There’s a lot going on. And it is not clear exactly who is in charge. It is like the movie The Adjustment Bureau (available on Netflix). It is a clever, fast-paced film, with plenty of confusing activity that is all big-stakes drama, but it boils down to this: is “the Chairman” (a higher power) or Matt Damon in charge of his destiny? It is a well-timed movie to reflect how we are all feeling about our inner control freak being subdued by the chaos here and around the world. In the One Thoughtful Paragraph, we explain how digital health investors can help.
The news this week identifies who is in control of health IT policy (spoiler alert: it is not you, unless you are HHS):
- President Biden signed an Executive Order (EO) to direct the federal agencies to regulate artificial intelligence (AI). For health care, the EO directs HHS to get an AI Task Force together to develop a strategic plan for all AI-supported activity, including research and discovery, drug and device safety, and public health. It also tells HHS to offer guidance about how AI should be used to support quality measurement, performance improvement, program integrity, benefits administration and patient experience — taking into account “appropriate human oversight” of the application of AI-generated output. Ready…go!
- HHS proposed a rule to ensure patients are in charge of their health care data. The proposal establishes disincentives for healthcare providers who commit information blocking or interfere with the access or use of electronic health information. The comment period is open until January 2, 2024.
- The American Hospital Association filed a lawsuit against HHS alleging that it didn’t have the authority to be so controlling. At issue is a December 2022 Office of Civil Rights bulletin that told hospitals that they shouldn’t use Google Analytics, Meta/Facebook, or other pixel-tracking technology because HIPAA-covered health information may be leaked.
The destiny v. free will conundrum is explained by Anthony Mackie’s character in the movie The Adjustment Bureau: “Most people live life on the path we [a higher power] set for them, too afraid to explore any other. But once in a while, people like you come along who knock down all the obstacles we put in your way.” This explains the entrepreneurial mindset that leads to software solutions that try to knock down the health care problems that seem intractable. And yet, some start-ups fail to recognize just how much attention to pay to the regulatory landscape that could make or break their business model. We were sorry to see that Olive AI is shutting down after raising a stunning amount of capital to automate many manual processes that needed automating in hospital and payer operations (e.g., revenue cycle, utilization management). There are always many reasons why even the start-ups with the best ideas and great people fail, but some investment firms seem to grasp more than others the challenges of this highly-regulated industry. They know that their portfolio companies must have insights into policy-driven changes to the market. Indeed, next year will be another explosion of federal activity after the President’s executive order on AI, in addition to the new rules coming about electronic health records and electronic prior authorization. As health care companies navigate this hard-to-follow and hard-to-understand landscape, they should use our MyMaverick map (kind of like the map the agents use in The Adjustment Bureau) because it helps to be clued into what the powers-that-be at HHS are trying to accomplish.
If any of this was new to you, then you need MyMaverick! Check it out here: https://www.maverickhealthpolicy.com/my-maverick/
