Virtual prescribing gets a reprieve

The ideas and innovators shaping health care

May 09, 2023 View in browser   By Ben Leonard, Ruth Reader and Erin Schumaker THE REGULATORS DEA Administrator Anne Milgram says her agency will take more time to decide the fate of virtual prescribing. | AP Patients who’ve used telemedicine for their prescriptions during the pandemic are getting a lot more time before they’ll need to see a doctor in person. That’s the result of the Drug Enforcement Administration’s decision on Tuesday to allow them to continue with virtual care through Nov. 11, 2024 at least. The agency didn’t say what it will do after that. Patients affected are those taking medicines regulated by the DEA, which include everything from Adderall to treat ADHD to Oxycontin for pain relief. The DEA could change the rules for new scripts after Nov. 11 of this year for patients without a telemedicine provider relationship. Why it matters: The decision is a win — at least for now — for virtual care advocates. They were alarmed when the DEA proposed in February to roll back the pandemic rules in November and require patients to visit with their doctors in person before getting new prescriptions in some cases, and refills in others. What’s next: The DEA could ultimately implement in-person requirements again. The agency is concerned providers have been too quick to write scripts for some drugs via virtual care and has investigated telehealth firms Cerebral and Done for allegedly overprescribing ADHD medications under the pandemic rules. The companies denied wrongdoing.   DON’T MISS THE POLITICO ENERGY SUMMIT: A new world energy order is emerging and America’s place in it is at a critical juncture. Join POLITICO on Thursday, May 18 for our first-ever energy summit to explore how the U.S. is positioning itself in a complicated energy future. We’ll explore progress on infrastructure and climate funding dedicated to building a renewable energy economy, Biden’s environmental justice proposals, and so much more. REGISTER HERE.     WELCOME TO FUTURE PULSE Great Smoky Mountains, N.C. | Sam Oates This is where we explore the ideas and innovators shaping health care. Move over, smart watches. The FDA recently cleared a smart toilet called the Heart Seat for measuring heart rate and oxygen saturation. How will it collect that data? With sensors in the toilet seat, of course. Casana, the company behind the technology, says it's planning an initial product launch by the end of the year. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, your host Ben talks with POLITICO's Maya Kaufman about a first-of-its-kind, federally funded study that will evaluate the impact of overdose-prevention centers in New York City and Providence, R.I., on future public health policy. Listen to today’s Pulse Check podcast DANGER ZONE The victims are far flung when hackers hit hospitals. | AP Photo When hackers hit a hospital system, the result can be “regional disaster,” a new study in JAMA Network Open says. How so? The study looked at how a monthlong ransomware attack on a system of four hospitals affected emergency departments in the area that were't attacked, as well as patient diversion data and stroke metrics. The ER was flooded with ambulances and patients, many of whom were forced to wait longer than normal or left without getting care. The attack knocked out digital systems, imaging and telehealth visits, forcing the hospitals to use paper records and direct ambulances elsewhere. Many of the hospitals hit were stroke centers, forcing patients to be transported to a more limited number of alternative treatment facilities. “Increases in health care cybersecurity incidents suggest the need for coordinated regional surge planning similar to that conducted for natural disasters,” the researchers wrote. Growing evidence: A previous study found that more than 2 in 5 ransomware attacks made it more difficult for patients to get care. Why it matters: The findings come as the Biden administration and Congress zero in on health care cybersecurity as a bipartisan issue of concern. Lawmakers are crafting legislation to address the issue, and the Department of Health and Human Services is trying to help with free cybersecurity trainings for health care workers.   GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGSITER HERE.     SAFETY CHECK The anesthetic ketamine has taken off as an anti-depressant. | AP Since the FDA approved a version of the anesthetic ketamine to treat depression in 2019, prescribing has soared. New data from Epic Research shows that, in 2022, nearly half of all prescriptions were for treating depression or anxiety compared with about 13 percent in 2017. Overall prescriptions rose by more than five times during that period. It could be even more. It’s unclear whether the data covers clinics that have popped up and prescribed the drug off-label. An Epic spokesperson said that it wasn’t aware of any dedicated clinics in the dataset, but it wasn’t something considered in the study. The FDA warned in February 2022 that there had been a “concerning number of case reports” about adverse events associated with compounded ketamine. And the agency said adverse events are likely underreported. It urged providers to follow prescribing rules. Even so: The increase in prescribing hasn’t led to a significant increase in overdose rates, Epic’s researchers found. THINK FAST Califf has an eye on AI. | Joe Raedle/Getty Images Regulating artificial intelligence in health care “is critical” to ensure the algorithms improve outcomes and don’t cause harm, according to FDA Commissioner Robert Califf, POLITICO’s David Lim reports. “If we’re not nimble in the use and regulation of large-language models, we’ll be swept up quickly by something that we hardly understand,” Califf said at the Science of Patient Engagement Symposium in Washington on Monday.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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