, Wyoming and Montana to [email protected]. Also, send news tips to @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

CMS SHARES MA DATA WITH WONKS: CMS has released the first year’s worth of Medicare Advantage data with CareSet, the health data NGO that will aggregate the information and release it for public analyses and studies.

“We’re pretty pumped about it,” CareSet founder Fred Trotter told me. “This will be the first time any organization that is not CMS can compare how MA and Medicare work in a way that can be made entirely public. It’s a huge deal in terms of transparency.”

The Obama administration, which released many other CMS data sets, announced the Medicare Advantage release for June 2017 but Administrator Seema Verma froze it out of concerns the data wasn’t clean. At April’s Health Datapalooza, however, she invited groups to apply for access, and announced Thursday that CareSet would be the first to get it.

About a third of the 58 million Medicare beneficiaries are covered through Medicare Advantage. Private plans weren’t required to provide the detailed data to CMS until 2012 and it took years to assure it was reliable. The figures could provide clues about whether the growing privatization of Medicare is beneficial to taxpayers and patients.

“Kudos to Administrator Verma and the CMS staff for filling in an important gap,” said Academy Health President and CEO Lisa Simpson, who said she was “really looking forward to the insights” that Trotter and his team will produce by crunching the data. “We are all just encouraged that the policy momentum toward transparency in health care is continuing. It is a fundamental building block for transforming care.”

“It’s only one year of data, so you can’t assess trends, but it’s great the data is finally making it into the hands of researchers,” said Niall Brennan, who was chief data officer in CMS under the Obama administration. “It will provide the first granular glimpse anyone has really had into the MA program.”

AN ALGORITHM FOR PREDICTING DEATH: A retrospective study by scholars at Harvard and the University of Pennsylvania found that a machine-learning algorithm using EHR data could accurately predict whether patients starting chemotherapy would be alive in a month. The algorithm, exposed to the data of about 27,000 patients who underwent treatment at the Dana-Farber Cancer Institute and the Brigham and Women’s Cancer Center from 2004 to 2014, was more accurate than predictions based on randomized trials or registry data, according to the study. Although it needs more validation, the authors concluded, the algorithm “may help to guide patient and physician decisions about chemotherapy initiation and advance care planning.”

WHY YA WANNA NOSE ABOUT IN THERE, MATE?: The Australian government has announced it will create a shareable national EHR record for 24.7 million of its citizens by the December, but on the first day they could, 20,000 Aussies decided to opt out, IEEE Spectrum reports. Citizens have until Oct. 15 to opt out of My Health Record, the government says. Otherwise they get a record that will be kept for 30 years after they die. Government and health care groups say the record will improve coordination, cut down on duplication of tests and reduce hospital admissions. Six million Australians already have a record in the system. But privacy hawks and the former director of the government’s Digital Transformation Agency claim that the medical benefits don’t stack up, and worry about privacy and security risks. Read more about it here.

WHAT WE’RE CLICKING:

Becker’s Hospital Review: Google’s six most recent hospital hires.

LA Times: Precision medicine offers glimmers of hope for alzheimer’s disease

Washington Post: Trump administration is working on new online privacy proposal

CNBC’s Chrissy Farr gets the physical of (one version of) the future. ... HisTalk’s cynical response here.

AHCJ: Will virtual check-ins drive telemedicine growth?