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January 27, 2020: For this episode of Tuesday Newsday, we will be focusing on one story that has been evolving all over the internet in the recent past. Judy Faulkner, CEO of Epic, recently wrote an open letter urging patients and Healthcare CEOs to oppose ONC’s proposed rule to make it easier for medical information to be shared. This episode chronicles the letter itself, various articles that have been written on the topic of interoperability, and some of the divisive opinions of patient advocates and other voices in healthcare shared over Twitter. In today’s show we discuss what patients could lose or gain from this decision, the relationship between developers and current healthcare app platforms, and the pro-patient versus the pro-Epic camps in this debate. Critiques on the potentially misguided focus of the debate itself are provided as well. Some recommendations for what the government should do to secure patient empowerment, privacy, and cooperation are also given. In addition, critique and further guidance for Epic’s strategies are presented toward the end of the conversation. This debate forms the frontlines of the battle of interoperability and digital innovation in healthcare. It has been a long time coming to get to this point but it is coming to a head right now and it is going to be interesting to see how it plays out over this election year.

Key Points From This Episode:

  • How Judy Faulkner’s letter to healthcare CEOs challenging ONC’s plan caused a stir.
  • The plan ONC had: to propose a rule that made it easier to share medical health info.
  • Twitter responses accusing Judy Faulkner of contradicting herself.
  • Adam Tanner’s findings revealing Faulkner’s ostensibly pro-patient perspectives on data.
  • The idea that Epic would still profit after releasing this letter if they were already doing so.
  • Different perspectives either supporting or criticizing Epic regarding their use of data.
  • A scathing letter from a patient advocate criticizing the health industry for not caring.
  • Bill’s agreement that lambasting CEOs before understanding legislation is brash.
  • Seema Verma’s framing of the benefits of the CMS rule.
  • Proposed changes to patient access systems listed on the CMS site.
  • Questionable interoperability strategies at Epic.
  • Changes involving lower tax for startups and developers to access App Orchard.
  • Why the apparently consumer-focused strategies of EHR providers are not such.
  • Cons to the data release: unintended consequences due to a poorly worded Act.
  • The idea that the root problem of this whole debate needs to be defined more clearly.
  • Benefits to more open data: patient empowerment and freer economies of care.
  • The reality that there is a cost to this freer data and somebody has to pay for it.
  • Bill’s recommendations for CEOs to stay out of the fight because of its divisiveness.
  • Three issues with Judy’s strategy: timing, poor advice, and its lack of a coalition.
  • Why not to fight the government as a corporation: it takes time and energy.
  • Two main belief camps in the fight: that Epic is either fighting for patients or themselves.
  • What Epic should do to win: win patients over to their strategy.
  • Three strategies for the government to make what Epic is planning safer for patients.
  • The reality that this fight is the frontline of the interoperability debate.


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