Thursday, July 23, 2009
Investigators are invited to submit proposals to carry out the HCP which will be funded for up to $6 million per year for five years. The HCP is the first of three Blueprint Grand Challenges projects to address issues in neuroscience research.
The HCP will optimize and combine state-of-the-art brain imaging technologies to probe axonal pathways and other brain connections and researchers will combine brain imaging technologies to map the brain’s connections. The HCP will develop new data models, informatics, and tools to help researchers make the most of the data. Funds will help build an on-line platform to disseminate HCP data and tools.
All institutions of higher learning, nonprofits, for profits, small businesses, and Federal, state, and local governments are eligible to apply. Letters of intent are due October 26, 2009 with applications due November 11, 2009. For more information go to www.nimh.nih.gov and click on Request for Applications or call Daniel Stimson, NINDS at (301) 496-5751.
In another effort to study the brain, the Department of the Army USAMRAA released information on July 10th on the Psychological Health and Traumatic Brain Injury Research Program with program funding of $24,000,000.
This grant award program supports research on promising new products, pharmacologic agents, behavioral interventions, devices, clinical guidance, and or emerging approaches and technologies. These awards are expected to yield potential products, approaches, or technologies to treat, prevent, detect, and diagnose psychological health and traumatic brain injuries relevant to the military.
Each principal investigator must be able to provide a transition plan including funding and resources to show how the product will progress to clinical trials and be able to deliver to the military market after the completion of the research.
The closing date for applications is October 28, 2009. There will be three grants awarded. For more information on the grant opportunity “Psychological Health and Traumatic Brain Injury Research Program” go to www.grants.gov.
MBI’s action plan is to:
• Assess broadband conditions in communities with or no broadband
• Promote access for essential state and local governmental services, homes, and businesses
• Inventory state and local government services to see if they can contribute resources
• Work to secure federal broadband stimulus funding
MBI is looking for letters of support from fiber network build and design contractors, fiber network operators, and last mile providers. Providers will need to address requirements such as how they plan to provide service in underserved areas, types of customers to be targeted, types of technologies that network service providers will need to deploy for last mile services, pricing levels to offer, examine whether service provider partners are applying for ARRA funds in the regions, and look into any past experiences that service providers have had with similar projects.
The Massachusetts House and Senate passed a bill last week that will make changes in the way state agencies interact. The bill makes changes in defining the state’s ownership of fiber it leases and for any wireless spectrum it might lease for expanding broadband access. The legislation gives MBI access to conduits that are already being laid along I-91 by the Massachusetts Highway Department for its own communications needs.
According to Sharon Gillett, Director of MBI, the bill makes it easier for the MBI to take advantage of existing infrastructure and build-outs already under construction. “It allows us to work collaboratively with other agencies, and to use what already exists so we can work more rapidly. We have to be able to show that our plans can be substantially completed in two years and totally completed in three. In order to do that there has to be streamlining of the construction.”
For more information, go to http://www.massbroadband.org/.
A new project plan will now need to meet the requirements of the Program Management Accountability System (PMAS) to be created by the project manager and approved by the VA’s Assistant Secretary for Information and Technology.
The PMAS requires projects to establish milestones to deliver new functionality to its customers. Failure to meet deadlines indicates a problem within the project. Under PMAS, a third missed customer delivery milestones is cause for the project to be halted and re-planned.
A partial list of the IT projects temporarily halted:
• Pharmacy R-Engineering Pre.5 and Pre 1.0
• Health Data Repository (HDR) II and Health Data Repository (HDR) Data Warehouse
• Home Telehealth Development and Home Telehealth Infrastructure Enhancements
• Barcode Expansion
• Clinical Data Service, Clinical Flow Sheet, and Clinical/Health Data Repositories Phase II
• BCMA Inpatient Medication Request for SFG IRA
• Radiology HL7 Interface Update
• Ward Drug Dispensing Equipment Interface
• Lab Data Sharing & Interoperability
• National Teleradiology Program
PMAS in conjunction with the analytical tools available through the IT Dashboard is going to assure the early identification and the correction of problematic IT projects. The IT Dashboard at www.usaspending.gov is a one-stop clearinghouse of information to track federal information technology initiatives.
For more information, contact Katie Roberts at Katie.firstname.lastname@example.org or call (202) 461-4982.
The funding goal is to establish or improve the local coordination of care. The grant program funds one year of planning activities to help rural communities provide for an integrated healthcare network if the participants in the network are not already collaborating.
There is considerable evidence that rural healthcare providers benefit greatly from developing networks. The realities of rural healthcare delivery create an environment where rural providers need to be able to build a more sustainable infrastructure by joining together in formal arrangements. However, identifying and exploring these kinds of partnerships can be a challenge.
The lead applicant organization must be a rural, non-profit, or public entity that represents a consortium/network of three or more health related entities that need assistance to plan, organize, and develop a healthcare network. For profit organizations are not eligible to be the lead applicant but can participate in the network. Faith-based and community-based organizations as well as tribal organizations are also eligible to apply for the funds.
