Breaking Down What to Expect in a Changing Landscape

Chilmark Research is proud to introduce a new video series, “So What?” In this series, we’ll be distilling down some of the more nuanced ideas and concepts that our research covers, not only for healthcare and HIT professionals, but everyday users of the healthcare system.

In the inaugural installment of the series, VP of Growth Strategy John Moore III takes a look at some high-level government officials, all of who will be on the frontlines of the evolving technology and healthcare policies of the federal apparatus. Some of them are new appointees, as the Biden administration attempts to redirect the nation’s course after an eventful four years, and some remain in their positions after being appointed under Trump.

All of them are experts in their respective fields, often with many years of government service, and have specialties ranging from interoperability, to A.I., to data security, to antitrust policy. Check out this video to see what this might mean for HIT vendors, providers, payers, and patients.

John Moore III: At the time of recording, Biden just gave his first address to the joint session after his first 100 days in office. So today we’re going to be looking at what he’s actually done in those first 100 days to set a precedent for the rest of his administration’s time in office, and who he is putting into positions of power that are going to help shape the health care industry over the next four years. I’m John Moore, and I’m the Vice President of Growth Strategy here at Chilmark Research.

I’m excited to announce that this video will be the first in a new series that we are producing called “So What?” where we take a look at some of the complex ideas and concepts that we write about here at Chilmark Research and look at them from a higher level where it’s a little bit more easy to understand exactly what this means for those of us that are actually using the health care system, and not working in the health care industry.

Before we get started today, though, I have to do a little reminder that we would love it if you’d subscribe to our channel and click the bell button to receive notifications for every video that we post. Also, please be sure to leave us a like and a comment and someone from our team will engage with you.

In the first few months since the Biden administration has taken power in the capital, we have seen a significant amount of activity from them trying to undo much of, shall we say, damage that was done by the Trump administration to American health care infrastructure and confidence in the system from the American people.

John Moore III: So one of the first things that Biden did to try to reset course and actually get us back on track happens to fall in line with one of the final things that the Trump administration did, which was focus on solving the health care interoperability issue. So building off of the interoperability blocking laws or passed in the former administration, we now saw Biden’s first appointment to the health care side of things, being Micky Tripathi, who is a noted interoperability expert with a significant pedigree around that topic. He was one of the primary members on the JASON task force back when the HITECH Act was just passed. He actually helped shape some of the HITECH legislation and was consulted for that. He’s also been involved with the Commonwell and Sequoia projects, as well as serving in the advisory role for a number of small companies that are either dealing with analytics or interoperability directly.

While Micky’s former interoperability work is notable, of course, this factors into a larger picture of what the administration has been focusing on, which you will see as I start discussing the other candidates and the other appointees that he has put into positions of leadership around health care I.T.

Arguably the next most important position at a federal level for all matters health care I.T. is who is sitting in the CIO role at the Health and Human Services Department. We have Perryn Ashmore, who is a seven year veteran of the HHS, now appointed to that role, taking over from Joseph Arietta back at the end of 2020. Ashmore was instrumental to converting HHS from being more of a collection and repository of health data across the country to a department that was actually more proactive and involved in the emergency response. Ashmore is a big believer and vocal supporter of all of the potential data that can be collected to truly innovate and inspire new ways of delivering care.

John Moore III: However, he’s a pragmatist about this and understands that there are inherent risks to collecting a lot of data about individuals and storing them either in the cloud or on premises. Because, as we know, there have been lots of security breaches over the last few years. With this in mind, he has made it clear that security is going to be one of his main initiatives when he talks to interoperability matters and how we can actually open up the pipes to make better interoperability and data flow happen between organizations to use the data that he’s so passionate about.

He is also a big believer in the utility of A.I. to mine this information for new insights and set a precedent by appointing the country’s first A.I. officer in Oki Mek. He’s actually a 19-year veteran of working for the government, starting his career with the Department of Energy and then moving to HHS in 2010. Previously to HHS, he served as their chief acquisition officer and chief technology officer for New Technologies, where he focused on artificial intelligence–no surprise there–and blockchain.

