Interoperability day at the White House

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

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WHITE HOUSE INTEROPERABILITY FORUM: The Trump administration is delving deeper into health data issues, this time with an interoperability discussion. CMS Administrator Seema Verma — who has partnered with White House senior adviser Jared Kushner on the MyHealtheData effort — is scheduled to attend, as is ONC head Don Rucker. We’ll have updates after the event this afternoon.

HHS: HOW ABOUT THAT INFO BLOCKING RULE?: Add HHS to the list of institutions calling for the release of its own information blocking ruling. In a report on encouraging competition in the health care sector, the department — along with collaborators from the Treasury and Labor departments and the FTC — approvingly cites the information blocking rule as a pro-competitive regulation before urging the administration to “expeditiously implement provisions of the 21st Century Cures Act to prevent information blocking.”

Last we checked, the rule is still pending review at OMB. You heard ‘em, OMB — HHS wants you to get this thing over with!

... The report also includes the requisite shout-outs to Blue Button 2.0, reduction of documentation burden, and telehealth (which the administration says could upset health care monopolies). HHS blamed regulation and licensing laws for limiting telemedicine use. (Lobbying group Health IT Now was among supporters.)

... Speaking of telemedicine, Health Affairs published a monster telemedicine-themed issue Monday, replete with researchers’ attempts to quantify the use and value of virtual check-ins, store-and-forward consultations, and remote monitoring. Our takeaway? Each study shines a light on a sliver of telehealth, but doesn’t definitively answer the question on lawmakers’ and providers’ minds: Is the technology a worthwhile investment? The fact that usage varies dramatically by geographic area, patient demographic and specific medical specialty doesn’t help.

Still, we found a few interesting tidbits:

— In one study, American Medical Association researchers Carol Kane and Kurt Gillis found that 15.4 percent of doctors worked in practices that used telemedicine to treat patients in 2016, and that 11.2 percent worked in practices using the service to connect physicians to other health care professionals

— Telemedicine leads to outcomes that are generally equivalent to in-person treatment, according to an analysis that reviewed 20 major articles published from 2004 to 2018. But evidence is unclear whether telemedicine reduces patients’ use of other health services, wrote the authors, led by Erin Shigekawa, a consultant at John Snow Inc.

— Medicaid, low-income and rural populations don’t use live telecommunication with providers as much as other groups do, researchers in another study found. That remained true even in states with less restrictive telehealth policies, according to a study authored by Jeongyoung Park and other George Washington University scholars. The authors suggested that making state policy less restrictive isn’t enough to encourage adoption, and that patients may need better incentives for using telemedicine.

— A study in Minnesota led by University of Minnesota PhD candidate Jiani Yu
found that in urban areas, telemedicine was primarily covered by private insurance and used for communication between nurse practitioners and physicians assistants. In more rural parts of the state it was primarily used by providers for Medicare and Medicaid patients to communicate with specialists, such as for telestroke.

—Routing patient calls to physicians instead of registered nurses led to briefer calls and fewer referrals to the emergency department, according to a study that analyzed 11,315 physician-directed calls related to chest pain and the same number of nurse-directed calls. Physician expertise could make the calls more efficient, write the study authors, led by Kaiser Permanente Oakland Medical Center emergency physician Dana Sax. Pros can read the rest of the story here.

eHealth Tweet of the day, in response to CNBC’s story on investor John Doerr’s prediction that Jeff Bezos will launch a Prime Health service: Beth Linas, @bethlinas: “Who wants to break it to Doerr that MANY have tried to be the google/uber of #health but failed BECAUSE of this attitude? #health is a unique domain, needing UNIQUE unused/not yet thought of disruptions. #digitalhealth #scicomm”

It’s TUESDAY at Morning eHealth. Your author appreciates your recipe suggestions; she and a friend whipped up a kale salad with grapefruit, fennel, goat cheese and a lemon-mint dressing. Tips and unseasonably summery side dishes go to [email protected]. Reach the rest of the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

MORE DIRT ON THE MAR-A-LAGO THREE: A ProPublica article based on FOIA’d emails and other documents shows how deeply the three Trump associates at the president’s Florida club were involved in efforts to overhaul the VA’s EHR — a role that VA Secretary Robert Wilkie has apparently rejected, as the GAO and House Democrats have promise an investigation of the trio.

According to emails, Marvel Entertainment chairman Ike Perlmutter, West Palm Beach physician Bruce Moskowitz and lawyer Marc Sherman reviewed a confidential draft of the $10 billion Cerner EHR contract and reworded a non-disclosure agreement to allow themselves to talk about it amongst themselves. In one June 2017 email, Moskowitz named himself, Perlmutter and Sherman to an “executive committee” that included VA officials and top health care executives who’d been brought in to counsel the VA on its EHR project. The emails also detail Moskowitz’s effort to get the VA and Apple to adapt an app created by his son.

In a March 8 email, Moskowitz fumed that the Apple partnership didn’t go his way. “We had an excellent group assembled on the call with Tim Cook,” he said. “The VA dropped all contact and proceeded on its own. So now we have a product of limited value.” Other documents indicate how John Windom, the leader of the Cerner acquisition and implementation, parried Moskowitz’s thrusts. In a March 6 email to then-chief information officer Scott Blackburn and others, he downplays the Apple arrangement. “Apple will not produce an EHR/EMR,” Windom writes. “It is a health record electronic file cabinet and will likely ultimately align to a commercial EHR. … Please don’t let people confuse the two.”

Windom notes that he has shared this position with Trump political appointee Camilo Sandoval, now the acting CIO. Sandoval, who appears to have carried water for the Mar-a-Lago group in the EHR modernization operations, “was to convey the message down South,” Windom wrote.

FROM THE HILL: House leaders unveiled a bill on Monday afternoon that will extend government funding until Dec. 21, moving a partial shutdown date two weeks down the road from this Friday’s deadline, our POLITICO colleagues report.

... And the House Judiciary Committee has postponed a Wednesday hearing with Google CEO Sundar Pichai because it would have conflicted with the national day of mourning for President George H.W. Bush. No make-up date has been announced.

AETNA, ASCENSION GO IN ON BLOCKCHAIN: Aetna, now a part of CVS, and health system Ascension, are joining a pilot project that would use the decentralized ledgering technology to ensure that providers’ contact information is current in their IT systems.

Humana, Quest Diagnostics UnitedHealthcare and Optum announced the launch of the pilot, operated through the Synaptic Health Alliance, in April.

RESMED BUYS PROPELLER FOR $225 M: ResMed, which sells devices for respiratory diseases, plans to acquire Propeller, which sells digital therapeutics for patients with asthma and COPD.

UMD RAMPS UP DIGITAL COACHING: The University of Maryland Medical System is working with tech company Pack Health to offer patients software products for managing type 2 diabetes, congestive heart failure, hypertension and COPD. Patients generally work with a “health advisor” who can discuss personal health goals and check in regularly.

PEOPLE IN THE NEWS: Jonathan Linkous, former CEO of the American Telemedicine Association and current head of the Partnership for Artificial Intelligence and Automation in Healthcare, has been appointed Editor-in-Chief of Healthcare Transformation starting in January.

— ICYMI: Nellie Bowles writes about personal pollution monitors for the New York Times

— MobiHealthNews’ Jonah Comstock reports on a VR-based class for surgeons