The validity of Model Clauses for EU personal data transfer to the United States is now in real doubt as a result of a new Irish High Court judgment stating that there are “well founded grounds” to find the Model Clauses invalid. The issue of Model Clauses as a legitimate data transfer mechanism will now be adjudicated by the European Court of Justice (ECJ), the same court that previously overturned the Safe Harbor arrangement. EU and US companies will need to consider various strategies in anticipation of this decision.
On September 15, 2017, the Texas Medical Board (Board) released proposed rules regarding telemedicine and mental health services (Proposed Rules) to implement Senate Bill 1107, which was passed on May 11, 2017. Most notably, the Proposed Rules provide that a physician-patient relationship can be established solely by the delivery of care via telemedicine services and eliminates the prior requirement that services for new patients be provided at an established medical site and with a telemedicine presenter. These changes to the Board’s approach create the same standard of care for in-person and telemedicine services.
McDermott previously reported on Senate Bill 1107 and provided relevant background on telemedicine in Texas. The Board is accepting public comments on the Proposed Rules. A public hearing regarding the Proposed Rules will be held at a later date to be determined.
In addition, the Texas Health and Human Services Commission (HHSC) recently adopted final rules regarding the reimbursement of telemedicine in Texas Medicaid (Final Rules) on October 6, 2017. The Final Rules are effective as of December 1, 2017. Continue Reading Texas Continues to Embrace Telemedicine
A recent article in Kaiser Health News highlights the health risks associated with the increased effort to get patients home—namely, the need for families to gain and effectively deploy the skills needed to care for themselves and family members. The article highlights the risks (and increased rates) of infections, particularly in relation to catheters. However, it does not take much imagination to identify other conditions where at home care is critical.
Concise and easy to follow instructions are key, of course, but information technology can play a role here as well. While the business plan for this type of digital health strategy may not be as clear as others, this is the type of sector that could demonstrate the digital health opportunity in the effort to increase value in health care delivery.
The US Department of Transportation’s National Highway Traffic Safety Administration recently released A Vision for Safety 2.0, an update to its prior guidance on automated driving systems. The new guidance adopts a voluntary, flexible approach to regulation of automated driving systems and clarifies that it alone, and not the states, is responsible for regulating the safety design and performance aspects of such systems.
A lot of us have argued that one of the floodgates for telemedicine has been reimbursement. If states and the Federal government more liberally reimbursed or required reimbursement for telemedicine service, we argue then a significant barrier to broader telemedicine will be removed. This is a valid argument, and the potential flurry of activity on Capitol Hill as of this writing (September 20, 2017) gives many hope that Medicare reimbursement for telemedicine may be greatly expanded soon.
Alas, another problem persists. A spate of recent surveys and reports on utilization demonstrate that awareness should be viewed as a similar sort of barrier. It is, of course, a generalization to say this, but consumers are largely unaware of the benefit being made available to them, or are unaware of the appropriate uses of a telemedicine service. It would be foolish to speculate as to the reasons why, but a recent trend may help to erode this barrier.
When it comes to customer service and user engagement, none are better than our technology industry. The West Coast tech giants clearly understand how to engage and attract users. The remarkable success of smart phones provides ample evidence—can you think of any other consumer product of comparably high-cost being as ubiquitous? It is also clear that the health care industry has failed to engage consumers as effectively. There are likely multiple reasons for this. Health care is: (1) highly regulated, resulting in limited ability to be quickly responsive to consumer demands; (2) run by professionals trained in many things, but not sales or consumer satisfaction and engagement; and (3) burdened both by a lack of competition at the point of sale, and by a third-party payment system that has so far proven to be impervious to the forces of disintermediation. Continue Reading The Way Forward for Telemedicine
New cybersecurity regulations issued by the NYDFS define the nonpublic information they regulate in exceptionally broad terms. This expanded definition of Nonpublic Information will create major challenges for regulated companies and their third-party service providers that will likely ripple through other ancillary industries.
Although the incorporation of technology into human endeavours—commercial, political and personal—is a normal component of technological innovation, the advent of artificial intelligence technology is producing significant challenges we have not felt or understood with earlier innovations. For many years, for example, there has been speculation, research and public debate about the impact of the internet, the functioning of search engines, and online advertising techniques on commercial and political decisions.
The alleged “hacking” of the 2016 US presidential election, and the concerns about such activities in the 2017 European elections, will only heighten the interweaving discussions on free speech, national sovereignty, cyber security and the nature of privacy.
The use of artificial intelligence and machine-learning technologies has only added to the list of issues and areas of concern. The consequences of automobile accidents involving “self-driving” technologies, the “flash crashes” on securities markets due to algorithmic trading, and bias in systems designed to determine benefit eligibility, are requiring us to consider what happens when we defer judgment to machines, and highlighting the importance of quality in data sets and sensors.
The government is continuing to ask for more help from the private sector to defend against cyber attacks. The National Infrastructure Advisory Council (NIAC) recently published a report discussing current cyber threats and urging private companies and executives to join forces with the government to better address those threats. The report proposes “public-private and company-to-company information sharing of cyber threats at network speed,” among other things discussed here.
On 6 August 2017, the UK government released ‘The Key Principles of Vehicle Cyber Security for Connected and Automated Vehicles’, guidance aimed at ensuring minimum cybersecurity protections for consumers in the manufacture and operation of connected and automated vehicles.
Connected and automated vehicles fall into the category of so-called ‘smart cars’. Connected vehicles have gained, and will continue to gain, adoption in the market and, indeed, are expected to make up more than half of new vehicles by 2020. Such cars have the ability through the use of various technologies to communicate with the driver, other cars, application providers, traffic infrastructure and the Cloud. Automated vehicles, also known as autonomous vehicles, include self-driving features that allow the vehicle to control key functions–like observing the vehicle’s environment, steering, acceleration, parking, and lane changes–that traditionally have been performed by a human driver. Consumers in certain markets have been able to purchase vehicles with certain autonomous driving features for the past few years, and vehicle manufacturers have announced plans to enable vehicles to be fully self-driving under certain conditions, in the near future.
The Enhanced Nurse Licensure Compact (Compact) has now been adopted by 26 states, which means the Compact will be taking effect on January 19, 2018. Nurses who seek to practice telemedicine and deliver in-person care across state lines and who meet the Compact’s licensure requirements in these states will have one less obstacle to overcome going forward.
The Compact is an updated version of the original compact allows for registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) to have one multistate license, which will enable them to practice nursing in person or via technology (e.g., videconference) in both their home state, as well as the other Compact states. Development and implementation of the Compact was not an easy feat, given the need for alignment of licensing standards across the Compact states, including federal and state fingerprint-based criminal background checks.
The 26 states participating in the Compact as of today are Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia and Wyoming.
For more information about the Compact, please visit: https://www.ncsbn.org/11070.htm.