The grant will be funded with FY 2010 appropriations depending on the funds available. The amount of the funding is anticipated to be $1,700,000 with 20 awards. The estimated average size of the awards is $85,000. The application deadline is September 14th
For more information, go to www.grants.gov or contact Eileen Holloran, Program Coordinator, Office of Rural Health Policy at email@example.com or (301) 443-7529.
The Board would help VistA and the Resource and Patient Management System (RPMS) user groups communicate and provide for interoperability between the systems. In addition, the Board would see that VistA and RPMS open source software include healthcare provider-based electronic health records, personal health records, and other software modules that would be updated on a timely basis.
The Board would also administer the “21st Century HIT Grant Program” to look at specific health information technology grant needs, provide technical assistance, help to integrate VistA and RPMS with records and billing systems, establish a child specific electronic health record, plus integrate the new grant program with the FCC’s Rural Health Care Pilot Program, the VA’s hospital system, and with other Federal health technology initiatives.
A public or nonprofit healthcare provider is eligible to receive funding. This may include post secondary educational institutions, community health centers, local health departments or agencies, community mental health centers, nonprofit hospitals, rural health clinics, and a consortia of healthcare providers.
Funding for $2,000,000 would be available for Fiscal Years 2010 to 2011 and $1,000,000 for Fiscal Years 2012 to 2014.
The bill was referred to the House Committee on Energy and Commerce and to the Committee on Veterans Affairs and Natural Resources.
Sunday, July 19, 2009
As moderator, Neal Neuberger, Executive Director of the Institute for e-Health Policy, explained, the NHIN CONNECT Gateway is an important tool needed to provide a secure gateway to obtain and handle the enormous amount of health data available from the federal agencies.
In the beginning, the Federal Health Architecture (FHA) program was started when a number of agencies came together to identify the problem, design, invest, and find ways to implement the solution, according to Vish Sankaran, Program Director, Federal Health Architecture (FHA). He continued to say that the agencies came together to not only to advance health information but to make it possible to release open source code for the “NHIN CONNECT Gateway.
As he explained, the first agency to go live with CONNECT was the Social Security Administration. At the HIMSS Annual meeting held in April, seven federal agencies including SSA, DOD, VA, IHS, NCI, CDC, and NDMS participated in demonstrations to showcase CONNECT.
According to David Riley, Architect for the FHA CONNECT Initiative Lead, progress is constantly being made. Initially, the Gateway Package was released in December, then in February, the Social Security Administration went live using CONNECT with Med VA. In April, CONNECT v2.0 was released to the public as open source, and CONNECT v2.1 will be released at the end of July with v2.2 scheduled for release in September.
He told the attendees that an enormously successful CONNECT Seminar was held in June in Washington D.C., with over 1,000 attendees from federal, state, tribal and local governments, universities, research facilities, healthcare providers, and health IT vendors coming together to share valuable technical knowledge.
Denny Porter, Executive in Residence, Institute for e-Health Policy, explained that for the first time, Americans will be able to use the FHR Gateway to find information on federally held clinical and claims data and be able to provide this information to providers and patients. Even better, this information could be included in personal health records.
He described a hypothetical scenario where a Vietnam veteran he called “Emil “J” needed to retrieve 40 years of information. Emil “J” wanted to have access to his records both from the VA and the military, plus from other places such as NIH, CMS, and other civilian providers that have held his medical records for the past 40 years. He used this hypothetical example to emphasize how important it is to have this type of information available and transparent everywhere so that all doctors are able to provide more coordinated care not only for veterans but for the American people.
Jim Traficant, Vice President and Senior Executive, Healthcare Solutions, Harris Corporation, approached the need for an interoperable system by describing his personal medical story and the difficulty in finding coordinated medical and research information when he underwent an organ transplant and then afterwards when he had organ rejection issues. With his medical and health issues to deal with, he and his doctors would have had an easier time if comprehensive information had been made available easily and quickly. As it was, he and his doctors were lucky to find information on a vital new drug that he needed to help to restore his health.
Now, he has a unique passion to make changes in the system and emphasized the importance for this country to move forward to have an integrated interoperable health enterprise that puts patients at the center of the system.
The series of lunch briefings is part of a 2009 series of educational programs on behalf of the Capitol Hill “Steering Committee on Telehealth and Healthcare Informatics.” HIMSS and their Institute for e-Health Policy manage the Capitol Hill HIT briefing series.
The Institute is coordinating the “Annual National HIT Week” activities to be held September 21-25, 2009. As part of the activities for the week, the “Capitol Hill Health Information Technology Showcase” will be held on September 24, 2009. For more information, contact Neal Neuberger, at firstname.lastname@example.org or go to www.e-healthpolicy.org.
The nurses report vital signs, draw blood, listen to patient’s heart and lungs, and make physical assessments. The clinic provides for teleconferencing, uses a high intensity camera with a magnified view, uses an otoscope to let the doctor look into the patient’s ears, and uses a smart stethoscope to listen to the patient’s heart and lungs.
The Craig Clinic is the only one using high technology on the Western Slope in Colorado but other clinics are due to be modeled after the Craig Clinic. Records show that nearly 45% of veterans live in rural areas where getting to a doctor or to a medical clinic may require hours of travel.
