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Volume XII, Number 146

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White House Office of Science and Technology Policy Seeking Information on Strengthening Community Health Through Technology

In a request for information issued on January 5, 2022, the White House Office of Science and Technology Policy (OSTP) announced that it is seeking input from stakeholders across the healthcare spectrum on how digital health technologies are being—or may be—used to improve community health, individual wellness and health equity. Comments must be submitted to the OSTP by 5 pm on February 28, 2022.

IN-DEPTH

On January 5, 2022, the White House Office of Science and Technology Policy (OSTP) issued a request for information (RFI) on how digital health technologies are used or could be used in the future to improve community health, individual wellness and health equity. The RFI solicits stakeholders from across the spectrum to provide information about a wide range of issues, from examples of successful use cases in the United States and abroad to perspectives on training needs and barriers.

This RFI is part of a larger effort of the Biden administration to promote and prioritize equity in policymaking. When President Biden took the oath of office back in January 2021, addressing the COVID-19 pandemic was a top priority; this continues to be the case today. But the pandemic also has brought into stark relief the social and racial disparities in healthcare as well as in many other aspects of American life. In response and as one of his first actions, President Biden signed Executive Order (EO) 13985, “Advancing Racial Equity and Support for Underserved Communities through the Federal Government.” This EO directed the entire federal government to “pursue a comprehensive approach to advancing equity for all.”

While this directive to use the lens of equity for policymaking is being implemented throughout the federal government, the Department of Health and Human Services (HHS) has been especially active in this area and has made addressing healthcare disparities a critical component of numerous major regulations, RFIs and other guidance documents that were released in 2021.

The prioritization of addressing health equity is also reflected in the strategic plans and mission statements of various HHS agencies:

As we enter the second year of the Biden administration, we anticipate that there will be continued efforts in this area.

Impetus for OSTP RFI

The RFI notes that despite significant investment into digital health over many years, the COVID-19 pandemic uncovered “substantial limitation in the U.S. healthcare systems, including profound disparities in healthcare and associated poorer health outcomes within certain communities.” Noting that part of OSTP’s mission is to maximize the benefits of science and technology for all Americans, OSTP issued the RFI to gain information and perspective on how digital health can be used to improve community health, individual wellness and health equity. The RFI is part of a broader agenda dedicated to “Community Connected Health,” which OSTP describes as “an effort that will explore and act upon how innovation in science and technology can lower the barriers to access quality healthcare and lead healthier lives by meeting people where they are in their communities.”

Specific Topics

The RFI seeks information, impressions, descriptions and comments in relation to eight specific topics. It should be noted that the RFI defines “digital health technologies” broadly to include “any tool or set of tools that improve health or enable better healthcare delivery by connecting people with other people, with data, or with health information.” The eight topics are:

  1. Successful models within the United States: The RFI requests information and comments about how successful models have worked, including information about organization or technology features that support success, examples of user protections (such as privacy best practices), examples of positive user experiences and descriptions of potentially successful models.

  2. Barriers: The RFI requests information and comments about barriers for individuals and organizations to adopt digital health in community settings, such as cost, training, reimbursement, community or organizational buy-in, and training. The RFI specifically notes interest in understanding the impediments to user comfort, such as concerns about privacy, security and discrimination.

  3. Trends from the pandemic: The RFI requests impressions or data on how the use of digital health by individuals and community-based organizations has changed during the pandemic, including impressions on how permanent these trends may be.

  4. User experience: The RFI requests descriptions of how developers and community-based providers and stakeholders consider and evaluate user experience, with particular interest in descriptions of ways user experience-based barriers can be overcome.

  5. Tool and training needs: The RFI requests information about technology, infrastructure and training needs for community-based providers.

  6. Proposed government actions: The RFI requests ideas on opportunities for federal government support to improve digital health-based community health transformation and when the opportunity could be implemented (immediately, or over the next five or 10 years).

  7. Health equity: The RFI requests information about how digital health has been, or could be, used in community-based settings to reduce health disparities or achieve health equity. The RFI also solicits concerns about how digital health impacts health equity.

  8. International models: Similar to the request for information about successful US models, this topic seeks information about successful foreign models, particularly from low- or middle-income countries. The RFI encourages suggestions about how these models could be applied in the United States.

Conclusion

The federal government’s relationship with digital health tools has been difficult. Broad policy goals related to, for example, insurance coverage, value-based care and cost, have generally dominated healthcare policy, leaving digital health and its potential for fundamentally altering (and improving) care delivery subservient to these policy goals. This is largely as it should be, but it does hamstring some digital health potential. It is not surprising that this RFI is presented in the context of one of those broad policy issues: health equity. And while this RFI provides an opportunity for digital health stakeholders to make their case, it also must be understood for what it is: a request for information on how digital health can serve a broader policy goal that itself may not be the best vehicle to showcase the many benefits digital health has to offer.

Regardless, this RFI provides digital health stakeholders with the opportunity to make the case for digital health tools, identify solutions to barriers to adoption that the federal government can correct, and describe the benefits digital health can provide to all.

© 2022 McDermott Will & EmeryNational Law Review, Volume XII, Number 25
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About this Author

Partner

Stephen W. Bernstein is a partner in the law firm of McDermott Will & Emery LLP and is based in the Boston office.  He is head of the Firm’s Health Industry Advisory Practice Group.  He specializes in e-health, deployment of electronic health record systems, health related matters impacted by the Internet and HIPAA, as well as mergers, acquisitions, affiliations and joint ventures in the hospital and physician areas. Stephen has particular experience working with regional electronic health record collaborations as well as pharmaceutical, biotech, device companies,...

617 535 4062
Lisa Schmitz Mazur, Health Law Attorney, McDermott Will Law Firm
Partner

Lisa Schmitz Mazur is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Chicago office.  Lisa maintains a general health industry practice, focusing on the representation of hospitals and health systems and other health industry providers.

Lisa’s representation of hospitals and health systems includes providing guidance on not-for-profit corporate governance matters, tax-exemption issues, conflict of interest compliance and overall corporate compliance effectiveness.  In addition, Lisa regularly assists hospital and health system clients to...

312-984-3275
Dale Van Demark, health care, attorney, McDermott Will, law firm
Partner

Dale C. Van Demark is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Washington, D.C., office.  He focuses his practice on a broad array of merger, acquisition, investment, and strategic structuring transactions, with clients in the health industry. He has extensive experience in health system affiliation and restructuring transactions and regularly represents for-profit and tax-exempt clients in a variety of transactions, including strategic transactions with physicians and hospitals. He regularly advises clients regarding the opportunities...

202-756-8177
Sheila Madhani, Senior Director, McDermott Consulting
Senior Director

Sheila advises clients on a wide variety of Medicare payment and regulatory issues. With more than 10 years of experience, Sheila is highly skilled in the areas of Medicare physician and hospital outpatient payment, Medicare quality programs, and the establishment and valuation of CPT® codes. Sheila has a deep understanding of emerging technology’s impact on Medicare reimbursement. She has facilitated relationships and discussions with physician specialty societies and industry stakeholders, helping to develop mutually beneficial collaborations. Sheila also has guided...

202-204-1450
Mara McDermott, McDermott Law Firm, Washington DC, HealthCare Law Executive

Mara is an accomplished health care executive with a deep understanding of federal health care law and policy, including delivery system reform, physician payment and Medicare payment models.

Most recently Mara served as the senior vice president of federal affairs at America’s Physician Groups (formerly the California Association of Physician Groups, CAPG), a professional association representing medical groups and independent practice associations practicing in capitated, coordinated care models. As head of the Washington, DC, office, Mara...

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