Tuesday, January 29, 2008
A combination of loans/grants will be offered at a special rate for electronic medical records systems projects. The loan-to-grant ratio for this special combination loan/grant program will be 4:1. For this special program, it is anticipated that $10 million will be available for loans that are paired with $2,500,000 in grants, for a total of $12,500,000.
Grants may be used to fund telecommunications-enabled information, audio and video equipment, and related advanced technologies to extend educations and medical applications into rural locations. Loan and combination loan grants may be used to fund projects where the benefit is primarily at the same location as the source of service.
Eligibility for grants, combination loan/grants, and loans can be organizations, partnerships, Indian tribes or tribal organizations, state and local governments, consortiums, private corporations organized as for-profit or not-for-profit, and electric and telecommunications borrowers. Individuals are not directly eligible for the DLT program.
The deadline is April 14, 2008 for FY 2008 funding. For more details and information, go to the January 28, 2008 Federal Register, email firstname.lastname@example.org, call (202) 720-0413, or fax (202) 720-1051.
The proposals submitted for the CT Health IT Plan should address:
· Objectives and goals consistent with the RFP
· The electronic data standards needed to develop a statewide integrated electronic health information system to be used by providers, hospitals, community healthcare centers, and physician groups
· How the HIE will be compatible with any national data standards to allow for interstate interoperability.
· How security and privacy will be addressed
· Implementation strategies and target dates must be given for completing each stage of implementation
· How consumer education and information about the HIE will reach providers
· Detailed budget estimates including the infrastructure needed for each provider group
· How the transition to the National Health Network will take place once it is available
· Any barriers to implementing the Plan and how proposed actions will be used to address each barrier
· How state government agencies, public and private health systems, and healthcare providers will link HIE activities to support quality improvement initiatives
Go to www.ct.gov/dph/lib/dph/rfp/pdf/hie_rfp2008-2037.pdf for more information on the RFP.
Saturday, January 26, 2008
The bill (HB 16) was introduced in the Utah House to allow telemedicine to be used for certified services to be reimbursed under the State Medicaid plan. The Colorado legislature is also considering legislation to allow for telemedicine mental healthcare services under the Medicaid program.
The West Virginia legislature is considering (HB 3225) that would appoint a Commission to develop and field test a comprehensive integrated statewide standardized electronic medical record access system to be compatible with federal EMR software. The Commission will need to obtain bids from qualified businesses to field test the proposed EMR system.
The state legislature in West Virginia is studying (HB 2177) to provide tax credits to medical providers in an amount equal to their investment in EMR technology. Another bill (SB 74) introduced in the state Senate would also provide specific tax credits but only to certain medical providers.
The state of Tennessee is considering (SB 3122) to allow health centers with registered nurses or certified pharmacy technicians to dispense prescription drugs without the direct on premises supervision of a pharmacist. This bill would allow a pharmacist to provide the needed supervision by being available via telemedicine. When providing this distance supervision, the pharmacist would have to be on duty at an appropriate pharmacy facility.
The state of Oklahoma is considering (HB 3368) to create the Oklahoma Rural Health Policy and Research Center at the Oklahoma State University College of Osteopathic Medicine. This bill would improve rural healthcare delivery in the state by coordinating rural medical education, telemedicine, research, and healthcare policy.
The state of Oklahoma is also considering (HB 2788) to create the KidSafe Child Abuse Task Force. The Task Force would have nine members and one member would be the Provost of the University of Oklahoma Health Science Center or a designee from the telemedicine department.
The bill (AB 1391) introduced in New Jersey’s legislature would establish the New Jersey Health Information Technology Commission in the Department of Health and Senior Services. The Commission would collaborate with the Office for e-HIT in the Department of Banking and Insurance to educate the public. Information would be distributed on the value of health IT, how to improve patient care, the process on developing healthcare policymaking, and data would be provided on clinical research, healthcare financing, and quality improvements. The Commission would also study the need to promote national standards for an interoperable system.
Hawaii is looking at (SR 15 and SCR 34) that would create the Maui Health Initiative Task Force to encourage the development and operation of electronic medical records systems to be interoperable with Hawaii’s regional health information organization.
In Florida, the bill (HB 637) would expand access to a patient’s medical records to facilitate the electronic exchange of data between certain healthcare facilities, practitioners, and providers, and attending physicians. The proposed legislation would create the “Florida eHealth Initiative Act” and establish the Electronic Medical Records System Adoption Loan Program.
