With help from Darius Tahir (@dariustahir)

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Jonathan Bush's take on the Epic feud: Bush chatted with POLITICO about privacy, his new board position at Innovaccer and the upcoming interoperability rules.

Apple, Microsoft support API provisions: The tech giants are among more than two dozen signatories on a letter urging HHS to allow API access to patient records in the department's upcoming interoperability rules.

FCC's $20B broadband fund advances: Commissioners on Thursday voted to set rules surrounding a planned subsidy fund supporting broadband in remote areas.

eHealth Tweet thread of the day: Stephanie Hughes @stephanie_h "Had never heard the words 'ambient biometric data' all in one place until I heard @natashanyt say them in an interview with @stewart_jack. Now I'm going to use them all the time."

Natasha Singer @natashanyt "For context: we were discussing Alexa, Ring and other technologies that can collect voice/facial data from visitors/passersby who may not know about, and did not consent to, the surveillance."

It's FRIDAY at Morning eHealth. What stories are flying under the radar as we brace for the interop rules? Keep us posted at mravindranath@politico.com. Tweet the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

BUSH CALLS EPIC'S HHS CAMPAIGN 'INDISPUTABLY CYNICAL' HHS' upcoming data sharing rules could loosen electronic health record companies' control over patient information, arousing fierce opposition from some health leaders. But for Jonathan Bush the firebrand founder of athenahealth the rules offer an opportunity not just to help patients, but also to dream up new businesses.

Bush says Epic's opposition to the rules is "indisputably cynical" and he said as much in an email to CEO Judy Faulkner, although the email bounced. (An Epic spokesperson says Faulkner's email is functioning, but did not confirm that she'd received the message.) "I think of you as a good person who wants good things in healthcare....I am losing my grip on that assumption. Please reconsider," Bush wrote.

Faulkner has said the rules, which would make it easier for patients to send their data to apps outside their providers' systems, don't do enough to prevent third parties from exploiting their data. Critics, like Bush, say the company is protecting its own interests.

"Consumers are NOT as dumb as you think they are," Bush told Morning eHealth in an email, noting that in this new data-sharing landscape, patients can send their records to new services that aggregate data and recognize patterns in a way that health systems can't. It could also open the door to companies like Firefly Health, a venture-backed primary care company where he's executive chairman.

"I would fight and die to protect Judys right to behave in an aggressive competitive manner to prevent other entrepreneurs to enter her space," Bush said, but "that falls short of using control of the law/regulatory system."

... Bush also chatted with us about what he's been up to since he stepped down from athenahealth in 2018. In addition to his role at Firefly Health as executive chairman, he recently joined the board at Innovaccer, which sells software to help engage patients, manage pediatric populations, and connect patients to social determinants of health services, among other products.

It's the underlying software platform at Innovaccer that interested Bush, he told us. "For every field, they go through and say, 'what is extractable out of this?' ... They map it to a common data model that anybody later on can come and write apps to [and pull that data]."

That's something he tried and failed to do at athenahealth. "[B]ut we had older architecture and, frankly, we didn't have a business model that justified all that mapping. I ended up spending so much on R&D that I attracted an activist [investor]. Athena had a common data model for claims or insurance rules or insurance package benefits, but we were never able to get a common data model for a medical record. We were in the middle of it and we got shot down."

Your author also asked him what the app economy might look like if the rules are finalized. These days "it's hard for developers to get this data because of sclerosis," he said, referring to lack of common data standards or widely adopted mechanisms for that exchange. Over time, he expects more API-first platforms that developers can use to access data, and that charge very little money. Once data sharing does become standard, "they would be very profitable because they don't have to manually force things through," he said, adding that when he left athenahealth in 2018, "there were still 35 people whose job it was to manually put an ink signature on a paper claim."

APPLE, MICROSOFT SIGN LETTER TO OMB ON APIs Tech giants Apple and Microsoft are on board to get API access into HHS' final interoperability regulations, having signed on to a Thursday letter to OMB with more than two dozen co-signatories.

The letter runs through the standard arguments for API access that itll allow patients to better direct their care and enable better technology and boasts companies like Aledade and Ciitizen as well as the American Academy of Family Physicians as signatories, in addition to the tech giants.

... OpenNotes, an initiative promoting patient access to their doctors' visit notes, sent its own letter to OMB. "A growing evidence base indicates that patients who have access to their full medical record, including the notes their clinicians compose following office visits, report better understanding of their health and illness, feel more in control of their health care decisions, and are able to identify important errors and inaccuracies in their records," they wrote.

FCC BROADBAND PLAN ADVANCES DESPITE OBJECTIONS Agency Chairman Ajit Pai said auctions for broadband buildout subsidies should begin later this year, following this week's vote by commissioners to set rules for the $20.4 billion fund. Pai said the Rural Digital Opportunity Fund would "permanently change the broadband landscape in America for the better."

Telehealth advocates have warned that while virtual care could help patients access care in remote areas with clinician shortages, hospitals don't always have the broadband connectivity to support the technology.

The proposal wasn't without detractors. Commissioners made changes to a letter of credit requirement in an attempt to quell telecom industry concerns, but Democratic commissioners partially dissented over other unresolved spats, Pro Tech's John Hendel writes.

Commissioner Jessica Rosenworcel, for instance, said the proposal relies on flawed broadband mapping, uses "stale" proposed speeds and cuts New York state from eligibility due to its earlier subsidy arrangement with the commission.

Republicans dismissed New York's concerns, which GOP commissioner Mike O'Rielly called "self-serving." And flawed mapping, the commission majority said, still accurately shows the unserved areas targeted in phase 1 of the program.

FLORIDA HOUSE PASSES GENETIC TESTING BILL The Florida House this week passed a bill to prohibit life insurance and long-term care companies from using genetic information when setting prices, our POLITICO colleague Alexandra Glorioso reports.

Speaker-designate Chris Sprowls' bill, FL HB1189 (20R), would stop those industries from using genetic testing data when setting premiums; state law already bars health insurers companies from doing so. The bill is now in position to head to the Senate for a hearing.

A Senate companion, FL SB1564 (20R), was amended Tuesday to allow life insurance and long-term care companies to use genetic information if it's included in a patient's medical record.

The House bill "prioritizes the genetic privacy of Floridians over the desires of big insurance companies who want to deny coverage or charge higher premiums using peoples DNA," Sprowls said late Tuesday.

TELEDENTISTRY FIGHT RESUMES California state lawmakers will consider a bill this year that would require dentists to conduct in-person exams before approving orthodontic treatment, our colleague Alexander Nieves reports. The bill, CA AB 1998 (19R), by Democratic Assemblyman Evan Low, escalates a fight between teledentistry companies and dentists that began last year with legislation requiring in-state dentists to examine X-rays.

The teledentistry model keeps prices low by eliminating in-person exams, Alexander writes. Companies such as SmileDirectClub have storefronts in California, but consumers never meet the doctor prescribing their aligners. Under the bill, a patient couldn't see a local dentist and then get aligners in the mail from a different dentist via a teledentistry company.

California is proud to be the incubator of innovation but we cannot sacrifice patient health and safety in exchange for making billionaires out of tech bros, Low said in a statement. The industry should view AB 1998 as a sign that the Legislature is serious about requiring meaningful safeguards if these questionable and controversial business practices are allowed to continue.

Eran Segal writes in Nature about using detailed data about microbiomes, genomes, physiological measurements and other characteristics for drug design, potentially reducing the cost of drug discovery.

Stat's Sharon Begley writes about the Boston Biotech Working Group's efforts to fix the gender imbalance in biotechnology.

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Jonathan Bush's take on the Epic feud - Politico

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