Who should reconcile differences in VA and DOD EHR?

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

WHO SHOULD RECONCILE DIFFERENCES IN VA AND DOD EHR? Now that the Veterans Affairs Department’s contract with Cerner is inked, and the rollout gets underway, oversight groups are warning that differences in the VA and the DoD’s EHR implementations will complicate their plan to create an interoperable system. But during the inaugural hearing of the House Veterans Affairs Subcommittee on Technology Modernization Thursday, officials and lawmakers disagreed about whose responsibility it is to reconcile those differences, Morning eHealth’s Arthur Allen reports. Subcommittee chair Rep. Jim Banks said Thursday that the two departments should clarify the powers of the Interagency Program Office — set up in 2008 to oversee their electronic health record collaboration — and empower it to resolve their differences.

But Lauren Thompson, the current head of the interagency office and John Windom, who leads the VA’s EHR implementation office, said IPO was serving as a facilitator and lacked the actual clout that Congress legally provided it a decade ago. Without more resources, staff and authority it can do no more, Thompson said.

Carol Harris, who leads IT acquisition issues at the Government Accountability Office, said in a report and testimony that DoD and the VA have ignored GAO’s advice over the years on empowering the IPO. Now, she said, they must clearly define its role.

No single person is accountable for the joint project’s success, she said. Congress could relieve the IPO of its legal responsibilities, but one way or another “a single point of accountability is critical,” she added.

Banks and Rep. Conor Lamb indicated they wanted IPO to get the power it needs to be that central decision point, but Rep. Mike Coffman said he preferred making either the VA or DoD the final arbiter. Pros can read more from Arthur on that hearing here.

HOUSE CLEARS MINIBUS SPENDING BILL, BUMPS UP HHS SPENDING : The House cleared a “minibus” spending bill for fiscal 2019 that bumps up funding for several health agencies including NIH and AHRQ, according to a summary and text released Thursday night.

The bill includes $90.5 billion for HHS, $2.3 billion above the current fiscal year. It gives an additional $2 billion to NIH, and an additional $86 million to the All of Us research program, which aims to collect biospecimens and health data from a million donors. The Cancer Moonshot would get $400 million, a $100 million uptick from fiscal 2018.

The bill also sets aside $338 million for the Agency for Healthcare Research and Quality, an increase of $4 million. The summary says the bill includes $1.5 billion in state opioid response grants. A vote will be held early next week. Pros can read more from our colleague Sarah Ferris here.

eHealth Tweet of the day, referring to the first day of FTC hearings on consumer privacy: Christine Bannan @ChristineBannan Disappointed that the FTC asked about the “privacy paradox” (consumers say they care about privacy but then act in ways that seem to contradict that). Makes them seem pretty out of touch with current privacy discussions. #FTChearings

It’s FRIDAY at Morning eHealth. Your author recently discovered the supremely macabre but fascinating podcast Dr. Death, which details the botched surgeries performed by Christopher Duntsch. Is anyone else listening? Send tips and thoughts to mravindranath@politico. com. Reach the rest of the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

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HEALTH LEADERS SAY STARK LAW BLOCKS INNOVATION IN MEDICARE: Elsewhere in the House, health leaders and lawmakers discussed the role of telemedicine, information exchange and anti-kickback laws in new value-based care models for Medicare patients.

Energy and Commerce’s health subcommittee chair Rep. Michael Burgesssaid he planned to hold an oversight hearing on the implementation of the information blocking ban by the end of the year.

Morgan Reed, president of ACT| The App Association urged Congress to pass the Connect for Health Act, which aims to remove barriers to Medicare reimbursement for telehealth services. He added that ONC’s information blocking rule could free up the exchange of patient data, because “we know that the only way to get patient the solution they need is to find out what’s wrong with them.”

