Boehler, Conway spar on regulatory process

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

Editor’s Note: This edition of Free Morning eHealth is published weekdays at 10 a.m. POLITICO Pro eHealth subscribers hold exclusive early access to the newsletter each morning at 6 a.m. To learn more about POLITICO Pro’s comprehensive policy intelligence coverage, policy tools and services, click here.

BOEHLER, CONWAY SPAR ON REGULATORY PROCESS: The lengthy regulatory process for approving CMMI models was a nuisance for Patrick Conway when he headed the agency during the Obama administration, but perhaps less so for current director Adam Boehler, who — despite President Donald Trump’s deregulatory efforts — says that process ensures no one’s whims shape the payment structures affecting millions of people.

Conway, currently President and CEO of Blue Cross and Blue Shield of North Carolina, recalled some models taking years to launch — months, in the best case scenario. He and Boehler chatted onstage at the LAN Summit in Tysons Corner Monday morning.

“The process could be easier, could be faster,” Conway said. “People should trust that Adam and the CMMI team … actually know what they’re doing.”

Each model goes through an examination process that’s similar to legislative rulemaking, and “I don’t think that’s how innovation happens,” Conway added. The Trump administration should re-evaluate “how do you give [CMMI] the tools, the flexibility, the ability to move fast?”

“A 27-year old whose experience with the healthcare system is like, they’ve been to a doctor, should not be able to...block an entire model...because they had some random thought in their head and they’re in the White House,” Conway said, to loud applause from the audience.
Boehler, who used to lead home health care provider Landmark, said the process wasn’t as bad as he’d expected. “You see a level of rigor, and checks and balance[s]...you’re getting so many agencies looking at it from so many angles.”

YOUR DATA IS NOT SAFE WITH US: Participants at an HHS symposium on privacy and digital security on Monday laid out research detailing just how exposed we are when we share personal data through websites.

James W. Hazel of Vanderbilt University said that when he and other researchers looked for disclosure documents of 90 direct-to-consumer genetic testing companies they found online— including ancestry and wellness sites and even sites that offered to surreptitiously sequence DNA for paternity questions — only 55 had policies governing genetic data. Few addressed ownership or commercialization of the data, and 95 percent provided no consumer notification in case of a security breach. Some 38 of the 55 companies addressed the sharing of information with law enforcement, mostly just saying data may be disclosed “as required by law.’’ Overall, the information was vague and ambiguous, Hazel said, and the industry is largely unregulated.

“We want people to feel safe participating in these data bases, which might have great value to society,” said Anthony Orlando, a professor of law at Cal State-Pomona. “If they view them as violating their rights, it erodes the trust and willingness to participate in research and law enforcement.”

Jason Chung, a researcher at NYU, said there are few assurances that the data is being shepherded properly, and no one responsible for assuring that it is. “Does anyone know where the buck stops?” he asked. “If everyone is responsible, no one is.”

eHealth Tweet of the day: Susannah Fox @SusannahFox Thinking about how the concept of “owning” health data is tied up in the old way of owning the physical file folder, like owning a CD of music. Obvious, but I was struck by the image again. (Photo credit: Penn State on Flickr) [Image of a person searching for a file folder]

It’s TUESDAY at Morning eHealth where it’s a touch too cold for your author. Anyone got an easy knitting pattern for an infinity scarf? Those and news tips go to [email protected]. Reach the rest of the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

POLITICO Pro ANNOUNCES DEDICATED CA COVERAGE: On Nov. 7, there will be a new authority on California politics and policy. Just in time to help policy professionals and business leaders in the Golden State navigate the twists and turns of a new administration, POLITICO California Pro is the only tool that will arm you with a team of state-level experts. Learn more.

PRESIDENT DONALD TRUMP SAYS A RED WAVE IS COMING ON ELECTION DAY. Is he right, or will the tide turn blue? Compete against the nation’s top political minds in the POLITICO Playbook Election Challenge, by correctly picking the winning candidates in some of the most competitive House, Senate and gubernatorial races in the country . Win awesome prizes and eternal bragging rights. Sign up today: Visit politico.com/playbookelectionchallenge to play.

