Final Senate vote all that remains for Cures

With help from Darius Tahir (@DariusTahir) and Arthur Allen (@arthurallen202)

CURES CLEARS PROCEDURAL VOTE: 21st Century Cures sailed through a procedural Senate vote Monday evening, easily surpassing the 60 votes it needed. Four Republicans joined nine Democrats opposing the bill. There’s now up to 30 hours of floor debate before a final vote, which could come as late as Wednesday morning.


NEW STAFF TO CARRY OUT THE LAW: HHS would need an additional 60 employees to carry out the EHR interoperability section of Cures, the Congressional Budget Office estimates. However, CBO’s prediction is based off the Senate’s Improving Health IT Act, which is slightly different from the bill expected to be signed into law. Overall, it would cost $122 million over five years to implement, CBO says.

Perhaps most notably from the report: “CBO expects that most health IT developers, networks, exchanges, and providers would not engage in information blocking. Therefore, CBO estimates that this provision would result in penalties of less than $500,000 in each year and over the 2017-2021 period.”

CURES DOESN’T DO ENOUGH ON ADDICTION RECORDS, LOBBYIST SAYS: The way 21 st Century Cures Act’s mental health section tries to advance the thorny issue of sharing substance abuse treatment records isn’t “satisfactory,” according to a group of organizations pushing for a change. Rep. Tim Murphy’s bill, which passed the Energy and Commerce Committee last year, would have allowed abuse treatment records to be shared within integrated care settings. (Current law requires patient approval of each individual provider who can view such records.) But the final bill tucked into Cures scales back this provision after objections from health privacy advocates. Instead, it directs HHS to wait until it publishes a final rule on the matter before convening stakeholders to talk about next steps. That rule is expected to be finalized before the end of the Obama administration.

— “We are advocating for Part 2 alignment with HIPAA for the purposes of health care treatment, payment, and operations; and the language in that section does not come close to that,” Rebecca Murow Klein, chair of the Partnership to Amend 42 CFR Part 2 and lobbyist for the Association for Behavioral Health and Wellness, told Morning eHealth.

HIPAA training programs: The bill does, however, authorize up to $7 million for HHS to develop model HIPAA training programs to help health organizations understand what they can and can’t share with others. “Many times, there is avoidable confusion about what is and isn’t allowed under current HIPAA law,” said Rep. Doris Matsui, who championed the change. “This increased clarity and training on the rules will empower providers to share limited information with family and caregivers when in the patient’s best interest, while maintaining patient privacy.”

WHAT ABOUT CURES FUNDING THIS YEAR?: Lawmakers by Friday must pass a stopgap spending bill to keep the government open, and text of that bill is expected as soon as today. Our Pro Health Care colleagues are reporting that the continuing resolution will contain some Cures money — but not necessarily the whole first year's worth. Also, it’s unclear what it will hold for the $1 billion in opioid funding that Cures promises. Continuing resolutions typically fund the government at current levels.

eHealth tweet of the day: Edward Tufte @EdwardTufte: Patient: "I learned more about EPIC than my heart today, doctor." Cardiologist: "Me too." #EMR #EHR #uxdesign #Cardiology #truestory

https://twitter.com/EdwardTufte/status/805409283953348609

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POLITICO EVENT ALERT – EMERGING HEALTH CARE LEADERS: Join POLITICO for the sixth annual Emerging Health Care Leaders event, a morning of one-on-one conversations with the emerging leaders who will influence the future of health policy. Thursday, December, 8 - Doors at 8:00 am; W Hotel. RSVP: here.

BIG EVENT OFF THE HILL: PEW, ONC TACKLE EHR SAFETY: The Pew Charitable Trusts and ONC will co-host an event today, diving into the many safety issues around electronic health records and how to fix them. It will outline more reasons for the government to address the issue. Creation of a health IT safety collaborative — which Congress has refused to fund — will be discussed. House Republicans squashed an initial effort to create a health IT safety center and also refused efforts to create a more modest "collaborative." Speakers today include ONC chief Vindell Washington, ECRI president Jeff Lerner and Michael McGinnis, National Academy of Medicine executive officer.

The country needs an National EHR Safety Center to investigate EHR-related medical errors and more investment is needed in EHR safety measurement, write Dean Sittig of the University of Texas, Adam Wright of Harvard, Joan Ash of Oregon Health & Science University, and Hardeep Singh of Baylor College of Medicine. Safety issues they identified a decade ago haven’t been addressed and now more issues have emerged, creating the need for solutions, they write in the Health Care Blog.

ALSO TODAY: In Alexandria, Va., a three-judge panel of the U.S. Patent and Trademark Office will hear opening arguments in a nasty patent dispute over the CRISPR genome-editing technology. While its impact on health IT is minimal, gene editing and sequencing is a health technology that will play a key role in health in future.

COAST GUARD’S EHR FAILURE UNDER THE SCOPE: The GAO is investigating the Coast Guard’s failed implementation of its Epic EHR system, our Darius Tahir scoops. The probe stems from a May request of the House Transportation and Infrastructure Committee. “GAO is investigating the total spent on the contract, reasons for the delay in canceling it, the rationale behind the Coast Guard's decision not to use a DoD EHR system, and whether the Coast Guard lost patient information when it copied information from its failing computer systems to paper,” Darius writes.

— The Defense Department declined comment, and Epic insists the failure wasn’t its fault.

MOBILE HEALTH APPS GET SOUR REVIEW: A review of 137 patient-facing mobile health apps found “few apps address the needs of the patients who could benefit the most,” according to research published Monday in Health Affairs. That’s just the beginning. There’s little correlation between clinical utility and consumer reviews, leading to patients using poor apps. Also, most apps share data poorly and don’t react well to potentially dangerous health information.

IT’S GOING TO GET WORSE?!: The Dyn attack that shut down parts of the Internet six weeks ago was only a preview, researchers from the Institute for Critical Infrastructure Technology argue. That’s of particular concern to health care, which is increasingly reliant on networked machines talking to each other. “How much would a healthcare network be willing to pay a cyber-extortionist to halt an attack that leveraged the healthcare devices within a hospital against the network?” the researchers ask, noting that a particularly aggressive hacker could shut down medical devices as a method of attack.

Elsewhere in cyber land: Security firm Tenable gave health care a “D” in its global cybersecurity report card. Meanwhile, Experian predicts more ransomware attacks for hospitals in 2017.

NAMES IN THE NEWS: George Komatsoulis will be the first chief of bio-informatics for the American Society of Clinical Oncology’s CancerLinQ, the group’s cancer-information sharing platform.

WHAT WE’RE CLICKING:

Epic Systems CEO Judy Faulkner disses government regulation in interview with journal editor.

Epic faces another class-action lawsuit over its overtime pay policies.

New Jersey legislature inches further on telemedicine regulation.

DirectTrust head comments on Cures’ health IT section.

Deloitte report looks at blockchain in health care

Tips, comments, suggestions? Send them along via email to our team: Arthur Allen ([email protected], @ArthurAllen202), David Pittman ([email protected], @David_Pittman) and Darius Tahir ([email protected], (@DariusTahir).

Follow us on Twitter Mohana Ravindranath @ravindranize



Darius Tahir @dariustahir