Information blocking rule likely delayed

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

INFORMATION BLOCKING RULE LIKELY DELAYED: The long-awaited rule defining which data-blocking practices are illegal appears to be taking longer than expected, a well-placed source tells POLITICO.

ONC officials previously said it would come out in April, but the source said a summertime release was more likely. An agency spokesperson on Thursday declined to set a deadline. ONC is collecting input from federal partners and expects to issue the proposed rule later in the year, the spokesperson said.

…. The delay introduces uncertainty to health information exchanges and potential participants in ONC’s Trusted Exchange Framework and Common Agreement, currently in the draft stage.

“A big and open question about the information-blocking rule is whether it would provide some type of safe harbor-like protection for providers and vendors who actively participate in TEFCA-sanctioned exchange,” says Micky Tripathi, CEO of Massachusetts eHealth Collaborative. Also in question: whether the rule will have mechanisms to “coerce TEFCA adherence,” making it a condition of participation in CMS programs, for example.

The 21st Century Cures Act makes it illegal for health systems and EHR vendors to interfere with the exchange of health data to keep patients within their networks. HHS’s Office of the Inspector General will eventually enforce the info-blocking law, but first ONC must define which practices are exempted.

The delay could boost private sector interoperability efforts, says John Halamka, CIO of the Beth Israel Deaconess Medical Center, who argues that a lack of technology standards, not profit-seeking, is largely what leads health organizations to block data flow. “I’m hopeful the private sector will make great strides over the next year, largely eliminating the need for prescriptive regulation,” he said. “Delays are helpful to empower the private sector initiatives.”

The full story, for Pros, here.

VA ‘DEBUNKS’ SHULKIN’S PRIVATIZATION NARRATIVE: The Veterans Affairs Department is rejecting former secretary David Shulkin’s claims that President Donald Trump fired him because he refused to move quickly on privatizing VA health care.

“There is no effort underway to privatize VA,” and that the suggestion is “completely false and a red herring designed to distract and avoid honest debate on the real issues surrounding Veterans’ health care,” a VA press release published Thursday evening says. It was signed by Curt Cashour, Shulkin’s spokesman before the latter left the agency.

Since his firing last week, Shulkin has appeared on numerous radio and talk shows to defend his position. In a New York Times op-ed published the night after his firing, Shulkin singled out “political appointees” seeking to “privatize veteran health care as an alternative to government-run V.A. care.”

The White House has also denied that Shulkin’s removal was about privatization. “No one is talking about privatizing the VA,” deputy press secretary Lindsay Walters told POLITICO’s Cristiano Lima in an email last week.

The VA release, titled “Debunking the VA Privatization Myth,” quotes House VA Committee chair Phil Roe, who said earlier this week that if the government were trying to privatize, “we’re not doing a very good job.” Roe has noted that VA’s workforce has grown from 250,000 in 2009 to 370,000 today, while more than doubling its budget.

But Shulkin has argued that allowing veterans to freely choose care outside the VA could end up gutting the agency.

GAO CALLS FOR TIGHTER DATA SECURITY GUIDANCE AT CMS: The agency needs to develop specific security rules for researchers who study Medicare data, similar to the controls it puts on use of the data by Medicare Administrative Contractors (MACs) or qualified entities, according to a GAO report released Thursday. The lack of specific guidance gives the researchers more flexibility to independently assess their security risks, but it increases the risk that external entities possessing agency data are failing to meet CMS data security standards.

eHealth Tweet of the day: Craig Garthwait @C_GarthwaiteOK -- I take it all back. I didn’t realize that the joint Morgan-Amazon-Berkshire health venture was going to use big data. Now it all makes sense and we are all saved. Thank you Mrs. Dimon, Bezos, and Buffett. The Wall Street Journal @WSJ Jamie Dimon says the health care initiative will use big data, virtual technology and other methods to address areas needing improvement on.wsj.com/2IrHbR1

It’s FRIDAY at Morning eHealth. Your author is wondering whether she should see Isle of Dogs this weekend or if the whole Wes Anderson thing is over. Make your opinions known at [email protected] and Tweet newstips to @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro, @Morning_eHealth.

57 VARIETIES FOR DIRECT TRUST PICKLE: An ONC-organized group seeking improvement in the clinical usability of Direct Trust for data sharing has published a consensus statement containing 57 recommendations.

More than 100,000 U.S. health care organizations have at least one Direct account, and over 1.6 million provider staff can use it to send and receive messages. ONC oversaw the creation of Direct in 2011, but there have been many complaints about the way EHRs make it available. At HIMSS last month, Direct CEO David Kibbe — one of the authors of the consensus report--told us that EHR vendors’ interfaces are getting much better, however. He believes that’s because there’s increasingly a business model for coordination of care chronically ill or high-risk patients. Referral management is one area of growing use.

…. But Direct still doesn’t account for most communication among doctors. In 2017 there were about 170 million Direct transactions, Kibbe told us. That’s double the 2016 figure—but it’s still dwarfed by the 3 billion health care faxes each year.

REPORT: FACEBOOK TRIED TO GATHER PATIENT DATA FROM HOSPITALS: CNBC’s Christina Farr reportsthat Facebook executives asked hospitals and health care organizations as recently as March to share data about their patients.

According to CNBC, Facebook’s plan was to make detailed profiles of patients that included their medical conditions and social and economic details. The tech giant asked groups including Stanford Medical School and the American College of Cardiology for anonymized data for a research project and aimed to help hospitals identify patients in need of special care.

Facebook has said that project, which never moved out of the planning stage, is on hold.

CNBC published a statement from Cathleen Gates, the interim CEO of the American College of Cardiology, confirming that the group was in discussion with Facebook about ways to use “anonymized Facebook data, coupled with anonymized ACC data, to further scientific research on the ways social media can aid in the prevention and treatment of heart disease,” and that so far “[n]o data has been shared between any parties.”

MEDPAC PUBLIC MEETING CONTINUES: Medicare Payment Advisory Commission public meeting continues today. Thursday’s topics included a proposed design for a hospital value incentive program, using factors such as readmissions, mortality, spending and overall patient experience to measure quality. Commission members debated the merits of those variables in reflecting quality and argued in favor of applying measurement systems to Medicare Advantage programs and eventually to the commercial sector. Today’s agenda includes “Long-term issues confronting Medicare Accountable Care Organizations.”

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