Several pieces of legislation are under discussion in the New York that would authorize an electronic medical records system when dispensing certain controlled substances and would authorize physicians with patients receiving Medicaid to dispense prescriptions through such systems.
The Kansas legislature is considering several bills (HB 2645) to establish a Broadband Technology and Application Advisory Council. The Council members would be both technology providers and users with knowledge of emerging technologies and innovative applications.
The New Mexico legislative body is considering both (HB 37 and SB 305) to create the Electronic Medical Records Act that would authorize the use of electronic medical records, and the Act would provide for individual rights concerning the disclosure of information, and protecting the privacy of the records.
HRSA’s Office of Rural Health Policy recently released the “Small Health Care Provider Quality Improvement (Rural Quality) Grant announcement to provide funding to improve patient care and chronic disease outcomes. The funding will help rural primary care providers implement quality improvement strategies and particularly focus on quality improvement for diabetes and cardiovascular disease.
By improving chronic disease management in rural primary care settings, the goal is to:
- Implement and use an electronic patient registry system
- Track and report specific health indicators by using nationally accepted performance measures
- Assess the need for additional quality improvement activities
- Participate in monthly conference calls and peer learning workshops
This program will provide funding for FY 2008 and 2009 with $4,500,000 available annually to fund 60 grantees. Rural Quality applicants may request up to $75,000 per fiscal year.
To be eligible for the program, the applicant organization must meet one of three geographic requirements, the applicant must be a rural public, or rural non-profit private healthcare provider, or a provider of healthcare services such as critical access hospital or rural health clinic, or be part of a network of small rural providers providing local care that has not previously received a grant, or be a faith-based and community-based organization.
The letter of intent deadline is February 08, 2008 and the application deadline is March 20, 2008. The projected award date is September, 01, 2008 with the project estimated to end on August 31, 2010. For more information, on (HRSA-08-058), go to www.grants.gov or contact Elizabeth Rezai-zadeh, (301) 443-4107.
The first step for potential grant applicants will be to identify alcohol-exposed pregnant high risk childbearing aged women that receive ambulatory women’s healthcare at a public or private managed care facility. However, this managed care facility must be one that employs electronic medical records systems for recording and tracking patient visits and services. Applicants need to be able to provide a plan on how they will integrate the screening interventions and the information on follow-up for the participants into the existing electronic medical record system.
The application deadline is expected to be April 6, 2008, and the award date is expected to be June 19, 2008.
Wednesday, January 23, 2008
Together the team will develop a two stage collaborative process to include all key stakeholders. Phase one will focus on stakeholder outreach along with the design and development of governing documents for AHIC 2.0. This phase is expected to take approximately four months with $2 million allocated for this stage. Upon completion of phase one, phase two will be funded with $3 million to fully establish AHIC 2.0. Additional funding may be allocated to support operations of the AHIC 2.0 once it is ongoing.
Secretary Leavitt said, “By securing a successor to the AHIC in the private sector while still maintaining broad public-private collaboration, we will help to ensure that the health IT standards process is truly self-sustaining.”
Subjects in the study include 80 family caregivers plus 80 adult patients dependent on HPN infusions due to nonmalignant gastrointestinal disorders. Researchers are designing a placebo-controlled longitudinal clinical trial design with crossover and interventions to be delivered by videophone nurse visits. In addition, internet-based home care will be tested.
Traditional cost analysis will be used to describe each family’s home care efficiency in relation to health services costs, and data will be analyzed to see the effects on the caregivers and patients. Traditional cost analysis will be used to describe each family’s home care efficiency in relation to health services costs.
For more information on Grant R01NR009078-03, contact Carol E. Smith at email@example.com or phone (913) 588-5000.
Sunday, January 20, 2008
All participating physician practices will be required to have a CCHIT certified EHR by the end of the second year. Physician practices must be using electronic health records for clinical documentation, ordering lab tests, recording lab tests, and ordering prescriptions. However, the core incentive payments will be based on performance concerned with quality measures. A bonus will be paid based on the degree of health IT used to manage care.
The demonstration project will be operational for five years and in years 3 to 5, demonstration payments will include bonuses each year based on how the practice has used electronic health records to change and has improved the operation of the practice. The demonstration project will be fully operational in 12 locations with two sites to be identified in early spring 2008 and the remainder sites by 2009.
The funding will be used to help the networks implement electronic health records to improve care in the health centers, and also to create sustainable business models needed for deploying health IT in the Health Center Controlled Networks. The funding will also enable health centers to form strategic partnerships to leverage other health IT initiatives in their states, communities, and regions.
