Sunday, August 29, 2010

VA Partnering with IHIE

The Department of Veterans Affairs launched their new pilot partnership in the Indianapolis region to improve the delivery of veterans’ health information. The Richard L. Roudebush VA Medical Center in Indianapolis is partnering with the Indiana Health Information Exchange (IHIE) to exchange EHR information using the Nationwide Health Information Network (NHIN).

The IHIE is made up of collaborative partnerships with Regenstrief Institute, private hospitals, insurers, local and state health departments, and other healthcare organizations that impact more than 60 hospitals providing care to more than 6 million patients.

The NHIN will provide the technology gateway to support interoperability standards and a legal framework to exchange health information, and clinicians from participating organizations will be able to share authorized patient data electronically

Veterans who participate in the exchange of their medical information will be able to have both their public and private sector healthcare providers and doctors share specific health information electronically, safely, securely, and privately. More than half of veterans and active duty service members receive some portion of their healthcare outside of the VA or Department of Defense facilities.

For more information, call 1-877-771-8537.

VP Touts Innovation Report

On August 24th, Vice President Biden detailed how the Recovery Act has played a part in funding innovation to build a more robust and competitive economy. The report “Recovery Act: Transforming the American Economy through Innovation” describes how investments in broadband, the smart grid, and health information technology is building out a 21st century infrastructure.

According to the Vice President, the report details how the HIT spending of $250 million to fund the Beacon Community program will showcase how HIT when used in combination with other delivery system improvements will transform how communities can manage health outcomes.

Three examples in the report describe how the Beacon Community program will use the funds:

• Eastern Main Healthcare Systems in Bangor Maine is using $12.8 million to improve home-based care and reduce unnecessary emergency department visits. The goal is to reduce avoidable emergency department visits by 15 percent. This will translate to a 7.000 visit reduction locally totaling $2 million in savings per year. The award will also be used to link healthcare providers to the existing HIE to promote telemedicine

• Southern Piedmont Community Care Plan, in Concord, South Carolina will use the $15.7 million award to increase the number of patients with well controlled blood pressure and lipids, and to help reduce the number of children with asthma that end up in the emergency department. This can translate to 14,000 people with reduced risk of heart attacks and strokes and 2 percent fewer childhood asthma patients ending up in the emergency department. The funding will provide for electronic health management and telemedicine equipment plus there are plans to develop an indexed image repository to avoid duplicate x-rays

• Western New York Clinical Information Exchange in Buffalo New York will use their $16.1 million award to help diabetics avoid hospitalizations and emergency department visits. The funding will be used to purchase clinical decision support tools such as registries, point-of-care alerts, and to develop and use new telemedicine solutions. The goal is for 5,000 patients with diabetes to improve control of their blood sugar and avert as many as 2,300 complications. This should reduce the number of emergency department visits by 15 percent and prevent hospitalizations and re-admissions for individuals with diabetes and congestive heart failure. In the end, this will help communities save $1.1 million per year starting in 2010

The report also highlights the fact that the Department of Veterans Affairs e-Care technologies along with telemedicine have dramatically reduced unnecessary hospitalizations through wide ranging efforts to help veterans manage chronic conditions at home. Hospital use has decreased by 25 percent overall and 50 percent for patients in highly rural areas. This has been accomplished by linking 32,000 chronically ill veterans with healthcare providers and care managers using video phones, digital cameras and messaging and telemonitoring.

To view a new innovation web page, go to and to download the report, go to

State Seeks Proposals

The New York State Department of Health (DOH), Office of Health Systems Management, in the Division of Certification & Surveillance, seeks proposals to help perform surveillance activities to oversee hospitals and Diagnostic Treatment Centers (DTC). Several surveillance activities are required to be carried out in several categories such as:

• Periodic surveys at DTCs and hospitals—these surveys are done to ensure ongoing compliance with state regulations and standards. On-site surveys are done unannounced but typically occur on a cyclical basis and spread out over the year. The surveys look at the operation of the facility including patient care and physical environment

• Complaint-initiated investigations and facility-reported incident investigations—these investigations whether complaints or allegations are received by the DOH either directly via the department’s centralized hospital and DTC complaint intake unit, or from CMS, or media reports. All complaints pass through the centralized complaint unit

• Review, triage, and quality assessment of facility-reported incidents—these reports are submitted through the New York Patient Occurrence Reporting and Tracking system (NYPORTS). Both hospitals and DTCs are mandated to report specific categories of adverse events

The NY Department of Health operates their hospital and DTC surveillance program with a regionalized approach. The state is divided into four regions with surveillance activities in each region overseen by the Hospital Program Directors.

Proposals addressing “State Surveillance Activities for Hospitals and Diagnostic & Treatment Centers” (FAU Control #1005101128) is due October 4, 1010. Proposals will be accepted from public or private organizations or corporations authorized to operate in New York State. Written questions were due August 17, 2010, and letters of intent are due August 30, 2010.

For details, go to or email, Jonathan Mahar at or call (518) 474-7896.

University Develops Technology

Purdue University researchers at the Bindley Bioscience Center have developed a technology with the potential to quickly identify food-borne pathogens to better respond to emergencies and bioterrorist attacks. The researchers at the university have received a $1.3 million seed grant from NIH’s National Institute for Allergy and Infectious Diseases to test the technology.

The technology creates a national identification system capable of correlating similar organisms identified at hospitals in the U.S. The technology works by creating a signature of each organism isolated from patients by using a laser to interrogate bacterial colonies and collect unique scatter fingerprint patterns that instantly identify each and every colony on a plate. The signatures are sent to a national biosecurity database network to link major hospitals around the country where the signatures can then be compared with other signatures.

