Government & Policy

HIMSS on Friday issued a call to the healthcare industry to take action in battling the ongoing opioid crisis in America by using health information and technology. While reported opioid drug overdoses killed more than 42,000 Americans in 2016 and nearly 48,000 in 2017, both tech and policy must align in the fight. Specifically, HIMSS recommended four ways: 1. Leverage Prescription Drug Monitoring Programs (PDMPs). A number of states and hospitals are already working on PDMPs to reduce opioid misuse and abuse, beginning with only prescribing opioids when entirely appropriate in the first place. They’re also tracking all prescription data with the aim of preventing avoidable deaths by overdose, allergies or drug-drug interactions. 2. Equip health workers on the front lines of battle against opioids with interoperable electronic health information. HIMSS said this will enable clinicians to make better decisions and, in turn,  more effectively engage patients as partners. 3. Use secure, interoperable technology across the care continuum. This includes integrating acute care, addiction and mental health data, counseling and community support, outpatient services and public health. 4.  Leverage today’s tech advances to appropriately and securely share information across disciplines. Doing so could enable “law enforcement, social services, behavioral health, healthcare, and public health departments to give care where it’s needed and better understand prescribing patterns, overdose rates and movement of the epidemic.” The HIMSS call comes days before its CEO, Hal Wolf, is scheduled to present on the crisis Monday, Sept. 24, at the Canada-U.S. Roundtable on Strategies to Combat the Opioid Crisis in Washington, D.C. Wolf will present the Honorable Mary Taylor, lieutenant governor of Ohio and the Honorable Margaret “Maggie” Hassan, senator of New Hampshire, who are on the front lines of fighting the epidemic in their respective states. HIMSS is the parent organization of Healthcare IT News. Twitter: @SusanJMorse Email the writer: susan.morse@himssmedia.com

The National Health Service announced that Robert Coles will serve in the newly created chief information security officer role.

Boston Medical Center, Brigham and Women’s Hospital and Massachusetts General Hospital let ABC film a documentary on site without obtaining patient authorization.

Dave Chase puts forth contrarian viewpoints in his new book, and predicts that millennials will redirect the future of healthcare – which is a good thing.

