VA using algorithms to predict suicide

With help from Arthur Allen (@arthurallen202) and Mohana Ravindranath (@ravindranize)

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Quick Fix

It’s a bursting full day. Here’s what to keep an eye on:

— VA using AI to predict suicide: The department has been rolling out algorithms to predict suicide and opioid overdoses.

— Price transparency order aftermath: Everyone’s scrambling to offer their takes on President Donald Trump’s executive order on price transparency.

— Report faults HHS cybersecurity: A bipartisan group of senators has added yet another damning report on HHS cybersecurity.

eHealth tweet of the day: Genevieve Morris @HITpolicywonk “Health IT policy is all fun and games until you sit in a room with providers and MCOs and try to do workflow redesign for hospital discharges.”

WEDNESDAY: It’s getting to about the temperatures where you slowly lose the motivation to wear anything but basketball shorts and T-shirts and live indoors. Share your cooling tips at [email protected]. Discuss ice socially @ravindranize, @arthurallen202, @dariustahir, @POLITICOPro, @Morning_eHealth.

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Driving the Day

CAN AN ALGORITHM SEE WHAT DOCTORS CAN’T? — It’s been about two years since the Department of Veterans Affairs started using an algorithm, dubbed REACH VET, to flag the patients seen in greatest need of mental health interventions. Officials estimate the prediction algorithm, which digs through patients’ records, prescription history and other health data, has prevented 250 suicide deaths since it was implemented.

Officials think the algorithms help clinicians figure out which patients to focus on. Patients “most likely aren’t going to talk to their doctor about [suicide] unless their doctor asks them directly,” NIH’s suicide prevention expert Lisa Horowitz said. But she and other mental health experts warn that algorithms shouldn’t replace the clinicians’ own judgment. Our colleague Mohana Ravindranath has the full story.

Inside the Humphrey Building

PRICE TRANSPARENCY ORDER AFTERMATH — Reaction to President Donald Trump’s executive order mandating greater up-front disclosure of health care costs is starting to pour in.

Consumer advocacy groups are at least somewhat happy with the Monday order. Families USA called the actions “potentially promising first steps,” though it cautioned the order could be vulnerable to a legal challenge. (Legal expert Katie Keith offered a similar warning in a Health Affairs blog post.) The AARP pronounced itself “appreciative.”

Other groups took a more skeptical tack. The Federation of American Hospitals said patients should have transparent price data, but warned that making data available could increase prices if it results in coordination between different entities.

Finally, some are skeptical it’ll have much of an effect after all. Economists have noted consumers don’t use existing price comparison tools, and Michael Newshel of investment bank Evercore said the executive order was “more about the optics” than a transformative change, which he is “skeptical” about. Newshel speculated that price disclosure could be a more important force politically, in fueling greater policy scrutiny of hospital practices, than commercially.

REPORT FAULTS HHS CYBERSECURITY — A bipartisan group of senators from the Homeland Security investigations subcommittee released a voluminous report faulting the federal government for its weak cybersecurity practices.

The report spends quite a bit of time on HHS, detailing many outdated IT systems. “For instance, in [fiscal year], auditors found that the FDA was still using a version of Microsoft Windows 2000 Server even though that system had been unsupported since 2010,” the report reads.

One positive factor? The report argues HHS has had less CIO turnover than other divisions in the federal government. That may come as a surprise given the turmoil at the Healthcare Cybersecurity Communications and Integration Center (which we first reported on).

The senators’ report is latest to scrutinize the department’s cybsersecurity practices. An April report from the HHS inspector general assessed the department’s cybersecurity practices as “not effective.”

COMMENTS SEASON CONTINUES — IT groups are beginning to weigh in on CMS’s inpatient prospective rule is the latest recipient of critiques.

This time around, the Electronic Health Record Association is happy with CMS proposals for relatively longer timeframes to adopt new measures related to opioid prescriptions.

The College of Health Information Management Executives, on the other hand, is concerned about the security risks for allowing third-party apps to connect to EHRs using application programming interfaces.

The organization also praises the House’s vote to overturn the longtime ban against federal funding being used to develop a national patient identifier. As we’ve previously reported, health care lobbyists and observers are skeptical both chambers of Congress will ultimately vote to overturn the ban.

In Congress

MODIFICATION TO MURRAY-ALEXANDER BILL — The leadership of the Senate HELP Committee added a pair of bills to a larger vehicle, the Lower Health Care Costs Act, S. 1895 (116), which is being marked up today.

Those modifications are relatively minor from an eHealth perspective, as they concern raising the age for legal tobacco purchases and generic drug competition. But the Murray-Alexander bill has a number of goodies for digital health watchers: beefing up public health and claims databases, increasing the accuracy of provider directories, and modifying HIPAA to allow investigators to consider whether entities had conducted recognized security practices when being examined for breaches.

DENOUEMENT TO CHINA STARTUP CASE — Startup PatientsLikeMe, which brings together patients in like-minded groups, will be sold to UnitedHealth. The sale ends months of uncertainty for the company, which had been forced to part ways with a Chinese genomics firm. The firm in 2017 had invested and partnered with PatientsLikeMe – a move which the Committee on Foreign Investment in the U.S., a task force that can block foreign investments into domestic strategic assets on national security grounds, deemed a risk.

— Also in health IT business: Call9, a startup serving nursing homes, is winding down its operations, CNBC reports. We had an interview with the company’s CEO, Tim Peck, back in January.

— Personnel notes: Crosscut Strategies adds Phil Newman, formerly of MSLQorvis, and Chelsie Jeppson, formerly with the House Budget Committee.

What We're Reading

An Atlantic article compares U.S. EHRs to Estonia’s and finds America wanting.

A Slate article looks into the telemedicine firms hawking beta blockers for off-label uses.

Reuters investigates the judges who are keeping evidence from the opioids trials secret.

Former ONC head Karen DeSalvo and UCSF official Mark Savage assess the nation’s progress on interoperability in Health Affairs.