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The collision of health care and technology. | | | | |  | | By Darius Tahir | | WHO BENEFITS: A service member leaving the military with a health condition waits on average 100 days to be compensated for benefits in connection to their tenure. Just over a quarter-million veterans wait longer than that. Yet, in January when the Department of Veteran Affairs said it was piloting technology to cut the wait from weeks to days, reaction from its employees and some veterans groups was surprisingly skeptical. After the announcement, “my phone started ringing,” Paul Fleming, a Mississippi local president of the American Federation of Government Employees who chairs its bargaining committee, said. His members were asking, “Am I going to have a job five years from now, 10 years?” Using technology to quickly gather relevant medical and service records appeals to officials who’d like to speed up decision-making. But Fleming’s union and outside observers fear the pilot program would put at risk the 60,000 jobs at the Veterans Benefits Administration. The initiative comes as the agency is investing in new pay and benefits policies to bolster its workforce. The push sets up a familiar tug-of-war: technologists who want the most efficient experience possible versus. Incumbents who see virtues in the status quo and worry newer systems will automate away the human touch.
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Charles Dharapak/AP Photo | Rob Reynolds, the official in charge of the project as the deputy undersecretary for disability assistance, stresses it’s too early to know exactly how the technology would affect jobs. The program is being tested in dozens of veterans’ cases for a specific condition, high blood pressure, at the agency’s Boise, Idaho, office. So far, he said, benefits adjudicators using automation technology resolved cases in an average of 21 days. In some instances, if the technology can efficiently retrieve the needed record, it might dispense with the need for a doctor’s visit — which in other circumstances is needed to verify the connection between a veteran’s service and a medical condition. As the project expands — the agency is eyeing medical conditions like asthma, sleep apnea and prostate cancer — the impact will become clearer. Reynolds said the agency might need more employees to deal with certain cases. Outside proponents think new technology is needed to clear up the backlog and serve the agency’s future needs. Lawyers and reporters estimate some 3.5 million veterans might need their benefits adjusted once so-called toxic exposures are covered, and a Congressional aide told Future Pulse new technology is needed to cope with the new requests. The benefits administration has a reputation of being a hard place to work, Ryan Gallucci, the director of the Veterans of Foreign Wars’ national veterans service, said. “I know anecdotally of VFW members who worked in VBA, who chose to leave, because of how stringent the standards are. You'll burn out if you work every Saturday,” he said. Gallucci hopes automating some systems might make those employees’ lives easier. But “faster isn't always better,” he said. Gallucci and his peers worry veterans, particularly elderly ones, can be confused by the agency’s systems and say interaction with a person is needed to help them. So if he has any concern, it’d be that the agency moved too fast. Welcome back to Future Pulse, where we explore the convergence of health care and technology. Share your news and feedback: @dariustahir , @samsabin923 , @_BenLeonard_.
| | | | BECOME A GLOBAL INSIDER: The world is more connected than ever. It has never been more essential to identify, unpack and analyze important news, trends and decisions shaping our future — and we’ve got you covered! Every Monday, Wednesday and Friday, Global Insider author Ryan Heath navigates the global news maze and connects you to power players and events changing our world. Don’t miss out on this influential global community. Subscribe now. | | | | | | Christina Farr @chrissyfarr “A friend told me about a telemedicine video visit where a doctor called them while driving. This is going to happen w/ MDs signed up for multiple Telemedicine platforms + juggling shifts on-site. It speaks to the need for much better scheduling across platforms.”
| | | HEALTH AFFAIRS LAYS INTO TWITTER, GOOGLE: Health policy journal Health Affairs laid into Twitter and Google’s systems for not allowing it to advertise an edition on racism and health. The issue covered research on systemic racism as well as racial bias in electronic health records and potential bias in machine learning. An ad-buy: Health Affairs tried to purchase ads for the issue on Google and Twitter, Health Affairs director of digital strategy Patti Sweet wrote, but they weren’t approved. A Twitter spokesperson told Future Pulse the company didn’t allow tweets to be part of an ad campaign because Twitter requires the account to get certified as a “cause-based advertiser.” “Advertising should not be used to drive political, judicial, legislative, or regulatory outcomes; however, cause-based advertising can facilitate public conversation around important topics,” the spokesperson said. A Google spokesperson said that the policy involved isn’t related to race, but to Covid-19 content. Health Affairs is appealing the decisions. “The research we published is exactly the sort of sensitive content our country needs right now: peer-reviewed research rooted in sound methods that demonstrate and explore the relationship between racism and health,” Sweet said. The incident comes amid heightened scrutiny on tech giants over misinformation and hate speech on their platforms.