Congressmen Jim Matheson reported in June that there is now a $7.3 million federal grant to start new telehealth outreach clinics in the Mountain West including the Moab and Price Utah-areas with funding allocated by the VA’s Office of Rural Health.
The funding calls for two primary care offices to be opened and be staffed by two full time registered nurses and one telehealth medical technician. Matheson said they will use computers equipped with cameras to help the staff to communicate via the internet with a VA doctor at a medical center
In May 2009, the VA provided $215 million in competitive funding to improve services specifically designed for Veterans in rural and highly rural areas. VISNs, VA’s regional healthcare networks, and Veterans Health Administration program offices were allowed to submit up to eight proposed projects each. The Office of Rural Health then selected 74 programs many of which were either national in scope or in affected multiple states.
The new funding is geared to improve access and quality but there is also emphasis on the use of the latest technologies, but also the recruitment and retention of a well educated and trained healthcare workforce is high on the agenda.
On the legislative front, Representative Ann Kirkpatrick from Arizona recently introduced the “Rural Veterans Health Care Improvement Act of 2009” (H.R. 2879) in the House to make it easier for veterans living in rural areas to access quality healthcare options.
The bill calls for demonstration projects to look at expanding care for veterans in rural areas. The projects will develop a partnership between the VA and HHS to coordinate care for rural area veterans at community health centers. Funding of $350,000,000 will be available for the demonstration projects for fiscal years 2009 through 2011.
The legislation also calls for the integration of electronic health records with the Indian Health Service. In addition, the Secretary of Veterans Affairs and the Secretary of the Interior realize the importance of having a Memorandum of Understanding between the agencies to ensure that the health records of Indian veterans can and will be transferred electronically.
Projects must advance both engineering and life sciences and may range from single investigator to multi-investigator collaborative research efforts. Development of these devices will require collaborative efforts between engineers, life scientists, and experts in nanotechnology, biomaterials, bioinformatics, and chemical and physical sciences.
The Biosensing program is specifically looking for highly sensitive and discriminative biosensing easy to operate sensor systems with a highly selective response to multiple analytes under variable conditions. Other needs are for cell and tissue-based sensors to monitor environmental physiological and genetic responses, smart field deployable molecular sentinels, molecular sensors capable for monitoring biological structures, and ways to combine the different sensing platforms.
The closing date for applications is September 17th, 2009. The full proposal window is from August 15, 2009 to September 17, 2009. The estimated total program funding is $2,300,000 and the award ceiling is $600,000, with five awards expected.
For more information, go to www.grants.gov, or contact Alex Simonian at (703) 292-4826 or email email@example.com.
The company specializes in both hardware and software development of optical and laser devices as well as systems for human physiological monitoring, remote and in-situ sensing and inspection, environmental monitoring, and biological/chemical warfare agent detection and identification.
One of the NIH grants funded research to develop a noninvasive optical sensor for hemoglobin measurements. Hemoglobin measurements are extremely important in blood transfusions, blood sugar monitoring, and provides the doctors with valuable information about the patient’s blood. Hematocrit testing is a common pediatric procedure to check for leukemia and anemia. Blood tests needed to do this are common but yet there is room for improvement.
The researchers came up with the idea of using a new absorption technique and multiple scattering analyses to measure hemoglobin and hematocrit continuously and noninvasively. The company is currently designing a real-time device to monitor both hemoglobin and hematocrit. So far, the researchers are able to apply differential absorption techniques and scattering analyses to continuously monitor the four major types of hemoglobin.
Another NIH research project, involves developing monitoring technology to provide real-time methemoglobin fraction readings to clinicians that are based on the state of the patient’s hemodynamic condition. Methemoglobinemia is a disorder often found in individuals exposed to not only environmentally but from work-related chemical exposures and also from exposure to pharmaceutical agents such as local anesthetics, acetaminophen, and drugs containing nitrates and/or nitrites.
Children especially under four months are particularly susceptible to methemoglobinemia and it is estimated that about 8 percent of newborns in neonatal intensive care units suffer from the problem.
The researchers are working on a reliable, noninvasive, and cost effective sensor to provide real-time methemoglobin fraction readings to clinicians based on the state of the patient hemodynamic conditions. The current technology used is invasive and does not provide real-time results. The new optically analyzed technology will be especially useful in neonatal care units since it is sometimes difficult to assess neonates intravenously.
The company is involved in other ongoing research. One project has researchers working on a device to detect intravenous infiltration when the leaking of fluid from an IV line goes into surrounding body tissues. This means that the patient experiences pain as the liquid meant to enter the blood stream instead leaks into body tissue. Such leakage can lead to necrosis requiring amputation, and even death in the most severe cases.
In addition, researchers are developing tissue perfusion and blood flow monitoring technology plus they are working on an advanced Laser Speckle Imager to monitor the progression of wound healing in diabetic patients when undergoing hyperbaric oxygen treatment therapy.
For more information, go to www.cwoptics.com or call (757) 872-4000.
The Iowa Department of Public Health (DPH) released a Request for Information (RFI) seeking options on developing and implementing a patient-centric Health Information Exchange with web-based technology to support the statewide Iowa e-Health project.
