Democrats’ stimulus bill: testing, reporting, surveillance

With help from Mohana Ravindranath (@ravindranize)

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Quick Fix

— Dem stimulus bill: testing, reporting, surveillance: The House Democrats’ latest stimulus bill contains several provisions aimed at boosting the information available to public health authorities.

— Epic is developing an immunity passport: The EHR giant is working on an app that would display users’ Covid-19 status, company CEO reveals during an interview.

— Telehealth updates: And a slew of updates from telehealth world.

And more. But first, the jump.

eHealth tweet of the day: Lucia Savage @SavageLucia “Of course #Medical #records get asked about in this morning’s SCOTUS arguments.”

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Driving the Day

DEMOCRATS’ STIMULUS BILL: TESTING, REPORTING, SURVEILLANCE — House Democrats’ latest bill to juice the economy and secure the nation’s health is full of goodies for health care, like a $100 billion fund to providers and hospitals.

But of greatest interest to health tech watchers is the spate of proposals to enhance testing, reporting and public health surveillance. The bill includes $75 billion for testing and surveillance.

It would require laboratories to send daily reports on coronavirus tests and their results, and HHS would have to make that data public. The bill would require manufacturers of diagnostics to tell the department how many tests they’re distributing.

The bill also targets public health technology. As your correspondent has previously reported, public health agencies rely on rickety IT: surveillance systems missing tons of data, and case reporting systems receiving paper and faxes.

The Democrats’ legislation pumps $130 million into public health data surveillance and analytics; it also requires HHS to publish a strategy, give out grants, and provide guidance as to best practices on surveillance and contact tracing.

Of course, the $3 trillion legislation is just House Democrats’ version of a stimulus bill: Senate Majority Leader Mitch McConnell is in no hurry to take up a new coronavirus rescue bill, so it’s plausible none of these ideas gets adopted by the full Congress.

EPIC DEVELOPING IMMUNITY PASSPORT — Epic is developing immunity passport technology, but not a contact tracing app, company CEO Judy Faulkner said in an interview Tuesday.

The technology isn’t expected to roll out anytime soon, a company spokesperson clarified, but it would provide users a way to display whether they’d had the disease or not, thereby potentially giving them entrée into restaurants and the like.

By contrast, Faulkner said, the company isn’t working on a contact tracing app, citing polling indicating America’s wariness.

TELEHEALTH UPDATES — As always, telehealth is a font of activity:

— Psychiatrists give thumbs-up to video, audio visits: A RAND/Harvard qualitative study finds that psychiatrists have largely embraced virtual care, and that many are impressed with how smoothly they’ve been able to transition.

About a third are mostly doing telephone-only visits, sometimes because their patients don’t have devices or internet required for video chats. And some point out that while video chat is generally a good substitute for in-person visits, it’s still not great for assessing nonverbal cues or specific conditions such as movement disorders.

People don’t always take phone visits as seriously as they would a video or in-person call, lead author Lori Uscher-Pines, of RAND, tells Morning eHealth. “We heard funny stories like people doing laundry while they’re having a visit with psychotherapists.”

Though federal and state policy has generally relaxed reimbursement barriers to telehealth, psychiatrists told researchers there was still confusion about coverage.

“They weren’t always getting clear guidance from the commercial payers especially,” Uscher-Pines said.

— Notes integration: An article in NEJM Catalyst details Beth Israel Deaconess Medical Center’s efforts to make prework for telemedicine visits easier using an OpenNotes pilot program known as OurNotes.

— Senators want broadband investment: A bipartisan group of senators is urging congressional leaders to include $2 billion to boost health care providers’ broadband access in the next coronavirus relief package, citing increased demand for telehealth during the pandemic.

The senators — Brian Schatz (D-Hawaii), Lisa Murkowski (R-Alaska), Angus King (I-Maine) and John Boozman (R-Ark.) — in a new letter call for significant new funding for FCC’s Rural Health Care Program, which heavily subsidizes technology investment helping rural and urban health care providers go digital.

— Florida renews telehealth order: The Sunshine State renewed its order boosting telehealth through the end of the month, our colleague Arek Sarkissian reported. Its boost to medical marijuana prescriptions from a distance is particularly notable.

AMA RELEASES PRIVACY PRINCIPLES — The latest body to weigh in on federal privacy legislation (or a lack thereof): the American Medical Association. The group on Monday put out principles for Congress to consider as lawmakers inch toward a nationwide privacy bill and as Apple and Google prepare to launch contact tracing software, our colleague Alexandra S. Levine reports.

CMS PRESSES ON PRICE DATA — CMS is once again pressing on hospital price data, our colleagues Rachel Roubein and Tucker Doherty report. In its annual Medicare rule issued Monday, CMS is proposing to collect data on the median charges that hospitals negotiate with Medicare Advantage plans and third-party payers for inpatient services, with an eye to boosting its leverage in negotiations.

The department has pushed its price transparency policy — with the intent of providing patients and researchers a closer view into the system — only to get snarled in the courts. The American Hospital Association was, naturally, not a huge fan of this latest proposal.

Health IT Business Watch

SHOULD NON-COVID STARTUPS STAY THE COURSE? — Companies pivoting to coronavirus (maybe research, therapeutics or diagnostics) might face fundraising hurdles — especially if they’re pitching to venture capitalist Mike Pellini, managing partner at Section 32.

“The companies that are best suited to do that, where the investment dollars should flow, and maybe we should even ratchet up a bit, are the ones that have already developed the platforms to move into this area. We don’t want them just taking a right turn just because there’s an opportunity,” he said during CNBC’s Healthy Returns event Tuesday. Companies like Vir and Moderna “were perfectly suited to head in this direction” and can easily “add on to what they were doing,” he said.

“The opportunities exist for the right companies that have been built to move in this direction,” Pellini added. “Otherwise what they should be doing is stay the course.”

TIM PECK RETURNS WITH NEW VENTURE — The founder of one shuttered startup hopes repurposing its technology will be the key to success during the pandemic.

Tim Peck, who headed emergency telemedicine virtual practice Call9, is launching a new company, dubbed Curve Health, that sells telemedicine and health information exchange software to nursing homes and physician groups. It’s built on the same technology platform as Call9, though that company struggled under pressure from customers slow to embrace value-based care contracts, Peck tells us.

The startup aims to help physicians easily access patient information before treating nursing home patients via telemedicine — and seamlessly exchanging information electronically is especially important when much care is virtual during the pandemic, Peck told Morning eHealth.

JOBS — The HHS Office for Civil Rights has a big list of jobs open — some relating to privacy, but some on religious freedom. ONC is hiring for a public health analyst position. Sage Bionetworks is hiring a project manager/data liaison position.

What We're Reading

Deven McGraw argues HHS should delay its interoperability rules no further in a blog post.

A Washington Post column wonders whether visiting the doctor will ever be the same.