Sunday, November 29, 2009

West Virginia Issues RFP

A Request for Proposals (RFP#HCC09) issued by the West Virginia Health Information Network (WVHIN) seeks vendors to provide a statewide Health Information Exchange for physicians, hospitals, other healthcare organizations, and consumers.

West Virginia has a population of 1.8 million people living in very rural areas. To serve this rural population, a relatively high number of hospitals have less than 100 beds, and a high level of clinics are serving the underserved. Based on the population profile and the number of small providers, a strong case has been made for the need for a statewide HIE.

WVHIN has set a goal for 60 to 75 percent of the physicians in the state to adopt EMRs or EMR- like products with connectivity to the network. Many physicians will be purchasing their own EMRs or will have access to high end EMRs through hospitals, Medicaid-sponsored resources, IPAs, and health plans. Many of these EMRs will have the capacity to achieve “meaningful use” as defined by the HITECH provision in ARRA.

However, there will be two additional groups of physicians that will also need to connect to the network. The first group with small paper-based practices will probably not easily adapt to EMR utilization. They will need very low cost and very easy to use entry-level products to help them migrate to a more fully functioning EMR and assistance to achieve “meaningful use”. The second group consists of practices that are currently electronic and using a Practice Management System but yet these practices will need assistance to achieve “meaningful use.”

The RFP contains three tiers with Tier 1 to provide for a set of entry level, very low cost, and easy to use integrated applications that are retrievable through the network. Tier 2 also requires very low cost easy to use applications to be integrated into the Tier 1 tools if feasible, and Tier 3 will provide for advance functionality to be integrated into the Core Exchanger User tools to include PHRs, CPOE, a registry, and clinical decision support.

In addition, the West Virginia Health Information Technology Regional Extension Center is applying for ARRA funding to be able to join with WVHIN to assist providers in implementing their electronic health information technology.

The proposal is due on January 15, 2010 with the vendor to be announced in April 2010. For more information, go to and click on Request for Proposal. The WVHIN Purchasing agent is Helen Wilson at

State Receives Funds

CMS announced that the Medicaid program in Iowa is the first state to receive federal matching funds to develop a plan on how Medicaid incentive payments would be used to help implement the EHR incentive program in the state. The incentive program established by the Recovery Act will provide the state with $1.6 million.

The federal matching funds awarded to Iowa will be used to determine the current status of HIT activities in the state, to gather information on existing barriers in using EHRs, and to study the state’s provider’s eligibility for EHR incentive payments. The state is also going to assess the incentive payments needed to get Medicaid recipients started using PHRs.

CMS requires all the states to receive prior approval for any initial planning activities if they want to be eligible for the 90 percent FFP match. The states are also required to develop a State Medicaid HIT Plan that defines the state’s vision for long term HIT use. The state plan requires the states to describe not only how their incentive program will be used to integrate current and planned Medicaid HIT assets, but also how their plan fits into the larger State HIT/HIE Roadmap.

“While Iowa is the first state to receive approval of its plan for implementing the Recovery Act’s EHR Medicaid incentive program, a number of other states have submitted plans as well”, said Cindy Mann, Director of the Center for Medicaid and State Operations at CMS.


After submitting an application to the Maryland Health Care Commission, the state’s “Chesapeake Regional Information System for our Patients” (CRISP) was selected to implement and operate a statewide HIE. In August 2009, CRISP received $10 million in start up funding through the Health Services Cost Review Commission to be used over the next two to five years to build the HIE. As a result in November, CRISP issued a Request for Proposals looking for vendors to help implement and operate their statewide Health Information Exchange (HIE).

CRISP is a not-for-profit membership corporation whose organizational members are Erickson Retirement Communities, Johns Hopkins Medicine, MedStar Health, and the University of Maryland Medical System.

This RFP is currently soliciting bidders to provide health information exchange core infrastructure solutions for the state. The HIE system resulting from this RFP will use a hybrid technology approach, allow consumers to have access to and control over their health information, enable a HIE to be built that is consistent with emerging national technology standards, develop a financially sustainable HIE, and enable the HIE to focus on the medically underserved.

To pursue their objective to develop the HIE, CRISP set up a three stage technology procurement process that included an RFP for Medication History and ePrescribing an award that is pending, and a RFP for a Master Patient Index that is currently being reviewed. Both of these previous RFPs required that the resulting technologies have the ability to be integrated into the current RFP that is soliciting bidders for the HIE Core Infrastructure project.

The RFP is due on December 16th. For more information and to download the RFP, go to For questions, email

VA & Kaiser to Share Records

The Department of Veterans Affairs and Kaiser Permanente are launching a pilot program to exchange electronic health record information using the Nationwide Health Information Network (NHIN). The pilot program will connect Kaiser Permanente HealthConnect ® and the VA’s electronic health record system VistA. These are two of the largest electronic health record systems in the country.

“Utilizing NHIN’s standards and network will enable organizations like the VA and the Department of Defense to partner with private sector healthcare providers to promote better, faster, and safer care for veterans,” according to the Secretary of Veterans Affairs, Eric K. Shinseki.

This week the VA and Kaiser will contact veterans in the San Diego area that receive care from both institutions to participate in this first-ever pilot program. This will enable the participating veterans to provide their records to both their public and private sector healthcare providers and enable their doctors to share specific health information electronically.

The program will guard patient privacy, provide for data security, plus the individual patient will need to give permission for others to see their records. The veterans’ access to care will not be affected at either institution if they choose not to participate.

The initial pilot is planned to begin mid December 2009 with the Department of Defense to be included in the next phase of the pilot program in early 2010.

$80 Million to Support Workforce

“Ensuring the adoption of electronic health records to use to exchange information among healthcare providers and public health authorities and to redesign workflows within healthcare settings, all depends on having a qualified pool of workers,” said Dr. David Blumenthal, HHS National Coordinator for Health Information Technology.

The agency has plans to make $80 million in grants available to help develop and strengthen the HIT workforce. The grants include $70 million for community college training programs and $10 million to develop educational materials to support these programs. These grants are the first in a series of programs to help strengthen and support the health IT workforce.

The Community College program will establish intensive, non-degree training that can be completed in six months or less by individuals that have a background in healthcare or in the IT fields. Participating colleges will coordinate their efforts through five regional consortia that will span the nation.

Sunday, November 22, 2009

HIT Progress Discussed

The “e-Health Policy Congressional Luncheon Seminar” took place on Capitol Hill November 19th, to discuss the Administration’s activities relating to health information technology. The speakers focused on legislation affecting the field, HIT workforce development, HRSA’s grant programs, HIT Policy Committee and Standards Committee’s plans, funding for community health centers, and in general, discussions centered on what is ahead for the health technology community.

Neal Neuberger, Executive Director of the Institute for e-Health Policy and moderator, reported that since 1993, the Congressional Steering Committee has held more than 130 briefings plus technology demonstrations to discuss telemedicine, eHealth, and HIT. As Neuberger said, “The sponsoring senators and representatives and their staffs have played an important role in enabling the seminars to continue and to keep providing invaluable information.”

He mentioned several bills presently under consideration. One of the bills introduced by Senator Tom Udall (D-NM) is the “Rural TECH Act of 2009” to improve community health. The bill would establish three telehealth pilot projects in place to analyze clinical health outcomes and the cost effectiveness of telehealth systems in medically underserved and tribal areas.

In addition, the bill would expand access to stroke telehealth services under the Medicare program, improve access to “store and forward” telehealth services in IHS and federally qualified health centers, and reimburse IHS facilities as originating sites.

Other bills mentioned at the briefing would help healthcare providers purchase electronic health records. The House just passed the Small Business Health IT Financing Act (H.R 3014). A similar bill was also introduced by Senator John Kerry (D-MA) to enable SBA to make loans to help providers to purchase hardware, software, and other technology to support EHRs. Both bills would allow $350,000 for any single qualified eligible professional and $2,000,000 for a single group of affiliated qualified eligible professionals.

In another recent legislative move, the “Small Business Early Stage Investment Act” (H.R. 3738) that passed would provide grants to help finance early stage small businesses in targeted industries such as information technology, life sciences, and digital media. The grants are not to exceed 100,000,000.

