Experts say quick action needed for VA’s Cerner project

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

EXPERTS SAY QUICK ACTION NEEDED FOR VA’S CERNER CONTRACT: As the House Veterans Affairs Committee today takes its first crack at oversight of the $10 billion contract to transform the VA’s digital health records, critics say the agency needs stronger leadership to assure the project succeeds, Morning eHealth’s Arthur Allen reports.

The VA made an apparent move in that direction late Monday, saying in an internal memo that it was reorganizing the office responsible for the implementation. The formally established Office of Electronic Health Record Modernization will be led by a chief health information officer and a deputy chief, it said. (More on that for Pros here.)

Two sources — one inside the VA and one out — said Genevieve Morris, HHS’s principal deputy coordinator for health IT, would henceforth lead the effort. At ONC, Morris has led work on a trusted exchange framework for the exchange of health information. She was detailed to the VA earlier this year. However, a VA spokesman said John Windom, who also led the Pentagon’s Cerner acquisition, was still on the job.

Officials within the VA say that the various parts of the 330,000-employee agency — including the Office of Information and Technology, the Veterans Health and Benefits administrations, and the EHR project team — will need to coordinate better than they have to date.

“Right now there’s complete chaos,” said a mid-level official, speaking on condition of anonymity. He said many of his colleagues were unclear about the intentions of former Trump campaign officials who occupy senior leadership positions in the VA’s EHR Modernization office.

The Senate is expected to confirm Robert Wilkie, a senior defense official, as the new VA secretary after his hearing Wednesday. But the agency has no permanent leader of its health administration or information and technology branch. Pros can read the rest of Arthur’s story here.

HEALTH IT GROUPS ADVISE AGAINST INTEROPERABILITY AS A CONDITION OF PARTICIPATION: Several health IT trade groups raced to meet the public comment deadline on CMS’ proposal to consider making seamless data exchange a condition of participation in Medicare and Medicaid, many of them strongly advising against it.

The Inpatient Prospective Payment System and Long Term Acute Care Hospital proposed rule rebrands the Meaningful Use program as the “Promoting Interoperability Program,” and would eliminate some potentially burdensome quality measures for acute care hospitals, among other steps.

“Medicare payment does not address the root issues at play,” CHIME wrote. "[A] distinction must be drawn between speeding and increasing data exchange among providers and achieving a true state of interoperability. The two should not be conflated.”

The Electronic Health Records Association argued that CMS should wait until ONC clarifies exceptions to the 21st Century Cures Act’s ban on information blocking, because any related requirements would be “contingent on ONC’s definitions on safe harbors.” A letter from AMIA also advised CMS to wait for the information blocking rule, expected in September.

Several other health companies, however, signed on to a letter supporting the measure, calling it a “tremendous benefit” to millions of Medicare and Medicaid patients. Co-signers include Beth Israel Deaconess Care Organization, Intel, and the National Association of Accountable Care Organizations.

... In other CMS correspondence, a group of several medical associations responded Monday to a request for information about price transparency. Paul Kivela, president of the American College of Emergency Physicians, said in a release that it is the “insurers’ responsibility to provide clear information about medical costs upfront to patients,” and that “[w]hile providers and hospitals may be able to provide raw prices to patients, without accompanying information from insurers, little can actually be achieved in the form of true transparency for the patients.” The American College of Radiology and the American Psychiatric Association were among co-signers.

eHealth Tweets of the day: Megan Douglas (@mdouglas1313): “New measures of interoperability by @j_r_a_m : Are hospitals sharing data w systems w most shared patients? Only 21% of hosp largely/fully interoperable with hosp that share largest # shared patients (in same HRR) *competition=common reason for not sharing #ARM18"

Walid Gellad (@walidgellad): “Among Veterans on long term opioids in VA who also fill opioids outside VA, almost all of them increased opioid dose outside VA after their VA dose reduced. Important @vahsrd funded work. Oregon PDMP data linked to VA data for post 9/11 Veterans. #ARM18"

It’s TUESDAY at Morning eHealth. Your author has been binging true crime miniseries “The Staircase” on Netflix. Did the owl do it? Avian conspiracy theories and news tips go to [email protected]. Reach the rest of the team at @arthurallen202, @dariustahir,@ravindranize, @POLITICOPro, @Morning_eHealth.

HOUSE APPROPRIATORS DELAY LABOR-EDUCATION-HHS MARKUP: House GOP appropriators have once again postponed consideration of their Labor-HHS-Education spending bill, POLITICO’s Kaitlyn Burton reports.

The markup, which had been rescheduled for Tuesday, is now slated to be held sometime after the upcoming July Fourth recess.

Subcommittee ranking memberRosa DeLauro suggested after an earlier postponement that the delay was related to Republican reluctance to debate the bill in the midst of a backlash over White House immigration policy. But aides to majority Republicans said it had to do with scheduling problems rather than larger disputes. Pros can read the rest of the story here.

MORE SPECULATION ON AMAZON-BERKSHIRE HATHAWAY-JP MORGAN CHASE: Details are still scarce on what exactly the three giants have planned for their health venture, but experts are taking guesses based on the recent appointment of Atul Gawande as its CEO. Speaking at an event Monday hosted by Leading Age, Deloitte’s Mark Snyder noted that Gawande and David Feinberg -- the Geisinger chief who according to some reports was the top choice but declined the offer -- are both preoccupied with ways health care can be delivered more efficiently, he said Monday. Snyder suggested that the entities combined can use their financial clout, purchasing power and more than one million employees to partner with an existing care delivery system that could treat its “actuarially significant population.”

CATCHING UP ON ASPEN: Audio and video from the Aspen Ideas Festival/Spotlight Health is here. Among health tech-related sessions were “Keeping Veterans Healthy” with former VA secretary David Shulkin, “Venture Capitalists Best Bets on Health,” and “Unlocking The Power of Blockchain in Health Care.”

WHAT WE’RE CLICKING ON:

— FiveThirtyEight profiles All of Us

— Woodside Cap’s Vini Jolly writes about the state of digital health