Congress and Gottlieb point to IT fixes for opioids

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

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GOTTLIEB POINTS TO IT FIXES FOR OPIOIDS: A robust e-prescribing system could reduce fraudulent prescriptions and improve opioid therapy in chronic pain patients by documenting appropriate use, FDA Administrator Scott Gottlieb said in a speech Wednesday on FDA’s efforts to counter the opioid epidemic.

It would also enable health care systems to embed evidence-based decision supports for opioid therapy into their EHRs “so that rational prescribing is the default option,” Gottlieb said. Only about 20 percent of doctors currently use e-prescription for controlled substances, AMA CEO James Madara said in a letter to the Drug Enforcement Administration released today.

Madara urged DEA to reconsider its stringent requirements for the devices physicians use to authenticate themselves into electronic prescribing systems, which currently preclude commercial devices such as iPhones that already have fingerprint scanners.

“DEA’s regulations have not kept up with technology and the much needed revisions would reduce regulatory burden,” Madara writes.

A new FDA analysis of opioid data suggests just one day of opioids is sufficient to control pain for many common surgical procedures, Gottlieb said at the National Rx Drug Abuse and Heroin Summit in Atlanta, basing his remarks on an FDA assessment of opioid use in nearly one million patients viewed through the agency’s surveillance program. More for Pros from our colleague Sarah Karlin-Smith here.

… in other news at the nexus of opioids and IT, the draft of a comprehensive new Senate HELP Committee opioid bill unveiled Wednesday afternoon would require the Drug Enforcement Administration to create a rule allowing prescription of controlled substances via telemedicine. It also would let mental health and addiction treatment centers register with DEA to treat patients through the technology.

The Opioid Crisis Response Act instructs the attorney general to craft a rule specifying the limited circumstances under which telemedicine can be used for prescribing such drugs, which include key addiction treatment medications like buprenorphine.

The bill also encourages states to share prescription drug monitoring program data with one another, streamlines federal requirements for such PDMPs to enable doctors and pharmacies to learn whether patients have a history of substance use, and requires HHS to develop best practices for prominently displaying substance abuse history in a patient’s EHR — with the patient’s permission. Morning eHealth’s Arthur Allen has the story for Pros here.

... A bit later Wednesday, the House Energy and Commerce health subcommittee chimed in, announcing that it will consider its own set of opioid-related bills at a hearing next Wednesday, including:

—A measure that would establish standards for PDMPs, direct state Medicaid programs to incorporate PDMPs into providers’ and pharmacists’ workflows, and require states to report to CMS on the status of PDMP systems

—H.R. 3528, the Every Prescription Conveyed Securely Act, introduced by by Reps. Katherine Clark and Markwayne Mullin, to require e-prescribing for coverage of controlled substances under the Medicare Part D program.

—H.R. 4841, the Standardizing Electronic Prior Authorization for Safe Prescribing Act, from Rep. David Schweikert, to standardize electronic prior authorization for controlled substances under Medicare Part D. More for Pros on those here.

NIH PUTS $1.1B TOWARD OPIOID ADDICTION RESEARCH: NIH plans to nearly double research funding dedicated to opioid misuse, addiction and pain, Sarah reports.

A new initiative called HEAL includes research to develop nonopioid pain therapies and better options for treating opioid addiction, NIH director Francis Collins announced Wednesday.

The Helping to End Addiction Long-term (HEAL) initiative outlines a long-term study following patients after the onset of pain and post-surgery to identify biomarkers that predict which patients will end up with chronic pain. It would also include studies on genetic and social factors putting patients at risk for addiction.

HEAL would also address medication-assisted therapies, known as MAT, for treating addiction and overdose. Pros can read more from Sarah here.

ONC RELEASES NEW PATIENT GUIDE FOR HEALTH RECORDS: HHS unveiled a guide Wednesday designed to help patients and caregivers access their EHRs as part of an initiative for patient engagement spearheaded by White House adviser Jared Kushner and CMS Administrator Seema Verma. Kushner and Verma announced the “MyHealthEData” initiative last month at HIMSS. To date, there has been no major publicity campaign to promote it.

