By David Pittman | 10/10/2017 10:00 AM EDT

With help from Darius Tahir (@DariusTahir) and Arthur Allen (@ArthurAllen202))

PRIVACY HOLDS UP PMI WORK: The NIH's precision medicine effort has a major problem: In early testing of its consent form, about 30 percent of patients don't want to share their electronic medical records with researchers. That kind of defeats the purpose of amassing nearly a million people's medical information to compare and spot trends in disease and treatments.

Pro eHealth editor Arthur Allen has more: "Those records are a crucial part of All of Us; without them scientists won't be able to correlate things like genetic mutations, environmental pollutants and exercise patterns with the subjects' health outcomes. The power to predict which genes, pollutants, foods or activities affect health would be lost."

Why?: In no great surprise to Morning eHealth readers, privacy is a big reason so many early recruits don't want to hand over their records. The NIH wants access to every aspect of participants' medical history, and with larger and larger hacks of databases, there's no guarantee the NIH will be able to protect patients' medical records even with a new, ultra-secure system.

About 4,000 people in 57 locations across the country have signed up. The NIH hopes to eventually gain 1 million people's information for the 10-year study. Recruitment will kick into high gear later this year. It's receiving $300 million a year in federal funding.

Pros can read all of Arthur's story here.

eHealth tweet of the day: Karen Snyder @KarenSnyder2: Healthcare is 10x more complicated than national security & that's why the gov't hasn't been able to fix it @newtgingrich #ahimacon17

Welcome to Tuesday Morning eHealth where it's do-or-die time for the Washington Nationals. Who do you have in tonight's game against the Chicago Cubs? Share you prediction and news tips to dpittman@politico.com and connect with us on Twitter @David_Pittman, @athurallen202, @DariusTahir, @POLITICOPro, @Morning_eHealth.

TELEMEDICINE THE SUBJECT OF OMB MEETING: White House budget officials were briefed on telemedicine this summer by an industry trade group as the administration plots a strategy for widening the technology's use. The meeting, according to a recently updated page on OMB's website , was requested by the Alliance for Connected Care and attended by Executive Director Krista Drobac, several member companies and eight staffers from OMB. Judging by supporting documents posted on the webpage, Drobac and company touted the benefits of telehealth and remote patient monitoring. CMS, in July's proposed rule on physician payments in Medicare, solicited broad feedback on how it could expand Medicare payments for telemedicine under current law.

What CMS is considering: Largely uncovered this summer, the proposed Medicare rule floated the idea of paying for remote monitoring services, saying that doesn't fall within the legal definition of "telehealth" that's highly constrained by geographic limitations. Instead, a doctor or nurse reading the health signal of a patient from home - rather than a costly hospital bed - is the same as interpreting an EKG that's been digitally sent to another provider. "As such, they are paid under the same conditions as in-person physicians' services with no additional requirements regarding permissible originating sites or use of the telehealth place of service code," states the rule, which is expected to be finalized in the coming weeks.

FIRST IN MORNING EHEALTH: POSITIVE SURVEY NEWS: A majority of the nation's health systems say they plan to expand telemedicine offerings or patient access based on early experience with the technology, a survey out this morning from KLAS Research and CHIME found. "The 104 healthcare organizations with telehealth programs that participated in the study raised questions about cost, reimbursement, available technology, value, the patient experience and integration," according to the organizations, which didn't release details about how many would expand telemedicine services or in what ways.

GOOD NEWS FOR ACOs: While the majority of Medicare accountable care organizations won't count as a qualified alternative payment model under MACRA, a new study finds they will still do very well under the law's Merit-based Incentive Payment System. The firm of Dobson | DaVanzo, working at the request of the National Association of ACOs, found all of the nearly 500 Track 1 ACOs, which is Medicare's most popular yet lowest risk type of ACO, scored above CMS's threshold to receive a bonus for good performance. However, since CMS officials set the bar for avoiding penalties so low and those penalty-payers will fund the good-performer bonuses, ACOs will benefit with only a 0.4 to 2.6 percent bump in Medicare payments under MIPS. More detail here.

ONE MAN LIKES CMS'S 'RED TAPE' CUTTING: Senate Finance Chairman Orrin Hatch wrote CMS last week praising its recent work proving regulatory relief and flexibility within Medicare. Aside from a request for information in the afore-mentioned payment rules, HHS officials have been meeting with stakeholders to field more feedback on what's needed to make their lives easier. The letter.

"I appreciate your commitment to reducing unnecessary and costly administrative burden," Hatch wrote. "I am confident that this can be done while also ensuring that providers are accountable for adhering to program requirements, protecting beneficiaries' access to care, and safeguarding program integrity to protect taxpayer dollars."

OBAMACARE LATEST: President Trump is expected to sign this week that executive order we've been hearing about aimed at undoing many Obama-era policies around selling health plans to individuals or small businesses, the Wall Street Journal reports.

Trump also called Senate Minority Leader Chuck Schumer about working with Democrats on a "great HealthCare Bill." Schumer naturally said later that an Obamacare repeal was a non-starter.

LEFT OVER FROM LAST WEEK: Sens. Elizabeth Warren and Chuck Grassley praised an HHS Inspector General report from last week that called for device identifiers on insurance claims to better track faulty devices ... Reps. Dave Trott and Susan Brooks introduced a bill (H.R. 3985 (115)) that would create a public-private partnership, led by the FDA, to create a voluntary cybersecurity framework for medical devices and other health care gadgets...The FDA approved a new device to treat moderate to severe sleep apnea.

DON'T FORGET ABOUT SOUTH CAROLINA: The Medical University of South Carolina last week was also deemed a national Telehealth Center of Excellence by HRSA. The designation means the school "will serve as a national clearinghouse for telehealth research and resources, including technical assistance," according to HRSA. We at Morning eHealth only told you about the University of Mississippi Medical Center snagging the honor last week, but not the folks at South Carolina.

HAPPENING THIS WEEK:

The House - the Energy and Commerce Committee on Wednesday will host a member day to field ideas on addressing the opioid epidemic.

The Senate - The Commerce Committee will hold separate events Friday; a roundtable on cybersecurity in South Dakota and a hearing on broadband expansion in New Hampshire. The chamber is otherwise on recess all week but returns next week.

Off the Hill - The Second National MACRA Summit takes place Thursday and Friday.

WHAT WE'RE CLICKING:

- The National Quality Forum, whose federal support lapsed at the end of September, must be funded, supporters argue.

- Virtual reality employed to help end-of-life patients.

- Wisconsin makes PDMPs more usable.

- L.A. outfit leverages technology in novel ways to improve health.

Tips, comments, suggestions? Send them along via email to our team: Arthur Allen (aallen@politico.com, @ArthurAllen202), David Pittman (dpittman@politico.com, @David_Pittman) and Darius Tahir (dtahir@politico.com, (@DariusTahir).

To view online:
http://www.politico.com/tipsheets/morning-ehealth/2017/10/10/precision-medicine-initiative-hits-a-snag-222722

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