CMS, VA policies highlight WH interop event

With help from Arthur Allen (@arthurallen202), Sarah Owermohle (@owermohle) and Mohana Ravindranath (@ravindranize)

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CMS, VA POLICIES HIGHLIGHT WHITE HOUSE INTEROP EVENT: CMS is hoping to help boost data sharing related to patient hospitalizations, agency administrator Seema Verma said at Tuesday interoperability event hosted by the White House.

Doctors have long wanted more information about patients’ admissions, discharges and transfers to help clinicians support their patients after a hospitalization. The Verma proposal would center on the discharge part of the equation, attendees said, and is targeting 2021 for implementation. “That’s pretty fast for a regulatory framework,” said American Medical Informatics Association President Doug Fridsma.

VA officials at the event, meanwhile, announced they were implementing a FHIR-compliant server for patients to potentially access data through use of an app.

Such a move would allow Apple, for example, to serve as a platform for apps that download veterans’ data, said health IT entrepreneur Aneesh Chopra. Apple has reportedly been working with the VA to ease access to patient data.

DATA-SHARING SALVES WILDFIRE WOUNDS IN CALIFORNIA: As burning ash and black smoke eclipsed six lanes of terrified motorists fleeing the worst wildfire in California history, Elizabeth Steffen was driving in the other direction — toward Oroville Hospital, where she would make health information exchange available for 200 patients evacuated from a burning hospital and nursing home in Paradise, which was being consumed by the Camp Fire.

Steffen, the director of the SacValley Medshare HIE, was comfortable being in the trenches in a way that few health informaticists will ever have to be. “I never once thought of turning around, and I’d do it again,” Steffen said of that Nov. 9 experience. “That’s the kind of person I am.”

Steffen’s actions underscored a growing challenge for health IT professionals, who from California to New York are increasingly called on to safeguard patient information during hurricanes, floods and fires aggravated by climate. The disasters — and the responses of health care officials in each state and hospital system —“exposes where they are along the path to health information exchange,” says Steve Lane, chief medical information officer for Sutter Health in San Francisco.

Access to the records of patients evacuated from the disaster areas can enable vital triage and save lives. The ability to retrieve these records is also a test of how far the U.S. health care system has come in its digital transformation. Judging from the response to natural disasters over the past six months, some progress is being made — especially in California. Hurricane-plagued states are trying to catch up.

The full story for Pros here.

eHealth tweet of the day: Doc @GnomeAndFairy “I understand how much of my work is tied up in the computer, but damn if it doesn’t feel like my knowledge is too...it is SO HARD to be a doctor when the #EHR is down.”

WEDNESDAY: Everyone your correspondent is talking to has their mind on one long-promised event: the release of those CMS and ONC interoperability rules. Therefore, we’re proposing a very informal contest. Send your prediction about what date the rule is announced (for extra points, whether it comes in the early-morning or late-afternoon batch), and we will give a prize to the winner. (The prize: public glory, in the form of your correspondent mentioning your name in Morning eHealth.) Send submissions to [email protected]. Social chatter at @ravindranize, @arthurallen202, @dariustahir, @POLITICOPro, @Morning_eHealth.

STUDY — TELEMEDICINE HELPS MORE WHEN YOU TALK TO THE EXPERT: If combined with a sophisticated triaging system, telemedicine can help health care organizations treat patients faster and cheaper — a notion policymakers may want to address when expanding reimbursement, says emergency physician Dana Sax.

In a study in the Health Affairs telemedicine issue, Sax and her team found that when patients calling to complain of chest pain were routed to physicians instead of nurses, the calls were shorter, led to fewer emergency department visits and resulted in patients adhering more to the doctors’ advice.

Systems built on a fee-for-service model may have less of an incentive to invest in technology that could screen and sort patients up front before they end up in the emergency department. Physicians’ time might cost more than nurses’, but health care systems could save by reducing those emergency department visits, Sax said.

Since patients are often instructed to visit the ER if they think they’re having a heart attack, the ones who call into a telemedicine consultation system are likely experiencing earlier-stage symptoms, Sax said. And virtual consultations let experts look at patients’ EHR in real-time during the call, she added.

FDA RECOGNIZES GENE DATABASE FOR FUTURE FILINGS: The FDA for the first time will allow drug and test developers to user genetic information from a public database as evidence in their approval filings. The agency on Tuesday formally recognized a genetic database formed by the NIH-funded consortium called ClinGen; the agency says will help genetic test developers and sequencers find supporting data rather than generating their own. Developers can now cite ClinGen data for a genetic variant that their product targets, rather than carrying out extensive tests to show why that genetic target matters.

ClinGen’s 700 researchers develop standard processes for reviewing data and genetic variants, connecting them to different diseases. That translation process has been a “major current challenge” to precision medicine, and this recognition will facilitate genetic test development, NIH Director Francis Collins said in a statement.

FCC OPENS COMMENT PERIOD ON RURAL HEALTH PROGRAM: The Federal Communications Commission is opening up parts of its Rural Health Care program to public comment, the commission announced Tuesday.

Subsidies from the program are based on the difference between telecoms’ rural rates and urban rates in that state, and the commission is seeking comment on various technical matters that determine the formula. Comments are due Jan. 21, 2019.

BEHAVOIRAL HEALTH IT COALITION LETTER TO CMS: The Behavioral Health IT Coalition wants CMS to boost health IT as it implements the new SUPPORT Act, H.R. 6 (115), law to combat the opioid crisis. Specifically, the coalition — with members like the American Psychological Association and Association of Behavioral Health and Wellness — wants proof of interoperability capability to be mandated to be eligible for CMMI demonstrations, as well as use of ePrescribing for medication assisted therapy demonstrations.

PERSONNEL NOTES: A few notes to share from the job market: Josh Trent, the chief health counsel for the GOP side of the House Energy and Commerce Committee, is joining Leavitt Partners … former ONC head Karen DeSalvo is joining the board of real estate investment trust Welltower.

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