The comments keep on coming

With help from Arthur Allen (@arthurallen202) and Mohana Ravindranath (@ravindranize)

COMMENTS KEEP ON COMING: Outside comments on ONC’s core interoperability data set and trusted exchange frameworks keep on piling in:

— Premier, Inc.: Health care consultancy Premier, Inc. isn’t sanguine about ONC’s initiatives, calling its timeline “overly optimistic” and urging the agency to work on harmonizing its various responsibilities, from information blocking guidance to rolling out standards for home health. They all interlock, Premier writes, and therefore the office needs to intricately knit everything together.

— Strategic Health Information Exchange Collaborative: The group, representing scores of HIEs, isn’t terribly enthusiastic about the effort – intended to allow exchanges to connect with one another. The collaborative argues that ONC’s proposal is likely to impede current data-sharing efforts. Coming into compliance will be difficult, the group says, citing “significant burdens” and “strict time constraints.”

“[T]here are too many unknowns to truly estimate the costs of compliance, staffing, contractual changes, privacy practices changes, education, and other system implementation and administrative costs,” the collaborative’s letter says. “It is important that ONC recognize this very real effort and cost, which comes with zero funding to address the business requirements.”

— AMIA: Like many others , the American Medical Informatics Association is wary about the time crunch, recommending that the office develop a three-year implementation plan. Its comments are particularly concerned about bulk transfer requests – in which a user asks for population-level data – which are exciting, but hold the potential for unintended negative consequences.

SCHEDULES, SET: Meanwhile, the second-ever meeting of the Health IT Advisory Committee spent a great deal of time on administrative matters. The committee has a number of deadlines to meet, as it must produce several reports and recommendations within a year’s time. But, because it relies on task forces to make recommendations for its own recommendations, there are deadlines within deadlines. To wit:

— Overall schedule: The committee is working through March on the trusted exchange framework. April and May are for ONC’s latest certification rule. May to September is devoted to standards and their use cases. The rest of the year is a progress report.

— Task forces stretched: Right now, the committee has two task forces: one on TEFCA and the other on the core data set for interoperability. And they’re stretched for time too. The TEFCA task force, according to a presentation given to the committee, is due to deliver final recommendations by March 21.

That’s a tough task, noted task force co-chair Arien Malec, who said they’d started a month later than they ordinarily would. They will need to “work really, really hard” to deliver on time, he said.

eHealth tweet of the day: Prof Chris Hollis @MindTech_Doc [on Facebook’s flagging posts featuring suicidal thoughts] Have the ethical implications and unintended consequences been fully considered? Do users give their informed consent to share highly sensitive and personal information with unknown third parities? How have users been involved by Facebook?

THURSDAY!: Your correspondent hopes you all have been enjoying the, ah, unseasonably warm weather, at least around here. What did you do to partake? Share with [email protected]. Discuss socially at @ravindranize, @arthurallen202, @dariustahir, @POLITICOPro, @Morning_eHealth.

“ALL OF US” COULD MAKE GENOMIC DATA AVAILABLE BY END OF 2018: NIH’s effort to compile a one-million-person database of health information could include genomic data as soon as the end of the year, research program director Bradley Ozenberger said Wednesday at a conference convened by standards group HL7.

But integrating genomic data is a work in progress, he continued. NIH eventually wants to make the massive dataset — which draws in health records and biological samples from volunteers — available to researchers studying precision medicine. About 25,000 participants are enrolled in the beta phase, and NIH teams are currently investigating ways to gather dental and genomic data as well as imaging records.

They’re building a data model for sharing genomic information “as we go,” Ozenberger said. They’re closely monitoring “Sync for Genes,” a public-private partnership that aims to standardize genomic data sharing using the FHIR protocol. Health Level Seven International , which developed FHIR, launched a consortium Tuesday that aims to make genetic data more widely available to clinicians and researchers.

WHITE HOUSE REPORT EQUIVOCAL ON HEALTH IT: An economic report released Wednesday by the White House was equivocal about some established health IT policies. The report argued that meaningful use and quality metrics reporting had overly burdened small, independent practices; that those practices had sold out to hospitals; and that the resulting consolidation had raised prices for consumers.

The report was slightly more bullish on prescription drug monitoring programs. The drug-tracking databases had had “some success ” in limiting pharmaceutical opioid diversion and abuse, it allowed, but some patients had switched to more dangerous heroin. (The same report cited $28 million in funding disbursed by the CDC to various PDMPs as one of the administration’s opioid crisis initiatives.)

NOTES FROM THE STATES: Some relevant state policies to keep track of:

— Florida PDMP: A bill tweaking the state’s PDMP received the unanimous assent of the House’s Health and Human Services Committee Wednesday. The bill requires practitioners to review the PDMP before prescribing or dispensing controlled substances, while expanding the reporting requirements to Schedule V drugs. The legislation also allows Department of Defense and Indian Health Service clinicians to access the PDMP, and allows EHRs to connect with the database.

— FTC weighs in on Washington state bill: The Federal Trade Commission isn’t fond of a bill in the Washington state legislature restricting telehealth for the use of prescription contact lenses, as it would reduce competition.

VA PARTNERS WITH ALPHABET SUBSIDIARY: The Department of Veterans Affairs is partnering with Alphabet subsidiary DeepMind to develop models powered by machine learning to predict patient deterioration. The department’s press release includes one notable example of such deterioration: acute kidney injury. DeepMind may have particular expertise in that area: the company previously partnered with the NHS to develop an app called “Streams,” which attempted to predict kidney failure.

But that partnership became mired in privacy concerns, and the company said last November that the resulting software doesn’t use artificial intelligence at all. Apparently it’s time for an old college try stateside.

PERSONNEL NOTES: A number of personnel moves to keep track of:

— Indian Health Service nominee withdraws: Robert Weaver, the Trump administration nominee to lead the Indian Health Service, has withdrawn after reporting from the Wall Street Journal questioned whether his claimed credentials were accurate.

— David Kibbe stepping down: David Kibbe, founding president of the EHR interoperability-focused industry group, is stepping down at the end of this calendar year. He tells POLITICO he has no concrete plans, other than taking some time off and maybe traveling.

— In the academic journal arena: The journal Health Services Research is adding former AHRQ director Andy Bindman as co-editor-in-chief; new senior associate editors include VA researcher and New York Times scribe Austin Frakt.

— Lobbying notes: Thorn Run Partners has added Andrea Maresca, formerly of CMS, as senior vice president for health care policy … John Riggi, a cybersecurity expert, has joined the American Hospital Association.

WHAT WE’RE CLICKING ON:

—Has the time come for unique patient identifiers? Ask John Halamka and David Bates, among other co-authors.

—Does an anonymous food safety reporting site give too much power to the people?

—Practice Fusion is going to start charging doctors for its service, reports CNBC’s Christina Farr.

—To improve risk adjustment algorithms, the government should consider a Netflix-style contest, propose Zeke Emanuel and Bob Kocher in the Wall Street Journal.