Cancer moonshot head recounts exchange with Epic’s Faulkner

With help from Darius Tahir (@DariusTahir)

BIDEN, EPIC TALK MEANING OF ‘EASY TO UNDERSTAND’: Former Vice President Joe Biden took to task an Epic executive who questioned during a January meeting of the Cancer Moonshot why patients should have their full medical record, a Biden aide recounted Tuesday. Epic CEO Judy Faulkner asked Biden during an (until now) private meeting between EHR executives and administration officials, “Why do you want your medical records? They’re a thousand pages of which you understand 10,” recalled Greg Simon, who worked on the moonshot and is now president of the Biden Cancer Initiative.


Biden responded, “None of your business,” according to Simon, who detailed the conversation during a MedCity conference in Philadelphia. “If I need to, I’ll find someone to explain them to me and, by the way, I will understand a lot more than you think I do,” the former VP said.

“And it went downhill from there,” Simon said.

— Someone familiar with the exchange tells us that Epic’s comments were focused on the just-passed 21st Century Cures Act, which sets a goal of having patient records in a “single, longitudinal format that is easy to understand.” The company’s argument: How is having a thousand pages easy to understand?

The exchange was about a subjective portion of a recently enacted law. Epic supports a patient's right to access their full medical record, the company said.

Simon told Morning eHealth later via email the issue was that EHR companies “want to make … and are required to make … only summaries available.” Instead, Simon prefers to “focus on [the] complete digital record.”

Simon’s account of the event offers a glimpse at the frustration the Obama White House faced in getting EHR companies to share patient records, despite giving billions in incentives for doctors and hospitals to buy systems. The software wasn’t reaching its potential despite years of investments. “We’ve made billionaires of the executives of these companies,” Simon said of EHR vendors. “They’ve had fun. Now, it’s our turn. Let’s get this thing changed.”

Pro subscribers can revisit our coverage of the meeting here.

— Later in Tuesday’s talk, Simon called concerns about HIPAA limiting data sharing “overblown.”

“That is not coming from the patient community, the HIPAA concerns,” he said. “It’s coming from the legal community and the consumer community.” He contends the overblown concerns about privacy and security are creating artificial barriers to doctors getting the patient information they need.

Watch the full chat here. Talk about data blocking, HIPAA and information sharing start around the 11:20 mark and run until 17:15.

McCONNELL MOVES FDA BILL FORWARD: Senate Majority Leader Mitch McConnell filed a motion to proceed to the FDA user fee reauthorization bill Tuesday night, meaning a procedural vote on the bill should come by Thursday. However, GOP aides said leadership is working on an agreement that could speed up a vote on the bill, ( H.R. 2430 (115)), so it could come sooner this week.

— HELP Chairman Lamar Alexander told reporters there’s no reason why they can’t pass the bill quickly. Remember it includes more money for the FDA’s digital health work, expanded use of EHR data for device reviews and oversight as well as creation of a class of over-the-counter hearing aids.

eHealth tweet of the day: Thomas Goetz @tgoetz: Hospitals should do this to their staff. Anyone who holds personal health info.

Retweeting Farhad Manjoo @fmanjoo: The NYT security people regularly send us fake emails, to test us. Then they shame you if you click. It's a good practice. Keeps you sharp

Welcome to Wednesday Morning eHealth where we have nothing snarky or witty to say this morning. Happy hump day. Reach out as always to [email protected] and connect with us on Twitter @David_Pittman, @athurallen202, @DariusTahir, @POLITICOPro, @Morning_eHealth.

POLITICO Pro Policy Summit, Sept. 14: An all-day summit featuring deep-dive conversations and incisive interviews that explore policy trends inside and outside government. Space is limited to current Pro customers at the director level or above. Learn More.

TELEHEALTH GETS LOVE FROM HHS NOMINEE: The HHS nominee to be the first-ever assistant secretary for mental health gave a nod to telemedicine as a way to better combat mental health treatment shortages during her confirmation hearing Tuesday. As Pro’s Adam Cancryn reports, Elinore McCance-Katz said care providers beyond psychiatrists, like nurses, should be able to treat mental health issues and that telemedicine is one way to reach more people.