Several members of Congress stopped by the briefing. Representative Patrick Kennedy (D-RI) reports that in Rhode Island there is a high rate for e-prescribing usage with 70 percent of healthcare providers in the state on the way to adopting electronic records.

Representative Kennedy continued to say, “Consumers are beginning to realize that they have a tremendous stake is seeing their EHRs and PHRs integrated. Today if everyone had a PHR it would really be beneficial and help the country deal with the current flu pandemic. To deal effectively with this worldwide health issue, we need to be interconnected and have readily available information on the ever changing flu situation. Interconnecting EMRs and PHRs would make it possible for everyone to be interconnected not only nationally but globally.

Representative David Wu (D-OR) Chair of the House Science Committee’s Subcommittee on Technology and Innovation, has been a strong leader and proponent along with other groups to bring HIT workforce training to the forefront. It is estimated that 40,000 rural health workers will be needed in the near future with others in the field making higher estimates.

He also pointed out the important role that standards play. The National Institute for Standards and Technology (NIST) is working full force on developing the standards needed with the $20 million they received from HHS.

According to Johanna Barraza-Cannon, Director, Division of Health IT Policy, Office of Health IT, at HRSA, HRSA is working very hard to expand the use of HIT. Recently, $27.8 million went to health center-controlled networks and large multi-site health centers to implement electronic health records and other health information technology innovations.

Specifically, funding is supporting EHR implementation and grants totaling more than $2.6 million and to help grantees implement a variety of HIT innovations, including the creation of health information exchanges. Another five grants totaling over $2.5 million will help health centers use EHRs.

Barraza-Cannon reported that HRSA provides assistance to help healthcare professionals by providing technical assist tools, conducting workshops and webinars, helping others to select EHRs, educating consumers, and providing a web site at to help interested parties find a network.

Christine Bechtel, Vice President for the National Partnership for Women & Families, explained how she is sometimes questioned as to how her organization relates specifically to health issues. She pointed out that her organization’s major effort is to help women and families in difficult circumstances provide economic security for their families. This means that it is very important for all women and families to have access to quality and affordable healthcare.

Bechtel, as a member of the HIT Policy Committee put in place to advise the Office of the National Coordinator (ONC) explained how the committee relates to the ONC and to the Standards Committee. She emphasized that the HIT Policy Committee makes recommendations to ONC on developing and adopting a nationwide health information infrastructure including standards for the exchange of patient medical information. Following that action, ONC then delivers the information to the Standards Committee.

She told the audience that the goal is to have a definition of “meaningful use” in place by 2011 with a proposed rule scheduled to be published by December 31. Request for public comments will follow with the final rule to be published.

Michael R. Lardiere, LCSW, Director, Health IT and Senior Advisor, Behavioral Health, National Association of Community Health Centers, informed the luncheon crowd that Community Health Centers serve 20 million people at more than 7,000 sites located throughout all 50 states and U.S. territories. In addition the Health Centers serve 20 percent of low income uninsured people, provide comprehensive care, and save the national healthcare system between $9.9 billion and $17.6 billion a year.

As Lardiere mentioned, health center-controlled networks are very important. For example, it was recently announced by HHS Secretary Sebelius that over $2 million alone would go to Colorado to fund health center-controlled networks and large multi-site health centers to implement EHRs and other HIT innovations. These funds are part of the $2 billion allotted to HRSA under ARRA to expand healthcare services to low income and uninsured individuals through the health center program.

He continued to say the plan is to use $1.5 billion for Community Health Center Capital Programs available from Recovery Act funding. So far, Capital Improvement Program Grants have funded 2,614 projects totaling $455,754,510 to provide construction repair, renovations, and equipment purchases including HIT.

Brian Wagner, Senior Director of Policy and Public Affairs, eHealth Initiative, oversees policy, government relations, and media efforts for the organization. He sees government successfully driving health technology, sees the benefits of using technology to outweighing the costs, but he also knows that it is essential for the user to be able to master the technology.

He looks to 2010 for a time when things in the field will start happening. For starters, the eHealth Initiative is going to hold their annual conference on January 25-26, 2010 at the Omni Shoreham Hotel in Washington D.C. to discuss and debate how to deal with the rapidly changing world of HIT. Discussions will be held on policies as to what is possible and what is practical.

The Conference will highlight how eHealth is being implemented across the country, and the plan for the country to move towards the universal “meaningful use” of health information technology by 2014.

New Jersey's Plans for HIT

ARRA funding includes $564 million to use for HIT planning and implementation activities conducted by the states. The Federal government has announced that it is distributing these funds through the “State Health Information Exchange Cooperative Agreement Program.” Each state will receive between $4 million and $40 million based on a formula.

Originally, planning began in January 2008, when the state of New Jersey created a HIT Commission to identify short-term priorities and long term goals to establish HIT in the state. The Commission brought together a broad base of stakeholders from across the healthcare industry to include clinical professionals, healthcare executives, health information technology experts, and several departments of state government.

The same legislation created the Office of e-HIT in the Department of Banking and Insurance. This resulted in the Commission and the Office of e-HIT working closely together to develop a state plan for electronic health records and health information exchanges.

According to a study conducted by Avalere with grant funding from the Robert Wood Johnson Foundation and Horizon Blue Cross/Blue Shield, there are several key findings that needed to be considered by the state when planning for HIT.

First of all, the state has higher than average hospital bed capacity and higher than average rates of hospital admissions, some hospitals are in relatively poor and declining financial conditions, there is a need for cost avoidance strategies, measuring quality is an issue, plus accessible measures are needed to assess the quality and efficiency of services provided in the state.

In addition, the physician community is fragmented and tends to be organized into solo or small group practices with little impact from the growth of managed care plans over the past ten years. There appears to be limited efforts at integration into larger groups specifically in areas of northern New Jersey.

The study found that the state is a net exporter of healthcare resources. This means that a higher percentage of New Jersey residents seek care from out-of-state providers compared to the number of out-of-state residents who travel to New Jersey for care. This has implications concerning the exchange of health information across health institutions and across state lines.

The “New Jersey Plan for Health Information Technology” recently finalized supports Medicaid funding for electronic medical records, supports Regional Extension Centers created under ARRA, supports Electronic Medical Records in physician practices, seeks broadband expansion, mandates the interoperability and expansion of community HIEs.

The state is supporting local and regional coalitions of medical providers through Health Information Exchanges with federal grants that will be administered by the state Department of Health and Senior Services. In August 2009, the state released a Request for Applications seeking regional health information exchange projects and accepted applications September 2009, and by October, the state began to seek funding from the federal government.

USDA Funds DLT Program

USDA announced that 111 projects for $34.9 million in grants will to go to 35 states to increase educational opportunities and to expand access to healthcare services in rural areas. The funding will be provided through USDA’s Rural Development’s Distance Learning and Telemedicine Program. The program’s goal is to help expand telecommunications, educational resources, and computer networks throughout rural communities. The funds are part of USDA’s annual budget and are not part of ARRA.

In general, the DLT grants going to health organizations and hospitals throughout the country ranged from $62,000 to $500,000. The grants went to facilities in Alaska, Alabama, Arkansas, Arizona, Colorado, Georgia, Hawaii, Iowa, Idaho, Indiana, Kansas, Kentucky, Maine Michigan Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Virginia, Vermont Wisconsin, West Virginia, and Wyoming.