Nishant Anand, chief medical officer at the Adventist Health System, asked lawmakers to modernize Stark Law regulations that prohibit physicians from referring patients to entities with which they have financial interests; lawmakers including Rep. Doris Matsui defended the original intent of those laws that prevent “pay for play at the expense of patients.”

Timothy Peck, CEO of Call9, which connects emergency response doctors via telemedicine to patients at skilled nursing facilities, expressed support for the Reducing Unnecessary Senior Hospitalizations or RUSH Act. That bill would let skilled nursing facilities provide telehealth and first responder services to Medicare beneficiaries.

OPIOIDS UPDATE: House and Senate lawmakers are working behind the scenes this week in pre-conference meetings to reconcile their opioid packages in an effort to advance a bill to the White House before the midterms. A provision that would increase physicians’ access to patients’ substance abuse information in certain cases is on the table; that provision passed in the House on its own and not as part of the House’s larger opioid package.

MORE REPORTS ON FLORENCE PREP: Morning eHealth chatted with Jonathan Bowers, the interim CIO of Atrium Health, a hospital system serving the Carolinas, about their preparations for the storm Thursday morning. The system did a lot of its preparation work years ago: its data is hosted outside the Carolinas, and the system has a direct line to the servers storing the data, so there’s no risk if the internet goes down. The system has multiple backup generators, which has enough power to run for four days.

More recently, Bowers said, the system has been changing its staffing schedules to make sure there’s enough personnel on-site during the storm. They’ve also brought in beds and food for those people.

RESULTS FROM USE OF LYFT IN MEDICAL TRANSPORTATION: There’s some more hard data available about using ride-hailing startups to coordinate non-emergency medical transportation, courtesy of a new blog post in Health Affairs. Patients, especially elderly and poor ones, have often struggled to get transportation to their doctors’ appointments; that can mean a lot of missed appointments.

The health care system has long partnered with the “non-emergency medical transportation” companies, but they’ve been plagued by inconvenient service. Enter the ride-hailing startups, like Uber, which debuted its medically-focused transport service in March.

But data about the effectiveness of such startups has been equivocal so far. The new blog post, drawn on data describing the partnership between Lyft and Medicare Advantage insurer CareMore, finds mostly exciting results: 92 percent on-time pick-ups; a 45 percent decline in wait time; high customer satisfaction, and lower costs. There’s one gap in the analysis: whether it reduces missed appointments.

INSIDE APPLE’S FAST TRACKED CLEARANCE: The tech titan wowed audience members at its launch event when it unveiled its next-generation smart watch, capable of performing an electrocardiogram scan within 30 seconds.

It’s not the first over-the-counter ECG device to get FDA clearance: Apple spokespeople tell Morning eHealth that it’s the first one that consumers can get without a doctor review, though AliveCor says its products, which got clearance in 2014 and 2017, are also available to the general public.

But at least one legal expert is more concerned about the speed with which the FDA granted Apple its clearance. Epstein Becker Green’s Bradley Thompson points out that Apple filed its ECG sensor application on Aug. 14, and the application for a system that notifies the wearer of irregular heartbeats on Aug. 9. “ FDA cleared not one but two Apple de novo reviews in fewer than 30 days. That’s remarkable,” he writes, noting that FDA’s goal has been to issue decisions for 50 percent of such clearance applications within 150 days of receipt.

APPROACHING A FAX-FREE WORLD: The Behavioral Health IT Coalition wrote a letter to CMS administrator Seema Verma supporting her pledge earlier this summer to make providers fax free by 2020. “No therapeutic areas will benefit more from this spirit of innovation than mental health and substance use treatment,” reads the letter, which notes that behavioral health providers lag behind other specialties in health IT adoption.

WHAT WE’RE CLICKING ON:

—NYT and ProPublica report on José Baselga’s resignation from Sloan Kettering after failing to disclose ties to industry

—CNBC reports that Apple has hired Fairview Health Services’ COO M. Osman Akhtar

—FierceHealthcare reports on Cigna’s new $250 million venture fund