Freeing health care data- POLITICO

A CONVERSATION WITH US FIRST CTO: The health care sector has long struggled with the swath of data it owns as it continues to transition to digital. It’s been difficult for that information to flow among organizations, lagging other industries. Aneesh Chopra, the first chief technology officer for the federal government during the Obama administration is now president of CareJourney and a prominent voice in the digital health space.

In a wide-ranging interview, Chopra spoke to Future Pulse about the challenges in the digital health ecosystem. The interview has been edited for length and clarity.

How do you unclog the current health care data flow?

It’s a laser focus on effective implementation of the Cures Act and CMS interoperability rules that are already on the books. A lot of what you’ll see in health care is this delicate hand-off between the public sector and the private sector. And understanding and navigating that hand-off is key. We’re entering a moment where the baton is being passed from the regulators, who’ve now said all certified electronic health records (EHR) systems have to meet Cures Act obligations by December of this year. But it’s up to the private sector to demand that it works.

What are you most excited about in digital health?

That we can address the access challenges that [we’ve seen] in the pandemic. We saw utilization fall more in underserved communities than we saw in those that are in more flourishing neighborhoods, and digital might allow us a vehicle to improve access and quality, even if we have historical challenges about clinic locations and other historical capital investments.

I am also excited that we are driving a new innovation agenda around discrete patient populations who are not navigating through the delivery system to the fullest extent. We’re flipping the model from ‘I have to learn how to navigate the fixed health care fragmented machine’ to ‘it’s reaching its hand out to me and serving people like me in a more coordinated fashion.’ More and more, that care coordination and navigation function can be performed digitally.

Looking back on your time as CTO, what are your biggest takeaways?

President Obama did it the right way by declaring on day one that he would shift the default setting on government health data from closed to open. We’re now clearly moving in that direction, asserting the role of consumers at the center of the health care data ecosystem. We still have work to do on that vision.

I am a little bit disappointed in the pace of value-based care adoption and use. I would have expected us to be further along than we are today.

President Biden hasn’t nominated a CTO yet. What does the vacancy mean right now?

In today’s environment, it is almost impossible to think about any policy issue that doesn’t have the need to understand the role of technology, data and innovation embedded in it. Continuing a cross-cutting role in the White House that advises the president is critical. The great news is that well, we don’t have a named CTO at the moment, we have a world-class team from the Biden administration and frankly, even the Trump administration. The agenda is moving forward functionally even if we lack the person at the top of the food chain.

What’s your focus right now at CareJourney?

My top priority at CareJourney is to deliver on that provision in the Affordable Care Act, 10332, that talked about the release of public data, Medicare data for provider performance measurement. We’re a decade in and there was one theory that we’d be awash in data-driven physician recommendations, who’s the best doctor for patients with X to see for Y … For us, the agenda continues to build in a public-private partnership manner, the vision as outlined.

Welcome back to Future Pulse, where we explore the convergence of health care and technology. Share your news and feedback: @_BenLeonard_“,”link”:{“target”:”NEW”,”attributes”:[],”url”:”https://twitter.com/_BenLeonard_”,”_id”:”0000017f-ff63-d3c6-a9ff-ff6bff230001″,”_type”:”33ac701a-72c1-316a-a3a5-13918cf384df”},”_id”:”0000017f-ff63-d3c6-a9ff-ff6bff230002″,”_type”:”02ec1f82-5e56-3b8c-af6e-6fc7c8772266″}”>@_BenLeonard_.

Christina Farr @chrissyfarr: “It feels like we need to have some real talk about virtual behavioral health & where it’s going. There’s stuff specific to a few companies but also lots of higher level q’s around how to deal with lack of access, limits to computer based approaches; the rise of coaching etc.”

BECERRA PUSHES TELEHEALTH ACROSS STATE LINES: Health and Human Services Secretary Xavier Becerra pushed Congress to expand telehealth access across state lines, with state license issues impeding telehealth expansion efforts.

“We’re trying to figure out how we allow that service to cross state lines,” Becerra said Thursday at a House Appropriations Committee subcommittee hearing on the fiscal 2023 HHS budget request. “There are different standards in different states. … That’s where we’ll need your help to give us the authorities to go beyond what we’ve gone before.”

Prior to Covid-19, virtual care providers usually had to be licensed in the state where the patient is located, which could prevent patients from accessing care out of state. Most states waived these restrictions temporarily during the pandemic, but many waivers have expired. The public health emergency permitting Medicare delivery across state lines could also expire in the coming months.