Some of the specific funding examples include:

• Avera Health in Sioux Falls, South Dakota to receive $396.693 to provide video conferencing and telemedicine services to connect 16 rural hospitals and clinics to regional medical facilities in Sioux Falls, Yankton, and Aberdeen
• Georgia Partnership for Telehealth, Inc. to receive $436,218 to add 14 Tele-Trauma sites in the state
• Brazos Valley Community Action Agency in Texas to receive $233,831 to use telemedicine to help provide health and educational services in the surrounding counties
• Oklahoma State University for Health Sciences to receive $287,013 to establish video conferencing and other telemedicine equipment to use to consult with four rural clinics and to provide rural medical education
• St Anthony Hospital in Oklahoma to receive $493,638 to serve as a hub for six rural hospitals to provide for a video teleconferencing network, to introduce imaging and interactive consultations, and to provide medical education for emergency services
• Iowa’s Clarke County Public Hospital to receive $356,243 to purchase video conferencing equipment and devices to connect the hospital to local sites
• Baptist Health in Arkansas to receive $295,357 to fund a critical care medical network to connect six rural medical centers and a major hospital site in Little Rock

Tuesday, November 17, 2009

Broadband News

USDA’s Rural Utilities Service and Commerce’s NTIA released a joint Request for Information (RFI) seeking public comments on the Broadband Initiative Program and the Broadband Technology Opportunities Program. This is the second joint RFI issued by both agencies since the enactment of ARRA. The comments received will help the agencies gather information and help develop the second round of funding and must be received by November 30th.

In additional efforts to fund broadband, USDA has selected 22 projects in ten states to receive $13.4 million in broadband Community Connect grant funds. The grant program provides financial assistance to furnish broadband service in unserved, often isolated, rural communities. The grants are used to help critical facilities such as fire or police stations, while also serving the community. The project must also provide for a community center where community residents can obtain free broadband service for the first two years.

The grants will fund $564,000 to go to the Yurok Tribe located on a reservation along the northwest coast of California to provide for wireless broadband services to the reservation. A community center will be refurbished with free internet access to tribal residents. In addition to the Yurok Tribe, the Round Valley Indian Tribes of the Round Valley Indian Reservation in California also received $474,886 in funding.

The “Community Connect” program awarded Nexus Systems, Inc. with a $924,308 grant to provide wireless broadband services to Enterprise, Louisiana where the volunteer fire department and the community center will receive free broadband service for two years. Nexus Systems will also provide the community with web-based services such as web hosting and video conferencing services for public meetings.

Other states receiving “Community Connect” grants include Arkansas, Colorado, Idaho, Missouri, New Mexico, Oklahoma, Texas and Virginia.

The “Community Connect” program is also helping in Alaska. In 2006, the Alaska Power & Telephone Company received a $1,031,133 grant to establish a wireless broadband system in the Native community of Kasaan. In order to provide service to this remote Southeast Alaska community, the construction of an antenna system on a mountaintop was required and constructed.

The grant also provided laptop computers and video conferencing services to the community center where a server was installed so local residents could store personal files. The wireless service has improved connectivity and attracted a number of cellular telephone companies that came to the area to install infrastructure resulting in enabling residents to be able to use more dependable mobile telephone services.

With other USDA Rural Development funding, Bassett Healthcare in Cooperstown N.Y. now uses digital mammography via a broadband network to connect Cooperstown with three remote sites to a mobile mammography unit. Digital breast screening images are relayed instantly through the network, enabling oncology experts to consult with patients and other healthcare providers in real time.

This program started in 2006, when USDA awarded Bassett Healthcare a $500,000 telemedicine grant to help purchase the digital mammography equipment at four sites and helped them purchase a 40 foot long mobile mammography unit and build the broadband network. The mobile unit has greatly improved access to mammography screening for women living in Bassett’s rural 8,000 square mile service area.

In state activities, Governor Steve Beshear of Kentucky, has recently announced the launch of the “Coal to Broadband: Making the Transition, Making the Connection” program to bring broadband service to Breathitt, Estill, Lee, and Powell counties in the state. These counties are the bottom 25 counties in Kentucky to have broadband available. Both Breathitt and Lee counties are the two lowest served counties in the state, with both counties having below 50 percent availability of broadband to the home. Nearly 7,000 homes in the four counties do not have high speed internet available in the home.

The “Coal to Broadband” program will use multi county coal severance dollars along with Appalachian Regional Commission funds to bring broadband to the Eastern Kentucky regions.

NINDS Will Publish RFA

The National Institute of Neurological Disorders and Stroke (NINDS) will issue a Request for Application (RFA) to find applicants to redesign the “Parkinson’s Disease Data Organizing Center” (PD-DOC). There is a need for a resource to collect and share data related to clinical and transactional research on Parkinson’s disease and then to develop a centralized repository of the clinical data from both observational studies and clinical trials.

This resource is needed to:

• Serve as a repository for data from large clinical research studies in Parkinson’s disease, including clinical trials as well as epidemiological and genetic studies. Data is needed from academia, non-profit disease organizations, and industry and needs to include clinical as well as genetic, imaging, and neuropathology data elements

• Link clinical data with other data sets including imaging, pathology, genetic, and biospecimens in an easily searchable format

• Develop a flexible open source web-based data entry system to facilitate the design, implementation, and harmonization of new clinical research studies in Parkinson’s disease

• Serve as a centralized listing of Parkinson’s disease related resources for sample collection, antibodies, and animal models

• Provide outreach to promote data standardization, data sharing, and the usefulness of the PD-DOC resource as well as provide oversight of data access

NINDS anticipates a total budget of $5.5 million for the project for over five years. The RFA is expected to be published in December 2009 or January 2010 and applications will be due April 30, 2010.

For information on Notice (NOT-NS-10-003), email Wendy Galpern, M.D., PhD at Go to to read the full notice.

Enhanced Disease Surveillance

The United States Agency for International Development (USAID) in their “Emerging Pandemic Threats Program” (EPT) is building disease surveillance and training programs, especially for avian and pandemic influenza. The focus of the EPT program is to pre-empt or combat at their sources newly emerging diseases of animal origin that could threaten human health.

In recent times, 75 percent of all new human illnesses such as HIV, SARS, Avian Influenza, and H1N1 have emerged as a result of the convergence of people, animals, and our environment. The speed by which they can spread across the increasingly interconnected globe makes it difficult to identify, contain, and respond when new viruses first emerge. It is essential to identify these viruses before they move to full scale human to human transmission.

USAID just awarded the Academy for Educational Development (AED) a non-profit located in Washington D.C., a five year multimillion dollar cooperative agreement called “PREVENT”. The plan is to develop and implement effective behavior changes and communications interventions to reduce the risk of emerging zoonotic diseases.

“AED will work in emerging infectious diseases under the PREVENT agreement. With the threats from avian flu and now pandemic HINI influenza, more people recognize the critical importance that communication can play in helping to control disease outbreaks,” said Margaret Parlato, Senior Vice-President and Director of AED’s Global Health, Population, and Nutrition Group.

AED just released the code for GATHERdata™ which is a system to collect data that can shave off weeks of data reporting and analysis. With built in business intelligence modules, the system integrates data analysis and report generation into a seamless process. In tracking incoming epidemiological reports, the system can automatically send urgent messages to alert authorities of potentially dangerous situations.

Because it is open source, GATHERdata ™ reduces cost barriers that typically render this advanced technology out of reach for small organizations and institutions in developing countries. To support these users, AED is creating a web site for collaborative development of the GATHER code to be able to share the technology, new applications, and electronic forms.

Other programs within USAID working to detect and control outbreak responses are:

• The PREDICT program has a five year cooperative agreement with experts in wildlife surveillance at the University of California, Davis School of Veterinary Medicine, Wildlife Conservation Society, Wildlife Trust, the Smithsonian Institute, and Global Viral Forecasting Inc. The goal is to monitor geographic hot spots to identify the emergence of new infectious diseases in high risk wildlife

• The IDENTIFY program is working with the U.N. World Health Organization, U.N Food and Agriculture Organization and the World Organization for Animal Health through existing grants that will develop laboratory networks

• The RESPOND program has a five year cooperative agreement to work with Development Alternatives Inc., University of Minnesota, Tufts University, Training and Resource Group, and Ecology and Environment Inc., to focus on the development of outbreak investigation and response training

• The PREPARE program has a three year cooperative agreement with the International Medical Corps to provide technical support for simulations and the field testing of national, regional, and local pandemic preparedness plans

Advisory Committee Seeks Members

The Department of Commerce is seeking applications for members to serve on the National Advisory Council on Innovation and Entrepreneurship to advise the Secretary. The Secretary is looking for members who represent diversity in industry, have the right experience, and are located in different geographic areas.

