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  • Julie Barnes

June 24, 2022

Maverick's Update

Only What Matters In Health Information Policy


If you’re a French bulldog, you’re understandably upset this week. Winston the Frenchie lost the Best in Show prize to a slobbery bloodhound named Trumpet at the 2022 Westminster Dog Show, which is uncomfortably close to the plot of Christopher Guest’s mockumentary Best in Show. Indeed, the judge in the movie looks remarkably similar to the real-life 2022 judge, who happens to have a French bulldog, Emmett, at home -- and poor Emmett is undoubtedly smarting from the betrayal. In the One Thoughtful Paragraph below, we explain how health data was the subject of a different decision by a set of judges this week -- but we are pleased to report that no French bulldogs were harmed by that one.

Other news that is less judgy about health information:

  • As the pandemic seems to be winding down, experts are trying to figure out how to better manage public health information so we aren’t so unprepared next time. Read exceptionally thoughtful insights here, here, here.

  • The HHS Office of National Coordinator for Health Information Technology (ONC) had a busy week. It made a big leap in standardizing and sharing genomic information -- which could be a game-changer in how we identify and treat diseases that are specific to an individual’s DNA. ONC also started working on patient safety issues related to using artificial intelligence in health care and launched a new task force to make sure data standards stay up-to-date. If you would like to help with all of this important work, the GAO is looking for more people to help advise the ONC.

  • Not much in life is free, but if your organization wants to be a Qualified Health Information Network (QHIN) to participate in TEFCA’s national connectivity of electronic health care records, you do not have to pay anything right away. In its first version of the TEFCA fee schedule, the Sequoia Project said that it would not charge an annual fee until later. Maybe that’s why Epic announced that it plans to become a TEFCA QHIN.


One Thoughtful Paragraph


Christopher Guest is one of those so-smart people (he married Jamie Lee Curtis, for instance) that he had to make parodies of real-life situations, probably just to overcome his frustration with the stupidity of everything. One wonders what he would make of the latest move by the U.S. Supreme Court. No, not the decision to allow New Yorkers to carry a concealed weapon -- though that seems ripe for a Christopher Guest mockumentary. We are interested in the Court’s decision this week to decline to review a complicated health care data issue. Basically, the high Court took one look at the D.C. Circuit’s decision to allow CMS to claw back overpayments to Medicare Advantage health plans and said “sure, we don’t need to deal with that one.” And yet -- while no one wants health plans to be overpaid by the federal government -- it is just a real, long-time truth that the data that is relied upon to decide whether health plans were paid properly is unreliable. If a plan was overpaid, it is because the data said a patient was sicker than they were -- and an entire fleet of system experts (examples here, here, here, here) have been trying for years to fix it and even more lawyers have tried to explain why this is a never-ending conundrum (examples here, here, here, here). MedPAC has some ideas about how to make the data more accurate -- but this entire situation is just like the latest Jamie Lee Curtis movie, Everything Everywhere All At Once. She plays an IRS agent who audits a laundromat owner that must connect with a parallel universe version of herself to prevent a powerful being from causing the destruction of the multiverse so that she can accurately file her tax returns. We will be on the lookout for a new federal rule on data collection in the multiverse... that seems like where we are headed.

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