By Darius Tahir | 10/12/2017 10:00 AM EDT
With help from David Pittman (@David_Pittman) and Arthur Allen (@arthurallen202)
COMMON ...: Wednesday resembled one of those Mad Libs games - people substituting their own endings to a phrase beginning with "Common." To wit:
- Rule: As reported in Morning eHealth, it appears the administration is contemplating a one-year delay of the implementation of the Common Rule - the massive federal regulation that governs much of the research-industrial complex. As we warned you in July, when big trade associations had advocated for a delay, the timeline for compliance and the Trump administration's general deregulatory fervor had induced confusion for many researchers. A delay in compliance may give them time to get used to the idea.
The rule still has notable skeptics. The American Medical Informatics Association said it "appreciates and supports the delay," and is eagerly anticipating learning "which provisions will be available for use before January 2019."
Meanwhile, the new issue of the New England Journal of Medicine includes an interesting argument-by-anecdote against the Common Rule. The authors, who hail from various Philadelphia-area institutions, are not fond of the institutional review boards' implementation of the Common Rule. By way of a hypothetical example, they propose that an institution would find it difficult to test different versions of a birthday card greeting cajoling recipients into having their colonoscopy because of the IRB's strict construction of the Rule's informed consent requirements. (The requirements mandate study participants consent to research of more than "minimal risk.")
- Well: Wednesday, Cerner announced it was extending free access for its clients' use of CommonWell, the information-sharing network. Vendors have been trying publicly to ease costs for interoperability. Think, for example, of Epic's recent introduction of a smartphone app allowing patients to share data with selected providers.
OTHER ADMINISTRATIVE ACTIVITIES: Some other updates to share from the administration's daily whir:
-Actor: Eric Hargan was designated Acting HHS Secretary Wednesday.
- CMS: An important update from MIPS land - CMS is opening its "election process" for becoming a virtual group, an initiative allowing small practices and solo docs to submit quality reporting collectively. The agency is opening a two-stage process - a soft election period during which interested providers can check whether they're eligible, followed by a more formal application process. The deadline for the latter stage is Dec. 1. (You can view a slide show produced earlier this year by CMS about virtual groups here).
- Antivirus: Earlier this week, numerous news outlets reported that Russian antivirus tools made by Kaspersky Lab were a conduit - whether knowingly or not - for the Kremlin's espionage efforts. According to these reports, the software could pick up sensitive information under certain conditions.
The reports follow a previous move from the Department of Homeland Security to ban Kaspersky's software from government computers. As it happens, NIH told your correspondent earlier this year that one institute used Kaspersky's software in 2008, and subsequently dropped the software at a later, unspecified date.
We followed up with the NIH in light of these reports to see if the Institutes knew whether the agency's info had been swept up in any digital dragnets. They referred us to the Department of Homeland Security, which declined comment.
eHealth tweet of the day: Carla Brenner @carlabrenner007 Perplexed that I still come across healthcare workers that still don't know what an emr/ehr is or means!
THURSDAY: You didn't ask, but your correspondent enjoyed a fine Sunday hiking in the Shenandoah Valley. It was a lovely time, but let's cut short the yadda yadda and focus on the important matters: the strange naming conventions of Charlottesville, Va.-area restaurants. The Mexican restaurants - and solely the Mexican restaurants, so far as your correspondent could tell - featured each establishment's name (e.g. "Guadalajara") and, invariably, a subtitle assuring customers that it was an "Authentic Mexican Restaurant." Doth the restaurants protest too much? Email email@example.com with your assessment. Suggest other outings in Shenandoah and/or Charlottesville socially at @David_Pittman, @athurallen202, @DariusTahir, @POLITICOPro, @Morning_eHealth.
ON THE HILL: A group of conservative activists is restless, having sent a letter to Senate GOP leadership asking the lot of them to step aside. The activists cite the lack of tangible legislative progress on their goals.
JOINT COMMISSION WITHDRAWS TELEMEDICINE STANDARDS: Hospital accreditor, the Joint Commission, has scrapped draft telemedicine requirements for hospitals. A May proposal would have required hospitals to confirm patients' location when receiving telemedicine services and obtain informed consent, among other requirements. "We will continue to accept comments and evaluate options," a Joint Commission spokesperson told FierceHealthcare. The rules were criticized as being more restrictive than current CMS standards and even some states' laws.
"I think that shows they are willing to listen to providers and hospitals in the telemedicine industry," telemedicine attorney Nathaniel Lacktman of Foley & Lardner told the site. "What that does mean is hospitals and telemedicine providers need to take time to submit comments or their feedback."
ANNALS OF VALUE-BASED CARE: A few updates from the frontlines of the movement to transition the American health care system from fee-for-service to fee-for-value:
- Docs (well many) don't like it: A survey of 980 doctors by Bain and Company finds resistance to pay-for-value. Seventy-three percent say they prefer fee-for-service payment systems, with anonymous doctors citing reasons reflecting intent that is both noble ("results in the best patient care") and ... self-interested ("offers the best financial reward.")
On the IT side, just over 60 percent of surveyed physicians say they have in place the user-friendly IT necessary to deal with value-based care - which is not what your correspondent would've predicted.
- Case study: The people at Aledade have published a case study of their experiences with one Louisiana ACO. Much of the blog post, published at Health Affairs, is about analog nuts-and-bolts, but one section highlights technological enhancements. Those upgrades are mostly focused on case management software: for example, using admission and discharge data to track patients' hospital stays.
PERSONNEL NOTES: A few notes on personnel to keep you apprised of: Abigail Fredenburg has joined Crosscut Strategies, working with the firm's health care clients ... Google Research has hired Michael Howell, a former executive at University of Chicago's health center. (First reported by Becker's.)
WHAT WE'RE CLICKING ON:
-Startup Propeller Health has released its asthma-forecasting API for open use.
-Fertility testing is often pretty useless.
-Services (and software), not just software, is eating healthcare.
-A JAMA viewpoint on cybersecurity.
-A report on AI automating jobs - with some attention on healthcare.
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