Priority will be given to successful entrepreneurs, innovators, angel investors, venture capitalists, and other experts drawn from non-governmental organizations, foundations, and non-profits that have proven experience in innovation and entrepreneurship.

The Council will identify and recommend solutions to issues critical to help entrepreneurs and firms successfully commercialize new ideas and technologies into high-growth innovation-based businesses.

The November 11th Federal Register, at has more information. Information is available at (202) 482-5336 and applications can be sent electronically to Applications must be submitted by November 30th.

Sunday, November 15, 2009

NIH Registry Available

NIH’s National Center for Research Resources now makes it possible for individuals that want to participate in research studies to be matched and connected online with researchers doing studies that may be the right fit for them. This first disease-neutral volunteer recruitment registry called “” is a convenient user friendly matching model complementary to

“Participant recruitment continues to be a significant barrier to the completion of research studies nationwide. Recent NIH data indicates that just 4 percent of the U.S. population has participated in clinical trials. “ResearchMatch” is a tool that can improve the connection and communication between potential participants and researchers so that the public is able to contribute to advancing new treatments,” said NCRR Director Barbara Alving M.D.

The site located at places the burden of connecting the right volunteer with the right study to the researchers, whereas asks volunteers to identify the trials that could work for them.

“ResearchMatch” offers a convenient solution to the complex competitive and often costly participant recruitment system. NIH data indicates that 85 percent of trials don’t finish on time due to low patient participation and 30 percent of trial sites fail to enroll even a single patient,” according to Gordon Bernard, M.D., Principal Investigator of the Vanderbilt CYSA hosting the national registry.

After an individual has self-registered to become a volunteer, ResearchMatch’s security features ensure that personal information is protected until the volunteer authorizes the release of their contact information to a specific study that may be of interest to them. Volunteers are notified electronically when a possible match is found and at that time the volunteer can make the decision regarding the release of their contact information.

For the first year, only researchers affiliated with participating CTSA institutions are eligible to use “ResearchMatch.” However, plans are in place to make the system available beyond the CTSA consortium by 2011. Currently 52 individual institutions associated with 40 CTSA sites are part of the “ResearchMatch” network.

Legislation Introduced

On November 5th, Senator Tom Udall (D-NM) introduced the “Rural TECH Act of 2009” to enhance community health. As he said when he introduced the bill, “As we continue to move forward with healthcare reform, we must make sure that we do not leave our rural communities behind. In my home state of New Mexico, 30 out of 33 counties are designated as medically underserved. I only hope that we use technology to connect experts with providers, facilities, and patients in rural areas, so that critical healthcare services are extended to underserved areas across the country.”

The bill would establish three telehealth pilot projects to analyze clinical health outcomes and the cost effectiveness of telehealth systems in medically underserved and tribal areas. The first pilot would focus on using telehealth for behavioral health interventions such as post traumatic stress disorder and would also explore reimbursement methods for third party payers. A second pilot project would focus on increasing the capacity of healthcare workers to provide health services especially for chronic complex diseases in rural areas using knowledge networks like New Mexico’s Project ECHO. Also proposed is a pilot project for stroke evaluation, treatment, and rehabilitation using telehealth technologies.

In addition, the bill would expand access to stroke telehealth services under the Medicare program. Primary Stroke Centers in the state are not accessible to much of the population. For example, there is only one certified Primary Stroke Center in the state located at the University of New Mexico Hospital and in New Mexico alone, there are almost 173,000 Medicare beneficiaries who could gain access to telestroke services.

The bill would improve access to “store and forward” telehealth services in IHS and federally qualified health centers. These services would permit rural health facilities to hold and share transmission to use for medical training and to obtain diagnostic information plus other data.

The bill would also reimburse IHS facilities as originating sites and would establish regulations to consider credentialing and privileging standards for originating sites in order to receive telehealth services.

In another piece of legislation to help doctors deal with the costs for technology, Senator John Kerry on November 10th introduced the “Small Business Health Information Technology Financing Act of 2009 (S 2765)” to enable family doctors and other small medical practices to be eligible for SBA loans. These loans would cover the costs of health information technology needed to create electronic health records and prescriptions and would include computer hardware, software, and other technologies.

The maximum amount of the loans may not be more than $350,000 for one qualified eligible professional and $2,000,000 for one group of affiliated qualified eligible professionals.

eHealth Center Established

Worcester Polytechnic Institute (WPI) recently formed the “Center for eHealth Innovation and Process Transformation” (CeHIPT). There is a need for major ongoing projects to be developed to improve the use of electronic medical records and other HIT tools at civilian medical centers and the Veterans Administration.

The Center will integrate WPI’s research technology, in engineering, management, and process development to help healthcare organizations use new HIT systems and related technologies to improve patient care and institutional efficiency.

CeHIPT researchers have joined with colleagues at MIT, Northeastern University, and the VA New England Healthcare System to form the New England Healthcare Engineering Partnership (NEHCEP). The consortium is funded by the VA with $3.4 million annually to apply engineering principles to improve patient care at the VA’s hospitals and clinics in New England.

Through the consortium, WPI faculty and students will be analyzing the VA’s extensive clinical and operational data and processes to design and implement systems changes. Changes are needed to improve functional areas, including bedside, colorectal cancer care, and the administrative processes for compensating disabled veterans.

Housed within the Boston VA Healthcare System, NEHCEP will serve the New England network of eight medical centers and 37 community-based outpatient clinics, which provide care to 1.2 million veterans.

Industrial engineering methods will be studied such as the Toyota Production System, GE six-sigma, and Lean manufacturing tools plus more advanced mathematical and computer modeling methods. In healthcare, these methods could be used to radically improve such concerns as access, waits and delays, safety, optimal care, efficiency, equity, and effectiveness. These are the six national healthcare priorities identified by the Institute of Medicine and the National Academy of Engineering.

In another project, the CeHIPT faculty is undertaking a three year international study funded with $750,000 available through the National Science Foundation. The funding is available to examine and analyze how implementing HIT systems in primary care settings affects medical providers, their patients, and the healthcare delivery system. The researchers are looking at HIT implementations, the roll-out of the systems in various locations, and how management and the staff can adapt to the new systems and tools.

In the U.S., the study is focusing on two organizations including Fallon Clinic in Massachusetts, a large group medical practice, and UMass Memorial Health Care, an integrated medical system that includes 700 primary care physicians, several community hospitals, and an academic medical center.

In Canada, the study will examine the primary care offices of the Vancouver Coastal Health District. While in Israel, the study will examine primary care practices in two of the health funds in the country.

AHRQ's Future Funding Plans

President Obama signed the Children’s Health Insurance Program Reauthorization Act (CHIPPA) last February. The Act requires pediatric quality measures to be established to strengthen initial core child healthcare quality measures established by the HHS Secretary.

AHRQ through the Office of Extramural Research, Education, and Priority Populations, issued a Notice (NOT-HS-10-003) on November 10th with information on grant and contract solicitations to be published that will develop pediatric healthcare quality measurement research and provide for demonstrations projects.

The funding is expected to expand existing pediatric quality measures used by public and private healthcare purchasers, advance the development of new and emerging quality measures, and increase evidence-based consensus pediatric quality measures available to public and private purchasers of children’s healthcare services. CHIPRA allows for the use of grants and contracts to achieve these aims and the measures developed through this program will be available by January 1, 2013.

Through a memorandum of understanding between AHRQ and CMS, AHRQ will be the lead agency but work collaboratively with CMS to implement the pediatric quality measures program. Applicants from a broad range of fields will be eligible to apply for the cooperative agreements.

AHRQ anticipates grant and contract solicitations to be published November 2009 with funding to begin in late federal fiscal year 2010. Until the solicitation is published, AHRQ is unable to provide additional information. Email for answers to general comments.

Go to to read the full notice.

Wednesday, November 11, 2009

Help for Heart Patients

The National Heart, Lung, and Blood Institute (NHLBI) awarded $566,000 in Recovery Act funding to help Vanderbilt University researchers develop an innovative optical system to study the heart. The funding will enable the present eleven year old research project to continue and the researchers will be able to test the innovative optical system. The plan is to simultaneously image electrical activity and metabolic properties in the same region of a heart in order to study the complex mechanisms that can lead to sudden cardiac arrest.

