White House shifts Shulkin narrative

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

WHITE HOUSE SHIFTS SHULKIN NARRATIVE: The White House seems to be changing its narrative about the departure of former Veterans Affairs secretary David Shulkin, our colleague Andrew Restuccia reports.

The White House press office previously said Shulkin — who has maintained that he was forced out because he refused to move quickly on privatization — “resigned from his position.” Now, the White House is saying he was “given the opportunity to resign,” and Shulkin is pushing back.

“I came to Washington with the commitment to make our system work better for veterans. That’s the commitment that I went to work every day. I continue to feel strongly about that. There was no reason why I would resign,” Shulkin said during an interview on CNN Monday.

But White House director of strategic communications Mercedes Schlapp aid during a Fox News interview that White House chief of staff John Kelly “called Secretary Shulkin and gave him the opportunity to resign. Obviously the key here is is that the president has made a decision.”

President Donald Trump “wanted a change in the Department of Veterans Affairs. He felt it was time,” Schlapp said. Read the POLITICO story here.

STATE DEPARTMENT LOOKS INTO NEW EHR: The State Department issued a request for information for a new electronic health record system last week, an aftereffect of the Coast Guard’s failed effort to procure such software that’s led the service to revert to paper records, Morning eHealth’s Darius Tahir reports.

The Coast Guard and State Department were collaborating to procure and deploy an Epic electronic health record system but were unable to implement it, leading to State’s withdrawal from the partnership and the Coast Guard’s use of paper records.

The use of paper records drew a scathing January report from the Government Accountability Office, but State now is trying to procure its own system through Friday’s RFI.

The EHR would serve agency personnel and their dependents, particularly those abroad, through the department’s medical clinics division. The document inquires about the possibility of sharing services with other parts of the federal government, specifically naming the departments of Defense and Veterans Affairs. The full story for Pros here.

INVESTORS KEPT FLOCKING TO DIGITAL HEALTH IN 2018’s FIRST QUARTER: Some $1.62 billion flowed into the e-health sector during the first quarter of this year, exceeding comparable investment marks for the previous two years, Darius reports on this analysis from Rock Health.

This time last year, Rock Health was warning that investor enthusiasm could level off, as startups raised less money through the first four months of 2017 than they did in 2016, making the forecast a surprise. But the sector surged for the remainder of the year, and momentum has carried over into 2018. Rock Health attributes the strong pace in part to government policy, in particular the FDA’s welcoming regulatory approach to digital health. More here for Pros.

eHealth Tweet of the day:

[In response to this Tweet from Farzad Mostashari @Farzad_MD: I’m willing to bet the walmart-humana acquisition doesn’t happen. Who’s willing to take the other side?]

John Moore @john_chilmark I’ll take that bet for a couple of reasons: Humana & Walmart have been working together for sometime now

Humana has been seeking suitor and won’t remain independent

It’s TUESDAY at Morning eHealth where your author is heartbroken that all her favorite salads have been retired in favor of spring seasonal menus. Send news tips and your favorite spring lunch options to [email protected] or Tweet at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro, @Morning_eHealth.

ZIPNOSIS BRANCHES INTO FAMILY MEDICINE: The American Academy of Family Physicians is offering Zipnosis, an online telemedicine video chat and messaging platform, to its 129,000 members and their patients.

Zipnosis is unrolling the service initially to a small group of physicians so the company can assess what kind of set-up support those practices need, Becki Hafner-Fogarty of Zipnosis told Morning eHealth. All members will have access later in 2018.

The software lets physicians video chat, message and issue questionnaires to patients who also have the app. Zipnosis generally charges a set-up fee and a flat subscription fee for each provider system, regardless of the number of clinicians using it. The AAFP partnership lets physician members pay a discounted rate for the Zipnosis set-up and service.

The partnership represents Zipnosis’ entry into the family practice market, as the company has so far marketed to larger networks of health care providers, Hafner-Fogarty said. Part of the company’s goal with the partnership is to refine a self-service installation model; Zipnosis usually sends a team of two or three employees to each major client site, but its 50-person team likely won’t be able to travel to each family practice, Hafner-Fogarty said.

Read the full story here.

INTEROPERABILITY HOLDING BACK MARYLAND VALUE-BASED CARE?: It just might be, suggests a report from researchers at RTI International evaluating Maryland’s unique health care payment system. The state has adopted an all-payer model, which sets caps on the Medicare and commercial payer rates for hospitals.

Results are mixed, though RTI’s report found the state is indeed saving money for Medicare. Some of the problems may stem from kinks in EHR data-sharing. In theory, in order to save money, EHRs could help ensure there aren’t duplicative tests, and so on and so forth.

The state’s health information exchange, CRISP, has been successful, but there are some familiar specters haunting the state’s hospitals. “Physicians at a few hospitals reported that, even within the same hospital, sharing information between the ED and inpatient units can be challenging and time-consuming because the ED uses a different version of the hospital’s EMR or an entirely different EMR system” the report reads.

CMS EYES BLUE BUTTON 2.0 IN MEDICARE ADVANTAGE: CMS looks like it wants to promote the use of Blue Button 2.0 – the second iteration of its effort to free claims data for consumers’ use — in private Medicare plans . In its announcement of 2019 rates for Medicare advantage, the agency indicated it would expand Blue Button 2.0 beyond its own walls to private insurers.

“CMS recommends and encourages plans to adopt data release platforms for their enrollees that meet or exceed the capabilities of CMS’s Blue Button 2.0,” the agency’s announcement read. “CMS is contemplating future rulemaking in this area to require the adoption of such platforms by MA plans beginning [2020].”

NEW IN HEALTH AFFAIRS: A couple EHR-themed reports caught our eye.

— Integrating data on social determinants of health into EHRs: It could be a while before non-traditional health data points — the environmental condition a patient lives in, or their education levels, for instance — flow into their electronic health records. Researchers say national standards for data on social determinants of health could help EHR vendors easily exchange that information. No such biomedical standards exist, they argue.

— Primary care practices struggle to show improvement with EHRs: Federal payment programs require practices to use a federally certified EHR and also to gather data on quality improvement. But many practices reported that their EHR didn’t produce adequate quality improvement reports, researchers concluded. In a survey of almost 1,500 practices, researchers found EHRs didn’t offer customizable measures such as date ranges or report frequency, practices couldn’t afford external consultants to prepare data, and delays in EHR upgrades, among other challenges .

WHAT WE’RE CLICKING ON

—Walmart could buy PillPackfor $1 billion

—Grindr sharesusers’ HIV status with other outside companies

—The visor-like device that can quickly detect strokes

—One interpretation of the “ patient-oriented personal health record”

—Paper criticizing CRISPR is retracted

—How useful is a cardiac calcium scan?

—Clinical trials are examining how Alexa and Cortana can improve health outcomes