HRSA is looking for projects with active quality improvement programs using data to improve care and demonstrate the value and effectiveness of health centers in the marketplace. At the end of the project period, grantees must demonstrate that they have implemented electronic health records in the sites initially proposed and that improvements will result with improved health outcomes.
Public and non-profit organizations including faith based and community based organizations from a network controlled by and acting on behalf of a health center, or health centers may apply as defined by specific requirements under the Public Health Service Act.
A pre application conference will be held for potential applicants on February 20, 2008 at 2pm. The call in number for the conference is 888-282-0170 and the passcode is 1383464. For more information, go to http://www.grants.gov/ or contact Samantha Wallack at firstname.lastname@example.org.
The recommendations addressing ways to reform the payment system include:
· Empowering individuals with information to give them choices and responsibility, and the need to improve the coordination and management of care especially for people with chronic diseases
· Increasing transparency and provider competition data on price and quality
· Sustaining the critical mass needed to create powerful incentives for providers to devote the necessary investment needed to fundamentally design the ways they provide healthcare.
Payment reform would move ahead in three stages. Level 1 would have payments tied to quality of care, level 2 would establish explicit care management payments to providers that have the infrastructure and systems to function as an effective medical or healthcare home capable of coordinating care, and level 3 would establish a system of accountability for the total cost of care.
Further suggestions would enable provider groups and care systems to compete for patients by submitting bids on the total cost of care for a given population. Patients would choose provider groups and care systems based on cost and quality, and payments to providers would be risk adjusted based on the health of the population they manage.
For more information, go to the Minnesota Health Care Transformation Task Force at http://www.healthstate.mn.us/.
Friday, January 11, 2008
The Department of Veterans Affairs health care system received a highly favorable review in an interim report published December 2007 by the Congressional Budget Office (CBO). The report requested by several Congressional Committees reviewed the quality of the VA’s healthcare, looked at the achievements, and examined the lessons learned from management initiatives and using health IT systems.
VA’s accomplishments are very important since the agency finds increased demand for services. From 1999 through 2007, enrollment in the VA Healthcare systems swelled from over three million to nearly eight million veterans. The number of veteran patients treated each year increased from 3.2 million to more than five million.
The VA’s restructuring efforts now permits more shared decision making between VA’s central office, regional managers, and facility directors. The VA is able to measure performance, process and outcomes, along with the effectiveness of the system-wide health information technology used at the agency.
The CBO report pointed to VA’s structure as an integrated healthcare system that allows for two important tools:
- Incentives given to managers and providers to meet quality of care and practice guideline targets
- Health IT systems that provide reminders about tests and treatments recommended by the practice guidelines. Research shows that computer reminders and prompts can significantly improve adherence to clinical guidelines particularly for preventive care
To see the interim report, go to www.cbo.gov. The final report expected to be released in early 2008, will address the potential for other public and private healthcare systems to apply similar approaches and will also address other issues.
Thursday, January 10, 2008
Governor of Maine John E. Baldacci on January 9, 2008 explained how the budget will ask the three largest purchasers of healthcare in Maine to come together to save taxpayers money and provide better care to consumers. The Maine State Employees Health Commission, University of Maine System, and the Maine Education Association plan to join forces to put their enormous buying power together to lower prescription drug costs.
Governor Eliot Spitzer discussed plans for New York on January 9, 2008 to bring the healthcare system out of the digital dark ages and has plans for the state to secure electronic health records whether on a card or online in 2008.
Governor Arnold Schwarzenegger mentioned the Health Care Security and Cost Reduction Act in California that he introduced and he is happy to see that the bill was passed by the state Assembly. Now the state Senate is discussing the bill that would contain costs and lower healthcare spending by specifically addressing chronic illnesses and also providing for broad access to preventive care.
Wednesday, January 9, 2008
It is sometimes difficult to maintain proper levels of fluid and each year hundreds of people either die or suffer ill effects because of dehydration. Studies have shown that up to 80 percent of troops become dehydrated and suffer from a fluid-electrolyte imbalance. This is of major concern to the military because the soldiers are not able to perform at peak levels.
Presently, Noninvasive Medical Technologies has ZOE on the market, but the device is now used primarily in home healthcare situations. The company’s goal is to improve the product, make it more robust, smaller, less expensive, and use to monitor individuals remotely.The researchers at ORNL were able to reduce the system to an integrated circuit or chip, which reduced the amount of power to operate the unit and also lowered the cost. A wearable wireless version of the ZOE instrument referred to as ZOEwi, will allow monitoring during activity and is planned for market introduction in 2008, according to Jeremy Copeland, Vice President of Marketing for Noninvasive Medical Technologies.