“The project demonstrates the power of what can happen when you put university research teams together by linking engineering, pharmacy, food sciences, basic medical science, computer science, and biosecurity,” said Bindley Director Richard Kuhn. The technology initially will be implemented at a hospital microbiology laboratory at the West Virginia University Medical Center to do routine testing.

Purdue University also reports that a new biosensor developed at the university is able to measure whether neurons are performing correctly when communicating with other neurons. The development of the biosensor will enable researchers to test the effectiveness for new epilepsy or seizure treatments.

The nanosensor not only measures glutamate around neural cells, it can tell how those cells are releasing or taking up glutamate, a key to the cell’s health and activity. Previously, people were only getting glutamate indirectly or through huge invasive probes. With this newly developed sensor, researchers now can listen to glutamate signaling from the cells.

The firing of neurons is involved in every action or movement in a human body. Neurons work electrically, but ultimately communicate with each other through chemical neurotransmitters such as glutamate. One neuron will release glutamate to convey information to the next neuron’s cell receptors.

Once the message is delivered, neurons are supposed to reabsorb or clear out the glutamate signal. It is believed that when neurons release too much or too little glutamate, the signal is not able to clear properly and as a result, people are prone to neurological diseases. Researchers are looking for more information on how neurons work in order to create more effective treatments for neurological disorders.

Organization Implements EHR

AIDS Care, the leading provider of HIV/AIDS services in Rochester, New York, is the only organization in the Finger Lakes region to focus exclusively on HIV/AIDS medical, social, and prevention education services. The clinic began the planning for their EHR in December 2009, went live in March 2010, and already, the clinic is seeing vast improvements in workflow and patient care.

AIDS Care selected e-MDs and their “Solution Series ™ integrated EHR/PM suite because the clinic was impressed with the vendor that was based on several successful product demonstrations, a site visit to the company’s headquarters, and the company’s willingness to thoroughly train employees and assist with implementation.

The tools included in the e-MDs program give providers critical information and prompts to ensure that patients are getting the required care for their specific conditions. The improved documentation helps to better coordinate the patient care plans among the network of specialists and other community providers as well as increase patient safety.

The President and CEO of AIDS Care, Jay Rudman notes that the clinic has seen several improvements within the agency since implementation was completed. With the integration of scheduling, clinical documentation, care management, and billing, the patient flow and documentation has improved along with timely billing practices.

Tuesday, August 24, 2010

Funding to Support Rural Health

More than $32 million in FY 2010 funds to go to rural areas was announced by HHS Secretary Kathleen Sebelius. The funds reach across seven programs administered by HRSA’s Office of Rural Health Policy.

“The grants will strengthen partnerships among rural health providers,” said HRSA Administrator Dr. Mary Wakefield Ph.D., R.N. “The funds will be used to recruit and retain rural healthcare professionals and to modernize the healthcare infrastructure in rural areas.”

Funding for the seven programs includes:

• More than $22 million for the Medicare Rural Hospital Flexibility Program to support improvements in healthcare quality in communities served by CAHs. The funding will help improve the hospitals financial and operating performance and help develop collaborative regional and local delivery systems

• More than $3 million for the Rural Health Workforce Development Program, a new one-time pilot program to support rural health networks that want to improve the recruitment and retention of emerging health professionals

• More than $2 million for the Telehealth Network Grant Program to help communities build capacity to develop sustainable telehealth programs and networks

• More than $1 million for the Telehealth Resources Center Grant Program to help healthcare organizations, networks, and providers implement cost-effective telehealth programs serving rural and medically underserved areas and populations

• Close to $1 million for the Flex Rural Veterans Health Access Program, a new program to help coordinate approaches, collaborative networks, and provide virtual linkages to rural veterans and other residents to obtain mental health and other healthcare services

• $770,000 for the Frontier Community Health Integration Demonstration Program to help develop and test new models for the delivery of healthcare services in frontier areas by providing care to Medicare beneficiaries

• Almost $500,000 to the Rural Training Track Technical Assistance Demonstration Program to analyze the challenges and barriers facing Rural Training Track residency program sites in order to increase the number of family medicine physicians

HRSA’s Office of Rural Health Policy is also seeking applications for the “Rural Health Network Development Planning Grant Program” or referred to as “Network Planning Grants.” The purpose of the grant program is to bring together key parts of a rural healthcare delivery system so that they can work together to establish or improve local capacity and to be able to coordinate care.

The major focus of the funding is to support rural entities and help them develop healthcare networks. Understanding a community’s health needs through a community assessment is an important step in building a network. If a network can understand and define the key needs of the community and its healthcare providers, it is well-positioned to provide solutions and offer benefits to the community and its providers.

The application due date is October 8, 2010. The approximate amount of funding anticipated is $1,150,000 with the maximum award request for the year to be $85,000 with 15 awards anticipated. The grants are to be funded with FY 2011 appropriations, pending the availability of funds.

The lead applicant organization must be a rural, non-profit or public entity representing a consortium/network of three or more healthcare providers that need assistance to plan, organize, and develop a healthcare network. For-profit or urban based organizations are not eligible to be the lead applicant but can participate in the network.

For more information go to or email Eileen Holloran, Program Coordinator, Office of Rural Health Policy at or call (301) 443-7529.

NIH Issues Pre-Solicitation Notice

On August 17th, NIH published a pre-solicitation notice with details on the new Chief Information-Officer-Solutions and Partners 3 (CIO-SP3) Government Wide Acquisition Contract (GWAC). The full solicitation will be issued on or about September 1, 2010 on but so far a definite date has not been set.