The research team will purchase a pair of $60,000 high-speed and highly sensitive digital cameras to record the changes in the metabolic and electrical activity of isolated cardiac tissue. The cameras will use low-intensity fluorescent dyes under conditions associated with heart failure, ischemia, fibrillation, and other pathological circumstances. The multimodal imaging system will be a less invasive instrumental tool to help scientists discover and test safe and effective ways to prevent or treat arrhythmias.

Support is also being provided by the Vanderbilt Institute for Integrative Biosystems Research and Education (VIIBRE), the American Heart Association, and the Simons Center for Systems Biology at the Institute for Advanced Study. John P. Wikswo, PhD, Professor and VIIBRE Director said, “The dual camera system opens up a new window for correlating metabolic and electrophysiological events which are usually studied independently.”

In another project involving a new medical device, Oregon Health & Science University’s hospital is the first hospital in the state to implant the HeartMate II, a new Left Ventricular Assist Device (LVAD) to dramatically improve survival and quality of life in patients with end-stage heart failure.

The HeartMate II is the first LVAD to have a rotor, rather than a pump, and works by providing a constant flow of blood to the body. The device only has one moving part, making it more durable and longer lasting for up to 10 years than previous LVADs. The device is about the size of a cell phone making it one of the first mechanical devices ideally suited for women and others with smaller chest cavities who previously had limited options.

In another part of the country, the Munroe Regional Medical Center in Ocala Florida is treating patients experiencing sudden cardiac arrest with hypothermia therapy. The program the first in the region to use the non-invasive technology was developed in partnership with the Marion County Fire Rescue and Ocala Fire Rescue departments.

Currently in the U.S., a patient has a 3 to 6 percent chance of return of spontaneous circulation after suffering a cardiac arrest but through the efforts of the rescue units and community hospitals, the rate has improved to 13 to18 percent which is three time the state and national average.

The device called the “Arctic Sun” is a cutting-edge device that cools the body to around 91 degrees Fahrenheit causing mild hypothermia to slow down brain activity. Lowering the body temperature in this way decreases the amount of oxygen the brain uses and at the same time, protects the brain and limits permanent brain damage.

The American Heart Association recommends inducing moderate cooling of the body within six hours after cardiac arrest and sustaining that temperature to be followed by gradual warming has been found to increase the patient’s chances to survive with improved neurological function. It is best if the emergency departments, intensive care units, and physicians work together to coordinate the cooling process.

State Research on the Rise

Now it is going to be easier for patients who want to participate in potentially life-saving clinical research trials in South Carolina to find it easier to do thanks to a $4.8 million NIH grant awarded to the University of South Carolina’s Center for Healthcare Quality.

Dr. Jay Moskowitz, President and CEO of Health Sciences South Carolina (HSSC), the grant’s principal investigator, reports that with the grant award, patients will soon be able to find clinical trials at HSSC partner organizations, provide informed consent, protect their privacy, and receive notifications of future trials related to their condition. They will also have the option of donating discarded tissue samples to research studies.

In another effort to produce more effective research, the Center for Healthcare Quality’s Center of Economic Excellence (CoEE) was established with state funds. In addition, there was a private match from HSSC and by The Duke Endowment. The CoEE authorizes the state’s three public research institutions, Clemson University, Medical University of South Carolina, and the University of South Carolina to do research that will lead to commercialization.

CoEE’s goal is to develop technology-based tools, to help people prevent and manage chronic conditions such as cardiovascular disease, diabetes, cancer, obesity, musculoskeletal problems, and the loss of function with aging.

The hope is that research will result in marketable products such as new communications technologies with additional applications for individuals that will result in new concepts for worksites and health systems. Secondly, the products need to include software and information systems for cell phones, smart phones, iPod technologies, and computerized kiosks. Thirdly, the results of the research could help attract new software development, lifestyle coaching, and computer hardware companies to the state with the result that start-up companies would develop based these technologies.

Right now CoEE is soliciting proposals suitable for small seed grant awards to do healthcare associated infection research. Research must show linkages with the HSSC Strategic Plan 2008-11 and the 2009 HHS Research Action Plan for HAIs.

For more information on the small seed grants, email Janet Craig, DHA, RN at or call (864) 422-8302. Proposals may be submitted at any time during the 2009-2010 fiscal years.

Broadband Funds Coming

The USDA’s Rural Utilities Service (RUS) and Commerce’s National Telecommunications and Information Administration (NTIA) announced that they are streamlining the ARRA’s broadband grant and loan programs. The agencies plan to award the remaining funding in just one more round, instead of two rounds, to increase efficiency and to better accommodate applicants.

The first round of these grant and loan programs produced about 2,200 applications requesting nearly $28 billion in funding which was seven times the amount of funding available in that round. The agencies are currently reviewing these applications and expect to award up to $4 billion in loans, grants, and loan/grant combinations in this round. The agencies expect to begin announcing funding awards in December 2009.

The agencies are also seeking public comments through a Request for Information (RFI) on how to best administer the second round of funding for the programs. The RFI seeks comments on how to best target the remaining funds. Comments will need to discuss the impact of their proposal based on metrics such as the number of end users or community anchor institutions connecting to the service, the number of new jobs created, and the projected increase in broadband adoption rates.

The RFI asks whether to focus second round funding on projects that create “comprehensive communities” by installing high capacity middle mile facilities between anchor institutions to bring essential health, medical, and educational services to citizens. The RFI also seeks discussion on whether the definition of remote area is too restrictive, how the agencies can best ensure that investments are cost effective, and ways the programs might impact regional economic development and stability.

Go to www.ntia.doc/frnotices/2009/FR_BIP_BTOP RFI_091109.pdf for more information on the RFI.

NIH Seeks New Technologies

NIH’s National Institute of Biomedical Imaging and Bioengineering (NIBIB) on October 30, 2009, released a Funding Opportunity Announcement seeking technologies to use with image-guided interventions (IGI). The goal of the initiative is to develop innovative technologies to replace traditional surgery and invasive procedures with minimally invasive image-guided procedures. NIBIB plans to commit up to $5,000,000 for this funding announcement and anticipates funding 4 to 6 awards with an award ceiling of $750,000.

The FOA is going to support the second phase of a two phase program that will deliver image guided interventions that will have a high clinical impact. Respondents to this FOA should be able to develop and deploy IGI technologies to the clinical arena and be able to test a complete IGI system in a small number of patients.

IGI may involve robotic manipulators capable of operating in small and difficult-to-reach spaces, such as the inner ear or “in utero” on the fetal patient. Thus IGI increases the variety of interventions at the clinicians’ disposal. Another advantage to these procedures is the IGIs can be done remotely, bringing clinical expertise to underserved communities and remote areas.

Eligible applicants include state, county city, special district governments, and Native American tribal governments, non profits, for profits, small businesses, and institutions of higher education. The closing date for applications is January 20, 2010.

For more information, go to or to

Rapid Blood Test Coming

According to an article appearing in the Army Medical Research and Materiel Command’s newsletter, “The Point”, a new rapid blood typing test is expected to be ready by the end of the year. The test will provide a rapid, portable, and cost-efficient way to determine the blood type of potential donors, so that blood collection is safer for soldiers in the field.

Col. Karl Friedl, Director of the Telemedicine and Advanced Technology Research (TATRC), said “Current blood screening methods are labor and time intensive with results available hours later at a remote collection center. Fast turnaround screening is needed to register new donors and to schedule blood draws in response to emergent medical needs.”

Sometimes blood products from military collection centers do not reach local areas of high demand because mobile surgical units have limited carrying capacity. Very often, medical personnel may have to wait hours or days to qualify a blood donor responding to emergency blood supply requirements.

The new “Micronics ABO/Rh Card” is a disposable credit card-sized device that can accurately determine ABO blood type and Rh factor from a single drop of blood in less than 30 seconds. It is the first device that does not require refrigeration or supporting equipment and works in a closed system to protect the blood sample and reagents from environmental contaminations.

