Day after: Surveying the aftermath
With help from Arthur Allen (@arthurallen202) and Mohana Ravindranath (@ravindranize)
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DAY AFTER — SURVEYING THE AFTERMATH: The electoral tides have changed — and now it’s time to see who’s still afloat. While the exact scale of the changes is TBD, we can see the shape of what’s to come:
— The House: With Democrats taking the House, there will be a whole new cast of characters in leadership. Party leaders began to signal their upcoming moves Wednesday, and we can start to prognosticate what’s going to happen next. The best guess right now is that we will see Speaker Nancy Pelosi in 2019, though many in the incoming Democratic class have said they’d like to see change atop the caucus.
Further down the totem pole, Rep. Diana DeGette of Colorado has said she’s running for majority whip, the number three job in the House. That’s currently Rep. Jim Clyburn’s spot, meaning that we could see a high-profile race in caucus leadership. Long-time health care watchers know that DeGette, of Colorado, was one of the architects of the mammoth 21st Century Cures Act.
We also got a sense of committee chairs’ priorities. Rep. Frank Pallone, the presumptive leader of the Energy and Commerce Committee, circulated a list of priorities to reporters Wednesday. Of note on Pallone’s list: lowering health care costs; protecting net neutrality; and providing meaningful privacy protections. The last item on the list is particularly important: Pallone was opposed to the 42 CFR Part 2 rule overhaul that consumed so much attention during negotiations over the massive opioid legislation, and many observers are discussing the possibility of bipartisan national privacy legislation. Our Health Care colleague Adam Cancryn has a more in-depth look at the New Jersey pol’s priorities here.
Energy and Commerce’s Health Subcommittee is another a spot to keep an eye on: Rep. Anna Eshoo has said she’s interested in chairing the panel. The Silicon Valley Democrat has long been known as a telehealth booster.
One last potential committee chair to keep an eye on: Mark Takano at Veterans’ Affairs. Takano did a Q&A with our own Arthur Allen and broke down his priorities for the panel. The Southern Californian Democrat praised his predecessor, Phil Roe, for his bipartisan approach to committee business and said he’d continue it, were he to chair the committee. Takano said he’d be keeping an eye on the Cerner implementation at the VA, as he’d been interviewing potential staffers with tech backgrounds. “It will take some strong, technical expertise to oversee this,” he said. He also seems to be skeptical about the parallel implementation at Defense, saying, “My initial impressions of the early rollout [at the military] weren’t great.”
At a lower level, some in-doubt races got resolved — or close to it — on Wednesday. Texas Republican Rep. Will Hurd, who has focused on IT and cybersecurity issues, holds a narrow edge — just over a thousand votes — in his closely contested race against Gina Ortiz Jones. Wednesday afternoon, the Democrat vowed not to concede until all votes – which include overseas military ballots and provisional votes — were counted.
In New Jersey, meanwhile, Democrat Andy Kim holds a narrow edge over Rep. Tom MacArthur, a key dealmaker in Republicans’ 2017 quest to repeal and replace the Affordable Care Act.
— Senate: Republicans tightened their hold on the Senate, though the exact composition of the upper chamber of Congress isn’t yet determined.
Still, GOP legislators signaled some of their priorities for the upcoming session. Iowa Sen. Chuck Grassley may jump chairs — from Judiciary to Finance — a move that could presage tough oversight or reform bills, our colleagues Rachel Roubein and Sarah Karlin-Smith write. Grassley has been a longtime advocate for two eHealth-related issues: the Open Payments database displaying money that flows to doctors from pharma and device companies; and unique device identifiers.
Democrats scored a key hold, as Sen. Jon Tester of Montana prevailed by a thin margin on Wednesday. Tester, the ranking member of the Veterans’ Affairs Committee, helped end Ronny Jackson’s ill-fated nomination to lead the VA.
— The president: Donald Trump began a shake-up of his administration Wednesday, shuffling Attorney General Jeff Sessions off stage left. (Sessions, as we’ve previously reported, had been interested in using prescription drug monitoring programs’ data to crack down on the opioid crisis.)
In a long press conference, the president also signaled at least some willingness to work with the new House majority, saying he could work with Democrats on drug prices and social media regulation.
eHealth tweet of the day: Sarah Kliff @sarahkliff “[following up on previous report of needing to schlep a CD-ROM of X-rays from one doctors’ office to another] Addendum: got a call from my doctors office - the files on the CD are in the wrong format! So now we are just going to redo the x-rays.
Not because I *need* new x-rays, but because there isn’t a way to transfer the data.”
THURSDAY: Hope everyone is rested and recovered from Tuesday night’s election results. Your correspondent is thinking of taking a day trip sometime soon — any recommendations? Send ’em to [email protected]. Discuss socially @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.
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MEDICAID EXPANSION A HIT: Besides the hullabaloo over Congressional control, voters delivered a decisive verdict on another aspect of health policy: Medicaid expansion. Whether in referendum, or for politicians pledging to expand, voters blessed Medicaid, our colleagues Rachana Pradhan and Alice Miranda Ollstein write.
“This election proves that politicians who fought to repeal the Affordable Care Act got it wrong,” said Jonathan Schleifer, executive director of The Fairness Project, which bankrolled the Medicaid ballot initiatives. “Expanding access to health care isn’t a blue-state value or a red-state value; it’s an American value.”
RESEARCH ROUNDUP: Some notable research and reports to share:
— Machine learning and epidemiology: A team of public health officials, Google techies, and Harvard researchers have built a new machine-learning model to detect foodborne illnesses. The model, described in a Nature Digital Medicine article, uses Google search data to zero in on queries suggesting foodborne illnesses, and then see what restaurants those users have been visiting recently. (That’s using location data, if you’re someone who’s squicked out by tech companies tracking you everywhere.)
A pilot run of their model in Las Vegas and Chicago found that identified restaurants were more than twice as likely to be found unsafe following an inspection.
Aside from whatever privacy qualms one might have, there’s one practical worry to keep in mind: Google Flu Trends, which used queries to estimate the incidence of the flu nationwide. It worked, until it didn’t. For technical reasons, the authors think this model is more reliable – but we suppose nothing is ever foolproof.
— Social determinant of health documentation: With increasing focus on the social determinants of health, a team of researchers wanted to know how frequently related data were documented in the EHR. The researchers, writing in Annals of Family Medicine, examined documentation at one system’s community health centers, and found it was limited. They said there are compelling reasons for recording the data – but noted that clinics need passionate staff to steward the concept.
TELECOM GROUPS BULLISH ON TV WHITE SPACES: Representatives from more than 40 companies are urging the FCC to modify its purview of TV white spaces, which operate on low frequencies and can, they say, easily and cheaply cover large areas. They say white spaces technologies are especially helpful in delivering broadband in rural areas.
Connect Americans Now requested that the FCC issue a notice of proposed rulemaking — in addition to its existing White Spaces efforts — outlining higher power for devices that these groups could operate on without interfering with broadcasters; and higher placement of antennas, among other things. Read the the letter here.
How to get rid of stupid stuff in the EHR, a perspective in the New England Journal of Medicine.
Researchers using wearables to understand how daily environmental exposures affect health.
A dispatch from former Celgene CEO Bob Hugin’s failed election bid, in Stat.
An update on the VA’s implementation effort.
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