The information will be used to provide background data for a possible Request for Proposal that may be issued at a later date. Essentially the purpose for this RFI is to let interested vendors present their ideas to DPH on systems that are currently available and systems that are under development.
Information is needed for the following:
- A hybrid infrastructure model
- Processes and technology to locate and match patient information in the absence of a single, standardized patient identifier
- Security controls to authenticate users and to monitor system activity
- Technical standards for interoperability, privacy, security, and disaster recovery
- Provider and patient portals
The RFI must be submitted by July 27, 2009. For more information, contact Dale Anthony, CIO, at firstname.lastname@example.org or call (515) 281-3216.
Tuesday, July 14, 2009
When the nursing home opened in 2001, it was the first in the nation to offer specialized care to people with Parkinson’s and other movement disorders in a nursing home setting. For years, the Parkinson’s patients at the home would typically make 10 trips a year to Syracuse, Albany, or Rochester to see a movement disorders specialist. The trips were exhausting for the home’s elderly patients.
Tony Joseph, the Administrator of the home approached URMC Ray Dorsey, M.D, a neurologist and his colleague Kevin Biglan, M.D, to find a solution as he was familiar with their work with the Parkinson Support Group of Upstate New York.
The solution to the problem already existed at the URMC, since the medical center has one of the largest “Movement and Inherited Neurological Disorders” program in the nation with more than 10 physicians and is designed as a Center of Excellence.
Patients are brought to a room in the nursing home with a flat screen television so they can see the physicians. All that is required by the doctors in Rochester is a computer equipped with a web camera. Telemedicine visits consist of an update on the patient’s health, a review of medications, any potential complications, and a standardized motor skills evaluation consisting of balance, gait, coordination, and stiffness. This examination is conducted by the physician with the assistance of a trained nurse at the home. At the end of the visit, recommendations are discussed with the patient.
An initial pilot project funded by the nursing home followed 14 patients for 6 months and then evaluated the outcomes of those who received telemedicine care with those that did not. The study found that telemedicine patients had significant improvements in quality of life and motor function. In addition, those receiving telemedicine were satisfied with their care.
The project was so successful that Joseph decided to continue funding the effort for another year with the help of a grant from New York State. Doctors Dorsey and Biglan also hope to expand the project to other nursing homes in upstate New York. According to Dr. Biglan, this is a serious problem as statistics show that the number of people with Parkinson’s will double over the next 25 years.
However, one of the biggest obstacles concerning the doctors involved in the program is the issue of reimbursement to pay for the telemedicine services needed. Currently, reimbursement is limited to certain areas and the town of New Hartford is not considered sufficiently rural.
The development of the PVAD builds on the innovative work of Dr. James Antaki, co-investigator and project director for the NIH grant supporting the research. The leaders on the development team are designing a device that will meet the special needs of patients with congenital and acquired heart defects who are as young or as small as newborn babies.
So far, the availability of VADs for use in infants and young children is extremely limited with no device specifically approved for use in this age group in the U.S. The team with 20 members is diligently working to fill the current technology void in this field to provide medical devices for the tiniest patients in need of heart surgery.
Dr. Harvey Borovetz, the team’s lead and co-principal investigator on the five year $4.5 million NIH grant said, “The smallest of our patients have the greatest need for the device because the only means of support available to them is ECMO which has unacceptably high mortality and complications rates. We hope to be able to develop a device that will allow more babies with congenital heart defects or end-stage heart disease to be able to survive to transplantation, or perhaps even recover cardiac function and avoid the need for transplantation.”
The specific goal is to develop a miniature centrifugal pump using suspended magnetic levitation technology for use in babies between 5 and 35 pounds. The team plans to develop a smart control system that will indicate patterns consistent with a recovering heart. Since the device will be fully implantable with a small lead to an external power supply, children supported by the device will be able to be mobile and active.
The Center has $3.4 million available annually in grant and matching funds from the Department of Veterans Affairs, and is one of four new Veterans Engineering Research Centers. Other partners include MIT, Worcester Polytechnic Institute, and several VA Centers of Excellence.
According to James Benneyan, Executive Director of NEHCEP, the idea is to leverage the broad expertise of the VA and academic partners to embed engineering improvement methods and principles into the fabric of the VA healthcare system. The ultimate goal is to create cross-educated engineers and healthcare professionals.
Housed within the Boston VA Healthcare System, NEHCEP will serve the New England network of eight medical centers and 37 community-based outpatient clinics to provide care to 1.2 million veterans. NEHCEP will use advanced mathematical and computer modeling methods to analyze, improve, and optimize various types of processes to significantly improve specific concerns such as access, waits and delays, safety, optimal care, efficiency, equity and effectiveness related to healthcare.
For more information, contact Jenny Catherine Eriksen at 617-373-2802 or email email@example.com.
SAMSHA plans to award grants totaling $2 million for up to one year. Individual grantees may get from $21, 467, to $113, 129 in funding depending on an allocation formula. These figures are based on the assumption that all 50 states and the District of Columbia will be approved for a NASPER grant, but the award range will increase if fewer states are approved.