With flexibilities allowing telehealth among states winding down, some advocates are pushing for a more permanent solution. Without one, they say companies have to deal with the cost and time of getting licensed in several states, which can be a barrier to telehealth expansion and cause patients to lose their doctors and therapists when they move.

Lawmakers have submitted several measures to address the issue, including the TREAT Act, HR 708 (117), which has 38 House co-sponsors. The bill is a stopgap that proposes allowing care in any state if a provider is licensed in one state while the public health emergency is active and for at least six months after the emergency is lifted.

NEW TELEHEALTH POLLING: Most providers think that telehealth improves health outcomes, a new Morning Consult poll of patients and providers on behalf of CVS Health found.

Close to seven in 10 providers surveyed said they “strongly” or “somewhat” agreed that virtual care bolsters health outcomes, with just 11 percent “strongly” or “somewhat” disagreeing. Ninety-one percent of providers said they “strongly” or “somewhat” supported having an option to deliver virtual care post-pandemic, with nearly three quarters of patients saying they should have the option to access telehealth after the pandemic.

State lines: The poll also showed broad support from patients and providers alike for telehealth access across state lines. Nearly 85 percent of providers back options for virtual care to be provided between states, along with 72 percent of patients.

Fifty-six percent of providers said that states rolling back waivers allowing telehealth in different states hurts patient outcomes.

Quality questions: The new survey did underscore some patient concerns about telehealth and quality of care.

About half of consumers said either “strongly” or “somewhat” agreed that patients can get “high-quality, clinically similar care” via virtual care, agreement well lower than that of practitioners. Patients who received telehealth care recently were more likely than in-person patients to return virtual care.

TALK VACCINES WITH A BOT: Johns Hopkins researchers are trying to fight vaccine hesitancy with a chatbot, an effort that began even before Covid-19.

The technology is spun off an IBM artificial intelligence program that debates with people, and was recently launched in WhatsApp in both English and Spanish. The chatbot responds to questions with expert-approved answers.

Future Pulse tried it out, and it worked fairly well, adeptly answering most questions about common Covid-19 misinformation including microchips, sterility and Bill Gates. It felt more accurate than many other chatbots on non-health care websites. You can try it yourself here.

Vaccine-resident people are using the bot, based on the questions being asked, said Rose Weeks, director of communications for the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health. The most frequent questions have been around vaccine and booster safety as well as concerns about fertility, she said.

“People seem to feel this is a space they can speak freely,” Weeks said. The researchers haven’t evaluated whether the chatbot changes attitudes, but research last year from France showed chatbots “significantly” bolstered people’s reported vaccination intentions.

Organizations in Baltimore and Kansas have put the bot into practice, according to the researchers. The researchers say they hope to spread the technology globally, adding they are “in talks” with health agencies in India and Africa.

Background: The effort is part of a larger surge in artificial intelligence-based chatbots in health care aimed at reducing persistent worker burnout by automating tasks. The goal has been to allow providers to spend more time with patients instead of on paperwork.

DIGITAL HEALTH CORRECTION?: Digital health venture funding dipped “significantly” in the first quarter of 2022, Rock Health researchers found in a new report, though the financing is still close to double pre-pandemic levels.

Venture funding was $6 billion in the first three months of 2022, down from $7.3 billion over the prior three months. And funding fell from $3 billion in January to $1.4 billion in February and $1.6 billion in March, the researchers found. It comes as digital health securities have tanked since July 2021, with securities in Rock Health’s Digital Health Index falling 38 percent.

“This quarter’s monthly funding numbers may be early indicators of a digital health venture funding correction,” the researchers wrote.

Digital health venture funding has exploded in recent years, particularly amid the pandemic, surging to $29.1 billion in 2021, up from $8.1 billion in 2019, according to the report.

Shift in where the money is going: Cash is increasingly flowing to startups trying to boost clinical workflow, which has been a focus as clinician burnout mounts. Funding has shifted away from startups working on research and development.

A 60-year-old man in Germany allegedly got as many as 90 Covid-19 vaccines to sell fake vaccine cards, The Associated Press reports.

Axios has this headline: “$4 billion health tech startup Olive overpromises and underdelivers”

Biden’s budget proposes allowing ONC to make an advisory process to issue opinions on info blocking, HealthInfoSecurity reports.

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