Tuesday, January 8, 2008
The Task Force on the Future of Military Healthcare, a subcommittee of the Defense Health Board, advises the Secretary of Defense and others in the defense department on how to sustain military healthcare services provided to the armed forces, retirees, and their families. The task force just recently published a final report that makes several recommendations for sustaining military healthcare services such as:
- Doing a better job at integrating purchased care and direct care at the point of delivery
- Making certain that healthcare is available for all individuals that are eligible and ensuring that TRICARE operates as a second payer when there is no other health insurance
- Improving wellness, preventive care, and disease management programs and measuring their effectiveness
- Streamlining procurement systems to produce more effective contracting
- Paying attention to the medical readiness of the Reserve component
- Restructuring the cost-sharing structure for retirees and their families and make changes as needed to enrollment fees, deductibles, co-payments, indexing, and the pharmacy benefit program
For more information on the task force and a copy of the report, go to www.dodfuturehealthcare.net.
Key presentations and discussions will focus on bioinformatics, broadband and wireless networks, cost benefit studies, developing countries and ehealth, electronic medical records, ehealth integration into routine medical practices, home monitoring, legal and ethical issues, telemedicine for diabetes care, telepsychiatry, and telemedicine applications and progress. Many additional topics will also be open for discussion.
The variety of attendees will include hospital directors, nursing/rehab facility directors, medical specialists, general practitioners, nurses, manufacturers, government representatives, funding agencies, pharmaceutical companies, information technology companies, researchers, investors, plus many others will be coming to network, establish trade contacts, and to talk about current business relationships.
For more information, go to www.medetel.lu.
According to the Hawaii Broadband and Task Force Initial Report recently published for the Governor and others in the state, the Broadband Task Force wants to see more promising high-speed broadband applications used in the state. Hawaii presents geographic challenges to installing broadband that differs from other states.
For example, Hawaii needs inter-island fiber optic systems to provide advanced broadband capabilities; however, these submarine systems are much more expensive than the terrestrial fiber systems for intra-state infrastructure used elsewhere. Additionally, since Hawaii is a long distance from the mainland and Asia, Hawaii is reliant on expensive trans-Pacific fiber optic systems. Unfortunately, the most recent fiber optic systems constructed to connect Asia to the U.S. have all bypassed Hawaii.
There are several existing e-Health broadband applications such as:
- A $10 million Weinberg Foundation grant linking Health Systems Corporation hospitals with healthcare facilities on Oahu is now completed
- The Veterans Administration main clinic at TAMC in Hawaii, offers telemedicine consultations at peripheral clinics on Kauai, Maui, the Big Island in Hilo and Kona, and in American Samoa and Guam. Specialists are available in dermatology, dietetics, cardiology, general surgery, vascular surgery, orthopedic surgery, endocrinology, psychology, and psychiatry. Remote viewing of electronic health records, images, along with the use of remote tele-pharmacy is available.
- The Pacific Island Health Care Initiative part of Tripler’s activities supports “store and forward” web-based telemedicine consultations to clinicians in rural areas in Hawaii and western U.S./western Pacific. The electronic ICU system can link Tripler intensive care experts with intensive care units in Guam and Korea.
- Access Grid an initiative led by the National Computational Science Alliance to support educational activities and clinical and diagnostic applications is being used by the John A. Burns School of Medicine at the University of Hawaii and at Tripler
- A federal grant of $4.9 million will be used to build a broadband network over three years to link 96 rural and urban healthcare providers throughout Hawaii and the Pacific island region. The project will interconnect the State Telehealth Access Network to several others serving the state government and the University of Hawaii. The project will also interconnect networks of the Department of Health, the Hawaii Health Systems Corp., the Hawaii Pacific Health System, the Department of Veterans Affairs Pacific Island Health Care System, and the American Samoa Medical Center
- A DOD funded demonstration project called the Pacific Rim Applications and Grid Middleware Assembly Avian Flu Grid Program brings together investigators from University of Hawaii, Korea, Taiwan, Malaysia, Japan, and China to develop a computational grid platform to study H5N1 avian influenza virus. The project is developing not only the methods to study the molecules computationally, but is studying how broadband communications systems can share data and computational capacity
During 2008, the task force plans to research how many states have initiated broadband data collection projects, their placement within the government structure, the nature of any regulatory changes that states have made, have any states created a unified telecom authority to drive broadband deployment, how many states have dark fiber networks for research and education that are tied into national networks, what drove these direct investments in advance broadband infrastructure, what states have passed legislation to improve competitive access to rights-of-way, and will any states drive the deployment of Fiber-to-the-Home or will telecommunication and cable companies provide the investment needed.