A GWAC is a procurement vehicle that can be used by any federal, civilian, or DOD agency to purchase information technology products and services. The new NIH CIO-SP3 GWAC contracting vehicle will support the full range of IT needs not only across the federal government, but emphasis agencies involved in healthcare and clinical biological research like HHS and NIH.

There are benefits to using a GWAC since this contracting vehicle enables a federal agency to get IT products and services faster, easier, and more cost-effective than by issuing their own individual contracts. This method of contracting enables NIH to have more knowledge on bidders plus the bidder’s prices have been pre-competed and pre-negotiated for below market pricing. The new GWAC will be the successor contract to NIH’s current CIO-SP2 and the Image World 2 New Dimensions (IW2nd) GWACs that are expiring December 2010.

NIH has made some changes in how they deal with the GWACs. The NIH Information Technology Assessment and Acquisition Center (NITAAC) have upgraded their capabilities to run the new GWAC. Several initiatives are underway to streamline the processes and to develop customer-focused initiatives such as providing for e-ordering systems to enable RFPs and RFQs to be completed in 10 minutes or less, development of automated tools to help fulfill FAR requirements, and the development of capabilities that will enable pre-competed and pre-negotiated prices to remain stable.

The government is planning to solicit a second GWAC for small businesses. The small business set-aside GWAC will be announced under a separate notice at

The point of contact is Donald Wilson, at To reach the contracting office, contact the NIH Information Acquisition and Assessment Center, in Bethesda MD.

Telehealth App Wins

The knowledge gained from the Army’s recent “Apps for the Army” applications development challenge will be used to quickly acquire software applications. The “Apps for Army” challenge gave one of the five top awards to the Defense Center of Excellence’s National Center for Telehealth and Technology for their Telehealth MoodTracker mobile application.

The T2 MoodTracker allows service members to track their moods and self-monitor their mood variations daily, weekly, monthly, or even from hour to hour. Doing this helps service members understand the impact of stress and common emotional reactions that follow a deployment and helps them understand related behavioral health issues. The application also has the capacity to store information and send the information to the service member’s healthcare provider.

Service members track their moods on a touch screen using a visual analogue scale which allows users to choose a point on a color continuum to reflect their current emotions. According to Dr. Robert Ciulla, psychologist and division lead, T2 MoodTracker is one of the initial tools in a series of mobile applications under development.

Fifty three applications were submitted when the contest closed on May 15th. The other four awards went to a physical training program to help soldiers develop their own PT program. Another award went to a web-based data survey, to a map routing app to use for road navigation, and to an app with information for potential recruits.

Lt. General Jeffrey A. Sorenson, the Army’s Chief Information Officer said, “The process to help develop applications for the Army’s use is time-consuming and difficult. With the acquisition process piloted during the “Apps for the Army” challenge, the Army demonstrated not only a faster way to get capability to the battlefield but how this process can extend to industry.”

He explained that the Army will give industry 30 days to submit an application for new software. At that point, commanders that have expressed a need for new software will have the opportunity to vote on what comes back from industry and the company will then have 60 days to develop the software.

The speed of the process demonstrated with “Apps for the Army” eliminates the need for writing a requirements document, doing a request for proposal, and dealing with the sometimes difficult acquisition process.

For more information on T2, go to or

Emphasizing IT Efficiency

In August, Arizona released their “Statewide IT Plan for FY 2011” emphasizing IT efficiency, cost savings, and ways to maximize the state’s IT resources. According to the plan, the state Project Investment Justification (PIJ) process and monitoring has been completely revamped.

The PIJ process will be used to approve all IT projects budgeted over $25,000. The new monitoring process is modeled after the Project Management Institute’s lifecycle management plan, and includes project phases, check points, metrics, and risk mitigation strategies.

A new standardized project management software tool has been instituted across all agencies that grades and tracks the progress on projects so that senior management can more fully understand how the projects are progressing.

A Memorandum of Understanding has been drafted which allows the staff to monitor the cyber health of the state’s network infrastructure. If there is a problem, the staff can automatically shutdown impacted services if an agency is infected. This is being done where there are specific critical incidents in order to prevent data breaches from spreading to other agencies. This disconnect policy has resulted in creating uniform risk and escalation ratings.

The Statewide Information Security and Privacy Office that is part of the Government Information Technology Agency (GITA), has also created and implemented a new standard risk reporting structure to streamline the security reporting process. A recent partnership with the Arizona Department of Administration now maintains a central statewide incident management system.

The Public Safety Interoperable Communications program is in place to coordinate disaster preparedness among the public safety agencies in Arizona. A recent grant allowed the state to create a Communication Assets Survey and Mapping tool and provide for a new outreach program. These activities have resulted in more cooperation to help the state plan interoperability among agencies.

In addition, the web site CopperList was launched to help agency CIOs make more effective use of their technology funding. The agencies are very interested in establishing a simple process to allow the efficient transfer of excess IT hardware between state agencies.

While some agencies have hardware assets sitting idle, other agencies have hardware needs but lack the resources to make new purchases. To meet this need, GITA has launched the web application “CopperList” designed make more efficient use of IT between agencies.

The “CopperList list is similar in concept to other online classified ad sites such as Craigslist. The site is available to state employees that have been authorized by their agency CIO to use the site. Now when agencies are purchasing IT products, they can check the CopperList site prior to the purchase and if they have excess equipment available, this equipment can be made available to other agencies.

To download the Strategic IT Plan, go to

Developing the HIE

Kansas has been developing and using telemedicine and telehealth to reach rural populations for a number of years. Today, the telemedicine program at the University of Kansas Medical Center and the Kan-Ed network reaches across the state. Also, for the past decade, the state has been exploring the use of health IT and working to establish a health information exchange.

