ATA sees physician burnout as a telemedicine opportunity

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

FOR ATA, PHYSICIAN BURNOUT IS A TELEMEDICINE OPPORTUNITY: Virtual consultations could take the pressure off physicians who are experiencing burnout and suicidal tendencies at alarming rates, American Telemedicine Association CEO Ann Mond Johnson says, two days into ATA’s annual conference. Burnout is just one of many public health crises telemedicine companies are poised to solve, Johnson tells Morning eHealth, which comes to you from the ATA in Chicago today.

Johnson said that in her two months as head of the lobbying organization, she’s noticed sharp interest from members in mental and behavioral health consultations. There’s also keen interest in addressing opioid abuse – and optimism there that Congress will pass legislation making it easier for providers to use telemedicine for virtual prescription of controlled substances that treat addiction.

During an ATA panel on the opioid crisis, Faegre Baker Daniels Consulting partner David Zook said he expected opioid legislation to take shape in the next three or four months, including some modification of the Ryan Haight Act to ease restrictions on the prescription of controlled substances online. He also cited a bill that would give providers access to patients’ past overdose information, if the patient authorized it. (As Morning eHealth reported last week, that bill, introduced by Rep. Markwayne Mullin, was left out of a recent House Energy and Commerce opioid package markup, so it’s not clear if the full committee will consider it.)

— In other news from #ATA18, American Well is acquiring Avizia, another telemedicine company specializing in acute care. The combined entity will be positioned to address behavioral health, chronic care, and stroke patients, among other areas, according to a news release.

THE QUEST FOR EXPLAINABLE AI: Despite its promise, clinicians will hesitate to adopt the new technology until they fully understand now artificial intelligence makes decisions, says Kamal Jethwani, senior director of Partners Connected Health Innovation, a division of the Partners Healthcare network in Boston. Diagnostic aids guided by artificial intelligence, for instance, aren’t yet transparent about the underlying algorithms. While research suggests AI-based diagnostic aids are grounded in evidence, if providers don’t know how the machine reached a certain number, they’re not likely to trust it, Jethwani said on a panel at ATA.

Jethwani said his team is investigating “explainable AI” that can clarify for clinicians how it works and what variables went into a particular diagnosis. He proposed medical schools integrate AI units into their curriculum so that future providers become more comfortable using AI-based clinical aids.

Eventually, AI could give generalists a level of knowledge that previously only specialists had, Jethwani added. “Today, decision making is concentrated in the hands of very few people,” he said — but a well-calibrated AI could help a primary care physician advise a patient on a dermatological issue without consulting a dermatologist.

Jethwani said his team is also investigating a system that combines Fitbit data with EHRs to predict COPD exacerbations — it can currently predict with 80 percent accuracy when patients will experience such an exacerbation, he said.

SIGN OF HOPE FOR VIRTUAL DIABETES PREVENTION?: In non-ATA news, some providers of virtual diabetes prevention programs are hoping that a blog post Monday by CMS Administrator Seema Verma’s could signal progress. Verma urged suppliers to participate in the Medicare program in what looked like a response to a lackluster start to CMS’s expanded prevention program, which kicked off April 1.

— Verma doesn’t refer to virtual prevention programs, which were frozen out of reimbursement when CMS announced its final rule for the program in November But her post suggests that CMS needs more program offerings, and “it’s our belief that qualified virtual DPP providers can and should be an integral part of creating this adequate network of suppliers, especially in suburban and rural areas,” said Adam Brickman, spokesman for virtual diabetes prevention provider Omada.

— Reimbursement for companies like Omada could happen a variety of ways, Brickman said. CMS could start a demo project for virtual providers; it could include virtual prevention in the next physician payment rule (probably in June or July), or Congress could intervene.

eHealth Tweet of the day: Hardeep Singh MD @HardeepSinghMD This#FunctioningAsDesigned hashtag could become the 1st task of a future health IT safety collaborative if/when it happens. Join in and spread the word. cc@ArthurAllen202 [In response to the following Tweet] Eric Thomas @EJThomas_safety 2/2 One of our MDs accidentally wrote a prescription with the EHR to dispense 8,100 losartan tablets. When reported to the EHR vendor the response was #FunctioningAsDesigned. You’ve got to be kidding. So what’s your example?

It’s TUESDAY at Morning eHealth and your author will stick around the Windy City for the last day of #ATA18. Where can she get Chicago’s finest hot dog in her few remaining hours? Send news and food tips to [email protected], or Tweet them to @arthurallen202, @dariustahir,@ravindranize, @POLITICOPro, @Morning_eHealth.

POLITICO’s Ben White is bringing Morning Money to the Milken Institute Global Conference to provide coverage of the day’s events and evening happenings. The newsletter will run April 29 - May 2. Sign up to keep up with your daily conference coverage.

HHS TO SLASH CDC HEAD’S SALARY: The Health and Human Services Department plans to cut compensation for newly-appointed CDC Director Robert Redfield, our colleague Brianna Ehley reports. Redfield was the subject of scrutiny after reports that he was getting paid almost twice as much as his predecessor, under a program drawing high-level scientists to government jobs.

Redfield earns $375,000. In contrast, the previous CDC Director Brenda Fitzgerald earned $197,300 and HHS Secretary Alex Azar makes $199,700. An agency spokesperson said Redfield requested his pay be readjusted because he didn’t want it to be a distraction. But officials didn’t immediately announce how much his pay was being reduced.

The Title 42 program offers accomplished scientists competitive pay for federal jobs, but its critics include Sen. Patty Murray, who has questioned its fairness. An HHS spokesperson defended Redfield’s hiring, calling his recruitment a “rare opportunity to hire one of the world’s leading virologists.” Pros can read the rest of Brianna’s story here.

BILL GATES SELLS TRUMP ON UNIVERSAL FLU VACCINE: Microsoft founder Bill Gates says Donald Trump has offered him a position as the White House science adviser, part of a larger conversation in which the entrepreneur got the president “super interested” in a universal flu vaccine, POLITICO’s Rebecca Morin reports. In an interview with STAT published Monday, Gates said he met Trump in mid-March but when Trump asked whether he’d take the adviser role, he said he replied, “That’s not a good use of my time.” Gates has pledged $12 million toward developing the vaccine. Pros can read the rest of Rebecca’s story here.

PCORI BOARD DOLES OUT $74 MILLION FOR RESEARCH: The Patient-Centered Outcomes Research Institute is funding nine clinical effectiveness research studies, including one investigating the usefulness of medication-assisted treatment, or MAT, for pregnant women with opioid disorders, and another that would combine MAT with certain behavioral approaches such as telemedicine consultations.

WHAT WE’RE CLICKING ON:

—Implementing Epic hurt Erlanger Health System’s earnings

—Health startups find opportunity in care for elderly and poor

—Cyber experts gathered in the Twin Cities to talk about medical targets

—Presidential physician Ronny Jackson and one-time VA nominee may have violated HIPAA laws — and the patient was Karen Pence

—Lawsuit challenges Trump’s selection of Robert Wilkie as VA Acting Secretary