Eligibility is limited to the Chief Executive in the states such as the Governor and in the District of Columbia that have enacted legislation or regulations that permit the implementation of a state controlled substance monitoring program.
The grants will be administered by SAMSHA’s Center for Substance Abuse Treatment. To apply, call 1-877-SAMSHA or contact Jennifer Fan at 240-276-1759 or email Jennifer.firstname.lastname@example.org. The application deadline is July 27, 2009.
Sunday, July 12, 2009
CIMIT is a clinically based consortium of Boston area hospitals and engineering schools working with multidisciplinary teams to develop medical devices and clinical technology system applications. The goal is to solve medical problems by developing innovative technologies. CIMIT exhibited their new technologies at the USAMRMC and TATRC 2009 technology exposition.
A group of researchers Fred Chen, Henry Wu, Pei-Lan Hsu, Brad Stronger, and Hongshen Ma from MIT and Robert Sheridan, M.D., from Shriner’s Hospital-Children and MGH, demonstrated a wireless adhesive-electrode-free autonomous ECG acquisition system. The team realizes that for trauma patients, time is critical, but so is continuous monitoring, but the problem is that it takes valuable time to attach the diagnostic equipment and to make sure that it works.
The research team created a silastic sensor to monitor ECG and the sensor is placed on a stretcher to automatically scan the patient using off-the-shelf materials. By using the sensor, the research team is able to acquire ECG signals for different body orientations which can be essential when cardiac monitoring is needed for trauma patients in a hospital or in a disaster setting.
In addition, the system called the “SmartPad” can be used to monitor trauma casualties during medical evacuations and important to use in austere settings where using more cumbersome ECG machines may not be practical. Forward Surgical Teams and combat support hospitals would find the system ideal for continuous monitoring.
Lino Becerra, PhD, Edward George, M.D., PhD, and Gary Brenner Borsook M.D, PhD, at MGH, studied how patients that are aware and in pain during anesthesia or sedation can experience problems afterwards such as PTSD. The research solution was to develop technology to detect brain cortical activity associated with pain and consciousness by using Near Infrared Spectroscopy (NIRS). NIRS demonstrated at the meeting is non-invasive and provides real-time evaluation of pain and consciousness. It can be potentially used to mitigate the incidence of surgical-related PTSD as well as monitor pain with soldiers that are unable to communicate.
The State Broadband Data Program under the Recovery Act requires that the National Telecommunications Information Agency (NTIA) within the Department of Commerce to develop and maintain a comprehensive and interactive national broadband mapping program.
Stimulus funding provides $350 million in grants to develop and maintain a broadband inventory map. NTIA expects grant awards to range between $1.9 million and $3.8 million per state for the mapping portion of each project. Up to $500,000 will be available for the planning portion of each project.
The State Broadband Data Program will fund projects to:
- Gather comprehensive and accurate state-level broadband mapping data to be used to develop maps
- Aid in the development and maintenance of a national broadband map
- Fund statewide initiatives for broadband planning
The applications will be accepted from July 14th to August 14th and must be submitted to http://www.grants.gov/. For more information, contact Edward “Smitty” Smith, Program Director, State Broadband Data and Development Grant Program at 202-482-4949. The full announcement can be located at http://www.grants.gov/ and in the July 8th Federal Register.
The Connect Minnesota broadband map was created through a collaborative, public-private approach to broadband mapping as prescribed by Congress in the Broadband Data Improvement Act of 2008. The map illustrates broadband service availability based on information from all types of providers across Minnesota, and shows where the service gaps are located that remain in rural and other hard to reach locations.
Through a rigorous system of broadband data collection, GIS analysis, and data verification, the mapping project shows that broadband service is currently available to 94% of Minnesota households statewide. This leaves 97,282 Minnesota households that are not served by any broadband provider.
Connected Nation a national non-profit organization conducted a recent study to study the impact of public private broadband expansion programs funded through the Broadband Data Improvement Act and ARRA. The study found that a comprehensive grassroots driven program for increased broadband access and used in Minnesota could result in a total economic impact of $2.8 billion through the creation of more than 48,000 jobs and result in cost savings in areas such as healthcare, the environment, and by telecommuting.
Governor Timothy Kaine unveiled Virginia’s first broadband availability map now available online. The state coverage map resulted from recommendations made by the Broadband Roundtable convened by the Governor in 2007 to plan to develop at no cost to the state a last mile telecommunications blueprint.
The development of the map is a collaborative effort between the Center for Innovative Technology, the Virginia Information Technology Agency, the Office of Telework Promotion and Broadband Assistance, and the voluntary participation of more than 25 broadband providers throughout the Commonwealth.
Commonwealth officials are actively monitoring the situation and are working to position state projects for broadband funding opportunities. The Governor’s Broadband Advisory Council will keep advising the Governor on policy and funding priorities related to broadband access in the state.
The “Healthcare Innovation Zone (HIZ) Program Act of 2009” (H.R 3134), introduced on July 8th in the House by Allyson Y. Schwartz from Pennsylvania would establish a new pilot program. The funding to be made available from HHS would use stimulus funding to award at least 10 but not more than 25 grants for not less than $250,000 or more than $1,000,000 per grant.
