Where is Tom Keane?
President Donald Trump unveiled on Wednesday a federally driven initiative that will allow Americans to access their medical records via an app, potentially marking the end of health care's long reliance on paper.
At a White House event, he invited 60-some companies in health care — from rural health care providers to tech giants — to agree to work to free up health data from within doctors' offices, apps, information exchanges and payer databases. But notably, Assistant Secretary for Technology Policy and head of the Office for the National Coordinator for Health IT Tom Keane was absent from yesterday's activities at the White House.
'You own your medical records. They're yours. Why you can't have access to them is this stunning reality in modern-day America,' Dr. Mehmet Oz, Centers for Medicare and Medicaid Services administrator, said at the event. The aim is to make patient data available for use in apps and artificial intelligence tools, enabling Americans to more easily book health appointments, receive health advice from AI agents and give their care providers better insight into their health.
Somewhat surprisingly, this effort is being driven by CMS instead of the Office of the National Coordinator for Health IT, which writes the rules for electronic medical records and the guidelines for how health data flows in this country.
So where was he? Keane spoke at a morning event in the Eisenhower building for both signatories of the commitments and members of the health care industry who were not invited to the White House announcement, about the need for trusted data infrastructure to support CMS new initiative, according to three health care industry advocates who attended.
TEFCA: Despite extensive discussions about interoperability, notably absent was any mention of the Trusted Exchange Framework and Common Agreement, also known as TEFCA, a federally supported health information network championed by former head of the Office of the National Coordinator Micky Tripathi.
'TEFCA is a huge piece of how this data exchange will be done to meet part of the commitments,' said Joe Ganley, vice president of regulatory affairs at electronic health record Athenahealth.
His company announced on Tuesday that all of its roughly 100,000 clients can now send and receive data on TEFCA. But he also said the commitments aren't prescriptive, and he expects data exchange to happen in other ways, including via more direct connections.
As part of those industry commitments, CMS had an opportunity to require participation in TEFCA, but notably didn't ask for that.
What else: Industry may also turn to data networks that it has long relied on instead of TEFCA. Jason Prestinario, CEO of health IT firm Particle Health, who signed the commitments along with Carequality, an existing network for sharing data, called on the latter to change its rules to require better data flow.
'A simple change of the [Carequality] rules from 'should' to 'must' on individual access would immediately accomplish many of the goals CMS set today,' he wrote on LinkedIn.
That would enable patients to get their records directly from Carequality participants, which includes health systems among others.
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WORLD VIEW
For American lawmakers hoping to make the web safer for kids, the last week in the U.K. offers a bracing lesson in unintended consequences, writes POLITICO's Aaron Mak.
Doctors, researchers, and even the former U.S. surgeon general under President Joe Biden, Vivek Murthy, have expressed increasing concern about the impact of social media on children's mental and physical health.
A new law to promote online safety in the United Kingdom has swept up a lot more content than social media users expected, and a wide range of advocacy groups and disgruntled consumers are rising to object.
The U.K.'s Online Safety Act took effect Friday to shield minors from 'harmful' content — not just pornography, but also material that's hateful, promotes substance abuse or depicts 'serious violence.'
The rules apply to any site accessible in the U.K., even those based in the U.S. This means sites like Reddit, Bluesky and even Grindr now have to abide by the OSA's speech regulations to stay online in the country.
The debut of the OSA has been met with swift pushback. After a petition to repeal the act received more than 350,000 signatures, the U.K. government responded Monday that it had no plans to do so. Nigel Farage, leader of the far-right Reform U.K. party, has also pledged to repeal the act. VPNs, which route a user's internet traffic through another country, have hit the top of the U.K.'s app download charts.
Though the U.S. isn't as tough on tech as Europe, both state and federal lawmakers take cues from their regulatory approach. For example, the language for California's Age Appropriate Design Code Act, which is on pause as courts decide whether it's constitutional, was inspired by the U.K. Children's Code.
U.S. lawmakers can't bar minors from particular kinds of content, even if it's hateful or age-inappropriate, because it runs up against free speech rules.
Still, the U.K.'s Online Safety Act may offer a window into how American youth are likely to respond to age-verification laws.
States, including Texas, Louisiana, and Utah, are passing rules that require app stores to get parental consent before kids can download apps. And the U.S. Supreme Court recently upheld age-verification laws related to pornography that at least 23 states have in place. While those laws are more limited than the U.K.'s law, the rollout of the safety act could offer lessons for states passing and enforcing age-verification requirements.
'We're seeing that regardless of where you implement these laws and these measures, users are still frustrated,' Paige Collings, senior speech and privacy activist at the Electronic Frontier Foundation, told Mak. She pointed out that Florida also saw a spike in searches for VPNs after it implemented an online porn law in January.
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