Sunday, June 15, 2008

Showcase Promotes HIT

The latest advances were highlighted at the highly successful Capitol Hill Technology Showcase and briefing held on June 12, 2008 in conjunction with Health IT week. Each year, the Capitol Hill Steering Committee on Telehealth and Healthcare Informatics devotes a day in June to highlight the progress and the steps taken to deliver better and more effective healthcare.

Senator Kent Conrad (D-ND) one of the Co-Chairs of the Steering Committee thanked Neal for his excellent leadership in organizing the Capitol Hill briefings since 1993. The sessions enable many people to have the opportunity to hear from leaders in the field on how to move the health IT movement forward.

The Senator said that dealing with the telehealth issues in Medicare is a slow process but he emphasized how telehealth is needed to save money, produce a more effective healthcare system, and save lives.

Representative Patrick Kennedy (D-RI) said he doesn’t see much happening to move HIT forward before the election but he does want to take part in healthcare discussions at the Democratic Convention. He sees the next President putting healthcare on the forefront of the agenda and is hopeful that HIT will make some progress next year.

The Senator from Rhode Island Sheldon Whitehouse told the attendees that the healthcare system is screaming out for reform. According to the Senator, the country needs a national HIT infrastructure, a focus on quality improvement, and a major change in the reimbursement system.

Senator Debbie Stabenow (D-MI) along with Olympia Snowe (R-ME) introduced S 1408 to improve quality in healthcare and the bill would provide incentives to adopt technology. Senator Stabenow wants to see support for the bill and is proud that her state is a leader in using technology.

For example, the South East Michigan e-prescribing group has been active since 2005 and so far, 25,000 doctors have used the system with incredible results especially in finding drug interactions. Also, the Upper Peninsula a very rural area in the state has been using telehealth for some time which has made a big difference for the residents.

Speaking from the administration viewpoint, Robert Kolodner MD, National Coordinator for Health Information Technology, discussed how the 5 year Strategic Plan recently released provides information on all of the HIT efforts that have taken place in the last four years.

Dr. Kolodner said that in the fall of 2008, 19 trial implementation awardees will participate in a collaborative effort to find the common interfaces that NHIN Health Information Exchanges need to operate. Awardees will work together on a cooperative interoperability testing event to effectively demonstrate real time information exchange.

According to Donald A. Lindberg, MD, Director, National Library of Medicine two new standards are under review. One standard applies to functional MRIs and the other standard applies to genetic testing if the data is to be included in the electronic medical record.

According to Dr. Lindberg, communications with others in disasters is failing and a solution needs to be put in place. The Wireless Information System for Emergency Responders (WISER) developed by NLM has been used very successfully and fire departments really like to use the handheld. WISER a mobile application designed to assist first responders in hazardous material incidents provides a wide range of information on hazardous substances including chemical identification support, physical characteristics, and human health.

Colonel Jonathan H. Jaffin, MD, Deputy Commander Medical Research and Materiel Command, Ft. Detrick, MD, said MRMC provides full spectrum support for warfighters. MRMC has many technologies under development and is working with a number of university and industry partners to support programs such as:

  • An automated clinical decision support and disease management system to help mostly patients with diabetes and heart problems. The goal is to provide telemedicine, home care, and monitoring involving biosensor development, plus provide for advanced immunologic testing
  • Robots to help the injured warriors in the battlefield and in surgery
  • Biosurveillance capabilities capable of doing threat analyses using computational methods
  • Medical modeling and simulation programs using digitally enhanced mannequins for training, interactive multimedia, and total immersion virtual reality systems
  • Advanced imaging and brain mapping technologies to provide portable imaging equipment
  • Pharmaco-vigilance systems to perform active monitoring to reduce adverse pharmaceutical related events
  • Mobile and remote computing to provide medical care immediately on the battle field using wireless information and sensor technology
  • Neurosciences to be better able to diagnose head injuries to improve the outcome
  • Regenerative medicine to provide cutting edge technology to help returning warriors

Adam Darkins, MD, Chief Consultant, Office of Care Coordination, Veterans Health Administration, reported that the VA is now providing telehealth care in the home and is taking care of 33,400 patients living independently in their homes. The program started in 2003 with 1,500 patients, and in the future expects to have 75,000 patients using the home-based technology in their homes.

Dr. Darkin pointed out that the VA is using video conferencing that is proving to be very effective and veterans are able to get help in 1,000 locations. The use of video conferencing is especially helpful in treating patients with mental health issues. Presently, there are 35,000 patients involved in the program and this is projected to rise to 80,000 patients.

VHA has training ongoing in home telehealth, general telehealth, and store and forward telehealth. Training on screening for diabetic retinopathy using store and forward technology is high on the agenda for the 20% of veterans with diabetes. Also important is the ability to use store and forward for teledermatology.

Another important issue brought up during the day concerned the development of the Legal Electronic Health Record. Michelle Dougherty, AHIMA, explained that it is very important for the Legal Electronic Health Record to be put in place. She told the attendees, that no matter whether the format is paper or whether a fully electronic system is used, the health record needs to and must meet the requirements of the official legal business record for the organization.

She continued to say “given today’s urgency to begin deploying EHR systems, healthcare entities, vendors, and others sometimes neglect to build in the record management processes and system capabilities needed to ensure that the electronic rather than the paper version can stand as the legal business record.”

The Technology Showcase featured federal agencies, associations, leading research organizations, and companies demonstrating their latest advances toward an “E-enabled healthcare system. Participating organizations included ATA, AT&T, Inc., Continua Health Alliance and Partners, eHealth Initiative and Partners, Encite, Himss and Partners, Department of Defense Military Health System, VHA, Greenway Medical Technologies, INRange Systems, Inland Northwest Health Services, Lehigh Valley Hospital and Health Network, SAIC, Siemens Medical, RCHN Community Health Foundation, National Association of Public Health Information Technology, iMDsoft, Eye Controls, NLM, and RTI International.

Many of the products and services displayed at the Showcase involved ongoing work in biosurveillance, battlefield medical information systems, robotic systems, chronic care and disease management tools, electronic health records, handheld devices, imaging, patient identification and tracking systems, and rural telemedicine technology.

It was announced that Neal Neuberger President of Health Tech Strategies, LLC has been selected to lead the newly launched HIMSS Institute for e-Health Policy and will also continue to head the Steering Committee. The Institute will provide educational opportunities in the Washington D.C area for public and private sector stakeholders impacted by e-health policy decisions. The Institute with have an Executive in Residence Program and will have government relations undergraduate and graduate level internship programs to support two college interns for three semesters each year.

Continuing Honorary Steering Committee Co-Chairs are Senators Kent Conrad (D-ND), Mike Crapo (R-ID), Sheldon Whitehouse (D-RI) and Representatives Eric Cantor (R- VA), Rick Boucher (D-VA), Bart Gordon (D-TN), Allyson Y. Schwartz (D-PA), David
Wu (D-OR), and Phil English (R-PA). The Steering Committee coordinates many activities with the House 21st Century Health Care Caucus, co-chaired by Representatives Patrick Kennedy (D-RI) and Tim Murphy (R-PA).

Be sure to attend the next session on July 16th on “Achieving Interoperability, Connectivity, and Continuous Availability among Systems: Is there a light at the end of the HIT Tunnel?” For more information on future Capitol Hill sessions, contact Neal Neuberger, at (703) 790-4933 or email