The HIZ as described in the legislation would be an integrated healthcare delivery network to work with local employers, community leaders, and private and governmental payers in a geographic region. The network would provide a full spectrum of care, including inpatient, outpatient, post-acute, and preventive care to all including Medicare beneficiaries. An academic medical center would be included to provide care.
The HIZ Planning Grants as provided for in the legislation would help and make it possible for eligible entities such as healthcare institutions, providers, academic medical centers, group practices, and other clinical organizations to research and prepare an HIZ model plan.
The model plan must provide:
- A description for innovative models of care to improve quality and decrease costs
- A provider network to provide the full spectrum of care
- A target population to support and participate in an HIZ demonstration
- A mechanism to provide for information sharing among the HIZ participants
- A description of how the HIZ would incorporate the training of the next generation of physicians, nurses, and allied health professionals
- A description of how the HIZ would be governed
- A description of non-financial barriers to innovation that will need to be addressed
- A process for data reporting and how to provide for annual site visits
- A set of indicators to help track performance and the success of the HIZ model plan
- A description of how to involve the community and external experts to monitor the success of the HIZ model
- Payment options to address funding mechanisms and how the HIZ would distribute funds to the participants
The legislation was referred to the House Energy and Commerce Committee and to the House Ways and Means Committee.
Wednesday, July 8, 2009
Grants up to $35,000 per facility will provide funding for programs to implement creative and replicable methods to improve the quality of patient care. Initiatives funded include targeted screening for methicillin-resistant staphylococcus aureus (MRSA), strategies to improve hygiene, electronic medical record implementation, and medication safety and reconciliation projects.
The grants were awarded based on the National Quality Forum’s priority areas on eliminating healthcare-associated infections (HAIs), specifically MRSA and C. difficile infection prevention and management. The idea is to reduce ventilator-associated pneumonia, surgical site infections, and blood site infections to zero. The goal is to concentrate on medication safety ranging from prescribing correct medications to ensuring the right medication gets to the right patient at the right time, plus assuring that the information is communicated and understood at key transition points.
Several centers received funds to see how electronic records can improve safety for patients. The North Shore University Health System in Evanston, Illinois received funds to specifically reduce catheter-associated urinary tract infection rates by using observation teams along with EMRs to study the problem. The North Shore Long Island Jewish Health System, Inc., in Great Neck, New York, will use the funds to develop a National Clinical Outcomes Database in Anesthesiology. The Scripps Whittier Diabetes Institute in La Jolla, California will develop a system wide standardization of glycemic control protocols.
AHRQ wants to hear from small and medium-sized practices on how they are studying or redesigning their workflow either before or after HIT implementation. The agency is interested in information on tools, methods, technologies, and the data reporting procedures used to analyze and possibly improve the delivery of healthcare in such settings.
In addition, AHRQ not only wants to hear from small and medium-sized healthcare practices or clinics but the agency also wants to see comments and opinions from workflow or health IT experts, vendors, professional associations, and others that have developed and or used workflow analysis or redesign tools.
Information is needed on:
- Number of physicians, providers, and staff in the practice or clinic
- Number of patient visits in the practice or clinic in 2008
- Any ancillary services located on-site at the practice or clinic. Examples can include lab, radiology, PT, occupational and speech therapy, and pharmacy
- Specific health IT applications and software that have been used in EMRs
- The use for each health IT application
- Tools used to perform process analysis, flowcharting, task analysis
- How to avoid the pitfalls of using complicate or inappropriate tools and software
- Impact of health IT on the organization and on workflow
- Support that helped during the implementation of IT
- The success for interfacing health IT applications
- Impact of health IT on job satisfaction, efficiency, workload, decision making, quality, and costs
- How health IT impacts communication in the practice, clinic staff, or external healthcare organizations
The comments are due by August 24, 2009 and should be sent to workflowRFI@ahrq.hhs.gov.
In general, the military’s science and engineering research programs are focused on designing the soldier system of the future to cross disciplinary boundaries, to focus on protection, injury intervention and cure, and to improve human performance.
Last year, the Department of Defense created the Armed Forces Institute of Regenerative Medicine made up of two multi-institutional consortia with $85 million to fund the effort. One consortia led by Wake Forest University, and the University of Pittsburgh, and the other consortia led by Rutgers University and the Cleveland Clinic will move forward on research efforts. The U.S. Army Institute of Surgical Research is working with both groups.
Progress is being made. For example, the Wake Forest Institute for Regenerative Medicine has developed a computer-controlled system to build properly organized muscle tissue in the lab. To do this, human muscle cells are attached to strands of collagen or connective tissue. They are then subjected to cyclic stretching in a bioreactor, which simulates the conditions of the human body. The preconditioning allows the cells to align in one direction to form muscle bundles and function like normal muscle.
Also, Wake Forest and the McGowan Institute for Regenerative Medicine are working to develop clinical therapies over the next five years that will focus on burn repair, wound healing without scarring, craniofacial reconstruction, limb reconstruction, regeneration or transplantation, and compartment syndrome a condition related to inflammation after surgery or injuries.