The guide reminds patients they have a right to access their health information and outlines ways to get that data, beginning with checking provider portals and filling out health or medical release forms. It also tries to explain why downloading the records could be useful.

In 2017, almost half of Americans who had access to their EHRs didn’t examine them, often because they didn’t think it was necessary, according to ONC survey data. The full story for Pros here.

eHealth Tweet of the day: Halee Fischer-Wright @DrHalee If you want to know what problem to solve immediately to change the course of health care in America, here it is: create more time for relationships. #patientengagement

IT’S THURSDAY at Morning eHealth. Your author appreciates the cherry blossoms but warns pedestrians to watch out for slippery sidewalk petal-residue, which led to a comical sequence of near-falls on her walk to the Metro. Send news tips and tales of hazardous commutes to [email protected]. Tweet them to @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro, @Morning_eHealth.

SENATE COULD UPEND TRUMP’S CABINET SHUFFLE: President Donald Trump is counting on the Senate GOP to confirm three new Cabinet members — including a replacement for former Veterans Affairs secretary David Shulkin — but the senators may disrupt his plans, POLITICO’s Burgess Everett and Eliana Johnson report.

“It’s unusual. But it’s the president’s prerogative,” Sen. Mike Rounds said of the recent Cabinet overhaul, which also includes the nomination of Gina Haspel for CIA director and Mike Pompeo as State Department secretary.

GOP senators viewed Shulkin as an ally. Trump’s nomination of his physician, Ronny Jackson — who has no relevant experience at the VA or in managing a large agency — reflects the president’s chaotic management style, they say, and few have publicly committed to voting for Jackson.

“I could see a case where he’s not supported just as a proxy on the way Trump is so out of control with all that he’s doing with nominees. I could see it happening,” said a Republican senator who spoke on condition of anonymity. “It doesn’t appear he’s got the most basic qualifications for the job. So I could see him not being confirmed.”

Read Burgess and Eliana’s full POLITICO story here.

ACTING SECRETARY WILKIE GIVES FIRST PUBLIC ADDRESS: Interim VA head Robert Wilkie, a former Pentagon official, appeared in a three-minute video this week highlighting his commitment to customer service, Stars and Stripes reports.

“If we do not listen to each other, we won’t be able to listen to our veterans and their families,” he said, adding that VA should be a “bottom-up organization” in which energy flows from people who are “closest to those we are sworn to serve.”

HITAC TASK FORCE CONTINUES USCDI DISCUSSION: A task force within the federal advisory committee to ONC is finalizing recommendations on how to modify the list of data elements vendors must exchange to be considered interoperable.

During a Health Information Technology Advisory Committee meeting Wednesday, members of that task force suggested tracking which parties lobby for a particular element to be included in the U.S. Core Data for Interoperability standards, which would update the Common Clinical Data Set. Before deciding which data elements should be included in USCDI, members are outlining the process by which ONC should select those elements.

USCDI standards would eventually funnel into the Trusted Exchange Framework and Common Agreement draft, an outline of minimum standards that health information networks must meet to be able to exchange patient health data. The USCDI task force will present its recommendations to the whole health IT advisory committee later this month.

INDUSTRY NEWS: Virta Health, a company that aims to reverse type 2 diabetes and other diseases through consultation with metabolic specialists, has raised $45 million in Series B venture funding. The service uses an app that automatically collects measurements from a body weight scale, a blood pressure cuff and a glucose meter.

WHAT WE’RE CLICKING ON:

—Microsoft sues Community Health Systems for copyright infringement, continuing to use software at recently-sold hospitals

—How data science affects real medical care

—Former U.S. chief data scientist DJ Patil on the role of data at NIH and in health care

—Lobbying organization Health IT Now’s video outlining its proposalfor a PDMP system that could update in real-time