The Kansas Department of Health and Environment (KDHE), the state designee for health IT, is working on the states strategic and operational plans for the statewide HIE. KDHE convened the e-Health Information Advisory Council (eHAC) to provide guidance on policy issues related to health IT and to help develop the plans for the state level HIE.

The state and KDHE have a long history of leading public health informatics initiatives and uses web-based technologies to share information throughout the state. For example, the Kansas Health Alert Network enables local and state emergency health and safety entities to share public, mental health, and general emergency preparedness information. Also, the Kansas Public Health Information eXchange enables the rapid exchange of information between public health providers.

In addition, KDHE’s system “EMResource”, a web-based program, provides real-time hospital emergency department status, information on hospital patient capacity, availability of staffed beds, and available specialized treatment capabilities. The system also communicates public health and bioterrorism/terrorism alerts.

KDHE’s immunization and disease registries have proved to be effective. The Kansas Immunization Registry has enrolled more than 1.3 million patients, and tracks more than 9 million immunizations across 205 provider offices statewide. KDHE also supports two state disease registries such as the Kansas Cancer Registry a population based source of information and the Kansas Diabetes Quality of Care Chronic Disease Electronic Management System in more than 90 healthcare clinic sites across the state.

KDHE has released their draft “Strategic & Operational Plan” along with what will be done to publicly report on key measures. According to the plan, the measures to be reported quarterly will include the number of stakeholders accessing the exchange and increases, the increase in the number of Kansans with their care coordinated through a medical home, and the number of Kansans participating in chronic disease management programs.

eHAC participated with a number of state agencies to include not only KDHE, but also regional health information exchange participants on advisory committees, the Kansas Health Policy Authority, Foundations, KanEd, KanWin, the State Information Technology Office, plus other state agencies.

A broad range of other Kansas stakeholders and other interested parties from both the public and private sector participated in eHAC meetings via workgroup meetings, and stakeholder outreach sessions. The groups worked on a variety of communication efforts and looked in detail at the key elements of the strategic and operational plans and participated in discussions pertaining to the future of the statewide HIE.

The stakeholders discussed ideas such as:

• Limited resources have long prevented the implementation of prior HIE plans. Stakeholders continue to believe that future efforts must be sensitive to the limited resources available in the state, and employ as many diverse and creative funding and implementation strategies as feasible

• The need for collaboration to assist state level planners and health organizations in meeting the challenges that result from limited resources. Collaborative efforts among HITECH-funded efforts, as well as between participating organizations will be key to HIE success in the state

• Stakeholders in several workgroups were adamant that the current HIE project maintain a focus with well-defined parameters, rather than broaden services or areas of attention. An example of concern was that the HIE should not offer an electronic health record to providers, but should rely on the Regional Extension Center and vendors to address EHR needs that do not involve health information exchange. The stakeholders do not want the HIE to enable quality reporting because the consensus was that to provide any services in this arena was outside the scope of the current project

Recently, in July 2010, the Governor issued an Executive Order to establish the Kansas Broadband Advisory Task Force as a result of the state securing $400 million from ARRA. The task force’s goals are to have the state to support strategic partnerships in the public, private, and non-profit sectors, implement a strategy to support universal state-wide availability and adoption of broadband services, and also work to coordinate input obtained from key stakeholders in both the public and private sectors

To download the Kansas draft “HIE Strategic & Operational Plan” go to

Sunday, August 22, 2010

Telehealth Network Launched

To help provide telemedicine in the state, the California Telehealth Network (CTN) shows what broadband technology can do for healthcare services. The plan is for CTN to connect to over 800 California healthcare providers in underserved areas and then eventually to a state and nation-wide broadband network.

The $30 million project is being funded with $22.1 million from the FCC with another $3.6 million available from matching funds from the California Emerging Technology Fund (CETF). UnitedHealth/PacifiCare, UC Davis HealthSystem, California HealthCare Foundation (CHCF), California Teleconnect Fund, California’s Telemedicine & eHealth Center’s regional eHealth networks, plus other public and private entities are also providing substantial funding and/or support.

According to Eric Brown, Executive Director for CTN, the network will ensure that clinics in rural and medically underserved communities will have access to the dedicated medical grade network and will support telemedicine applications like high definition televideo consultations and enable the exchange of medical records, x-rays, and other information.

Governor Schwarzenegger explained how San Diego has two health centers serving the Native American population with one center in North County and the other in South County located in very remote areas and up to now unable to provide specialty care. In addition to these health centers, there are 12 family health centers, and seven Clinicas de Salud del Pueblo in remote Imperial County that do not yet provide immediate access to specialty care. Now, with the launching of CTN, instantaneously all of these health facilities will have access to physicians and to new physicians being trained via the network.

One of the first services to operate across the CTN is the “Specialty Care Safety Net Initiative” (SCSNI) funded by CHCF and carried out by the Center for Connected Health Policy. The SCSNI will use the CTN to connect providers via video, via data, and provide image transfers. This will enable providers to collaborate and improve care in low income populations, both in rural and remote urban populations. Consultations will be provided in eight specialties from dermatology and ophthalmology to neurology and psychiatry.

Because of the SCSNI, Dr. Alino in Oroville is now successfully able to use telemedicine to consult with UC Irvine and UC Davis. He reported how successful telemedicine can be. For example, Anthony is a four year old child who is hyperactive, inattentive, and impulsive. At two years old, Anthony was of danger to himself and other children, and as a result, his mother brought the child to see Dr. Alino.

Because Anthony was just four years old but also had has problems with prematurity at 27 weeks old and developmental delays, Dr. Alino did not feel completely comfortable taking care of the child. So Dr. Alino contacted Dr. Fernandez from UC Irvine a psychiatrist to help diagnose and manage Anthony.

