The Apple-Google API is here. Now what? - Politico

With help from Darius Tahir (@dariustahir), Sarah Owermohle (@owermohle), Tim Starks (@timstarks) and Eric Wolff (@ericwolff)

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— The Apple-Google API is here. Now what? States are now deciding whether to rely on the tech giants or strike out on their own.

— FDA's Amy Abernethy on data and COVID-19: The agency's acting CIO chatted with our colleague Sarah Owermohle.

— Congressional momentum for post-pandemic telehealth: More than 30 lawmakers urged House and Senate leaders to lay the groundwork for virtual care even after the national emergency.

eHealth tweet of the day: Beerbecue @Beerbecue7 Question: If I have an evening telehealth Zoom appointment, is it acceptable to have a beer during the appointment?"

Given the unprecedented public health challenge confronting regulatory affairs teams, the AgencyIQ leadership team has decided to pull research and analysis content concerning the virus and its regulatory implications in front of the paywall. It is available here: https://agencyiq.com/covid-19-resource-center/

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PROGRAMMING NOTE: Due to Memorial Day weekend, Morning eHealth will not publish on Monday, May 25. It will return Wednesday, May 27.

Driving the Day

OFF TO THE RACES — A handful of states have signed on to use Apple and Google's Bluetooth proximity tracking technology, but others are opting to build out their own GPS-tracking apps instead, your author reports along with Pro Tech's Steven Overly. The technology giants dropped their API this week and states such as Alabama, South Carolina and North Dakota are already planning to use it, while others tell us they're still exploring all options. In the coming weeks, we'll be watching to see who else joins the Bluetooth tracking camp, who defaults to GPS, and who eschews contact-tracing apps all together.

... States could face mounting skepticism from the public. Nearly half of Americans say they're unlikely to, or will refuse to, opt-in to Covid-19 contact-tracing apps, software company Checkmarx found in a survey out this week. Their concerns are myriad: how their data will be shared, stored or used (45 percent); third-party access (29 percent); general hacking (28 percent); risk of health record exposure (27 percent) and risk of location data exposure (25 percent).

The skepticism might not be unfounded. A blog post from privacy company Jumbo says North Dakota's contact-tracing app, which gathers GPS location data, shares that and other information with Foursquare.

ABERNETHY ON RWE, PRE-CERT — FDA is working with health tech company Aetion — which has ties to former commissioner Scott Gottlieb — to track and analyze Covid-19 treatments and diagnostics, Sarah reports. The agency is hoping to learn more about doctors’ approach to drugs like hydroxychloroquine that are being used off-label for coronavirus, and whether it helps or hurts patients.

A few takeaways from that conversation:

— Asked whether Aetion data, or real world data in general, could be used to aid approval or authorization of Covid-19 drugs, Abernethy said the agency was "really focusing on understanding what can be done with real world data for Covid-19, how we can rely on it for operational tasks, how we can rely on it for research tasks, how can we do this work quickly and efficiently at scale."

... But she said she couldn't really "contemplate the direction it would go in terms of questions around approvals or our current authorizations."

She also wasn't sure if the data could be used for digital health pre-certification. "I think right now, Aetion is really a platform for common analysis and different data sets get brought to that platform," she said, but added that she didn't know the answer to the question.

A PLEA FOR PERMANENT TELEHEALTH POLICY CHANGES — CMS and Congress have slashed telehealth restrictions during the pandemic — mainly by removing licensing barriers and increasing reimbursement — but advocates worry those changes will evaporate once the public health emergency is over. Snapping back to the old policy could mean some patients abruptly lose coverage for virtual care; even under normal circumstances, many can't make it to in-person appointments because of work, child care and transportation challenges.

... This week Reps. Tom Emmer and Paul Tonko and about 30 colleagues urged congressional leaders to expand access to telehealth for behavioral services in upcoming pandemic response packages, and to ensure that there's a "reasonable transition period" after the pandemic so that policymakers can gather enough data about policies that should be continued permanently.

"Without regular access to behavioral health services, we are concerned that thousands of individuals will be seeking emergency care, with many turning to substance misuse or suicide risks," they wrote.

One health tech company had a similar ask. The founder of WEConnect, a digital system focused on substance use disorder treatment, urged CMS to allow opioid treatment to be provided over the telephone instead of requiring visual elements, among other asks. (The agency temporarily waived some long-standing requirements that virtual visits include both audio and visual components to accommodate patients who don't have reliable Internet access or video-equipped devices.) The pandemic "has the potential to exacerbate substance abuse for years to come," wrote WEConnect CEO and co-founder Daniela Tudor.

New telehealth stats: American consumers are fearful of medicine in the real world, and telemedicine is benefitting, a new survey conducted by Alliance of Community Health Plans and AMCP concludes.

The survey found increasing embrace of care from a distance, with 24 percent using mail-order pharmacies and 28 percent using telehealth in the past 90 days. The latter figure is three times the previous average, the groups say. And respondents like telehealth: 89 percent who’d done a recent visit said they were satisfied with their experience. The survey reached 1,263 adults.

EHR ROUNDUP — The Electronic Health Record Association says health record software can help physicians address the opioid crisis by screening patients for withdrawal symptoms, suggesting tapering schedules, offering clinical decision support, and calculating appropriate amounts of medication for tapering, among other features. The group published a white paper on the topic this week.

... And EHR giant Cerner debuted two public health tools this week: One is designed to help providers plan for reopening elective services by displaying local COVID-19 trends, and the other forecasts treatment needs at the county level.

WARNING FOLLOW-UP — A bipartisan group of senators asked the FBI and CISA on Wednesday what legal authorities and financial resources they would need in light of their warning last week that Chinese hackers were trying to steal U.S. Covid-19 research. Thom Tillis (R-N.C.), Richard Blumenthal (D-Conn.), John Cornyn (R-Texas) and Ben Sasse (R-Neb.) also solicited details on how the agencies are informing companies and research institutions about the threat, and what they’re doing to help defend against it. “While any government sponsored hacking of American companies is a cause for concern, it is especially troublesome that the Chinese government would target companies developing vaccines and treatments for the novel coronavirus,” they wrote.

In other cyber news — 'Slight increase' in National Labs cyberattacks: Energy Secretary Dan Brouillette said the national labs, which have been dedicating much of their resources toward Covid-19 research, are being targeted. "We are seeing increased activities around our national laboratories in particular, with regard to cyberactivity, slight increases in the number of hits that we see there," Brouillette told members of his Secretary of Energy Advisory Board on Thursday, via our friends at Morning Energy.

... "We know that there are nation-states around the world interested in some of the research being done in the laboratories," he said. "They are very interested in the specific research into Covid-19. We are very very protective of that type of information and that type of work."

What We're Reading

—The University of Texas at Austin's Dan Stanzione describes how supercomputing can boost vaccine research.

—TechCrunch's Jonathan Shieber profiles digital mental health company Mindstrong.

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