HHS delays interoperability rules, officially

With help from Mohana Ravindranath (@ravindranize) and Tim Starks (@timstarks)

Editor’s Note: Morning eHealth is a free version of POLITICO Pro eHealth’s morning newsletter, which is delivered to our subscribers each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day’s biggest stories.Act on the news with POLITICO Pro.

Quick Fix

— HHS delays interoperability rules, officially: In a big release Tuesday, HHS officially delayed major portions of its interoperability rules — and published a companion rule outlining enforcement.

— Contact tracing: The workforce for contact tracing isn’t close.

— Black doctors blast data release: Government is starting to release data on the racial and ethnic impacts of the coronavirus — but black doctors are saying it’s inadequate.

And more. But first, the jump.

eHealth tweet of the day: Ethan Perlstein @eperlste “Contact tracer will be 2020’s Job of the Year.”

WEDNESDAY: Anyone watching any good movies lately? Your correspondent enjoyed Keri Russell in “Waitress” on Monday evening and is, as always, looking for more flicks. Share movie recommendations by email at [email protected]. Discuss movies socially @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

POLITICO Pro is here to help you navigate these unprecedented times. Check out our new Covid-19 Coverage Roundup, which provides a daily summary of top Covid-19 news coverage from across all 16 federal policy verticals as well as premium content, such as DataPoint graphics. Please sign up at our settings page to receive this unique roundup sent directly to your inbox every weekday afternoon.

Driving the Day

HHS DELAYS INTEROPERABILITY RULES, OFFICIALLY — As we’ve warned before, HHS is delaying enforcement of major parts of its landmark interoperability rules.

Parts of the CMS rule — like the admissions, discharge and transfer data-feed requirements — will be delayed as much as six months; parts of the ONC rule -- such as the patient API requirements -- will be pushed back three months or so.

The delay is tugging along an interesting caboose: a proposed OIG rule on enforcement for information blocking. The agency says it won’t enforce information blocking penalties until 60 days after the final rule — that is, likely quite some time from now. The agency is seeking comments on how the coronavirus should affect information blocking enforcement; comments on the proposed rule are due 60 days from publishing in the Federal Register.

The idea of a delay had divided the health care sector: Many providers had said complying with the rules was unfeasible given the multiplying burdens of the coronavirus pandemic. But data-sharing advocates felt the rules were needed now more than ever.

Some of the advocates weren’t too piqued by the proposal; Pew’s Ben Moscovitch, outspoken on interoperability issues, approvingly called the delays “minimal.”

Others in the tech community agreed. Enforcement discretion and a delay are “sensible given the crisis,” said Aneesh Chopra, president of CareJourney and former U.S. chief technology officer, in an email, but he added that work on interoperability will continue. “It is clear to all stakeholders how limited our public health infrastructure is in linking clinical information for covid +/- patients on race, comorbidities and disease progression. We must do better.”

Not everyone agreed the delay is necessary. “I understand calls for delaying the rules because of COVID as hospitals struggle to meet the demands of treating patients,” said Joel White, executive director of the Health Innovation Alliance, which had previously called on HHS to redo the rules. “But most hospitals are not in hot spots, and most are not even at capacity or experiencing a surge.”

Sign up for POLITICO Nightly: Coronavirus Special Edition, your daily update on how the illness is affecting politics, markets, public health and more.

CONTACT TRACING: NOT CLOSE — Contact tracing — a critical practice, aided by data and tech, for mitigating the spread of coronavirus — isn’t close to optimal levels, public health experts say.

— You need more people: The workforce needed to do contact tracing nationwide isn’t anywhere close to robust enough. Experts are guesstimating a need for hundreds of thousands of trained contact tracers, our colleagues Dan Goldberg and Alice Miranda Ollstein report, but pre-pandemic state and local public health departments had fewer than 2,000.

Public health authorities are contemplating relying on digital tools as an alternative, which pose privacy risks — and might not be all that effective anyway.

“It’s not clear that phones can say who is in contact with who and when at a high enough or accurate enough rate to be useful,” Former CDC director Tom Frieden said. “This is fundamentally a person-to-person process. It’s about talking to someone earning their trust, and helping them remember who they were in contact with.”

— Homeless clinics put out pleas to developers: Apple and Google’s recent contact tracing partnership might help smartphone users track their exposure, but it probably won’t do much for homeless patients unless developers dream up a way for them to access it, leaders from the National Health Care for the Homeless Council tell Morning eHealth.