Dr Fernandez was able within one week to diagnose the problem and reach Dr. Chitnis, a neurologist from UC Davis to help manage the child. The consultations were accomplished and the doctors were able to help the child and mother using telemedicine to communicate with major centers.

Addressing Global Health Issues

The U.S. Agency for International Development (USAID), NASA, Department of State, and NIKE Inc. are partnering on an initiative called LAUNCH: Health. The idea behind the program is to identify, showcase, and support innovative approaches to humanity’s sustainability challenges. The second event in the LAUNCH forum series will focus on health issues related to the first 20 years of life concerning nutrition, physical activity, and preventive healthcare.

LAUNCH: Health forum will bring together entrepreneurs from around the world who will be selected based on their innovative approaches to addressing health issues. People can submit their innovative ideas through the “InnoCentive” website which allows hundreds of thousands of problem solvers throughout the world to collaborate on the posted challenges.

Innovators can submit their health related proposals via the LAUNCH Health Challenge at Proposals will be accepted until September 12, 2010 when the challenge will close and the winners will be selected.

After the winners are selected, a two and a half day forum to discuss the proposals and new ideas will be held at NASA’s Kennedy Space Center on October 30-31. The winners of the competition will discuss their proposed solutions with council members who will represent business, policy, engineering, science, communications, and sustainability sectors.

“USAID is excited to team up with NASA, NIKE and the Department of State for this unique forum,” said Alex Dehgan, Director, USAID Office of Science and Technology. “We see LAUNCH as a great opportunity to support innovators and entrepreneurs who are helping provide sustainable solutions to today’s biggest development challenges.”

State Moving Towards HIE

Provider and vendor-hosted networked systems are ready to meet local and regional HIE needs in Washington State. However, a common shared infrastructure has yet to be developed to support statewide HIE. The Health Care Authority (HCA) is developing a state wide HIE Strategic and Operational Plan that will include the “State Medicaid Health Information Technology Plan” (SMHP). SMHP is a collaborative effort with the State Medicaid Purchasing Administration (MPA) and HCA.

MPA issued a “Request for Qualifications/Quotations” (RFQQ) and invited proposals from qualified bidders to help develop the SMHP with $400,000 in funding available. Proposals were due by July 11nd. The project requires experience with Medicaid and HIT.

The deliverables of this contract include an “as-is” assessment of the HIT environment, the state future vision for HIT, a plan to implement and administer the EHR incentive program, a HIT Road Map for Washington Medicaid, and a draft Advanced Planning Document. The bidders selected must be able to fully integrate SMHP with the State HIT Plan.

For details, go to or contact Angela Williams at

In another project the Washington State Department of Social and Health Services issued a RFQQ the beginning of August for a consultant to make recommendations on a project to study the Pay-for-Performance Payment Subsidy System. The evaluation needs to include a review of the CMS demonstration project to explore the feasibility of P4P systems in Medicare certified nursing facilities. The RFQQ is due August 27, 2010.

In 2010, the legislature directed DSHS to contract with an outside entity to review pay-for-performance strategies used in other states to sustain and enhance quality improvement efforts in nursing facilities. The legislature has appropriated $200,000 for this project, however, the contract will be awarded contingent upon the availability of funding.

For details, go to

Washington State has been actively advancing telehealth and broadband technologies for several years. In March, an $84.3 million grant was awarded from the Department of Commerce through the National Telecommunications and Information Administration’s Broadband Technology Opportunities Program. The funding will enable NoaNet to deliver broadband capabilities to some of the more remote regions of the state.

In another project, the Washington Telehealth Exchange coordinated by the Association of Washington Public Hospital Districts is evaluating proposals for the FCC’s first phase of the Rural Health Care Broadband Pilot program. The Exchange is going to work with the Statewide HIE to coordinate efforts in telehealth, telemedicine, and exchanging electronic clinical data.

RFP Issued for Consulting Services

Maine’s Office of the State Coordinator for HIT (OSCHIT) seeks proposals from individuals or organizations that are qualified to provide consultation services to advise a legal work group on issues involving security and privacy of health information. This information is needed to support health information exchanges.

The state’s legal working group held meetings in 2009-2010 to focus on emerging issues related to privacy and security of health information as applied to electronic health information exchange. The legal working group made a number of recommendations that were included in the Request for Proposal (201007748).

The scope of work is divided into distinct parts. The contractor is to:

• Facilitate four to five meetings on health information. The HIT Steering Committee’s legal working group’s draft recommendations for the state HIT plan can be found at

• Advise on recommendations needed to address restrictions to electronically exchanging health information data on persons with behavioral health and/or HIV diagnoses

• Research all of the provisions of ARRA/HITECH including the HIPAA amendments, Maine’s General Privacy Law, Maine’s HIV Privacy Law, and Maine’s Mental Health Privacy Law to provide the information to the legal working group to use to reach a consensus on the recommendations.

• Develop a position for statute changes to healthcare privacy and security law consistent with the consensus of the legal working group.

• Facilitate discussion and deal with the input from the public on any changes proposed

• Prepare a draft document for review by December 31, 2010

• Finalize a summary of findings and prepare a position paper for use in developing recommendations to the legislature on changes to the health information privacy law if supported by the legal working group

• Provide input to OSCHIT on legislation hearings to articulate rationale for changes in health information privacy law if recommended

For more information, go to The proposal is due by August 31, 2010 with the work to run from September 2010 through March, 2011. The point of contact is James F. Leonard, Director of the Office of the State Coordinator for Health Information Technology within the Governor’s Office of Health Policy and Finance. The email is or fax (207) 624-7608.

