Big opioids bill coming

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

BIG OPIOIDS BILL COMING: The Senate’s focus on opioids continues, with a bipartisan group of eight members unveiling a new bill and a HELP hearing.

— CARA 2.0: The bill, an update to the first CARA legislation, was unveiled Tuesday. Like the first version, it’s got a variety of provisions, from funding to regulatory tweaks. There’s a bit of PDMP language, requiring physicians and pharmacists to use the databases when prescribing or using opioids.

If enacted, the federal legislation would codify statewide trends. According to Brandeis’s PDMP center, 40 states require prescribers to use the programs — 14 also require dispensers to use PDMPs — as of January 2018. Academics who study PDMPs generally agree such requirements are very successful at reducing opioid prescription rates, though whether that change is wholly positive is up for debate.

That’s the headline PDMP change — but it’s actually somewhat of an octopus. It requires state PDMPs to share data but doesn’t have clear criteria for judging whether such data is shared. And PDMP data must be analyzed, a lot: State agencies administering the programs are required to proactively analyze the data sets and inform law enforcement and professional licensing boards of potentially disturbing patterns.

It also requires states to implement “proactive notification” capabilities, which ping doctors when their patients’ prescription patterns suggest a risk of addiction. Physicians have long desired such a feature.

Less consequential is a requirement that prescription data be uploaded to the PDMP within 24 hours. That change would only affect 8 states, according to Brandeis’s research.

The bill is co-sponsored by Rob Portman, Sheldon Whitehouse, Amy Klobuchar, Dan Sullivan, Maggie Hassan, Bill Cassidy, Shelley Moore Capito and Maria Cantwell. The group is not just bipartisan; those senators represent a lot of geographic diversity.

— Hearing: Meanwhile, the Senate HELP Committee held a hearing on technology solutions to the opioid crisis. Our colleague Mohana Ravindranath was on hand, and heard division over proposals for a national hub linking PDMPs.

“We’re futzing around with PDMPs,” said Cassidy, who with the committee’s ranking Democrat Sen. Patty Murray argued that the statewide programs were insufficiently interoperable. Along with trade group Health IT Now, they argued a national hub would be a valuable tool.

Established groups say the PMP InterConnect program, which counts 45 states as members, will connect the state programs. Indeed, a federal initiative would be a distraction from their efforts, they argue. Pros can get the rest here.

eHealth tweets of the day: @deray: My father told me he recorded this talk on a CD and that he was going to send it to me. I don’t have a single device that plays CDs, bless his heart

@AureliaCotta (citing deray): Funny enough, this is a problem with electronic health care records of CT scans, MRIs—hospitals give them to patients on CD/DVD, no one can open them

WEDNESDAY: As your correspondent has mentioned, he’s recently moved apartments, and is now seeking furniture. But Craigslist is puzzling; Literally every type of furniture is called “midcentury modern.” Huge, soft, puffy armchair? It’s a midcentury modern! La-Z-Boy? Midcentury modern! A folding picnic chair? So midcentury modern, Don Draper sat in one in like five episodes of Mad Men. Nominate other midcentury modern furniture at [email protected]. Discuss modernity socially at @ravindranize, @arthurallen202, @dariustahir, @POLITICOPro, @Morning_eHealth.
INFO BLOCKING GOING TO TAKE CARE OF ITSELF?: ONC head Don Rucker says so. In an introductory speech for the Bipartisan Policy Center’s and Health IT Now’s report on the future of health tech policy, Rucker confessed that information blocking is the lowest priority of three policy areas, that he hopes ONC doesn’t become an enforcement agency, and that he hopes the problem takes care of itself. The agency is bound to define exceptions to information blocking — that is, describe when information blocking is acceptable — in an upcoming rule this spring.

More prominent on Rucker’s punch list are the trusted exchange framework and enabling open APIs. Apple’s newly announced pilot, in partnership with hospitals, to help consumers download their medical records, was Rucker’s preferred example of the power of such APIs.

“It’s simple stuff, but I think it’s the first step in a long and empowering journey,” he said, as the app will help consumers shop around and go to different providers.

Rucker also mentioned enabling greater data-sharing to insurers as a possible benefit. “If you want to compare institution A with B, you don’t have any data standards to do that,” he said.

— Other comments of note: The consistent tone from participants in the BPC/Health IT Now event was the need to scale back on requirements — particularly quality measure reporting — weighing down EHRs. One commenter, Stephanie Zaremba of athenahealth, suggested an FDA-like move: certifying software developers, rather than their products’ specific capabilities, as a more effective regulatory regime.

VA: MORE FOR YOUR MONEY? VA Secretary David Shulkin, fresh off a win against conservative dissent within the department, says that the VA will be getting much more bang for its buck from the Cerner contract. Shulkin expects 30 percent more capability than the Department of Defense’s agreement, and declined to set a specific timeline for actual signatures on the dotted line for the completed deal.

TELADOC HAS MIXED RESULTS: The telehealth giant’s year-long revenue jumped 89 percent relative to 2016, the company announced late Tuesday, but its year-long losses increased by roughly 25 percent. The company showed strong growth in subscribers and visits.

PROVIDER DIRECTORS STILL STINK, SURVEY SAYS: The majority of doctors see patients monthly who mistakenly believe they’re in-network, a survey released today from the AMA and LexisNexis finds. About three-fourths of nearly 700 respondents weren’t aware that payers are required to maintain accurate listings of in-network providers.

Last month, a CMS audit found that 52 percent of Medicare Advantage directories had at least one error in providers’ address, phone number and if they were accepting new patients or not. Federal officials issued 23 notices and 31 warning letters to Medicare Advantage plans following its audit.

WHERE’S THE FHIR BURNING NEXT?: The Argonaut Project — a group of collaborators seeking to advance the newfangled FHIR standards — announced its 2018 plans Tuesday. It’s going to focus on clinical notes standards, bulk data access, and questionnaires and their responses.

GRANTS: Rice University won a $10 million grant from the National Science Foundation, the Houston university announced Tuesday, to study gadgets — wearables and microscopes — to non-invasively view inside a patient’s skin to monitor and diagnose certain conditions.

NOTES ON THE TECH: Duke is live on Apple’s health records pilot, a university staffer tweeted … Barbara Streisand cloned her dog twice … Former Twitter CEO Dick Costolo’s fitness-focused social network is shutting down.

WHAT WE’RE CLICKING ON:

Alphabet’s Verily is considering entering the health insurance market

Brookings’s Niam Yaraghi gives his thoughts on the trusted framework initiative.