| TELEHEALTH LOBBYING BLITZ: Lobbying to expand telehealth access is in overdrive ahead of an election-year spending showdown, POLITICO’s Megan Wilson and Ben Leonard report. The number of groups lobbying to bolster virtual care has exploded. A POLITICO analysis of 2021 disclosure forms found 485 entities listed as lobbying on telehealth issues. That’s more than triple the total from 2019, before the Covid-19 pandemic pushed millions to virtual care. A mixed crowd: Disparate companies, including dairy cooperative Land O’Lakes and defense behemoth Lockheed Martin, jumped into telehealth lobbying in 2021, pushing lawmakers to continue pandemic telehealth rules that eased access restrictions. More traditional players like Teladoc also upped their lobbying spending 60 percent in 2021 to $400,000. “America kind of woke up, as well as, frankly, the lobbying stakeholders kind of woke up almost overnight, and said, ‘We don’t want to lose this. This has become embedded in the way we deliver care,’” Dean Rosen, a partner at lobbying firm Mehlman Castagnetti Rosen & Thomas who works on telehealth issues, said. “That’s why you’re seeing so many new folks lobbying on this.” Many groups are pressing Congress to temporarily continue Medicare payment flexibilities for two more years after the Covid-19 public health emergency — which is keeping many telehealth rules in place — expires. The groups are looking to attach the extension to a potential spending package next month. “Nobody wants to see telehealth come to an abrupt end … [But] I don’t think that folks are quite ready yet for a permanent fix,” said Krista Drobac, executive director of the Alliance for Connected Care. Public health emergency’s future: With the Omicron surge dissipating, the public health emergency’s status has come into focus. More than 70 House Republicans recently signed a letter to President Joe Biden and HHS Secretary Xavier Becerra that calls for the administration to make “long overdue” plans to end the public health emergency while still preserving access to telehealth. Meanwhile, the Federation of American Hospitals wrote to Becerra calling for the emergency to be extended “well beyond” when it’s set to run out in April.
| | | | DON’T MISS CONGRESS MINUTES: Need to follow the action on Capitol Hill blow-by-blow? Check out Minutes, POLITICO’s new platform that delivers the latest exclusives, twists and much more in real time. Get it on your desktop or download the POLITICO mobile app for iOS or Android. CHECK OUT CONGRESS MINUTES HERE. | | | | | | | | STUDY: RING DETECTS COVID ANTIBODY RESPONSE: Wearable devices can detect signals, including body temperature, associated with the level of a person’s antibody response to a second Covid-19 mRNA vaccine dose, a new study suggests. Researchers from the University of California, San Francisco, and UC San Diego, among other institutions, studied nearly 1,200 people who received their second dose of Moderna or Pfizer and who wore Oura Rings. The “smart” rings can measure heart rate, temperature and sleep and breathing patterns. The team found that the night after getting the shot, the participants saw increases in temperature deviation and heart rate that were significantly correlated with stronger antibody responses. Elevated temperature was the strongest predictor of higher antibody reactions. The data could help identify people susceptible to lower levels of antibody response, lead author and UCSF researcher Ashley Mason said in a blog post. Wearables have been the focus of much Covid-related research, with the Pentagon analyzing results from testing using a digital watch and ring to predict whether a person has gotten Covid-19 up to three days before symptoms appear.
| | | A novel treatment appears to cure HIV in another patient, The New York Times writes. A breakdown of digital health pioneer Akili’s initial public offering documents in STAT News. And Bloomberg reports on telehealth startup Ro’s $150 million fundraising round. | | | | Follow us | | | | |  |