Developing HIT Testing Tools

NIST within the Department of Commerce is developing the core health IT testing infrastructure that will provide a scalable, multi-partner, automated, and remote capability for current and future testing needs. As mandated by ARRA, NIST’s “Health IT Standards Testing Infrastructure Project” is developing a suite of software tools to support the infrastructure.

The set of 45 approved test procedures will evaluate all of the components of electronic health records that need to function properly and work interchangeably across systems that are developed by different vendors. Testing laboratories will use these tools in the testing component of the certification programs established by ONC.

The tools once they are tested will help vendors test their health IT products to ensure basic functionality. The testing infrastructure will not only provide testing services, but also support numerous health data standards, provide a component-based user interface, enable user customization, support changing user requirements, and leverage existing testing initiatives.

However, the health IT testing infrastructure does not create any new standards but only creates the tools necessary to test for compliance with existing standards as announced last year by HHS. Also the testing infrastructure does not perform certifications and does not conduct operational testing.

A “Health IT Standards and Testing” web site has been established at to provide more information on the program and the testing infrastructure suite. The site provides an overview of the program, plus access to the test method needed to meet meaningful use technical requirements and standards, access to the Health IT Implementation Testing and support web site, and provides educational material dealing with conformance and interoperability testing.

To submit input on the suite of software tools to support the health IT testing infrastructure, email

Posting Info on Vendors

eHealthConnecticut is reaching out to interested health information technology vendors to enable them to submit information on their EHR products for review, approval, and for possible listing on the eHealthConnecticut website. The on-line database will have information on qualified EHR vendors and will help providers meet the needs of their practices and achieve meaningful use under the HTECH Act. eHealthConnecticut will maintain and update the list on a regular basis.

eHealthConnecticut issued a Request for Information to locate interested vendors that wish to post on the web site. All responses were due received by August 18th with vendor information to be posted on September 15th. Vendors must agree to meet the standards for EHR certification established by ONC and must regularly review the information and submit revisions if needed. Also, the vendor must be willing to provide web-based on-line demonstrations of their products.

In April 2010, eHealthConnecticut was awarded a $5.75 million grant by ONC to serve as Connecticut’s Regional Extension Center (REC). The REC is going to help providers to purchase ONC certified EHR solutions which may include bundled packages of hosted practice management applications, hardware and communications infrastructure, and on-going telephone and on-site support.

The REC’s goal is to assist 2,300 of the state’s 8,000 practicing physicians during the next four years. The long term objective is to have 80 percent of Connecticut’s providers go live with EHR systems and be able to exchange health information securely and privately via the HIE. In the first two years of the ONC grant, the REC will serve at least 1,308 priority primary care providers to include physicians in small practices and/or those caring for underserved patient populations.

The REC will administer services through a Core Team to receive referrals and commitments of providers from various physician organizations called “Channel Partners” and will contract with a number of preselected Direct Assistance Contractors to help providers select, implement and achieve meaningful use.

Go to and RFIs.aspx for information on the RFP.

Wednesday, August 11, 2010

Funds to Adopt EMR Systems

Niagara Family Medicine Associates, a primary care physician group received $50,000 and Dr. Ronald Clark, DO Family Medicine received $10,000 to purchase and implement their EMR systems. The funds were available through a new program administered by HEALTHeLINK, Western New York’s clinical information exchange and funded by BlueCross BlueShield of Western New York, Independent Health, and Univera Healthcare. The program is designed to help Western New York physicians acquire and implement EMRs.

In addition to the funding HEALTHeLINK is providing 100 hours of consulting services to each practice to help transform their processes and workflow to ensure a smooth transition from paper to EMRs. Effective use of an EMR system will help Niagara Family Medicine Associates and Dr. Clark qualify for available federal stimulus funds.

To be eligible for financial assistance, a physician practice must be located in Erie, Allegany, Cattaraugus, Chautauqua, Genessee, Niagara, Orleans or Wyoming County and be a participating provider with BlueCross BlueShield of Western New York, Independent Health or Univera Healthcare. In addition to primary care providers, the program will support pediatricians and OB/GYN providers.

Program to Provide Outreach

The Department of Defense is working to provide the best medical care and outreach programs to all service members and veterans that suffer clinical levels of major depressive disorders, PTSD, and TBI along with disorders at subclinical levels.

Online resources, interactive media, and social networking help supplement traditional healthcare options and help service members and veterans find treatment from trained providers. In addition to social networks, two other technologies such as telehealth and medical informatics are greatly assisting in treating mental health.

The Healing Heroes Program (HH) is going to develop and apply all of these technologies to improve the medical and psychological healthcare for service members. HH will be developed as an online resource with compelling and helpful information and will be an ever changing flexible platform to allow for the development and testing of new internet technologies and ideas by third-party developers.

Specifically HH will feature psychological health education and outreach, a social-networking hub with advanced functionality, a telehealth portal for consultation and/or treatment, and serve as a medical informatics platform to create new medical capabilities.

The Defense Advanced Research Projects Agency recently posted a Broad Agency Announcement Funding opportunity that will result in multiple awards with a final closing date of October 13, 2010. The initial closing date was July 13, 2010, but proposals will still be accepted by October 13, 2010.

DARPA is soliciting innovative research proposals to address web-based approaches for medical and psychological health social networking, care deliver via telehealth, and for work in informatics. The proposed research needs to address innovative approaches that will advance science, technology, or systems.

Go to ,,, email, or fax (703) 248-1818, for more details.