The ABO/Rh card will make it possible to recruit individuals with specific blood types and put them at the head of the line. This will greatly help military field operations respond during times of natural disasters or other medical emergencies. The card also provides another layer of safety by enabling personnel in the field to confirm the blood type stated on the soldier’s dog tag.

TATRC has been collaborating with Micronics’ Dr. Diane Wierzbicki to help advance the care through clinical trials with the goal to get the FDA to approve the product and then get the product out to soldiers in the field. Wierzbicki also reports that TATRC has helped Micronics enlist investigators with access to large volunteer populations to complete field trials of the device in a timely manner.

Funds for Networking

NIH awarded $27 million to Harvard University Medical School and the University of Florida to help resource networking in the scientific fields. The awards will develop internet-based tools to be used for social networking to help scientists in the field of biomedical research. These modern technologies have the potential to enhance interdisciplinary research and enable individuals to connect with each other and with other resources in new ways.

The awards were made possible through the Recovery Act with the funding to be administered by the National Center for Research Resources within NIH. The Harvard award will create a home where experts can share resources, while the Florida award will create a social network to enable connections among the scientific community to create pathways to lead to others they know in their field. The awards will create 45-60 new jobs in information technology, research, and in other fields to develop, implement, and evaluate the projects within a required two year timeline.

Harvard will work with eight other institutions to include Dartmouth College, Jackson State University, Morehouse School of Medicine, Montana State University, Oregon Health and Science University, University of Alaska Fairbanks, University of Hawaii Manoa, and the University of Puerto Rico.

The nine institutions will form a team to be called “Networking Research Resources Across America” to work together to build and implement a “Federated National Informatics Network” to enable investigators to discover research resources that are presently invisible.

By the end of the two year funding period, the nine sites will be able to find invisible research resources, update their own research inventory, provide for a local inventory management system, develop a simple user-friendly comprehensive data query system, provide reports, and develop methods so that new sites can be added to the network.

The University of Florida will work with other participating institutions to include Cornell University, Indiana University, Weill Cornell Medical College, Washington University in St. Louis, Scripps Research Institute, and Ponce School of Medicine in Puerto Rico. The funding will help these institutions establish a national network of scientists by using a new software system called “VIVO”. Scientists using VIVO will be able to find other scientists doing similar or complementary work.

The project will provide a first release of the software to be used at the participating institutions and will focus on institutional resources. A second release will incorporate all national networking features to demonstrate the viability and utility of national deployment, and a third release will incorporate features to establish sustainability through a sustainable open product development process.

Wednesday, November 4, 2009

Mobile Tech Use Growing

Today and in the future, smart phones and wireless technology will play an important ever growing role in delivering healthcare especially in developing countries. To find out the latest news in the mHealth field, an overflow crowd attended the Foundation for the National Institute of Health’s Inaugural “mHealth Summit” held on October 29-30. Leaders and experts came to the Summit to hear in-depth discussions on using mobile communications to advance global health for all in the 21st century.

The Foundation was established to support NIH in their role to improve health through scientific discovery. The Foundation’s goal is to identify and develop opportunities for innovative public-private partnerships involving industry, academia, and the philanthropic community. As a non-profit corporation, the Foundation raises private sector funds for a broad portfolio of programs to complement NIH’s priorities and activities.

Keynote speaker Kathleen Sebelius, Secretary HHS sees mobile technology empowering patients, consumers, and providers while she emphasized that HHS is committed to driving the technology. She explained that since phones are everywhere and can touch everyone’s life, they can and should be used to provide better healthcare in this country and the world.

Secretary Sebelius mentioned how today and more so in the future, patients will have the capacity to take photos and videos and instantly send the information to their provider using a smart phone. The provider will be able to see the information and then rapidly send back an opinion as to what the next steps should be. This technology will make it possible for the worldwide population to have a doctor in their pocket.

She continued to say that when one out of five patients is discharged from the hospital, they are readmitted within 30 days with most people not talking to a healthcare provider within those 30 days. Mobile tech could help in these cases by providing the means to ask for and receive follow up information.

As the Secretary pointed out, getting people under 40 to change behaviors is a difficult task. For example, HHS has been holding regular briefings on the flu pandemic that have been very helpful to many, but the agency wanted to reach younger people, so information now goes out to Face Book and You Tube.

Keynote speaker Francis S. Collins, M.D., PhD, Director, of the National Institutes of Health said, “Using mobile technology will certainly provide NIH with major opportunities. Researchers will be able to apply high throughput technology to understand biology, be able to translate basic discoveries into new and better technologies, put science to work for the benefit of healthcare reform, encourage a greater focus on global health, and also reinvigorate and empower the biomedical research community.

Dr. Collins discussed how mobile technology research can be applied to genetics research programs. He noted that there is a strong case for a U.S prospective cohort study of genes and environment. This would enable researchers to detect the relationship among genes, environment, and health by collecting valuable data via mobile technology and then organize the data to find answers as to how the environment interacts with genetics and how this all relates to illness.

Dr. Collins pointed out that the National Children’s Study underway is examining the effects of environmental influences on the health and development of 100,000 children across the U.S. and will follow the health of the children from before birth until age 21. The use of mobile technology to send data to the researchers is really going to help to provide timely and important information as needed.

Dr. Collins also sees the practical advantages for mobile technology and smart phones and technology to address obesity by assessing food intake and calculating food nutrients for people. Equally important is the need to determine how much exercise people really do. Cell phones will be able to measure physical activity by assessing the type and duration of physical activity in real-time. Dr. Collins sees the wireless accelerometers increasingly that are now being built in cell phones in Asia to soon become standard worldwide.

For more information on the Foundation for NIH’s “mHealth Summit”, go to or call (301) 402-5311.

Children Helped with ASD

CDC estimates the rates for Autism Spectrum Disorders (ASD) are as high as 6.7 children per 1,000 or one in 150. However, today there is a greater availability of resources, scientific progress, and research opportunities due to computerized information, bioinformatics and information technology to help children and their families with ASD.

Since research is key to understanding ASD, NIH has pledged $60 million made available largely through Recovery Act funding. The funds include $30 million for NIMH, $5 million for NINDS, $20 million for NICHD, and $5 million for the National Institute for Environmental Health Sciences.

The funds will provide for 40-50 grants to do research, develop diagnostic screening tools to use for diverse populations, to adapt effective pediatric treatments for teens and adults, to initiate clinical trials to test early interventions, and to assess risk from prenatal or early life exposures.

The funding will be used to jump-start some of the short term objectives in the “Strategic Plan for Autism Spectrum Disorder Research” developed by the Interagency Autism Coordinating Committee. This committee coordinates all efforts concerning autism spectrum disorders for the agency.

Telemedicine is playing a part in helping parents of children with autism. The Life Span Institute in their “Juniper Gardens Children’s Project” at the University of Kansas, is developing a Research-to-Practice Outreach Training model to teach parents of children with ASD how to implement research-based interventions with their child.

Phase II of the program will have the families complete an online tutorial in a telemedicine session. In Phase III, the parents will use online tutorials to learn general information and concepts related to an intervention or treatment protocol followed by either an onsite or telemedicine clinic intervention. Parents in Phase III will be randomly assigned to either a telemedicine or to an onsite clinic.

Registries are playing an important role in locating resources and providing information in the field. NIH has set up the “National Database for Autism Research” to facilitate and to share research information for autism research. The database provides an important resource to keep up with the tools and techniques needed to work in the field.

Several states have now set up registries to provide researchers with information to empower family members and caregivers. New Jersey has set up a registry designed to streamline treatment and services for families with autism and other special healthcare needs. The plan for the registry is to help find an easy way for families to be connected to the appropriate diagnostic, treatment and support services in their communities.

The New Jersey Registry requires psychiatrists, psychologists, neurologists, and other medical professionals to register the children diagnosed with autism and birth defects. The information is confidential and is used to refer families to services and to enable state officials to more effectively plan for future needs.

Today, approximately 50 of the state’s hospitals offering birth and delivery services have been trained in the use of the new electronic registry system. In addition, the staffs at six Autism Centers of Excellence funded by the state Autism Council were trained in the use of the system.