The task force hopes that the interim report will help the 2008 legislation make future plans for high-speed broadband applications to benefit Hawaii. In addition, the task force will continue to monitor the federal landscape to help guide the actions needed by Hawaii to maximize opportunities.
For further information and a copy of the Task Force Interim Report, go to http://www.hbtf.org/ or go to www.state.hi.us/auditor/meetings.htm. For details on the Internet Innovation Alliance White Paper “Advancing Healthcare Through Broadband: Opening up a World of Possibilities”, email Neal Neuberger, President email@example.com.
Responders need to provide a description of their current capabilities in bar-code enabled point-of-care technology as well as any other information available on automated solutions that could address this RFI (APOC-RFI-0002). Solicitations are not available at this time and information collected via this notice will not limit or screen potential organizations from future consideration for selection.
Responses will also be used to help determine set-aside possibilities. Responding companies need to state whether they are considered a large or small business based upon the size standards provided in the announcement.
The response deadline is January, 25, 2008. For more information on the request, go to http://www.fbo,gov, or contact Julius Tidwell, NIH Contracting Officer at 301-496-0101 or email firstname.lastname@example.org.
Friday, January 4, 2008
“This is so important for our flying population,” said Dr. (Maj) Judy Manno, optometry services flight commander and practicing optometrist. “When we put in drops to dilate and check the retina, it precludes flying duty for 24 hours.”
The Optos digitally scans the retina, the interior lining of the eyeball and creates an Optomap, which is a digitalized image of the retina. Once the digital image of the retina is uploaded, doctors and technicians are able to determine if there are retinal lesions and are able to spot early signs of glaucoma, macular degeneration, and retinal tears.
Wednesday, January 2, 2008
The new legislation provides facilities with the authority to share information in order to identify all sources of infections and to ensure appropriate care for the individual patients. The legislation also promotes increased active surveillance, by requiring the collection of monthly infection data to provide immediate feedback to the reporting hospital.
In addition, the State Immunization Information System put in place to prevent gaps in reporting was extended by legislation enacted in 2007. The System operates as a demonstration program and collects information provided by healthcare providers on a voluntary basis in order to track and monitor the immunization of children.
To help all New Yorkers have access to affordable high-speed internet service, the New York State Council for Universal Broadband has been established. In addition RFPs were released in early December to distribute funds for competitive grants to research, design, and implement accessible high speed internet for neglected urban and rural communities with the purpose to narrow the digital divide.
In 2007-2008, the New York State budget appropriated $5,000,000 to provide seed money through competitive grants to promote research, design, and implement innovative solutions to provide for affordable internet in the state. The New York State Office of the Chief Information Officer and the Office for Technology administers the broadband access grant program.
Tuesday, January 1, 2008
Recently Washington Governor Chris Gregoire proposed spending millions for patient safety to move the state towards safe high quality affordable healthcare. The Governor originally started the process to improve the healthcare system by chairing a Blue Ribbon Commission to find out what is needed to make healthcare more affordable. The Commission came up with 20 initiatives to improve the safety and quality of the healthcare system to better manage chronic diseases, empower consumers with information, and expand the use of health IT.
The Governor’s proposed provisions to spend $7.89 improve patient safety were announced recently and includes:
- $930,000 to ensure that the providers in the state are well qualified. The Governor plans to introduce legislation to strengthen the state’s standards for credentialing and disciplining healthcare providers, including support for national background checks
- $2 million to rigorously investigate complaints against healthcare providers
- $1.4 million to help provide real-time information to reduce medication errors. The Governor wants to see investment in a new online database to give providers and pharmacists access to all the prescription drugs that their patients are receiving
Hospitals will be required to report adverse events to the public
- $3 million to help hospitals train more qualified nurses to address staffing shortages
- $560,000 to increase licensing standards for registered counselors
The state is now seeing results in providing access to high quality affordable healthcare. For example, 84,000 more children have access to health insurance, the state is ranked the 12th healthiest state, up from 15th one year ago, and more than 68,300 Washingtonians are saving 20-60% on prescription drugs by using the state’s free discount card, saving consumers $1.8 million.