Access Point Grants Available

HRSA announced that $250 million in grants is available through the Affordable Care Act to support New Access Points (NAP). The plan is to deliver primary health care services to underserved and vulnerable populations under the Health Center Program. A new access point is a new full time service delivery site that provides comprehensive primary and preventive healthcare services.

HRSA anticipates that there will be approximately 350 NAP grant awards with $650,000 estimated to be the size of the average awards to support more than 19 million people nationwide in FY 2011.

Applicants seeking NAP grants will need to demonstrate a high level of need in their community, present a sound proposal, and demonstrate collaborative and coordinated deliver systems for the provision of healthcare to the underserved. Applicants also need to show that NAPs will provide quality primary healthcare services, including oral health, mental health and substance abuse services. Applicants can be private non-profit entities including tribal, faith-based, and community-based organizations that meet health center funding requirements.

Availability of applications was announced August 9th and the application deadline is November 17, 2010. The projected award date is August 1, 2011 and the project period is estimated to be two years.

For more information on (HRSA-11-017), go to or contact Tiffani Redding at

Cancer Initiative Launched

The Vanderbilt-Ingram Cancer Center (VICC) just launched its new “Personalized Cancer Medicine Initiative” to become the first cancer center in the Southeast and one of the first in the nation to offer cancer patients’ routine “genotyping” of their tumors at the DNA level.

The University will use its EMR system to use the genotype information to help in point-of-care decision-making. “The EMR for each patient is automatically updated to contain the latest genome-based treatment information, so that all healthcare provides at Vanderbilt are fully informed and guided by the latest decision support on advanced therapies,” said Dan Masys, M.D., Chair of the Department of Biomedical Informatics.

Jeff Balser M.D., Ph.D, Vice Chancellor for Health Affairs and Dean of the School of Medicine, notes, “We are rapidly expanding our ability to precisely identify genetic differences between patients, and make rational treatment decisions at the bedside. Through a unique and cohesive set of advances that combine innovations in healthcare informatics, genomics, and drug discovery, we are beginning to deliver on the promise of the Human Genome Project, with highly personalized therapy for our patients.”

The first tumor types to be tested are certain forms of lung cancer and melanoma. Both have been difficult to treat but new therapies that target specific genetic alterations in the tumors have shown promising results. According to William Pao, M.D., PhD, in charge of the personalized cancer medicine program at the university, the VICC program will examine more than 40 mutations in lung cancer and melanoma that are potentially relevant to existing and emerging targeted therapies. As additional tumor-specific mutations are identified, they will be added to the screening panel and new screening panels for cancers are in development.

For more information, go to

State Addresses Integrated Care

The North Carolina Health and Wellness Trust Fund (HWTF) awarded $1,001,736 to the North Carolina DHHS Division of Medical Assistance (NCDMA) to form the North Carolina Center of Excellence for Integrated Care. The goal is to develop a ground-breaking initiative to help move towards coordinated care using a model that combines the delivery of medical and mental healthcare services.

The Center will be managed by the North Carolina Foundation for Advanced Health Programs and will build upon “Integrated, Collaborative, Accessible, Respectful, and Evidence-based” care referred to as ICARE a partnership created in 2006. The program addresses the need to combine mental health treatment with medical care in primary care settings.

The project started with primary care practices where 40 percent of all patients present with mental health issues. The Center of Excellence will continue to work with primary care offices and expand integrated care into other healthcare systems such as hospital emergency departments and mental health agencies. The Center will also ensure that consistent standards of care are adopted across different healthcare settings.

NCDMA will match HWTF’s funds to create the Center to support educational opportunities to improve the quality of care for high risk and high cost Medicaid patients. The Center will operate with a small interdisciplinary team working with experts in multiple fields of medicine, mental health, emergency care, and healthcare management.

ICARE also partnered with the North Carolina Office of Rural Health and Community Care to implement pilot projects at practices across the state. Results from the pilots have indicated that access to outpatient mental healthcare improved and than many patients benefited from integrated care.

For more information, contact Barbara Moeykens, at HWTF at (919) 855-6881.

Sunday, August 8, 2010

Mental Health Bill Introduced

Last year, ARRA provided incentive funds for health information technology however behavioral health, mental health, and substance abuse treatment professionals and facilities were excluded. To address this issue, Senator Sheldon Whitehouse (D-RI) just recently introduced legislation to correct that inequity.

“These providers are the backbone of our mental healthcare system, and it is vital that they have access to cost-saving and quality-enhancing advances in health IT”, said Senator Whitehouse. “By expanding the use of EHRs, my legislation will give mental health professionals access to comprehensive and up-to-date medical histories to enhance the precision of diagnoses and reduce medication errors.”

The legislation referred to as the “Health Information Technology Extension for Behavioral Health Services Act of 2010” will:

• Expand the types of providers eligible for Medicare and Medicaid incentives that use electronic health records to include licensed psychologists and clinical social workers
• Expand Medicare hospital incentive funding eligibility to include inpatient psychiatric hospitals
• Expand Medicaid hospital meaningful use incentive funding eligibility to include community mental health centers, mental health treatment facilities, psychiatric hospitals, and substance abuse treatment facilities
• Clarify eligibility of community mental health centers, psychiatric hospitals, behavioral and mental health professionals, substance abuse professionals, mental health treatment facilities, and substance abuse treatment facilities to obtain technical assistance from regional HIT Extension Centers

Companion legislation has also been introduced in the House by Congressman Patrick Kennedy (D-RI) and referred to the Subcommittee on Health.

Broadband Projects Announced

On August 4th, Secretary of Agriculture Tom Vilsack and USDA’s Rural Utilities Service Administrator Jonathan Adelstein announced the release of $1.2 billion for grants and loans to develop an additional 126 broadband infrastructure projects. The ARRA funded projects will create jobs and provide rural residents in 38 states and Native American tribal areas access to improved service. An additional $117 million in private investment will be leveraged, bringing the total funds invested to $1.31 billion.