The state of North Carolina established the “Autism Spectrum Disorders Registry in collaboration with TEACCH, the largest provider of autism diagnostic and treatment services in North Carolina. TEACCH has 9 regional centers across the state serving over 750 individuals each year. Families using the TEACCH Centers for services can participate in the Registry and may also be referred to the Registry by other clinical service providers. The registry has been operating since 2001 and enrolls approximately 500 new participants each year.

Other states with registries addressing autism include Utah’s registry that collects and shares information on people with ASD, West Virginia’s registry tracks the number of new cases of ASD, Missouri’s registry unites resources at state agencies with healthcare providers and families, and New Hampshire’s registry tracks diagnostic findings.

Measuring Glucose Levels

New non-invasive technology designed to painlessly measure glucose levels in the human eye shows promise of being able to replace the finger stick blood test, according to the results of a pre-clinical study funded by Freedom Medtech, Inc. The company is a developmental stage medical device company currently focused on the commercialization of novel technologies to use to manage diabetes.

The consumer ready product will operate like binoculars with light being shined on one eye for less than a second and then the digital glucose reading will be displayed on the device. The study involving rabbits showed that the eye scanning technology produced non-invasive, in-vivo glucose measurements tracking blood glucose readings with only a five minute delay.

In addition, through a calibration and validation analysis, the mean absolute percent error for glucose prediction was below 13 percent as compared to an estimate 32 percent error commonly derived from the finger stick blood test. The results of the study were presented at the Biomedical Engineering Society’s 2009 Annual Fall Scientific Meeting.

Craig Misrach, President and CEO of Freedom Meditech said, “We believe that the human eye represents an ideal point of access for the monitoring of bodily glucose without the interferences commonly present in other non-invasive glucose measurement approaches.”

The company performs primary research and development operations throughout Ohio with supporting corporate and engineering activities in San Diego, California. The company is looking to secure $8 million B-round of preferred stock financing and is in the process of interviewing investment banks.

The company is also looking into select partnership arrangements to ideally provide complementary R&D capital, near and long term marketing/sales support, and experience in the distribution and manufacturing of ophthalmic equipment.

For more information, go to or call Craig Misrach CEO, (858) 551 0096.

CMA Starting New Program

The California Medical Association (CMA) is going to help physicians adopt and become “meaningful users” of health information technology. The association is going to launch the CMA HIT List Program to provide CMA members with objective and transparent physician reviews of products, an online vendor neutral comparison tool, a secure online community for physicians to discuss products, technology, successes or failures in implementing the technology, and information on direct assistance.

CMA has selected 10 best in-class EHR vendors and HIT service providers to participate in the program. These vendors selected via a thorough physician-directed vetting process will work with CMA to help physicians assess and implement EHRs and other HIT products. The selected vendors include Allscripts, Atenahealth, Cerner, eClinicalWorks, e-MDs, GE Healthcare, Greenway Medical Technologies, McKesson, NextGen, and Sage.

Through the HIT List program, CMA members will receive preferred pricing and member’s only discounts from participating vendors. Members will also be guaranteed fair market practices on product upgrades, support, maintenance fees, and have access to model EHR vendor contracts, as well as ongoing EHR educational seminars and webinars.

For more information, email Enid Gallegos at or call (916) 551-2030.

Sunday, November 1, 2009

Moving Healthcare Forward

Taking time out from his busy schedule on Capitol Hill, Congressman Edward Markey (D-MA) appeared via video at Partners Healthcare’s 6th Annual Connected Health Symposium held October 21-22 in Boston. He stressed that this is a monumental moment for real healthcare reform.

Congressman Markey has had a front row seat in working on health IT issues. In 2008, he introduced the “Independence at Home Act”, to establish a three year Medicare demonstration project using a patient-centered healthcare delivery model to help Medicare beneficiaries with multiple chronic conditions to remain independent for as long as possible.

Also in 2008, he introduced the “Technologies for Restoring Users Security and Trust in Health Information Act.” This piece of legislation would provide patients and consumers with access to health information and ensure privacy, security, and confidentiality.

Most every powerful constituent group focuses on health reform but if it is not their plan—they prefer the status quo, according to Stuart Altman, PhD, Professor of National Health Policy, Heller Graduate School for Social Policy and Management, at Brandeis. “Most people don’t want their healthcare touched.”

In talking about the current healthcare reform bills before Congress, he said “we need to change the way we pay for care and move away from the fee-for-services system while at the same time fully utilizing technology. He touts the Massachusetts plan and how the state is trying to change the payment system.

Dr. Altman wants to see bundling care payments for acute and post acute care, more funds available to train and increase the workforce, value-based payments, the wider use of gain sharing between hospitals and doctors, more efficient home-based services available, and investments in comparative effectiveness to include both clinical and cost effectiveness components.

Jay Sanders, MD., President and CEO, Global Telemedicine Group, looks down the road to see what is here now and what the future holds for healthcare. As a pioneer in the telemedicine field, he has the vision to see how technology can improve the delivery of medicine in the coming years. For example, the exam room will move to where the patient is located since technology is available to help the doctor provide care without the patient ever leaving their environment.

Dr Sanders questions whether yearly physical exams are really needed or they are done because medicine has always been practiced that way. Sometimes patients will come into the doctor’s office with high blood pressure and the doctor puts the patient on medication. But we must begin to realize that this office visit detecting high blood pressure was not the beginning of the patient’s problem— the blood pressure could have started three weeks or maybe years before.

In some cases, it can take weeks or years to move from normal to abnormal. Sometimes chronic illnesses average years before they are diagnosed—sometimes the chronic condition can be detected as long as 10 years before. In the future, if we routinely use monitoring technology, then doctors should be able to define and treat illnesses sooner.

How the power of social networks can greatly influence our health was discussed at the Symposium by Nicholas Christakis M.D., PhD, MPH, and Professor of Medical Sociology at the Harvard Medical School. He along with James Fowler PhD, Associate Professor at the University of California, San Diego, have both written a thought provoking book titled “Connected”. The book points out how the surprising power of social networks is able to shape lives.

Dr. Christakis in discussing the science of social networks talked about the epidemiological study known as the Framingham Heart Study that started in 1948, and how the study has provided physicians with invaluable data throughout the years. The Study kept meticulous handwritten records with information on friends, relatives, coworkers, and neighbors for each participant. These records provide thorough information on the social networks of all the participants and information on their weight and height was easily retrievable.

In studying these facts, it was found that the average obese person was more likely to have friends, friends of friends, and friends of friends of friends who were obese than would be expected due to chance alone.

This finding illustrates that social networks have communities within them and these communities can be defined not only by their interconnections but also by the ideas and behaviors that their members share. Further study showed that if a mutual friend becomes obese, it nearly triples a person’s risk of becoming obese. In addition to friends, it was found that weight gain could spread through a variety of social ties from person to person but they had to be close relationships.

According to the authors, studies have shown that obesity is contagious but scientists are trying to understand how this is possible and how other health problems may spread in this way. So the authors are posing the question “What are the implications of knowing that a key feature of our health depends on a key feature of the health of others found in social networks?”

For more information on the Symposium’s many speakers and sessions held, go to

West Virginia Committed to HIT

The state of West Virginia expects that 80% of the physicians in the state and 100% of the hospitals will use EMRs for clinical support by 2015 plus the state will have a statewide health information exchange in place by 2014. In addition, broadband and telehealth technologies will connect consumers and providers to help with core chronic diseases, health, and wellness needs.

Overall West Virginia has 1.8 million citizens, 70 hospitals including 52 acute care, 18 critical access hospitals, 6 rehabilitation facilities, and 4 Veterans Affairs facilities, 3,743 plus active and practicing physicians. Over 8% of the population lives in communities of less than 5,000, the state ranks in the bottom ten in State Health Rankings, and healthcare costs are estimated at approximately 19% of the gross state product.

The use of health IT is beginning to help the state deliver more efficient care. Expectations are that the Bureau for Medicaid Services will begin using automated systems, 80% of all lab tests will be ordered and delivered electronically, 100% of immunization records will be transferred electronically, and new telehealth applications such as telestroke and telecardiology initiatives as well as advanced life support for trauma cases will be integrated with the state’s Medical Command Infrastructure.

