Pediatric telehealth worries docs

With help from Arthur Allen (@arthurallen202), Mohana Ravindranath (@ravindranize), and Sarah Owermohle (@owermohle)

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Quick Fix

It’s another sizzling day for news:

— Pediatric telehealth worries docs: Seeing kids by video consults might be convenient, but it poses overprescription risks, pediatricians tell our colleague Mohana Ravindranath.

— Mobile telehealth urged for military: The military wants to use more telehealth but needs to get mobile-optimized software for fullest effect, a new Health Affairs analysis says.

— 2019 is shaping up to be another record-setting year on breaches, an expert warned a Senate cybsercurity group.

But first, the jump.

eHealth tweet of the month: Sami Inkinen @samiinkinen [founder of diabetes reversal startup Virta Health]
“It is both fascinating (and scary) that when I speak w/ health care decision makers about patient outcomes (e.g. @virtahealth clinical trial results) many can’t separate b/w..

* prospective vs. retrospective trial

* peer-reviewed vs. self-published

* ITT vs. completers

..data!”

WEDNESDAY: Thanks for all who wrote in with tips about selecting the best melons. Sadly, despite your correspondent’s diligent efforts, ill-tasting melons are still making their way into his household. Something’s going wrong with the melon economy. Share tales of fruit woe at [email protected]. Discuss fruits socially at arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Driving the Day

PEDIATRIC TELEHEALTH WORRIES DOCS — A group of pediatric health experts believe more research into apps that let parents video-chat clinicians directly from their phones is needed before children receive care over video.

Two recent studies published in the journal Pediatrics suggest that doctors on these direct-to-consumer telemedicine platforms treat patients differently than they would in-person: children are prescribed antibiotics more frequently after direct-to-consumer consultations than after in-person urgent or primary care visits, according to a UPMC study from earlier this year. Another study published last week finds that parents are more likely to report satisfaction with video consultations for respiratory tract infections when their children are prescribed antibiotics.

“The technology is being deployed very rapidly,” said David McSwain, who chairs the American Academy of Pediatrics’ telehealth task force. (AAP publishes the Pediatrics journal that included those studies.) “There’s a lot of effort to establish a pediatric telehealth footprint in the market, but at this point the technology is not optimized to do that” in a way that protects children from being overprescribed, he said.

Patients need to know more about guidelines for care, said pediatrician Sue Kressly, an author of AAP’s policy statement on nonemergency acute care. “The general consumer family does not know what appropriate care is,” she said. “Patients come in to get a treatment for whatever illness they’re presenting.”

When they’re seeing patients in-person, pediatricians reassure and educate parents about safe options — including not prescribing antibiotics at all. But it’s not clear if that happens in direct-to-consumer visits, she said. With more analysis from Mohana Ravindranath.

MOBILE TELEHEALTH URGED FOR MILITARY — The military is relying more on telemedicine to deliver care, but could optimize its use with mobile software, a new analysis in Health Affairs says. Such mobile software would allow providers to deliver care on the battlefield, which would decrease the need for evacuations.

Currently, the military relies on bulky equipment, and the authors suggest the military develop new technology. The new Cerner EHR might help, as it’s web-enabled.

Names in the News

— Kidney policy architect leaving administration: Abe Sutton, a White House aide who quarterbacked the Trump administration’s kidney care initiative, is set to depart this week, our colleagues Dan Diamond and Adam Cancryn report. Sutton helped advise outgoing CMMI director Adam Boehler during an earlier posting in HHS.

Eye on FDA

— Bad data submitted to FDA in gene therapy application: Drug developer AveXis — now a part of Novartis — knowingly submitted erroneous data to the FDA as part of an application to approve a $2.1 million gene therapy treating spinal muscular atrophy. While the agency says it’s confident in the therapy’s safety and efficacy overall, it warns that the false assurances could expose AveXis to civil or criminal penalties.


In Congress

Competing surprise billing legislation brewing?: The House Ways and Means Committee is working on its own iteration of surprise medical billing legislation. It will be different from a version approved by the Energy and Commerce Committee last month, our colleague Rachel Roubein reports.

— Senate Cybersecurity Caucus briefing on health care: Breaches of health institutions are on track to break another record this year, Protenus executive Robert Lord warned during a briefing held by the Senate Cybersecurity Caucus on Tuesday. Through June there have been 285 breaches, a pace ahead of last year’s record 503 breaches. This year’s breaches have involved 31.6 million records, already beating the record of 27 million set in 2016.

Those breaches aren’t all attributable to your shadowy hackers, of course; 28 percent of breaches are due to insider threats, such as a provider improperly looking at records.

But hackers are adopting more sophisticated tactics, warned John Riggi, a senior adviser to the American Hospital Association. For example, ransomware is targeting not only providers’ computers — which locks up their data — but their backup data, making it all the more necessary to pay hackers to free their information.

Health IT Business Watch

Global investment trends: Investment in health care companies around the world is slightly up in the first half of 2019 compared to the same period last year: total investments reached almost $27 billion in the first six months of 2019, compared to $26.5 billion last year, according to a new report from CBInsights. Among other interesting tidbits: AI companies globally raised $864 million in the second quarter. And in the United States, California is still the top state for digital health deals (85 in the second quarter), but Massachusetts (29) stole the second spot from New York (24).

Aledade announces MIPS scores: ACOs run by startup Aledade performed quite highly by the government’s Merit-Based Incentive Payment System formula, the company announced Tuesday. In 2018, 80 percent of its organizations received perfect scores.


What We're Reading

Pay-for-play clinical trials arousing scrutiny from ethicists, STAT reports.

Docs are using social media to raise funding for research into firearms injury risk, MedPage Today reports.

Cybersecurity pros are increasingly aspiring to political office, Slate reports.

Examining efforts to share pediatric cancer data in Science Magazine.