Smartphones-based contact tracing, which can use systems like Bluetooth to figure out when two devices may have been near each other, is “a very wealthy technology,” said Barbara DiPietro, senior director of policy. “Maybe 50 to 60 percent of the population might be able to participate, but those who are poorest, those who are most disadvantaged it will probably bypass,” she said.

But given alarming infection rates among homeless populations, and the potential for asymptomatic transmission among them, a contact tracing system would be helpful to identify which people to focus limited health resources on, said Bobby Watts, CEO of the council. “If you’re elderly and you’ve been exposed and we want to take you out of a park into a room, [knowing] that would be very helpful,” he said.

BLACK DOCTORS BLAST DATA RELEASE — While all levels of government are starting to release data on how coronavirus is affecting communities of color, black doctors and civil rights groups are blasting the data as “anemic,” our colleague Maya King reports.

Their concerns focus on a familiar problem: the vast number of reports that have no racial or ethnic data at all. (For example, the CDC’s data is missing that information in around three-quarters of cases.) That incomplete information stunts the policy and medical response to the coronavirus, advocates and health professionals agree.

JUDGE: DEA SUBPOENA FOR COLORADO DATA OK — A Colorado judge has ruled a Drug Enforcement Administration subpoena for prescription drug monitoring program data concerning 14,000 patients is valid, and that the state PDMP should provide all requested information to the federal government.

In doing so, the judge’s ruling dismisses the importance of a new precedent — Carpenter v. United States — in a footnote. Privacy hawks had hoped the case, which required a search warrant for accessing cellphone location data, would form the basis for requiring more stringent protections of prescription drug data. The data is routinely accessed by law enforcement with no more than a subpoena.

“The federal government’s request in this case is extraordinarily broad, encompassing hundreds of thousands of sensitive prescription records of Colorado residents,” said Nate Wessler of the ACLU. The organization had filed an amicus brief backing Colorado. “Under the Fourth Amendment, that kind of invasive search of people’s personally identifiable medical records should require a warrant.”

The case is one of two where privacy advocates had hoped to make headway: the other, in New Hampshire, is at the appellate level.

HEALTH CARE ADVICE — A bipartisan group of senators on Tuesday advised CISA and Cyber Command to issue guidance to the health care sector, as well as offer technical resources and take steps to deter hackers. The sector has seen a rise in cyberattacks from Russia, China, Iran and North Korea. Sens. Richard Blumenthal (D-Conn.), Tom Cotton (R-Ark.), Mark Warner (D-Va.), David Perdue (R-Ga.) and Ed Markey (D-Mass.) want the agencies to take aggressive action against adversaries, urging them to “evaluate further necessary action to defend forward in order to detect and deter attempts to intrude, exploit, and interfere with the health care, public health, and research sectors.”

DOD, VA BOOT UP HIE — The Departments of Defense and Veterans Affairs have booted up a shared health information exchange, with the intention of making longitudinal records of service members more available to doctors.

Cerner, however, thinks the move could go farther. In a blog post, company executive Travis Dalton writes that the organization thinks “it’s necessary to establish a national HIE at the federal level. It could help predict the next disease trend or outbreak and has the potential to help improve health outcomes for all patients, improve research efforts and help manage the response in the event of the next national emergency.”

GOP SENATOR ASKS APPLE, GOOGLE CEOs TO HOLD THEMSELVES PERSONALLY LIABLE — Missouri Sen. Josh Hawley wants the CEOs of Apple and Google to hold themselves personally liable for any privacy holes in their various corona tech initiatives, our colleague Cristiano Lima writes.

In response, an Apple spokesperson referred POLITICO to the companies’ previously announced privacy protections for the project, which state that consumers control what data is shared and that users are not identified to each other, Google or Apple. Google spokespeople did not immediately offer comment.

NEW BATCH OF FCC AWARDEES — The agency doled out its latest tranche of pandemic telehealth funding, this time to Banyan Community Health Center in Florida, Health Partners of Western Ohio, NYU Langone Health, St. John’s Well Child and Family Center in Los Angeles,, and the University of Michigan Hospital. The agency has now awarded about $7 million of the planned $200 million in funds under CARES Act.

What We're Reading

Coronavirus stalls clinical trials — leaving researchers scrambling to use digital tools, WIRED reports.

Large data breach at NIH, Gates Foundation, and other health organizations, Washingon Post reports.