House E&C, Senate HELP feel out health IT’s role in opioid crisis

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

HOUSE E&C, SENATE HELP FEEL OUT HEALTH IT’S ROLE IN OPIOID CRISIS — House and Senate committees separately reviewed opioid packages Wednesday, each quizzing witnesses about the role of PDMPs and telemedicine in preventing and treating opioid abuse.

The Energy and Commerce committee considered 34 bills, some of them dealing with health IT issues during a marathon hearing Wednesday, but Democratic leaders on the committee charged the majority with cramming so much in that some would not receive proper attention.

That otherwise bipartisan hearing mirrored the Senate HELP committee review, also Wednesday, on its own ambitious 29-measure opioid package, including language to encourage states to more widely share data with one another and increase the use of telemedicine in prescribing treatment for opioid addiction and certain co-occurring mental health disorders.

In the House:

—Members checked with the sole witness, CMS principal deputy administrator for operations Kimberly Brandt, on the importance of PDMPs – and whether telemedicine could really save the federal government money on treatment.

—Rep. Morgan Griffith questioned the value of prescription drug monitoring programs, asking Brandt if PDMPs could actually reduce opioid abuse. He referenced a draft for the Medicaid PARTNERSHIP Act that would incorporate PDMPs into Medicaid clinicians’ and pharmacists’ workflow. He also asked if having both prescribers and pharmacists checking PDMPs would be duplicative. There’s “a lot of promise to having greater access to PDMPs, and making sure that people are utilizing them,” Brandt said. CMS views “the pharmacist as part of the decision” to prescribe opioids, she noted.

—The Access to Telehealth Services for Opioid Use Disorders Act, one of the several measures considered, garnered support from various tech groups including HealthITNow and the Alliance for Connected Care.

—A few Democrats expressed concern that the committee wouldn’t have time to examine each bill. Among them was Rep. Gene Green, who said he feared some legislation might be advanced without being “fully vetted” by stakeholders and be subject to grandstanding without meaningfully addressing the crisis.

In the Senate:

—Sen. Patty Murray asked witnesses whether a national health data system was needed to aggregate PDMP data from each state. Robert Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors, responded that the data could be used to identify where opioids are being overprescribed and then target prevention messaging to those areas,

—Sen. Pat Roberts said that he and Sen. Heidi Heitkamp, co-chair of the Rural Health Care Caucus, planned to introduce new legislation to expand access to telemedicine-based treatment but did not elaborate on its purpose or timeline, and his office didn’t respond to a request for more detail.

—Sen. Lamar Alexander, the HELP committee chairman, said members plan to mark up the bill April 24 and present it to Majority Leader Mitch McConnell later in the month, month, after consulting with the judiciary and finance committees.

—Senators are still considering adding new provisions. Sen. Bill Cassidy argued in favor of clarifying HIPAA laws in the package so that providers know they’re allowed to notify the family of a patient who experiences a non-fatal overdose in order to get them into treatment. Pros can read the full story here.

APRIL 25 DATE TENTATIVELY SET FOR RONNY JACKSON HEARING -- The Senate Veterans Affairs Committee plans to hold a confirmation hearing for VA secretary nominee Ronny Jackson on April 25 if the White House gets the necessary vetting materials to the committee by then, Chairman Johnny Isakson said Wednesday.

Jackson, the chief White House doctor, was nominated by President Donald Trump on March 28 after Trump fired Secretary David Shulkin by tweet. Many veterans groups and members of Congress have criticized the choice, saying Jackson lacks management experience that would prepare him for overseeing the 360,000-member VA bureaucracy. Shulkin has maintained that he was fired because he refused to move quickly on privatizing.

Arthur Allen’s report on the coming confirmation hearing is here for Pros, who can also check out a DataPoint graphic explaining private health care at the VA here.

eHealth Tweet of the day: Michael Capaldo @consultbenefits Had a teledoc interaction recently; was seamless, timely and painless. Of course, it was courtesy of my insurer; although the provider was great, I doubt that we’ll ever interact again - and this method won’t work for every situation. Still, it was appreciated.

And another from former CMS deputy administrator Patrick Conway, linking to a picture of him on-site with Habitat for Humanity: @PatrickConwayMD Building house with BJ and Cheryl. BJ works in patient transport and is helping build her house. We talked about health care and children. Great person! #ceobuild2018 @durhamhabitat @BCBSNC. I worked in construction growing up but not so good now.

Good THURSDAY morning to you. Your author is befuddled after being mistaken on the street four times for somebody else, just in the past week. She hopes it’s not an evil twin. Send news tips and doppelganger stories to [email protected]. Tweet them to @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro, @Morning_eHealth.

FDA APPROVES FIRST AI SOFTWARE FOR RETINOPATHY — The FDA has approved marketing of the first medical device that uses artificial intelligence for ophthalmology — specifically, to detect diabetic retinopathy. (It is not, however, the first time AI has been used in an FDA-approved device, according to an agency spokesperson. A previously-approved app used AI to analyze indicators of stroke.)

The cloud-based IDx-DR software provides a screening decision without the need for a clinician to interpret its results. It uses artificial intelligence to analyze images taken with a retinal camera, then indicates whether the patient has a retinopathy that requires further examination by a specialist.

The FDA reviewed IDx-DR under its De Novo pre-market review pathway for low- to moderate-risk devices. FDA based its approval on a study of 900 diabetic patients’ retinal images at 10 primary care sites. IDx-DR was able to correctly identify the presence of more than mild diabetic retinopathy 87 percent of the time, the agency said in a news release. Pros can read Arthur’s story here.

HARD CORE DATA — The Core Data for Interoperability Task Force took another whack at the recommendations it is presenting to the full Health IT Advisory Committee next Wednesday. This whacking occurred even more deeply in the weeds than most of the health IT discussions we cover. It concerned mechanisms to receive stakeholder feedback on data class priorities; proposed categories to which data classes would be promoted and objective characteristics for promotion; how the core data set should be expanded, and any factors associated with the frequency with which it would be published.

LIVONGO PARTNERS WITH CAMBIA — Livongo Health, which sells software that collects and analyzes glucose meter data for diabetic patients, has raised $105 million in Series E funding. The company also has partnered with one of its investors, Cambia Health Solutions, to offer Livongo’s diabetes services to its customers of its subsidiary Regence Blue Cross and Blue Shield in Idaho, Oregon, Utah, and Washington. Their goal is to co-develop more products using principles from human-centered design, chief executives Glen Tullman (of Livongo) and Mark Ganz (of Cambia) told Morning eHealth.

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—How one hedge-fund manager is lobbying for VA privatization