BIG DATA, MEET FAST MACHINE: Scripps Research Translational Institute and NVIDIA announced a collaboration today to use deep learning to analyze genomic and digital medical sensor data. The project will focus initially on taking Scripps’ massive data from the two sources to help predict the risk of atrial fibrillation, the irregular heartbeat condition that can sometimes lead to stroke.

NVIDIA uses AI in various fields including self-driving cars and robotics. The hope is that it can set its tools loose in Scripps data to find patterns that lead to better medicine, said Kimberly Powell, the vice president for health care, in a telephone briefing.

For example, Scripps has 14,000 whole genome sequences from very healthy elderly patients, as well as years of data from various wearables. “We think there’s a lot of information there but we need to work with Kimberly’s team to extract meaning from it,” said Scripps director Eric Topol. High blood pressure and diabetes are two other areas where he sees great potential for AI.

“The problem with expert humans is, we can only see certain things,” Topol said. “We don’t have the capability that really good machine algorithms have.”

LEAN STARTUP PIONEER KEEPING AN EYE ON APPLE WATCH: Steve Blank, the Stanford Professor credited with creating the Lean Startup model, tells Morning eHealth the ECG-scanning Apple Watch is a formidable step into the health care market that competitors such as Phillips should prepare for, but that he’ll be watching its next moves to see if it can really become a leader in medical technology.

Now that watches are equipped with fall detection and ECG-scanning capabilities, “every year now they need two to three new apps to say, ‘We’re really in the game,’” Blank said. He said he’ll be looking at the ecosystem of third party developers trying to develop products compatible with Apple’s software and hardware, or whether the Cupertino giant establishes a fund to acquire or invest in health-related projects.

USDS NAMES PERMANENT DIRECTOR: The tech team that emerged out of the White House’s troubleshooting efforts for Healthcare.gov now has a permanent director, our colleague Nancy Scola reports.

Former Google executive Matt Cutts had been acting administrator of that office, which exists to upgrade federal agencies’ digital products and services, since President Donald Trump took office.

The job as head of USDS is also being reconfigured to be a two-year career appointment, rather than the political appointment it had been until now. The previous administrator, Mikey Dickerson, was appointed by Barack Obama and stepped down when Obama left office.

Eddie Hartwig, who had been acting deputy administrator of USDS, has been named deputy director. That job has similarly been converted into a career role.

In an interview with POLITICO, Hartwig called the appointments a strong signal of support from the Trump administration for the work of USDS, an Obama initiative. The switch to career appointments, said Hartwig, “reflects the non-partisan, public-service focus [of USDS] and signals to the rest of government that we’re here to stay as long as we add value.“

A ROADMAP FOR CONSUMER PRIVACY: Tech industry trade group ITI is trying to get ahead of Congress with a “ legislative roadmap” for consumer privacy released Monday, acceding to some Democratic asks for what a comprehensive data privacy bill should look like, our colleague John Hendel reports.

ITI, which counts Amazon, Facebook and Google among members, said in a news release that federal regulators should be able to impose on companies that fail to protect user information “a meaningful penalty on the first offense.” And “some aspects of any privacy framework will necessitate regulatory rulemaking,” the group said in a footnote to the roadmap.

The roadmap also says consumers should have transparency about data collected about them and companies should mitigate consumer risk by anonymizing, pseuodonymizing and at times encrypting data.

Lawmakers in both parties say they want to move privacy legislation in 2019. Some Republicans have said they hope to move quickly in order to preempt strict California privacy rules set to go into effect in 2020.

—The Health Care Payment Learning and Action Network’s new report on APM adoption

—Marketplace’s episode on the intersection on tech and legal pot

—Raremark raises $3.9 M, Mobihealthnews reports