| | | |   | Good morning! Mohana here with a deep dive into the telepharmacy market, a federal rule that’s stymieing health plans trying to reach underserved patients, and state regulatory barriers to virtual abortion care. | | | Telepharmacy race: local shops vs. big box stores Independent pharmacies using technology to help them fill prescriptions for patients in pharmacy deserts face significant hurdles to keeping those virtual operations going, including concerns about safety. But big box competitors like CVS are testing out their own versions, which could have a longer runway, my colleague Katie Palmer writes. Telepharmacy set-ups would allow pharmacy technicians to send orders and photos of pills to pharmacists elsewhere for review before filling prescriptions. “It’s this constant battle between pharmacy as a specialty merchant and pharmacy as health care provider,” Ben Urick, a scholar of pharmacy history, tells Katie. “And what CVS is selling you is CVS as a health care provider.” Katie has more. | Why health plans can't text customers first Health plans and the companies they hire to communicate with patients say a decades-old federal rule is stopping them from reaching underserved patients by blocking texting without prior consent. And it’s posing a threat to health equity: low-income and underserved patients are more likely to see and respond to text messages about their health compared to calls from unknown numbers and mailed notices, Abner Mason, who heads up patient engagement company SameSky Health, tells me. The Telephone Consumer Protection Act — a 1991 law aimed at curbing unwanted telemarketing calls — generally stops companies from texting customers without their permission, meaning they can’t ping them with reminders about mammograms or routine checkups unless they’ve reached the person by phone or mail first. The issue is all the more urgent as millions of people covered by Medicaid may soon have to renew their enrollment when the formal Covid-19 public health emergency ends, Mason says. Here’s the full story. | Could state licensing hobble telehealth abortion? Startups like HeyJane, which prescribe abortion medication online and deliver it by mail, are expanding post-Roe: People in states that allow virtual abortion care can access these services from anywhere as long as the provider is licensed there, while those living in more restrictive states will have to travel to states where abortion rights are protected to access them virtually. But the state institutions responsible for physician licensing and regulation could stand in the way of further expansion, Trisha Pasricha writes for STAT. The U.S.’s state-by-state licensing system means that most doctors typically practice in just one state. And while pandemic-era waivers have temporarily allowed doctors to practice across state lines via telemedicine, the state-by-state regulations are returning, Trisha writes. “Logistically speaking, for widespread telemedicine abortions, licensing is one of the primary barriers,” says Kathryn Fay, an OB-GYN physician at Brigham and Women’s Hospital in Boston. Even for doctors in states that have preserved abortion rights, like Massachusetts, “Who’s going to pay the legal fees if another state brought a criminal case against a clinician?” Read the whole story here. | A new EMA-qualified framework for using AI-generated prognostic digital twins in clinical trials For the first time, the European Medicines Agency (EMA) has qualified a machine learning-based method, called PROCOVA™, that leverages prognostic digital twins to reduce sample sizes in pivotal trials. PROCOVA was developed by Unlearn for use in TwinRCTsTM — smaller, faster randomized controlled trials. The EMA’s validation of Unlearn’s cutting-edge technology signifies broader regulatory acceptance of artificial intelligence in clinical development. Read more about the announcement. | What to expect from Google’s Pixel Watch Mario kept us up-to-date on the long-rumored Pixel Watch Google teased in May, and now we have more details. Last week, the search giant shared more on the wearable device, which will incorporate fitness tracking elements from Fitbit, which Google acquired last year. It’ll retail starting at about $350. Google also plans to add fall detection next year. As Mario has noted in the past, open questions remain, including: How will this device stack up to the Apple Watch, especially when that consumer tech giant has spent seven years building out its health functionality? | How risky is sharing health data? A group of MIT researchers attempting to quantify the risk to patients of sharing de-identified data say the risk of re-identification is low compared to the risk of data breaches. That could mean that the benefits of sharing health data for improved diagnoses and treatment could outweigh individual privacy risks — at least according to their analysis, which scoured media reports between 2016 and 2021. “Of course, it’s good to be concerned about patient privacy and the risk of re-identification, but that risk, although it’s not zero, is minuscule compared to the issue of cyber security,” lead researcher Anthony Celi said. I welcome your thoughts on their analysis and the costs and benefits of sharing your own health data. | What we’re reading A cyber attack on CommonSpirit underscores growing concern in the industry, Associated Press Apps could one day diagnose illness based on speech, NPR | | | Thanks for reading! More on Thursday,  | |
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