HIMSS buzzing

With help from Arthur Allen (@arthurallen202), Mohana Ravindranath (@ravindranize) and Renuka Rayasam (@renurayasam)

Editor’s Note: This edition of Morning eHealth is published weekdays at 10 a.m. POLITICO Pro eHealth subscribers hold exclusive early access to the newsletter each morning at 6 a.m. To learn more about POLITICO Pro’s comprehensive policy intelligence coverage, policy tools and services, click here.

The eHealth team is divided between cold and damp D.C. and warm and damp Orlando, with news spanning from business to government. Here’s what’s up:

— HIMSS: The conference’s second day brought new announcements from Seema Verma (including a new rollout allowing some ACOs to bulk-download claims data) and business.

— HIPAA RFI: Meanwhile, the frenzy about regulatory changes continued, with comments pouring in to the Office for Civil Rights’s HIPAA request for information. There wasn’t a lot of consensus to be found.

— Texas nurses pushing for wider scope of practice: Texas nurses, optometrists and other providers are pushing for wider scope-of-practice rules.

But first, the jump.

eHealth tweet of the day: Steven Posnack @HealthIT_Policy
“What do we want?
Standards-based APIs!

How do we want them?
Without special effort!

#HIMSS19
#CuresNPRM”

WEDNESDAY: We’ve been treated to an onslaught of regulatory and business news this week. What news is getting undercovered? Send suggestions to [email protected]. Talk about overlooked tidbits socially at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

HIMSS: Health IT’s biggest conference continued to buzz Tuesday, with a raft of speeches, announcements and interviews:

— Verma speech: CMS Administrator Seema Verma touted her agency’s record and discussed upcoming plans.

Verma countered concerns that upgrading APIs, as required by the proposed new interoperability rules, saying she doesn’t “see that as an issue.” Meanwhile, she was excited about the future of the API standards, saying they could help reduce duplicate tests. (“In the thousands” of beneficiaries had downloaded their claims data through Blue Button 2.0; 18 developers have created apps using the agency’s API.)

Verma said the agency is considering whether it should push for standards allowing patients or providers to add their own data, though Monday’s proposed API requirement is purely focused on giving patients’ data back to them.

Verma also touted a new standard to allow some ACOs to bulk-download claims data on their beneficiaries they’re responsible for. Getting access to Medicare claims data has been a longtime ask of many providers and vendors hoping to enable value-based care. CMS’s website describing the initiative is here.

— ONC’s Elise Sweeney Anthony: ONC’s executive director of policy also dropped some thoughts in Orlando about the office’s new rules.

Asked whether ONC would consider requiring APIs to support the “write” capability allowing patients and providers add their own data, instead of merely downloading it, Anthony said this first proposal was focused on the “read” capability.

The rule proposes a new certification criterion requiring vendors to be able to mass export patients’ electronic health information, which was designed to help providers struggling to switch vendors. The proposal, long sought by provider groups, has some more details to it: developers also need hand out a data dictionary explaining how the information is stored, so the patient and the new vendor can transition it over, she said.

Anthony hopes public comments will help ONC understand what kind of legal and liability challenges might arise from the information blocking clarification, and “whether there are additional exceptions we should consider.”

— New Uber partnership announced: Speaking of APIs, medical transport company Ambulnz has integrated Uber’s API into its booking platform. Ambulnz also integrates its platform into EHRs so medical professionals can request rides for patients directly.

HIPAA RFI GETS DIVERSE RESPONSES: If the Trump administration is hoping for enthused unanimity for plans to ease or streamline HIPAA privacy requirements, reading through the comments to OCR’s request for information on the rule should be an enlightening experience. Comments reviewed by your correspondent revealed little consensus on any of the questions, which ranged from tightening timelines to respond to patient requests for access to creating explicit permission to share data with social services and law enforcement agencies.

The privacy rule has long been groused about, and HHS Secretary Alex Azar, in a speech Tuesday to the American Medical Association’s conference in D.C., described HIPAA as one of the “regulations [that] need to be reexamined to give you, as physicians on the front lines, the freedom to drive better value in our health care system.”

Yet how exactly the rule should be changed is not a subject with a lot of consensus. Some commenters wanted faster patient access and more vigorous enforcement; others, fewer burdens and mandates. Pros can get the rest here.

— Also from Azar speech: Azar’s wide-ranging speech mentioned in broad terms Monday’s interoperability and info blocking rules. And Azar also targeted Stark Law, which he described as the one law that has “probably been as beneficial to the bottom lines of many lawyers as it has been detrimental to the lives of many physicians.” Changes to Stark and anti-kickback regulations could result in more subsidization of wearables for remote monitoring purposes, and perhaps hospital aid to independent practices for cybersecurity infrastructure purchasing.

— Thoughts flowing in on Monday’s rules: We’d be remiss if we didn’t keep you updated on responses to Monday’s interoperability and information-blocking rules.

MedStar Health’s Raj Ratwani, one of the most prominent proponents of EHR usability, wrote that the rule, while appreciated, lacked a few provisions: requiring evidence that user-centered design went into EHR development; requiring evidence that test-case scenarios were used to assess EHRs; and encouraging collaboration between providers and developers.

The American Academy of Family Physicians’s Steven Waldren also wrote in to convey his appreciation, but also had a few quibbles: “With respect to the proposed information blocking rules, we are gratified that many of the examples cited in the proposed sound similar to what we’ve heard from our members. We look forward to more clarity from the federal government around the process and approach to determining whether specific actions violate these information blocking rules.”

TEXAS: NURSES AND OTHER PROVIDERS PUSH FOR MORE AUTONOMY: Nurses, optometrists and a variety of other medical providers are stepping up their lobbying efforts this session to pass bills that would allow them to practice more independently from physicians. Such scope-of-practice fights play out perennially across the country and many state legislatures remain deadlocked on the issue, which pits doctors against nurses. But this year due to growing physician shortages and other factors, Texas providers see an opening to expand their authority.

Scope of practice rules often impact telemedicine practitioners. More for Pros.

PERSONNEL NOTE: Ted Tanner Jr., formerly the CTO of startup PokitDok, is now the CTO and chief architect of IBM Watson Health, he announced on Twitter.

Since 26 million-plus people have taken an at-home ancestry test, the genetic genie’s out of the bottle, reports MIT Technology Review’s Antonio Regalado.

Embryo profiling — selecting infants with an eye on maximizing IQ scores — is possible, write researchers in STAT.

The ambulatory EHR market is starting to consolidate, writes Health Data Management.