January 29, 2020
Maverick's Update
Only What Matters in Health Information Policy
Deputy National Coordinator Steve Posnack kicked off the ONC Annual Meeting in Washington, D.C. with a Captain Obvious moment: “If you’re wondering if there will be an announcement about the final interoperability rules, there won’t be, so just relax and enjoy the education.” And that was a few hours before the CARIN Alliance (including heavy-hitters Apple, Microsoft, Humana, Walgreens, etc.) met with OMB to encourage the feds to hurry up. Which probably is one of the reasons why Secretary Alex Azar felt emboldened to say: “Scare tactics are not going to stop the reforms we need” -- a not-to-subtle response to Epic’s lobbying / litigation threats to slow the momentum of the interoperability rules. (Alex Azar used to be Justice Scalia’s Supreme Court law clerk, among other top shelf legal positions -- so a little litigation doesn’t scare him anyway.)
CMS hosted an invite-only “Healthcare Industry Innovation Day” to connect with industry and policy leaders on price transparency, interoperability and Health Reimbursement Arrangements.
This just in and not yet reviewed: A D.C. district court ruled that HHS cannot limit the fees charged for copies of medical records that go to third parties. This changes current policy, but HHS, under HIPAA’s right of access, can still limit fees charged when individuals request access to their own medical records. See notice published by the HHS Office of Civil Rights. To be determined: how this will impact future interoperability rules that plan to require health plans to disclose individual health care data to third party apps for free.
The Sequoia Project Information Blocking Workgroup (comprised of an impressive and diverse set of health information and privacy experts) released its implementation hints -- all 105 slides worth -- that look very helpful for parsing out the information blocking proposed rule definitions and other confusing parts of the proposed rule, and offers thoughtful suggestions on how organizations may prepare for compliance.
Senator Warner is upset that the FTC is not cracking down on software products that are selling the personal information of consumers, after learning that a joint investigation by Motherboard and PCMag that free antivirus product Avast collects people’s web browsing activity and sells it to large companies around the world.
One Thoughtful Paragraph
ONC is weirdly popular these days, with thousands of registrants showing up from all over the country to fill a massive D.C. ballroom and non-registered hopefuls getting seated in the ROOM OF SHAME (must watch the event by video -- they were later seated in the ballroom too). While there was no big final rule announcement to dwell on, the community and excitement evident in the 2-day conference was oddly refreshing in an otherwise caustic political environment. This positive feeling may well be attributed to the leadership of HHS National Coordinator of Health Information Technology Don Rucker, who was introduced by one of his staff as “a nice guy.” Dr. Rucker obviously commands much respect from his impressive team: Lisa Lewis, COO, Teresa Zayas Cabán (recently delegated to the NIH to work on genomic data), Katherine Marchesini, Chief Privacy Officer, Elise Anthony, Chief Policy Officer; Andy Gettinger, Chief Clinical Officer, and Deputy National Coordinator Steve Posnack. Other takeaways from the meeting:
How to handle patient-matching is unresolved, but Dr. Sarah Corley advocates for a Unique Patient Identifier with a 2-step verification process, and ID.me is a company to watch in the digital identity space
There is a global consortium on interoperability, led by HIMSS, HL7, and IHE
Don Rucker: “The challenge of modern society is privacy.” AHIP just did a survey that shows regular people think that privacy is more important than access.
Public health reporting and data collection is ridiculously complicated, chaotic and more than a little bit troubling, but FHIR-based health IT solutions may help the CDC, NIH, state immunization and opioid-related data collection efforts. Anyone who cares about this area should ask for a slide deck by emailing meaningfuluse@cdc.gov