ECRI to stand up AHRQ guideline site replacement

With help from Darius Tahir

FIRST IN MORNING EHEALTH: ECRI TO OFFER GUIDELINE SITE SHUTTERED BY AHRQ: The nonprofit, which has developed and maintained the National Guideline Clearinghouse for AHRQ since its inception 20 years ago, will continue to maintain a version of the web-based clearinghouse that has provided doctors, insurers and health systems with up-to-date information about best medical practices. The AHRQ site, as we reported Monday, went dark last night. ECRI’s interim site will go up in the fall, according to a news release.

“We will be making changes, improvements to make the site easier to use and more implementable,” said ECRI spokeswoman Laurie Menyo. “Because we are a nonprofit and do not have financial backing at this time, we will have to charge a fee for this service.”

AHRQ’s decision to shutter the site saddened researchers and professional groups whose members relied on it. Letter writers including Doug Fridsma, president of the American Medical Informatics Association, said the clearinghouse was used by researchers looking for gaps in knowledge, EHR vendors seeking information to use in decision support software, and insurers setting quality measures—in addition to clinicians and others. Closing the site “may lead to negative health effects and increased health costs through lack of access to patient-appropriate and trustworthy clinical information,” they wrote.

“Removing medical evidence from the public space is harmful to the practice of medicine, and thus harmful to patients,” said Risha Gidwani, a Stanford health economics researcher. “This is a new level of stupid,” tweeted former Obama administration health official Bob Kocher.

The agency “understands that guidelines play an important role in clinical decision making, but difficult decisions were necessary about use of available resources,” AHRQ spokeswoman Alison Hunt said. The agency had warned it would have to slash programs because of a $30 million budget cut in 2016. Its $334 million current budget is $120 million lower, in inflation-adjusted dollars, than it was in 2010, said Lisa Simpson, CEO of AcademyHealth and leader of a grass-roots group, Friends of AHRQ.

Tweet of the Day: Alt WASO NPS @AltWASONPS #SaveAHRQ #SaveTheGuidelines If you don’t hear much from us over the next few days, it’s because we are busy getting everything set up. We have the publicly available data and are working to get stuff online. Until then, everything can still be accessed at @internetarchive

Welcome to Tuesday Morning eHealth. We’re substituting for Mohana, who is in Belize, possibly snorkeling as you read this. Send colorful fish to [email protected], or pass along rainbows of illumination (or just normal tips) @ravindranize, @arthurallen202, @dariustahir, @POLITICOPro, @Morning_eHealth.

JUST RELEASED: View the latest POLITICO/AARP poll to better understand Arizona voters over 50, a voting bloc poised to shape the midterm election outcome. Get up to speed on priority issues for Hispanic voters age 50+, who will help determine whether Arizona turns blue or stays red.

BIG NEW CYBER THREAT TO HOSPITALS — HIJACKING: Move over ransomware, there’s a new threat to hospitals’ networks: being hijacked. At a Capitol Hill briefing, the American Hospital Association’s cybersecurity advisor John Riggi said that digital rogues are increasingly targeting hospitals’ computing power as a way to “mine” cryptocurrency. (We’ll save you the long technical description of how cryptocurrency works by simply saying that new currency is produced by squadrons of computers solving math problems, with the new coinage being a reward for the solutions). Riggi, a former FBI official, said that while this hijacking might seem benign, if entirely weird, in fact it’s a problem: commandeering computers for mining purposes means less power available for hospital business.

DOCTOR, DOCTOR, HERE’S THE NEWS: In a letter to about 1 million of her closest doctor friends, Seema Verma tells them “Washington is to blame” for most of their frustrations with EHRs and the like, and promises that CMS under Donald Trump is coming to the rescue with streamlined regulation. She lays out an explanation of the Evaluation and Management codes in last Thursday’s rule drop, and asks physicians to pitch in with comments on that rule and other recent CMS proposals.

VC FUNDING IN DIGITAL HEALTH KEEPS SURGING: It reached a record $4.9 billion in 383 deals in the first half of 2018, according to Mercom Capital Group. That compares to $4 billion in 359 deals in the first six months of 2017. Digital Health companies have now received $30.6 billion in the 3,833 VC funding deals Mercom has tracked since 2010. A summary of the company’s report here.

PAY NO MIND TO MENTAL HEALTH APPS?: A review of 61 mental health apps used in the U.S., U.K., Canada and Australia in 2016 found most of them to be of little value. The scholars examined apps for such conditions as anxiety and mood disorders and found that they focused on abnormal responses to mild triggers. Therapeutic strategies included relaxation, cognitive guidance and self-monitoring. “Mental health apps may promote medicalization of normal mental states and imply individual responsibility for mental well-being,” the scholars concluded. “Within the health care clinician-patient relationship, such messages should be challenged, where appropriate, to prevent over-diagnosis and ensure supportive health care where needed.”

EDITOR’S NOTE: In a newsletter item Monday about a CMS rule proposing telemedicine expansion, we quoted Qualcomm’s Robert Jarrin as saying, “On the one hand [they’re] being permissive with allowing these digital health services but much like R2-D4 in Star Wars, there’s a restraining bolt.” The comment caught the eye of several Star Wars fans, who denied there ever was a robot called R2-D4 (although surely there will be eventually given the endless stream of Star Wars movies...) We were set to make a correction, but Jarrin took time from a vacation with his wife on a Greek isle to respond, “In Star Wars: A New Hope (Episode IV) there’s a scene where Luke and his uncle Owen Lars meet the Jawas at their Sand Crawler to purchase droids, including R2-D2s and R5-D4s … Although R5-D4 is not ‘R2-D4’ you will note that Luke refers to him as an ‘R2 unit.’ Because of this I have always referred to R5-D4 loosely as ‘R2-D4.’ … that’s the way I refer to him, for good or bad.”

… This explanation failed to convince program analyst Wes Barker, who is “one our Star Wars experts (ONC has more than one?),” according to ONC spokesman Peter Ashkenaz. Referring to R5 as an R2 unit “makes no logical sense,” Barker states, and the metaphor is misplaced because the restraining bolt kept R2-D2 “from fulfilling his true potential and completing his important mission of finding Kenobi and delivering the Death Star plans to the Rebel Alliance.” Confused? Wait for the sequel… (Jarrin strikes back?)

What role will Hispanic voters over 50 play in Arizona this Fall? Read POLITICO Magazine’s new series “The Deciders” which focuses on this powerful voting bloc that could be the determining factor in turning Arizona blue.

WHAT WE’RE CLICKING:
—Triad Business Journal: LabCorp reports suspicious server activity; says no data disclosed