Checking in with Blue Button 2.0

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

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CHECKING IN WITH BLUE BUTTON 2.0: A new CMS initiative to get usable Medicare data into the hands of 53 million beneficiaries has attracted 1,200 software developers since it was announced in March, an early show of support for an idea that proponents think will simplify data sharing, Morning eHealth’s Arthur Allen reports.

So far, only about 100-200 patients are actually downloading their data through apps using CMS’s Blue Button 2.0 interface, which CMS Administrator Seema Verma announced at the HIMSS health IT conference. But putting data in the hands of patients, which has bipartisan support, is to provide an end-run around the thorny technical, legal and business obstacles to health system interoperability.

Verma’s initiative has a simple objective: She wants to encourage software developers to create apps that will take newly available Medicare claims data and present it to patients in useful, easy-to-manage ways.

For example, patients could fix common errors in their medical records, update medications, share data with health researchers or use apps as “health coaches” to help manage chronic diseases like diabetes and asthma. Insurers, with patient permission, could use the data to point patients toward cheaper or more sensible plans, drugs or treatments.

Blue Button 2.0 is an extension of a program started by the Obama administration. But it devoted few resources to the program after being forced to shunt vast IT brainpower into the repair of HealthCare.gov after its 2013 crash.

The Trump administration has aggressively promoted its relaunch of Blue Button, seeing it as ideologically consistent with its emphasis on expanding patient choice in health care.

Improvements in Blue Button’s programming interfaces have made it more practical for use by software developers, said former White House chief technology officer Aneesh Chopra, now a health IT entrepreneur. And many think patients are increasingly ready to take advantage of the technical upgrades.

“The world’s changing,” said Yale Medical School professor Harlan Krumholz. “Once people get their data there will be apps and uses we can’t even imagine now. In every other field, once data is put to work for us, it achieves things we hadn’t imagined.” Pros can read the rest of Arthur’s story here.

REP ROBIN KELLY SETS SIGHTS ON HEALTH IT FOR NEXT CONGRESS: Rep. Robin Kelly — who says she’s gunning for a position on the House Energy and Commerce Committee, or perhaps the top spot on Oversight’s IT subcommittee — tells Morning eHealth she wants to focus more on telemedicine, artificial intelligence and diversifying the health and tech workforce in the 116th Congress.

The Illinois Democrat currently chairs the Congressional Black Caucus’ Health Brain Trust, which recently hosted a briefing on Blockchain technology in health. Her office also co-authored a report, with that of Rep. Will Hurd calling for safety standards for AI-based algorithms.

Now that lawmakers have passed the massive opioid response package carrying many health tech measures — waiving the geographical restrictions for reimbursement on telemedicine treatment of substance abuse disorders, for instance — Kelly tells Morning eHealth she doesn’t know what the next big legislative vehicle will be.

“How we do it, and the progress we really make, depends on who’s in Congress,” she said. But she hopes at least to ease access to telemedicine to encourage patients who fear the “stigma around mental health” to seek help.

She also hopes to educate minorities and low-income groups about the “importance of sharing their data” with researchers, and to build trust among groups that have historically avoided the health care system. “With clinical trials, it’s hard to get people of color to share...They don’t have the trust.”

Kelly added that she plans to promote diversity hiring and training in the tech and health fields, so low-income and minority patients can interact with health professionals who look like them.

eHealth Tweet of the day: Vanessa Mason @vanessamason I’m a confirmed speaker for a panel and workshop at a women’s conf. Yesterday I get an email saying they have another speaker interested in joining the already panel but it’s already full. Organizer asks if I would like to leave the panel. How offensive on a scale of 0-7?

It’s FRIDAY at Morning eHealth. Your author is interested in the incentives health insurers provide to beneficiaries for exercising. Have any good incentive stories? Tips and news goes to [email protected]. Reach the rest of the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

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TRUMP ADMINISTRATION SUED FOR VA CORRESPONDENCE: The influence of three individuals linked to President Donald Trump and his Mar-a-Lago club on the VA is getting increased scrutiny in Washington this week. Following Rep. Tim Walz’s letter earlier this week demanding that the VA hand over correspondence between Ike Perlmutter, Bruce Moskowitz and Marc Sherman and VA officials, several activist groups filed a lawsuit against the Trump administration for withholding those records.