To further address these regenerative research issues, the Center for Advanced Bioengineering for Soldier Survivability (CABSS) has been established in the College of Engineering (COE) at Georgia Tech. Research funds for CABSS will enable partnerships to develop to include investigators in regenerative medicine and cranial and maxillofacial surgery at Morehouse College of Medicine, Children’s Healthcare of Atlanta, Emory University, and the Medical College of Georgia. These education institutions will combine their expertise to work with the engineering faculty at Georgia Tech.
Priorities of CABSS involve doing research on the healing of segmental bone defects, improved healing of massive soft tissue defects, improved wound healing, tissue viability assessment, and wound irrigation. In addition, the Army is funding research to study demographic and injury data on the battlefield, long-term outcomes of casualties, how to improve pre-hospital care for orthopedic and craniofacial injuries, and how to develop novel light weight materials for use in integrated robotic prostheses.
There remains the critical need for technologies to transfer into medical products which are safe and effective. To accomplish these goals, research teams at CABSS will include clinicians with expertise in combat medical care, and biomedical engineers and bioscientists with industry and regulatory expertise to shorten the process from invention to clinical use.
Dr. Barbara D. Boyan, COE Associate Dean for Research and Price Gilbert, Jr. Chair of Tissue Engineering is leading the new CABSS center. Funding is available from DOD’s Institute of Surgical Research, the Orthopedic Trauma Research Program, and the Armed Forces Institute of Regenerative Medicine, as well as from corporate partners. Dr. Boyan’s goal is to establish funding for developing new technologies. In addition to musculoskeletal tissues, CABSS will investigate the interface between materials and nerve cells to enable the development of robotic prostheses to integrate directly with the patient’s tissues.
To bring the research together, a coalition of universities, life sciences companies, healthcare investors and patient advocates with the common goal for advancing cell-based therapies all united on July 1, to launch the Alliance for Regenerative Medicine. The organization located in Washington D.C., will promote regulatory, research, and study how reimbursement policies can help foster innovation in regenerative medicine.
AHRQ envisions using a practice-based orthopedic registry across a broad provider network to define short and long term benefits and to help determine if implantable orthopedic devices and are harmful. The applicant is expected to form the core of the registry—a Research and Data Coordinating Center containing an infrastructure involving at least 5 separate clinical centers.
The Agency not only encourages community-based small practice sites to apply but in addition high volume institutions are encouraged to participate in the registry. State, county, city, and Native American tribal governments are eligible to apply along with public, state, and private institutions of higher education.
The grant application is due on September 23, 2009. There will be one award for $3,000,000 in FY 2010, and there are plans to award a total amount of up to $12,000,000 over four years.
For more information on (RFA-HS-10-008), go to www.grants.gov.
Roshan has teamed with Cisco, the Afghanistan government, Aga Khan University Hospital, Karachi (AKUH), French Medical Institute for Children (FMIC), Aga Khan Health Services, and other technology suppliers.
The Bamyan region in Afghanistan has some of the highest levels of maternal and child mortality in Afghanistan. For every 22,000 births, there are 382 maternal deaths and 3,937 infant deaths. The hospital established in 2001 has grown from 30 beds to the present capacity of 74 beds. An estimated 514,698 people are served by the hospital on an annual basis.
The project already links FMIC in Kabul to AKUH in Karachi Pakistan and now the second phase links BPH to FMIC. Today more than 340 patients have benefitted from medicine and more than 231 Afghan medical personnel have participated in diagnostic and training opportunities.
Plans are for telemedicine links to be extended to other provincial hospitals and eventually to medical institutions in Europe and North America. The initial service provided teleleradiology and now an average of 40 teleradiology cases are evaluated monthly between FMIC and AKUH. Eventually, telemedicine capabilities will be expanded to other rural regions of Afghanistan and will include the use of smart-phones and PDAs. Over the next three to five years, Roshan is planning to invest $1.5 million in the telemedicine project.
Sunday, July 5, 2009
The Recovery Act provided a total of $7.2 billion to go to the USDA Rural Utilities Service (RUS) and to the Department of Commerce’s National Telecommunications and Information Administration (NTIA) to accelerate broadband deployment.
NTIA established the “Broadband Technology Opportunities Program” and will use 4.7 billion of the $7.2 billion to not only provide broadband where it is needed in un-served and underserved communities, but also to expand public computer center capacity and encourage sustainable adoption of the service.
RUS will invest $2.5 billion to deploy broadband to rural communities where it is needed. RUS established the “Broadband Initiatives Program” to extend loans, grants, and loan/grant combinations to facilitate broadband deployment in rural areas.
NTIA and RUS will be accepting applications for loans, grants and loan/grant combinations to be awarded by each agency under a single application form. This collaborative approach will ensure that the agencies activities are complimentary and integrated. This is the first of three rounds of funding that will be provided.