West Virginia is taking other actions to develop effective health IT in the state. The Governor’s “West Virginia Health Information Technology Statewide Strategic Plan” developed by the West Virginia Health Improvement Institute, presented their final draft revisions in September. The plan presented the vision for HIT in West Virginia and was completed to meet HIT priorities in the state for the next ten years.

The State’s strategic plan makes several suggestions:

• Establish an HIE to help physicians, public health officials, and researchers. The West Virginia Health Information Network initiative is underway and the goal is to design a system within five years

• Develop a Regional Information Technology Center to help with purchasing decisions, training, the adoption of telemedicine technology, e-prescribing, and the use of personal health records.

• Encourage the state’s broadband infrastructure and complete a statewide broadband inventory, align a reimbursement model to support a local business case for investments in infrastructure, and work with the vendor community to encourage local investments

• Leverage the Medicaid Information Technology Architecture (MITA) to establish a state data infrastructure, encourage payers to voluntarily report claims data to a centralized warehouse quarterly, report clinical data centrally on a monthly basis, and use the information to drive improvement in key areas

• Recruit and retain professionals with HIT skills by building a pipeline of HIT professionals. The goal is to contact professional societies, coordinate activities with the state university system and community colleges, and use technology to provide medical education and training not only by educational institutions but also by hospitals

• Ensure financial viability and sustainability by requiring federal partnerships with CMS, develop partnerships with ONC, and HRSA, and require user fees along with a viable marketplace supported by reimbursement reform,

Legislatively the State in 2009 launched a comprehensive strategy to establish health reform through Senate Bill 414. A variety of initiatives including administrative simplifications and chronic care management were included in the legislation. This effort resulted in the establishment of a new office called the “Governor’s Office of Health Enhancement and Lifestyle Planning (GOHELP) to help improve and expand the state’s healthcare system.

Presently, the state has several other ongoing initiatives including the West Virginia Medical Institute (WVMI) to provide quality management and HIT services. The Institute has top security clearance with CMS, DOD, and the VA. WVMI has developed technical resources for providers in accordance with its 8th Scope of Work with CMS. As part of that effort WVMI launched an e-Health Initiative to develop strategies to accelerate the adoption of health information technology throughout the state as well as the states of Delaware and Pennsylvania.

The West Virginia Telehealth Alliance also in place is a nonprofit organization to help advance telehealth throughout the Mountain state. The Alliance is one of the 69 organizations in the U.S. that is participating in the FCC’s Rural Health Care Pilot Program. The WVTA received $9.7 million in state and federal funds to improve broadband connectivity among eligible healthcare entities in the state.

Other initiatives in the state include the launching of a Center for Health Information Technology and the State University Research Consortium at Shepherd University to focus on building the state capacity for health information technology services and research opportunities.

In addition, the West Virginia Emergency Medical Command has been established and is exploring the role of HIT to support emergency responses. The West Virginia Department of the Corrections and the West Virginia Regional Jail and Correctional Facility Authority are working to acquire electronic health records.

Resources such as an online resource are available to help West Virginians understand electronic health records as the switchover takes place. The eHealthWV effort funded by a federal grant is available at Also available is the Health Information Security and Privacy Collaboration Provider Education Toolkit available at to offer providers physician to physician advice, resource links, and information from experts.

Investing in Global Health

The Obama Administration has pledged $63 billion for the “Global Health Initiative” and is now moving ahead with projects. For example, a newly created high level Trans-NIH Global Health Research Working Group is the result of a two year effort to analyze global health research activities at NIH and to find better ways to coordinate efforts across NIH and throughout the government.

Participants in the working group will focus on three overarching issues such as improving data collection on NIH international activities, ensuring that clinical trials supported by NIH meet the highest possible standards no matter where they take place, and discuss the best ways for NIH to play a strategic role in global health activities.

One of the road blocks to having all the data is that foreign sites that receive direct awards from NIH are in the system but foreign components of domestic awards are not. This means that the database needs to be strengthened so that the funding gaps can be understood according to Dr. Sally Rockey, Acting Director of Extramural Research at NIH.

In another effort, NIH’s Fogarty International Center is going to award more than $9.23 million to eight global health informatics programs over the next five years. The Fogarty “Informatics Training for Global Health” program is in place to increase informatics expertise in low and middle income countries, to train scientists to design information systems, and to apply computer supported management and analysis to biomedical research.

The grants are being awarded to both new and ongoing informatics programs at various international sites:

• The University of Pittsburgh and Javeriana University in Bogota, Columbia will educate more individuals in health informatics with an emphasis on clinical research

• Oregon Health and Science University will combine their informatics and epidemiology program with the Italian Hospital in Buenos Aires, Argentina, to focus on clinical and translational research informatics

• The Andean Global Health Informatics Research and Training Center administered by the Cayetano Heredia University in Lima Peru, will have participation from the U.S. Naval Medical Research Center Detachment in Lima, University of Cauca in Colombia, Andia University of Simon Bolivar in Ecuador, and the University of Washington in Seattle.

• The University of Georgia, the Oswaldo Cruz Foundation Rene Rachou Research Institute, the Federal University of Minas Gerais in Belo Horizonte, Brazil, and the Oswaldo Cruz Institute in Rio de Janeiro, will expand into bioinformatics, epidemiology, and molecular evolution

• The University of California, San Diego will support the Biomedical Research Informatics for Global Health Training Program and help the South network to expand

• Vanderbilt University will support a new informatics training partnership with two leading research institutions in India, to include the National AIDS Research Institute in Pune, and the National Institute of Epidemiology in Chennai

• The University of KwaZulu-Natal in South Africa will develop research and training capacity in informatics through a Pan-African collaborative initiative involving institutions in Uganda, South Africa, and Zimbabwe

• The East African Center of Excellence in Health Informatics is going to be resource for improving health informatics and clinical research in sub-Saharan Africa

Technology is also playing an important role in the Fogarty Challenge Grants now available with Recovery Act funding. The goal is to study chronic diseases, climate change, emerging technologies, and the effect of cultural beliefs on health. “These grants will help support cutting edge research in priority areas and help scientists explore new ways to leverage emerging technologies to improve human health, “said Fogarty Director Dr. Roger I. Glass.

Funding for one project at the University of Alabama at Birmingham will focus on long distance communication and distance learning applications. The project will develop four courses which will be offered over a two year period to 150 study coordinators at various international sites. The approach will be to have internet-based classes, courses on CD-ROM, podcasts, and text messaging.

Another study will analyze how electronic protocols might improve adherence by healthcare providers and patients. The study to be carried out by Dr. Marc Mitchell of Harvard University and his team, have designed software that can guide providers through electronic protocols related to childhood illnesses.

According to Dr. Mitchell, the software can be operated on a PDA or cell phone and help providers avoid skipping steps or arriving at an inaccurate diagnosis. The study is going to be carried out in Tanzania Evangelical Lutheran Church clinics since they currently use paper based protocols to treat children.

ATA Meeting in Puerto Rico

The leaders and innovators in telehealth in the Caribbean and Latin America will be gathering at the Caribe Hilton in San Juan, Puerto Rico December 6-8 for the 2009 annual meeting of the American Telemedicine Association Latin American and Caribbean Chapter (ATALACC).

This is a unique forum for cooperation among colleagues throughout the Americas to exchange ideas related to the growth and diffusion of telehealth throughout the Caribbean and Latin America.

Telehealth professionals and regional experts will lead lively group discussions and provide for social networking. At the same time, leading companies from the telehealth industry will display, demonstrate, and discuss their products and services with attendees.

The ATALACC 2009 program will address:

• Initiatives and programs in the Caribbean and Latin America
• Innovative technology applications
• Government, humanitarian, and non-governmental organization initiatives
• Collaborative multinational distance education in public health and medicine
• Disaster preparedness and response
• Tourism applications
• Regional civilian-military collaboration

Registration is open at $350 USD which includes access to all sessions and the exhibit hall. For information and to register, go to For exhibiting and sponsorship information, email Del Tillman, ATA Director of Corporate Relations at or call (202) 223-4249.