MOVEMENT ON TRUMP NOMINEES: The Senate HELP Committee will vote on McCance-Katz’s nomination and several others later today. Meanwhile, the Commerce Committee is expected to also approve three FCC commission nominees today. The goal is to get all of them into a “cleared package” of nominations, a process of negotiation now between Senate leaders and with the hope of confirmation before August recess, our friends at Morning Tech tell us.

FDA PILOT TO START SOON: The FDA plans to start the first of a "phased approach" for its digital health pilot next month, Darius reports. The agency wants to create a "pre-certification" program that endorses certain developers, rather than their products, as high-quality. “The first phase will involve three of the eventual nine participants,” Darius writes. “The agency is hoping to have a public event in January to discuss its interim findings.” More for Pros.

TELEMEDICINE’S CBO STRUGGLES OUTLINED: Medicare’s complex system of paying for health care makes it harder to predict whether expanding telemedicine payments will actually save the government money. The Congressional Budget Office explained as much in its score of the Senate Finance Committee’s chronic care bill ( S. 870 (115)), released Tuesday. While paying for tele-stroke care would help keep patients healthier, Medicare doesn’t pay for long-term care, which would presumably see savings from fewer stroke victims or less serious cases. Instead, Medicare gets the bill for more stroke treatment up front, the CBO said.

— While allowing accountable care organizations greater freedom to use telemedicine, Medicare would pay more in bonuses to those ACOs, who would be more likely to hold down costs because of using telemedicine. More here and the CBO score here.

CONCERNS WITH VA’S CERNER SWITCH NOTED: With the VA's switch to the Cerner EHR looming, the Pew Charitable Trusts is pressing the agency to further patient matching and adopt better standards. Pew also singles out the VA’s patient-matching struggles and other patient safety enhancements. The letter.

REACTION TO OPIOID REPORT: The Association for Behavioral Health and Wellness and Health IT Now separately called for the White House’s opioid commission to finalize preliminary recommendations around enhanced interstate data sharing between state prescription drug monitoring programs. The recommendation would be a “smart step forward and, if fully implemented,” Health IT Now executive director Joel White said.

— New Hampshire Democrat Rep. Ann McLane Kuster demurred there was “little new in its findings,” pointing to a June report from the Bipartisan Heroin Task Force that had similar recommendations including about privacy laws and PDMPs.

CHIME, AEHIS BACK DEVICE-CYBER BILL: CHIME and its cyber-focused sister organization have endorsed a bill that would raise the expectations for the cybersecurity of medical devices. The bill ( S. 1656 (115)) by Sen. Richard Blumenthal would mandate a publicly available cyber report card and allow devices to upgrade the security of products without the FDA’s OK.

“The recent cyber attacks underscore the importance of this legislation,” said Deborah Stevens, board chair of the Association for Executives in Healthcare Information Security.

CHANGES AT ATHENA: Outspoken athenahealth CEO Jon Bush is stepping aside as board chair — but will remain CEO — as the company shakes up its corporate structure and spending, it announced. Athena wants to also cut spending by $100 million as it looks to further move into the hospital market. The Wall Street Journal has more.

ODDS AND ENDS: ONC on Tuesday published a report outlining how its regional extension centers are working with Medicare accountable care organizations … HIMSS will name a new scholarship, endowed by the HIMSS Foundation, after its president and chief executive of the last 17 years who is retiring at the year’s end … HHS will award Michigan State $3.2 million to establish a data registry for Flint residents exposed to lead-contaminated water in 2014 and 2015.

WHAT WE’RE CLICKING:

Stat’s Erin Mershon dives into HHS Secretary Tom Price’s work to cut regulations for doctors.

Ninety-two percent of hospitals’ outpatient clinics use EHRs, new HIMSS Analytics data show.

Doctor on Demand starts patient visits in Arkansas.

Drugmaker Sanofi seeks to better understand “digital biomarkers.”

Physician lobbyists brag about writing the recently passed tort reform bill.

Blog post on patients correcting errors in their records.

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