What happens when test results arrive before doctors can explain them?

Today’s edition: Vice President Harris is promoting her achievements in combating medical debt during her campaign. A Senate committee has subpoenaed the head of the nation’s largest physician-led hospital system. But first …

Patient portals deliver alarming news before doctors can respond

Mike Day received his cancer diagnosis while relaxing at home last summer. His wife, a former registered nurse, discovered the term “adenocarcinoma” in the biopsy results posted to his electronic patient portal.

With his gastroenterologist on vacation, Day faced difficulties in scheduling an appointment to discuss the cancerous tumor in his esophagus. Tragically, Day passed away within weeks, leaving his family shocked by the hurdles they faced in obtaining an explanation for such a serious diagnosis.

“Receiving medical results shouldn’t feel like tracking a DoorDash order,” remarked Andrew Day, Mike’s son.

Day’s experience exemplifies a significant issue discussed in an article for The Washington Post: A new federal mandate requires individuals to have immediate access to medical test and scan results. But does this practice ultimately benefit or harm patients?

The concept of medical transparency, supported by provisions in the 2016 Cures Act, has garnered widespread approval. However, the implementation of regulations expanding access to medical records, effective since 2021, has sparked controversy.

As more individuals receive concerning results online simultaneously with their doctors—often waiting days or weeks for treatment plans—medical associations are advocating for more time for physicians to disclose records that reveal cancer and other severe diagnoses, ensuring patients don’t have to confront the news alone.

The American Medical Association has been lobbying federal health officials, without success, to adopt a rule that would give physicians 72 hours to inform patients before electronically releasing life-altering results or dire diagnoses. California and Kentucky have enacted similar provisions in recent state legislation.

“This is yet another instance where we feel that individuals unfamiliar with our patients are interfering with the sacred doctor-patient relationship,” stated Jack Resneck, the former president of the medical association who led the advocacy on this matter.

Federal health officials assert that these concerns will be addressed as technology evolves and medical practices adapt to better prepare patients for results.

“There is a moral imperative here; this is their information, and patients should have access to it whenever they wish,” said Micky Tripathi, the national coordinator for health information technology overseeing this requirement for the Department of Health and Human Services. “They also pay for it; they should be able to access what they have paid for.”

Grace Cordovano, a patient advocate, suggested that one effective way to alleviate anxieties without overwhelming doctors is for insurers to fund health navigators who can prepare patients before their consultations. The Centers for Medicare and Medicaid Services created billing codes allowing public insurers to pay for “principal illness navigation” to connect patients with cancer and other high-risk conditions to health and social services.

Before the advent of readily accessible medical records, Cordovano noted that patients often struggled to obtain the necessary documents for second opinions, clinical trials, or specialist appointments.

For more insights into the effects of instant patient notifications—both positive and negative—and the experiences of doctors and patients navigating this new landscape, you can read more here.

Election watch

How is Kamala Harris addressing medical debt — with Roy Cooper’s assistance?

Harris has dedicated nearly three years to leading federal efforts to alleviate medical debt—an often-overlooked initiative she is likely to emphasize as her presidential campaign unfolds, as reported by our colleague Dan Diamond this morning.

Key context: Collaborating with the Consumer Financial Protection Bureau and other agencies, Harris-led initiatives in 2022 prompted credit reporting agencies to remove medical bills from the credit reports of approximately 30 million Americans. The administration also proposes prohibiting medical debt from influencing evaluations of borrowers’ eligibility for mortgages and other loans. This rule could be finalized next year if she is elected president.

What’s next: Harris is collaborating with North Carolina officials on a pilot project aimed at forgiving the medical debt of approximately 2 million residents. Under this proposal, hospitals that take measures to alleviate patients’ existing medical debt and implement policies to prevent new debt accumulation would receive additional funding through the Medicaid program. Federal approval from CMS could be granted today.

“Falling ill or caring for loved ones should not lead to financial distress, and I commend North Carolina for their innovative proposal,” stated Health and Human Services Secretary Xavier Becerra.

North Carolina Governor Roy Cooper (D), who is being considered by the Harris campaign as a potential running mate, expressed optimism that his state’s plan could be “a significant breakthrough—if it succeeds.” However, some hospitals have indicated they may not participate.

Readers help us

The Post’s Sabrina Malhi is seeking to connect with individuals who have taken the postpartum pill zuranolone, marketed under the brand name Zurzuvae, for an upcoming article. If you have used this medication, please complete this form.

On the Hill

Senators initiate investigation into Steward Health, subpoena CEO

The Senate health committee has officially launched a bipartisan investigation into Steward Health Care, the largest physician-led hospital system in the country, and voted to subpoena its CEO, as reported by Dan.

Key context: Steward is currently undergoing bankruptcy proceedings and attempting to sell its 31 hospitals nationwide. Community leaders and healthcare workers have criticized the for-profit company’s executives for extravagant compensation while the hospitals struggle to meet mortgage payments and cover other expenses.

Senators echoed these concerns during a hearing yesterday, accusing Steward executives of “outrageous corporate greed” that jeopardizes access to medical services, including spending nearly $100 million on private jets.

“At a Steward-owned hospital in Massachusetts, a woman died after giving birth when doctors discovered mid-surgery that the necessary supplies to treat her had been repossessed due to Steward’s financial difficulties,” stated Sen. Bill Cassidy (R-La.), a physician and the panel’s leading Republican. “Patients’ lives are at stake. Americans deserve answers.”

The committee had previously sought testimony from Ralph de la Torre, Steward’s CEO and founder, but was rebuffed. Now, for the first time since 1981, the panel has issued a subpoena to compel him to testify at a hearing scheduled for September 12.

In other news from Capitol Hill …

GOP leaders on the House Energy and Commerce Committee are demanding transcribed interviews and documents from HHS and the National Institutes of Health regarding mpox virus research. Lawmakers have threatened to issue a subpoena if the agencies do not comply with their request by August 8.

Agency alert

HHS reorganizes ONC, enhancing focus on health technology and AI

The federal health department announced a major reorganization aimed at streamlining and strengthening its initiatives in artificial intelligence, cybersecurity, data, and technology.

Details: Oversight of technology, data, and AI policy and strategy will now be consolidated under the newly appointed assistant secretary for technology policy and the Office of the National Coordinator for Health Information Technology.

Micky Tripathi will lead the new office while continuing as the national coordinator for health IT and acting chief AI officer. The agency is seeking candidates to fill the permanent chief AI officer role and new chief technology and data officer positions.

Additionally, responsibility for private-public partnerships between the health sector and federal government on cybersecurity will be transferred to the Administration for Strategic Preparedness and Response.

Meanwhile …

From our notebook

The Post’s Lena H. Sun sends this update:

Colorado is reporting three additional poultry workers infected with bird flu, bringing the total human cases in the state to 10.

The workers are experiencing mild illness, according to the Centers for Disease Control and Prevention. They were directly involved with infected poultry at a commercial egg-laying operation.

Colorado’s dairy herds and poultry farms have been significantly affected by this year’s H5N1 outbreak, which has infected 13 people nationwide. On Tuesday, Colorado announced it would require weekly milk testing of all licensed dairy herds for signs of the virus, becoming the first state to implement such a measure. The health department will also provide twice-weekly updates on bird flu cases in humans.

Earlier this month, six workers on a different poultry farm were infected after heat limited their ability to wear protective gear properly. One dairy worker was infected in early July. Colorado has tested 118 people for bird flu.

In other health news

The Post’s Camila Kerwin has released a graphic deep dive on a Republican who previously blocked gun violence research. Check out her full comic here.

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