Democracy Forward and VoteVets filed the suit Thursday. The Trump administration’s attempts to “outsource decision-making on issues that affect veterans’ lives is deeply troubling, especially when this authority is secretly shifted to patrons of the President’s resort, " Democracy Forward Executive Director Anne Harkavy said in a release. Their withholding those records “leaves open a question that has consistently plagued this Administration: What exactly are President Trump and his cronies trying to hide?”

Arthur first reported that those three people may have swayed former VA secretary David Shulkin’s handling of the giant Cerner EHR modernization contract, pressuring him to delay its signing.

CAREQUALITY TESTING WATERS ON FHIR: The health information exchange framework known as Carequality is looking to expand its purview to exchanges based on the FHIR standard, used by tech companies including Apple to exchange records. Carequality is soliciting input about ways to support FHIR-based exchange, as well as specifications and security.

The Carequality framework has already “demonstrated the power of a nationwide governance framework” in linking disparate health networks, and FHIR exchange could “will ultimately encounter some similar challenges to those that Carequality has helped to address with document exchange,” executive director Dave Cassel said in a release.

Incorporating FHIR into the Carequality framework could make more clinical information available and could lower the costs of participating in an exchange, he said.

FDA CONTINUES CRUSADE AGAINST E-CIGARETTES: HHS officials are continuing a campaign to slash e-cigarette use in minors. In an op-edin the Washington Post published Thursday, HHS Secretary Alex Azar and FDA Commissioner Scott Gottlieb wrote that while it is “crucial that e-cigarettes do not become an on-ramp for children to become addicted to nicotine,” the devices can be useful off-ramps for adults addicted to traditional cigarettes. They emphasized that HHS’s strategy in protecting consumers from tobacco’s lethal effects is two fold: reducing nicotine levels in combustible cigarettes, and helping adults obtain less harmful substitutes such as e-cigarettes. They’re also considering restricting the marketing of e-cigarettes and also “actively reconsidering our policy” on which devices can be on the marke without submitting a new pre-market application to the FDA, they wrote.

...In other FDA news, the agency has warned of cybersecurity vulnerabilities in two models of Medtronic programmers used with heart implants such as pacemakers, defibrillators, resynchronization devices and implantable cardiac monitors, Arthur reports.
Medtronic’s device programmers allow health care providers to gather data from the implanted devices, such as performance data and battery status, and to adjust settings. The agency said that when the programmers were connected to the internet for software updates, a connection to Medtronic’s network could be exploited and allow an unauthorized user to change the functions of the implanted device.

FDA said it knew of no reports of actual harm resulting from the vulnerability. The company’s fix is considered a voluntary recall, FDA said. Pros can read the rest of the story here.

... And in other Azar news, the HHS chief appears to be pushing back against reports that President Donald Trump is considering him as a replacement for Attorney General Jeff Sessions. “Secretary Azar has repeatedly said that this is the best job he has ever had and that this is his dream job,” HHS spokeswoman Caitlin Oakley says. “He plans to continue serving President Trump as his HHS Secretary.”

HEALTHCARE.GOV ATTRACTS MORE INSURERS: More plans and lower premiums will be featured on federally-run Obamacare markets next year, our colleague Adam Cancryn reports. The Trump administration on Thursday took credit for improving conditions despite its pledge to repeal the Affordable Care Act.

CMS confirmed prices for key plans sold on HealthCare.gov will drop by 1.5 percent on average in 2019. Enrollees in Tennessee will see the greatest rate decrease, with premiums for benchmark plans falling more than a quarter compared with this year.

The Obamacare markets will also boast more competition, with 23 more insurers selling plans next year and another 29 opting to expand their coverage areas. Just 39 percent of counties in 2019 will have a single insurer on the Obamacare exchange, down from more than half of counties this year.

—STAT News reports on a study demonstrating how easy it is to link people to their de-identified genetic data

—Members of Mayo Clinic emergency departments write about data-focused efforts to prevent anaphylaxis

—The NY Post reportsthat athenahealth is considering new bids from old bidders