Data sharing woes slow advance of clinical registries — SCOTUS hears health data sharing case — Fewer meaningful use hardship exemptions than expected

With help from Darius Tahir and Joanne Kenen

DATA SHARING HEADACHES SLOW REGISTRY DEVELOPMENT: The cost and hassles of building interfaces are interfering with the creation and use of the big databases that aim to track and improve health care. Computerized cancer registries started in the 1980s, but their use has taken off in tandem with electronic health records. The hope was that a shift to electronic health records would allow for software to snatch the relevant data seamlessly. Large-scale, long-term observations recorded in registries serve what advocates term the “learning health system.” But the learning health system can’t learn if registries can’t grow. Administrators of some registries say high costs are stunting their growth. Pros can read more about it in Darius Tahir’s takeout here: http://politico.pro/1NrOwwC

Tweet of the day: ‏@ jathansadowski I would appreciate it if everybdy could postpone hyping the Internet of Things until my dissertation is done nxt year http://politi.co/1QYsoQ1

Bienvenidos en Tuesday eHealth, where we still can’t get used to how quiet this week is compared to last, news-wise. We feel somehow like a dog chasing rabbits in his sleep — can’t keep our fingers still even though there’s relatively little to type. Send us news @ arthurallen202, @ dariustahir or via the email [email protected]

MEANINGFUL USE HARDSHIP DEADLINE TOMORROW: Nearly 21,000 eligible providers have filed for hardship exemptions to avoid penalties for failing to attest to meaningful use in 2013, a CMS official said Monday. Andrew Morgan, from CMS’s division of IT, said he expected the total to be well fewer than the 46,000 who sought exemptions last year. However, he notes that about 86 percent of last year’s candidates filed in the final week. “Eligible providers are great procrastinators,” Morgan said during a session at the annual meeting of the American Health Lawyers Association. CMS had anticipated 50,000 or more exemption requests, Morgan said. He added that CMS is conducting meaningful use audits on somewhere between 5% and 10% of eligible providers. The most common reasons doctors fail Stage 1 audits are failures to conduct risk analyses, register clinical summaries, or use certified EHRs. Risk assessment is also a major problem for Stage 2 attesters, as is failure to conduct secure messaging with 5% of patients.

WATCH FOR HACKS OF THAT INTERNET OF THINGS: A trade association that includes medical imaging makers among its ranks is urging members to make their supply chains more secure against cyber threats. The National Electrical Manufacturers Association in a white paper outlines several steps firms can take to head off the possibility of viruses or other threats creeping into their production via suppliers with sloppy security. The integrity of hardware and software purchased through a globally-dispersed supply chain has become an increasing worry among cybersecurity experts, concerned that malicious parties could insert hidden malware into products whose malfunction might cause physical damage. The concern is still more theoretical than real, since hacking software is typically the easiest path for a cyberattack.

SPEAKING OF THE INTERNET OF THINGS, don’t miss POLITICO magazine’s 13-part series on the topic, which focuses on regulation, legislation, lobbying and jurisdiction over the emerging technology.

EVERYBODY’S DOING IT: The global market for health self-monitoring technologies reached nearly $3.2 billion last year and is likely to reach $18.8 billion in 2019, according to a report from BCC Research. “About 21 million individuals globally used their smartphones for self-monitoring their health in 2013. Approximately 17 million (81%) of these individuals lived in the U.S., while the remaining 4 million (19%) lived in other countries,” said research analyst Andrew McWilliams. “The number of smartphone self-trackers in other countries is expected to grow from 6.3 million in 2014 to 60.6 million in 2019.”

SCOTUS TO HEAR HEALTH DATABASE CASE: The Supreme Court on Monday agreed to hear a case about whether self-funded insurers have to share clinical data with state databases. The state of Vermont wants to collect clinical data from Liberty Mutual, but the insurance company says ERISA exempts private payers from having to share the information. The Court of Appeals for the Second Circuit ruled that insurers don’t have to share the data and Vermont appealed to the Supreme Court. The Obama administration sided with Vermont in the lower courts but had asked the Supreme Court not to hear the case, 14-181, Gobeille v. Liberty Mutual Insurance. Arguments are set for the fall.

AAP SETS GUIDELINES FOR TELEMEDICINE: It’s OK if incorporated into a pediatrics setting, according to a American Academy of Pediatrics position paper published this week, but it can be distruptive and wasteful if not used correctly. Telemedicine can improve management of difficult chronic illnesses and help docs communicate better amongst themselves. “On the other hand, telemedicine technologies used for episodic care by nonmedical home providers have the potential to disrupt continuity of care and to create redundancy and imprudent use of health care resources. Fragmentation should be avoided, and telemedicine, like all primary and specialty services, should be coordinated through the medical home.”

HARK: FROM THE MOUNTAINS, SPEAKETH THE HERALD OF SELF-QUANTIFICATION: Scripps Research Institute cardiologist Eric Topol, guru of all things eHealth, told the Aspen Spotlight Health conference on Saturday that we are at a “Gutenberg moment” in medicine. Just as the printing press democratized information, so shall apps and sensors democratize our health information. “Now you are generating your own data,” he said “ You can just wear a watch and get your heartbeat.” But Topol (in response to a grandfather who asked about whether his granddaughter could get the disease history of a potential date) noted that there are still questions about who owns the data. “My biggest concern of everything we talked about it is privacy and security,” Topol said. “It has to be kept to you, or your family member … and we don’t have any safeguards for that now.”

TELADOC GOES TO WASHINGTON: Apparently, telehealth giant Teladoc believes there’s one area in which the personal touch really does matter: lobbying. The firm, which retained Mehlman Castagnetti Rosen Bingel & Thomas, is returning to DC lobbying after a three-year hiatus. (It terminated relationships with Foley Hoag and Akin Gump in October 2012.) Teladoc seems to stand alone as a virtual visits firm with personal lobbyists — other big players like American Well, MDLive, and Doctor on Demand don’t rate entry in the Senate’s lobbying database. Teladoc will be pursuing expanded coverage, healthcare reform, Medicare and Medicaid, according to their registration, along with on unexpected area: Veterans Affairs. Only one other group in the Senate’s lobbying database combines telehealth and the VA: the American Physical Therapy Association. “While health care is primarily regulated state-by-state, there are a number of important programs that are governed at a Federal level, such as Medicare and Veteran Affairs,” said Teladoc spokeswoman Patty Sullivan. “Teladoc is reshaping access to quality, non-emergency care and it’s important for key stakeholders to understand how telehealth can benefit patients in these public programs.”

WHAT WE’RE CLICKING:

Turns out that FDA regulation of medical devices is not too cold, not too hot but juuust right, according to a Penn Wharton School study http://whr.tn/1IJ9enr

Wearables all give different information, a techie exercise freak discovers http://bit.ly/1H8fABY

New York Times on reading the small print of privacy disclosures http://nyti.ms/1LFhCKO

Susannah Fox, the new HHS CTO, states her case http://1.usa.gov/1BAKu3z

Forbes interviews a tele-radiologist http://onforb.es/1GIXakL