Feds, Mayo seek business process models for medicine

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

FEDS, MAYO SEEK BUSINESS PROCESS MODELS FOR MEDICINE: Leading health IT specialists at the Mayo Clinic, the Pentagon and elsewhere are touting a process to standardize tasks in electronic health records. They hope to bring the same kind of consistent quality in other data-heavy industries like manufacturing and banking — and avoid problems like those seen in the troubled rollout of the Pentagon’s new EHR system, they tell eHealth’s Arthur Allen.

This spring a group of health industry and technical experts released a field guide to sharing clinical activities through use of Business Process Model and Notation and related methods for reducing clinical steps to simple computerized orders. Many other industries use BPMN to standardize and optimize everything from assembly lines and money routing.

Currently, most healthcare systems use pictures of flow charts to describe how work gets done. Such charts, stored in loose-leaf binders or on hard drives, are difficult to access and don’t describe the steps in sufficient detail. Clinicians in a large health system might have thousands of ways to do a procedure.

The BPMN technology is “a few years away from being mainstream” in health care, said Ken Rubin, director of standards for the VA Office of Knowledge Based Systems, but there’s a crying need for it. “Putting ourselves as an industry in a position of being able to rapidly share and distribute good clinical practices across institutions could be a game-changer,” he said.

The work involves “transforming tacit information into explicit knowledge,” Col. Jacob Aaronson, an IT leader in the Pentagon’s Defense Health Agency, said at a recent conference. This knowledge lets the EHR help clinicians do their jobs more efficiently. Pros can read the rest of Arthur’s story here.

NIH GENOME STUDY FOLLOWS IN PATHWAY OF GEISINGER PROGRAM: NIH kicked off its vast vast All of Us health research study program Sunday, beginning to recruit what it hopes will be 1 million volunteers. It’s following in a path laid out by a rural-based health system that has focused on returning relevant health information to patients who donate their DNA for study, Arthur reports.

Geisinger Health scientists since 2014 have overseen the DNA sequencing of 93,000 patients in Pennsylvania and New Jersey — more than any other U.S. health system — and Geisinger doctors have contacted more than 500 patients whose genomes put them at increased risk for developing early cancers or heart ailments.

The return of helpful information during the course of what could be a 20-year study is also a basic principle of All of Us. If Geisinger’s experience is any basis, increased understanding of the significance of genes in different populations will eventually pay off, Arthur writes.

“As we return more and more results we see this as a really high-value proposition,” said Marc Williams, director of the Genomic Medicine Institute at Geisinger and lead author ofa Health Affairs study in that journal’s precision medicine issue this month. “It’s moving us to more of a clinical preventive service rather than a pure research project.”

The NIH is hosting a Twitter chat today for anyone with more questions on All of Us. Pros can read the rest of Arthur’s story here.

INVESTORS MAKE $7B TAKEOVER OFFER FOR ATHENAHEALTH: Activist investors made a $7 billion takeover offer for athenahealth, sending the company’s shares higher Monday, Morning eHealth’s Darius Tahir writes. Athenahealth and its CEO Jonathan Bush had no immediate response to the offer but are reviewing it, according to a CNBC report.

Elliott Management, which made the offer, argued in a letter that the Massachusetts-based EHR firm required more stable management and better execution on its software rollouts.

Elliott Management acquired nearly a tenth of athena’s stock last year, and management responded to the threat of a takeover by laying off 9 percent of the company’s workforce in October. Bush has said the Elliott investment had helped the company “find its way.” Pros can read the rest of Darius’s story here.

eHealth Tweets of the day: Larrykaiser @LarryKaiser We don’t download applications, we download habits#BrandHIT

Atul Butte @atulbutte Sometimes I think there are more meetings & conferences about#AI in biomedicine, than there are actual practitioners of#AI in biomedicine…

It’s TUESDAY at Morning eHealth where your author is still thinking about her weekend trip to the National Museum of African American History, which was well worth the time despite lines and crowds. Send tips and your favorite museum hangouts to [email protected] or Tweet at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro, @Morning_eHealth.

RESCISSION BILL WOULD CUT INTO CMMI: The White House is expected to send Capitol Hill its plan today for slashing at least $15 billion in spending that Congress had previously approved. The so-called rescission bill would cut $800 million from the Center for Medicare and Medicaid Innovation, among other groups. The full story for Pros is here.

SPEAKING OF CMS, SEEMA VERMA CONTINUES TO PLUG MYHEALTHEDATA: CMS administrator Seema Verma spoke at an American Hospital Association meeting Monday, singling out ACOs that don’t want to be held financially accountable if they fail to hold down Medicare spending, our colleague David Pittman reports.

She also used the speech — and tweets that accompanied it — to rail against information blocking by EHR vendors and health systems. “The days of finding creative ways to trap patient data in closed systems MUST come to an end,” she tweeted. “No longer is it acceptable to limit access to patient records, or to prevent them & their doctors from seeing their complete history.” Pros can read the rest of David’s story here.


HEALTH IT DISCUSSIONS CONTINUE ON THE HILL: House lawmakers are holding a hearing today on 42 CFR Part 2, which restricts what information physicians can access about patients’ behavioral health data. The House Energy and Commerce health subcommittee plans to mark up Rep. Markwayne Mullin‘s Overdose Prevention and Patient Safety Act, which would give physicians access to data about a patient’s substance abuse history.

That meeting is part of a larger effort within the House and Senate to finalize massive opioid packages in the next few months.

Another measure being considered would direct CMMI to establish a demonstration program incentivizing behavioral health providers to adopt EHRs. The Electronic Health Record Association has expressed support for the Improving Access to Behavioral Health Information Technology Act on behalf of its 34 member companies, arguing that EHRs could exchange data with PDMPs to identify substance abuse patients.

“Behavioral health providers have adopted EHRs and health IT more slowly than other providers in healthcare,” EHRA executives wrote to bill sponsors Sens. Sheldon Whitehouse and Rob Portman and Reps. Lynn Jenkins and Doris Matsui. “[T]hey have never been incented or given the financial means to adopt health IT at the same pace as the remainder of the healthcare market.”

E&C also released 26 billsscheduled for markup Wednesday as part of the House panel’s larger work to address the deadly opioid epidemic, our colleague Brianna Ehley reports. Those proposals range from expanding access to medication assisted treatment, to building up the behavioral health workforce and encouraging the development of non-opioid pain therapies. Chairman Greg Walden plans to have the committee’s opioid package to the floor by Memorial Day.

In non-opioid news, the House Veterans’ Affairs oversight subcommittee is holding a hearing today on VA logistics modernization.

TRUMP’S DRUG PRICE SPEECH SLATED FOR MAY 11: Trump is now tentatively set to deliver his first major speech on drug prices this Friday at 2 p.m., our colleague Adam Cancryn reports. Trump’s remarks are expected to kick off the administration’s efforts to lower pharmaceutical costs through a slew of policy initiatives, potentially including changes to parts of the Medicare and Medicaid programs. More for Pros here.

ICYMI: Recode reportsthat HealthTap’s CEO Ron Gutman was fired for intimidating and threatening employees.

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