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  • Writer's pictureJulie Barnes

October 14, 2022

Maverick's Update

Only What Matters In Health Information Policy

After a stunning career singing on stage and acting on the big screen, Angela Lansbury died this week shortly before celebrating her 97th birthday. She is probably best known for her small screen role as Jessica Fletcher in the long-running (1984-1996) tv series Murder, She Wrote. Every week, Ms. Lansbury would ride her bike across the screen playing the retired English teacher-turned-mystery writer who solved a weird number of murders in her little town of Cabot Cove, Maine. A reassuring, lovely character, J.B. Fletcher was thrust unwittingly into these murder-solving situations and was just trying to help the professionals who were struggling to get it right. The show was a nice alternative to the competing tv series at the time -- Knight Rider -- about an AI-powered car that talked to David Hasselhoff so much it is a meme now. While Knight Rider is the show that Elon Musk must have been watching, it is obvious to us that the staff at CMS who drafted the latest health data proposal were watching Murder She Wrote. We explain why in the One Thoughtful Paragraph below.

This week’s news about people who are just trying to help with health data:

  • The FTC appointed Stephanie Nguyen as Chief Technology Officer as the agency focuses on Big Tech oversight. More on Ms. Nguyen here.

  • The Sequoia Project released a draft of its FHIR implementation guide for the policy and technical requirements for Qualified Health Networks (QHINs) participating in TEFCA. It is open for comments until November 7, 2022.

  • The Coalition for Health AI, with members like Duke AI Health, Mayo, MITRE, Google, and Change Healthcare, published the notes from its first meeting where they discussed how to create guidelines for the responsible use of AI in healthcare.

One Thoughtful Paragraph

You ever try to find a new doctor? Maybe you ask a physician friend for a recommendation. You probably also explore your health plan’s provider directory to see which doctor accepts your insurance. But when you call, you discover that the doctor is not accepting new patients, or they left the practice, or some other reason that wasn’t obvious from the directory. Is it too much to ask that these directories are up-to-date? Apparently, it is -- multiple vendors (including start-ups, and long-standing technology companies) have tried to solve this problem for years. So, just last week, CMS published a proposal about creating a national directory of healthcare providers. CMS outlined the many policy efforts -- beginning with the Balanced Budget Act of 1997 -- that tried and failed to address this keep-track-of-the-doctors issue. Why is this so difficult? It turns out, doctors do not work in one place forever. In fact, doctors usually practice in multiple places and sometimes they go to a new practice or health system. Also, the contracts between insurers and providers are constantly being renegotiated, so one day they may be in-network and the next they may be out -- changing the price tag for patients. So CMS is going to be like Jessica Fletcher in Murder, She Wrote and swoop in to put the puzzle pieces together in one big national database of doctors. On the show, Angela Lansbury was joined by hundreds of super-famous guest stars to help her solve the mysteries each week. CMS will also need a small army to accomplish the data-gathering it has in mind. For starters, we suggest the staff watch this Murder, She Wrote clip about how doctors can keep secrets.

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