So there’s definitely some excitement and expectation that there may be some blockchain projects coming out of the government following his appointment. But the bigger story is his focus on A.I. and all of the things going on in the A.I. industry right now. As we all know, artificial intelligence has transformed a number of industries that are very data driven and it is starting to see its way into health care. However, as we also know, there are significant issues with the data sets that are used to train the A.I. that is utilized in health care, and we are still trying to figure out how to address that. So look to him for guidance on how we deal with ensuring equity in algorithmic intelligence and new ways of doing predictions that utilize all of the big data that we’ve been able to collect over the last 10 years since the High Tech Act was passed.

John Moore III: Another holdover from the Trump administration, Andrea Norris, is the CEO of the National Institutes of Health there. She has played a role in really focusing on improving data interoperability. And it’s clear that she also has a big passion for this need in the industry to help make sure that various researchers and people at the front lines of health care are actually able to utilize and exchange the data that they need to innovate on new models again.

Prior to joining the NIH, she worked at both the NSF and NASA, helping both of those large organizations implement new and better I.T. infrastructure for managing all of their data assets. She is currently the lead of the STRIDES Initiative, which is a government program to work with major cloud vendors like Amazon and Google to help open the pipes in a effective and, you know, privacy conducive manner to enable greater collaboration across organizations and departments.

Ms. Norris also serves as the director for the NIH’s Center for Information Technology, which houses one of the world’s fastest supercomputers. So I’m sure she’s having a blast with that. But we can expect to see her really focus on enabling better cloud infrastructure to help scientific researchers and the scientific community collaborate more effectively across organizations.

The Centers for Medicare and Medicaid Services is the single largest payer of health care in the country and overseas. The administration of health services to a vast majority of the population. In the new CIO role. We have Rajiv Uppal, who is a big believer in both agile design and human centered design. So we can expect to see a lot of innovation coming out of CMS around equity for accessibility and making sure that new tools actually meet the end user requirements, the patient requirements.

John Moore III: So don’t expect there to be much leniency from the CMS around any new solutions being sold into the government if it’s not going to be usable by the end user. Make sure you do your user testing, because that’s going to be absolutely critical to getting approval from this new lead of the CMS CIO role.

Last but not least, we have–pending approval by the committee–the new commissioner for the FTC, Ms. Lina Khan, who will be the youngest commissioner ever appointed to the FTC if she is approved, at age thirty two. She is well known for a paper that she produced while she was at Yale–and this is a very comprehensive paper–titled Amazon’s Antitrust Paradox, wherein she posits that traditional antitrust laws no longer meet the needs of a modern economy, where all these new players have platform plays and are very diversified across industries. And she tries to examine exactly how we can start prosecuting and looking at anti-competitive behavior in a modern context.

This paper was influential enough to receive almost 800 citations in the four years since it’s been published. So you know that it struck a lot of chords when it was first put out there and has a significant amount of relevancy to today’s economic landscape. And surprisingly, she’s actually been receiving very favorable interviews and questions from the approval committee because anti-tech sentiment is very strong right now across the board on both parties.

John Moore III: So this might be the easiest appointment that Biden actually has to make with that current sentiment. Everybody’s trying to figure out exactly how we can deal with these giants in the tech industry who may or may not be actually participating in monopolistic behavior. So look to Lina for any insights and further understanding of how the government is going to start regulating these massive tech giants–who are honestly participating in some fairly anti-competitive behavior, but it just doesn’t meet necessarily the traditional threshold that has been used in the past.

Lina’s appointment fits in with the rest of the Biden administration strategy around antitrust matters and regulating the technology industry, and fits with his recent appointments of Tim Wu for the National Economic Council and Vanita Gupta with the Justice Department. So definitely expect there to be some legislative changes around how anti-competitive behavior is seen under this new administration.

Hopefully this video has helped you understand what the Biden administration is going to be doing with regulating the health care industry and helping to catalyze innovation in I.T. for the health care industry over the next four years. If you liked what you saw here today, please be sure to give the video like and subscribe to our channel, and we will be with you again shortly.