Senate HELP to push beyond 21st Century Cures

With help from Darius Tahir

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A busy week in health IT, with Senate HELP looking beyond the 20th Century Cures Act, Health Datapalooza in DC and the American Medical Informatics Association convening in San Francisco.

— Two of the witnesses at tomorrow’s HELP hearing, Ben Moscovitch and Lucia Savage, are pushing agendas that go beyond (but include) interoperability and data sharing.

— CHIME has laid bare the gaps in hospital cybersecurity in a letter to Sen.Mark Warner.

— Canadian researchers find that health apps leak your data.

Tweet of the Day: Saurabh Jha @RogueRad If you want to know what’s wrong with a rocket you listen to a rocket scientist. If you want to know what’s wrong with medicine you listen to an economist

Welcome to Monday Morning eHealth on my 60th birthday, which, as they say, is better than the alternative. I’m just back from examining health IT in the UK and Denmark on a wonderful Association of Health Care Journalists fellowship and will be putting out stories soonish. One key finding: having a single-payer health system does not guarantee a smooth transition to the digital era!

Also, I must share this insight from Simon Stevens, chief executive of England’s National Health Service, who spoke to us fellows while Parliament dithered over Brexit: “The U.S. and the U.K. health care systems have one important thing in common: In each country, to suggest that an idea has originated from the other is enough to kill it stone dead.”

Bring me up to speed on your troubles and triumphs at [email protected], or share with us on the Twitter @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

HEARING ON HEALTH IT: The Pew Trusts’ Moscovitch is expected to call for more government involvement in EHR safety initiatives, which got a boost last week when departing FDA Commissioner Scott Gottlieb called for regulators to keep a closer eye on EHR safety. That’s a topic FDA has been basically mum about since 2014 when it set out its regulatory blueprint for medical software (it decided not to regulate “administrative” software such as enterprise-wide EHRs).

Savage, the former ONC chief privacy officer, now at Omada Health, will bring thoughts on updating HIPAA law for the digital health age, and the perspective of startups that want to use EHR data to expand patient engagement.

CHIME TO WARNER: Coordination of cybsecurity across HHS “remains elusive,” according to a letter to Sen. Mark Warner (D-Va.) from the College of Healthcare Information Management Executives and its sister group, the Association for Executives in Healthcare Information Security, The groups were responding to a request of information from the Finance Committee member on gaps in cybersecurity in health care.

“The absence of a national health care cybersecurity standard contributes to the frustration and confusion of the industry,” they write. “Guidance and regulations authored by different operating divisions within HHS run counter to one another.” FDA and the Office for Civil Rights should align their guidance and enforcement activities, the letter states. It argues that health care provider organizations “unduly shoulder the burden of protecting [personal health information] in situations outside their control.” Among other things, the letter calls for changes in the Anti-Kickback Statute to assure that larger health care organizations can provide cybersecurity tools and guidance to smaller affiliates and partners.

... Most health care organizations lack a comprehensive inventory of the average of 10,000 devices on their networks, the letter states. In June 2016, one large urban hospital system said it was aware of 600,000 vulnerabilities; after a concerted cybersecurity push, the number is down to 30,000 now.

The complete CHIME letter here.

NEW FELLOWS AT BIPARTISAN POLICY CENTER: Former ONC chief and assistant secretary of health Karen DeSalvo is joining former FDA Commissioner Andrew von Eschenbach as a senior fellow at the Bipartisan Policy Center. Von Eschenbach is president of Samaritan Health Initiatives. DeSalvo is a professor of medicine and population health at Dell Medical School at the University of Texas.

FLEXING YOUR APPS: Four of five health-related apps sampled by a British Medical Journal shared user data with third parties, especially with companies that did analytics or advertising. Some of the third parties advertised their ability to share the user data with “fourth parties” according to the study by University of Toronto scholars. It concludes that data sharing by such apps is far from transparent. “Clinicians should be conscious of privacy risks in their own use of apps and, when recommending apps, explain the potential for loss of privacy as part of informed consent,” the authors conclude. The full study here.

HEALTH IT ELSEWHERE: Burnout isn’t an exclusively American ailment, we learned before our European trip, in an interview with Moshe Bar-Siman-Tov, director-general of the Israeli Ministry of Health. Israel has a “Bismarkian” health care model—universal care based on Germany’s system of insurance provided by highly regulated, government-funded integrated care organizations. Almost all providers use EHRs, the most popular being an Israeli platform called Chameleon.

… But while record visibility is good within the system, says Bar-Siman-Tov, an increasing number of doctors complain about the burdens of technology. “You have to record everything, you spend all day with the computer, you have to switch between systems. We’re trying to make it as friendly as possible but this is something we hear more and more. The administrative part of their jobs is becoming more and more complicated and taking more and more of their time.”

Medpage Today: EHR glitches and the case of the disappearing gender information