President Trump on Wednesday threatened to add new import taxes on an additional $257 billion of Chinese goods to the $200 billion established on Monday. This was in response to China on Tuesday announcing plans to impose new tariffs on $60 billion in U.S. exports. Even though it’s only a threat at this point, rather than brush it off, hospital IT executives would be smart to monitor the developments because further tariffs could bring higher prices on everyday technologies, such as computer hardware and software, not to mention consumables, pacemakers, MRI Machines and other medical equipment manufactured in China. Hospital supply chain directors, in fact, “are appropriately paranoid but cautiously optimistic,” said Peter Allen, executive vice president of sourcing operations at Vizient, which is a member of the Healthcare Supply Chain Association. Allen and others from the management consulting company have met with the top 20 hospital supply chain managers in the country. Because supply contracts through a Group Purchasing Organization are often three years long and many got renewed last year, hospitals are currently much more concerned over whether the government is going to cut 340B or Medicare reimbursement to unsustainable levels, Allen said. But Allen said, “We work everyday on pricing. It’s still a work in progress. The next question is, what’s the supplier going to do? They might just move the production to Vietnam.” The trade war began in July, when the U.S. implemented tariffs of 25 percent on $34 billion worth of Chinese imports and Beijing retaliated with its own tariffs on $16 billion worth of U.S. goods, according to CNBC. If fully implemented, the new tariffs would cover virtually all imports of Chinese goods, according to The Wall Street Journal. Two hospital supply chain directors interviewed said they won’t fully know the impact of the tariffs until they start doing their new, yearly budgets. Jerry Dea, executive director of Supply Chain Management at Cedars-Sinai in Los Angeles, will begin the budget process in February for a July 1 start to the fiscal year. The hospital has its group purchasing organization through Vizient. The consumable supply contract will keep prices stable for now, he said. “Our contract is recent and the price is locked,” Dea said. But when current contracts with suppliers expire, whether in a year or three years, the tariffs could increase prices on everything from medical devices to parts for printers and copiers, computers, furniture, machinery for paper products - which in turn could affect the cost of paper towels or toilet paper - batteries, microscopes and scientific equipment. Consumables include such high-use devices as pacemakers. Cedars Sinai purchases from 600 to 700 a year, according to Dea. Dea said he would be asking for budgetary quotes from vendors about any tariffs on the products when he starts his budget. “At that time we will go through categories of supplies to see where we’re expecting an increase,” Dea said. “Where I’m more concerned is some of the capital equipment.” For instance, MRI machines are bought on as as-needed basis. “That’s where I’m more concerned about the tariffs,” Dea said. “I still think this is one of those situations where you don’t know what you’re going to be hit with, until it comes up.” There’s also the unknown of which goods will be added to the federal exemptions list. For instance, Apple products have been given an exemption. Dea said he originally thought orthopedic implants would be a concern, and then the ortho implants were given an exemption. Cedars-Sinai uses products from Cisco, Dell and HP, companies which have all requested exemptions to the tariffs. “We buy from all those companies,” Dea said. “Our primary provider for PCs is Dell, we use a lot of Cisco Systems. Even from a technology standpoint we could be hit by these tariffs.” Reddy Gottipolu, chief supply chain officer for the Memorial Hermann Health System, said the tariffs could affect a lot of imaging items and the commodity items. Another piece that’s difficult to estimate is the impact due to the assembly that goes into a final product. Components could be made in China, but assembled in the U.S., or the other way around. They’ll know when the suppliers come back asking for price increases, he said. Gottipolu admits the tariffs have the potential to adversely impact all hospitals’ profitability and cash flow. “We just started discussing it, we haven’t seen the impact yet,” Gottipolu said. “I’m a little concerned but at the same time not too alarmed.” Allen believes that competition will help to keep prices low on supplies from China, even with the tariffs. For instance, one wheelchair manufacturer they use makes wheelchairs in China. But if their competitors do not, they can’t increase prices and stay competitive, he said. “I still think it’s a wait and see of what’s impacted and how it’s going to impact each individual system,” Dea said. Twitter: @SusanJMorse Email the writer: susan.morse@himssmedia.com

The National Health Service in England has announced two new innovator programs to accelerate the use of digital health tools that benefit patients and remove barriers slowing adoption of innovation.  NHS England is funding a small number of proven innovations through the Innovation Technology Payment (ITP) 2019/20, part of a wider effort led in collaboration with the country's Academic Health Science Networks. Solutions eligible for the programme have to be used in at least three NHS sites and demonstrate the potential for a return on investment within a year of deployment. A PUBLIC report published earlier this year, authored by former Health Minister Nicola Blackwood, found that partial interoperability and poor procurement practices were some of the key hurdles to selling new tech into the NHS, making the health service a 'challenging digital terrain'.  Recent innovations selected to take part in the ITP scheme include the HeartFlow FFRct (fractional flow reserve) Analysis technology from California-based company HeartFlow, which uses data from CT scans to create a personalised 3D model of the coronary arteries and then analyse the impact of blockages on blood flow to help clinicians diagnose coronary artery disease by eliminating the need for patients to undergo invasive procedures. Applications are also open for the 4th call of the NHS Innovation Accelerator (NIA), providing bespoke support, aimed at innovators whose solutions are addressing one or more of the following priorities: prevention and early diagnosis, mental health, and primary care. “These two programmes will allow exciting innovations to flourish and spread as NHS England is once again prepared to support innovators and foot the bill for a select group of products so patients can benefit faster,” said Professor Tony Young, NHS England National Clinical Lead for Innovation. Innovations supported through the last round of the NIA include Healthy.io’s Dip.io tool, a home-based urinalysis kit that turns a smartphone into a clinical-grade diagnostic device. The start-up, which recently received FDA 510(k) clearance for Dip.io, announced in June that it was partnering with the UK's Salford Royal NHS Foundation Trust in a project known as the ‘virtual renal clinic’. “Technology has the potential to transform healthcare and we must do all we can to break down the barriers that prevent patients from accessing the best possible treatment," added Health Minister Lord O'Shaughnessy.  Innovators have until 3 October to apply for the ITP programme and until 24 October to submit their applications for the NIA.  .jumbotron{ background-image: url("https://www.healthcareitnews.com/sites/default/files/u2231/Innovation-month-jumbotron.jpg"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Focus on Innovation In September, we take a deep dive into the cutting-edge development and disruption of healthcare innovation.