Applications will be accepted from July 14, 2009 until August 14, 2009. For more information, go to www.usda.gov/recovery , www.commerce.gov/recovery, and www.recovery.gov
For example, the Johnson Health Center in Lynchburg Virginia will divide approximately $700,000 in funds to use for information technology, dental equipment and for renovations. Several health centers in Dayton Ohio received $250,000 to buy an electronic medical record system and will also use the funds for renovations. Reno and Carson City in Nevada will use $3 million for construction at the centers, but also to purchase advanced health IT.
In the next 100 days, funding will enable 1,129 health centers in 50 states and eight territories to provide services to 300,000 patients. This includes treating more than 16 million patients, providing 2.8 million with dental services, and 617,000 with mental health care. The health centers employ more than 100,000 in underserved communities.
One study shows that a large portion of costly emergency room visits could have been redirected to a health center where the care can be as good or better and can be more effective than in other facilities. The lead author for the study was Dr. George Rust, Director of the National Center for Primary Care and a Professor at the Morehouse School of Medicine in Georgia. The study specifically acknowledges that health centers work well at managing and reducing chronic conditions, such as diabetes, hypertension, and asthma.
For a complete list of grantees listed by state, go to www.hhs.gov/recovery.
The survey was conducted March 2009 with 1,943 out of 12,000 APIC members responding. Three quarters of the people that responded to the survey work at acute care hospitals, with responses received from all sizes of facilities and hospitals.
According to the survey, three-quarters of those whose budgets were cut experienced decreases for the necessary education to train healthcare personnel in preventing the transmission of HAIs. Half saw reductions in overall budgets for infection prevention, including money for technology, staff, education, products, equipment, and updated resources. Nearly 40 percent had layoffs or reduced hours, and a third experienced hiring freezes.
The survey also found that only one in five respondents have data mining programs that allow infection preventionists to discover and investigate potential infections in real-time, enabling them to intervene quickly. Nearly two-thirds of respondents have one or less than one full-time staff person dedicated to infection prevention, while almost 90 percent have zero or less than one full-time staff person for clerical or analytic support.
“We are concerned by these findings,” said APIC 2009 President Christine J. Nutty, RN, MSN, CIC. “At a time when the federal government will be requiring hospitals to meet national targets for HAI reduction and infection prevention, departments at our nation’s healthcare facilities need to be growing, not shrinking.”
Therefore, the APIC recommends using surveillance technologies to help remedy the situation. The systems can be invaluable to streamline and facilitate the efficient review of relevant data, reduce infection prevention department time spent on surveillance and clerical tasks, and help with regulatory compliance.
The APIC recently released position paper “The Importance of Surveillance Technologies in the Prevention of Healthcare-Associated Infections” enforces the benefits of using automated surveillance to improve efficiency in terms of personnel and enforces the idea that as gains in efficiencies are achieved and more time is spent in prevention and intervention, healthcare administrators will see the added value of effective infection prevention programs.
Although the peer review literature is still limited on the cost effectiveness associated with electronic surveillance systems, two studies demonstrated substantial cost-effectiveness. Case reports from facilities or groups using electronic tools have reported significant reductions in infections and subsequent significant cost savings.
The National Council on Disability (NCD) funding opportunity “Keeping up: Technology’s Rapid Changes and Effects on People with Disabilities” is going to evaluate how Americans with disabilities are faring in this new digital media age. NCD hopes that the report resulting from this funding opportunity will help to motivate and drive the development of new technologies for employed people with disabilities.
The idea is to examine the accessibility of new media, look at the technologies developed, study successful document development, understand consumer needs, and identify the barriers to transferring the technology for employment purposes. The research will try to provide technology developers with knowledge on how their complex products can be developed in a cost effective way for the market and at the same time increase the employment for people with disabilities.
The advent of digital media offers both blessings and challenges to Americans with disabilities from an accessibility of information standpoint. Digital television offers opportunities and challenges regarding captioning. Unlike analog closed captions, digital caption capability provides tremendous flexibility and a new level of user control over caption display. However, set design, remote control design, and transmission within cable systems are all critical factors that can determine whether captioning can be used at all.
Similar issues exist regarding video description in that the system for transmission must be implemented and viewers must learn to access it. Education of viewers and implementation by broadcasters are necessary for digital television to be available to people with disabilities. Digital radio also can offer challenges especially for people who are deaf or hard of hearing but offers the first opportunity to receive radio information in an accessible manner via captioning.
To meet the needs of the disabled, Microsoft Corporation has joined with industry and advocacy group leaders worldwide to launch new software that will make it easier for anyone to create documents and content that will be accessible for people who are blind or have vision disabilities.
However, some of the major questions to be answered are:
- How can technologies be used to improve the employment outlook for people with disabilities?
- How can universal design principles be incorporated?
- What are the policy barriers in federal assistive technology policy that could prevent the availability to assistive technology devices and services?
- What kind of technical assistance can be provided to employees to increase knowledge of new technologies?
All potential applicants are eligible. The anticipated type of award is a Cooperative Agreement with estimated funding of $150,000 for one award. The due date for the Funding Opportunity is August 7, 2009 with the project scheduled to start September 2009.
For more information on Funding Opportunity (09-04), contact Joan Durocher Senior Attorney/Advisor, NCD by email at email@example.com.