And there’s already one in the JASON Report from 2014 that was eclipsed by the industry’s excitement about open APIs.

Beginning Sept. 21, VA will start accepting proposals for contractors to handle the technical and administrative services of its legacy EHR.

Countries around the globe are dealing with legacy fax machines and the UK organization is looking to get rid of its devices by 2019.

With a rare near-unanimous vote, the United States Senate passed The Opioid Crisis Response Act of 2018 on Monday evening. It's a massive bill comprising a wide array of proposals drawn from five Senate committees, and has many implications for the use and funding of health IT. Senate Majority Leader Mitch McConnell, R-Kentucky, called the bill – drawn up using input from more than 70 senators and passed by 99-1 vote – a "landmark" piece of legislation meant to combat the nationwide opioid epidemic from all angles. The legislation comes amid an ongoing opioid crisis in the U.S. as policymakers and technology vendors are working to address the issue, while hospitals are piloting apps to find blindspots in prescription drug monitoring programs and using mobile technologies to write fewer prescriptions. It contains funding for stopping the flow of illegal opioids from other countries, and for supporting local programs for prevention, treatment and recovery. The bill also seeks to spur research and development of new non-addictive painkillers and stem "doctor shopping" by boosting prescription drug monitoring programs. It also has funds to give behavioral and mental health providers the tools they need to offer treatment and recovery – including potential electronic health record incentives – and for hospitals to better care for infants with neonatal abstinence syndrome. The legislation's sponsor, Senate HELP Committee Chairman Lamar Alexander, R-Tennessee, said he is working to combine the Senate bill and a similar House version passed in June "into an even stronger law to fight the nation’s worst public health crisis, and there is a bipartisan sense of urgency to send the bill to the President quickly." The Senate bill contains many new proposals specifically related to information technology. Among them, it would: Call for the U.S. Department of Health and Human Services to "develop best practices for prominently displaying substance use treatment information in electronic health records, when requested by the patient." Enable the Centers for Medicare and Medicaid Services to test various models that "provide incentive payments to behavioral health providers for the adoption and use of certified electronic health record technology to improve the quality and coordination of care through the electronic documentation and exchange of health information." Require physicians to prescribe Part D-covered controlled substances electronically and direct CMS specify a list of exceptions and outline the penalty for failure to comply when the e-prescribing requirements. Require that prior authorizations related to Part D e-prescriptions use a standard format to improve the way the authorizations are processed. Provide support for states and localities to improve their Prescription Drug Monitoring Programs and "implement other evidence-based prevention strategies, encourages data sharing between states, and supports other prevention and research activities related to controlled substances." Reauthorize HHS's NASPER grant program, allowing states to "develop, maintain, or improve PDMPs and improve the interoperability of PDMPs with other states and with other health information technology." Authorize new program through the Substance Abuse and Mental Health Services Administration for the establishment of comprehensive opioid recovery centers. "These entities may utilize the ECHO model, which supports care coordination and services delivery through technology." Give support for states to collaborate on strategies to improve care substance-exposed infants, including the development and upgrades of new technology and monitoring systems to more effectively implement plans of safe care. Require CMS to set up an online portal to enhance communication between the agency, Medicare Advantage plans with prescription drug plans, stand-alone drug plans and Medicare Drug Integrity Contractors.   .jumbotron{ background-image: url("http://www.himss.org/sites/himssorg/files/u351641/opioid-collection-hero-712.png"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Opioid Crisis: Tech fights epidemic Learn how tech is being used to battle abuse. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com