The announcement is part of a second round of USDA broadband funding through ARRA. USDA has provided loans and grants for $2.65 billion to construct 231 broadband projects in 45 states and one territory. The remaining authorized funds will allow an additional $1 billion in loans and grants by September 30, 2010 which means that between $3 and $4 billion of program activity will take place.

The investment in broadband will help first responders in rural and remote areas have the tools to keep their communities safe. According to Secretary Vilsack, “We will certainly work to advance rural healthcare to enable medical specialists to use telemedicine to provide advanced diagnosis for patients and for consultations. It will also provide another opportunity for HHS to encourage electronic medical recordkeeping in rural hospitals and in clinics.”

Improving Automation of REMS

iReminder, a healthcare technology company focused on increasing medication compliance, is calling for the greater automation of “Risk Evaluation and Mitigation Strategies” (REMS) programs. Jean Steckler, Senior Vice President, speaking at an FDA public meeting on REMS, advised pharmaceutical manufacturers and the FDA on how automation should be used to improve patient communications, prescriber and pharmacy access status, and provide patients with reminders for laboratory test requirements.

Many of the speakers at the public meeting, called for greater efficiencies in administering REMS programs for both prescribers and pharmacies. The challenge facing the FDA is to find the right balance between designing REMS templates for different classes of drugs and accommodating drug specific risk profiles.

Since patient medication treatment decisions are not made in isolation and are based on the patient’s aggregated risk profiles, Steckler recommends automating patient communications and reminders regarding protocol requirements.

“We know from research on memory that one day after information is presented, people remember only 20 percent of what they have learned,” Steckler noted. She pointed out that patients have different optimal learning styles in terms of visual and auditory, but it has been found that individuals learn best through interaction and by restating their understanding of their risk profiles.

“Despite the collective best efforts of pharmaceutical manufacturers and the FDA to design readable and culturally appropriate Medication Guides, these guides are typically quickly discarded by patients,” Steckler added.

Steckler proposed a methodology to simplify and provide consistent patient communications across all stakeholders such as with patients, prescribers, pharmacy chains, and independent pharmacies. Specifically, she recommends sending IVR, email, and SMS reminders to patients for upcoming laboratory testing and refill dates, sending automatic alerts to healthcare providers and pharmacies when patients report that they will not comply with laboratory testing or pick up their refills, and to distribute Medication Guides electronically to patients.

A new whitepaper “Risk Mitigation Regulation and Compliance Review” published by iReminder LLC provides guidance on meeting FDA requirements as set forth in the FDA Amendments Act of 2007for products with known or potential risks.

To download the whitepaper on REMS, go to To contact Jean Steckler email

Reducing Health Disparities

NIH is working with a multidisciplinary network of experts who will explore new approaches to understanding health disparities or differences in the burden of disease among population groups. Using state-of-the-science conceptual and computational models, the network’s goal is to identify important areas where interventions or policy changes might have the greatest impact in eliminating health disparities. The computational models will function as computer-simulated laboratories to look at the causes of health disparities as well as their solutions.

The Office of Behavioral and Social Sciences Research (OBSSR), part of NIH, is contracting with the University of Michigan’s School of Public Health at Ann Arbor to establish the “Network on Inequality, Complexity, and Health” (NICH). Comprised of scientists with expertise across disciplines, NICH will be the first network to apply systems science approaches to the study of health inequities.

Systems science methods enable investigators to examine the dynamic interrelationships of variables at multiple levels of analysis simultaneously. They also enable the researchers to study the impact on the behavior of the system as a whole over time. For, example, factors such as access to healthcare, neighborhood environment, educational opportunities, physiology and genetics, all may interact over the course of a person’s life to influence risk for diseases like diabetes and cardiovascular disease.

Led by Chair and Principal Investigator, George A. Kaplan, Ph.D., at the University of Michigan, School of Public Health, NICH’s primary goal is to catalyze groundbreaking research on health disparities and population health using systems science methods. NICH will foster areas of health disparities research that is receptive to using a systems science approach.

I-HITEC Selects Vendors

The Indiana Health Information Technology Extension Center (I-HITEC) has selected three software vendors to assist I-HITEC to help primary care healthcare providers adopt EHRs and achieve meaningful use.

The software vendors selected are:

• Athenahealth Inc., (Boston)—Helps medical providers use medical billing practice management and EHR services. Serves over 23 medical providers to help improve their billing and clinical operations
• iSALUS Healthcare, (Indianapolis)—Provides a web-based EMR and practice management solution that serves more than 40 distant medical specialists
• MDLand, (New York)—Helps providers with EHR medical practice management and emerging technologies

I-HITEC funded by $12 million by ARRA will aid Indiana’s small practices of 10 or fewer healthcare providers, community health centers, federally qualified health centers, and rural health clinics.

In April, I-HITEC began operations and is accepting healthcare providers into the program. Information and sign-up is available at

More than 200 vendors were vetted by I-HITEC and the three web vendors were chosen for their ability to meet the needs of small and/or rural healthcare providers. The vendors have agreed to provide preferred pricing and terms and are working toward a definitive agreement with I-HITEC.

I-HITEC is administered by Purdue’s Healthcare Technical Assistance Program (HTAP) and is one of 60 nonprofit organizations nationwide that receiving ARRA funding to help meet a goal to use electronic health information technology by 2014.

ATA Mid-Meeting Coming

The ATA 2010 Mid-Year Meeting will combine multiple telemedicine events and a telehealth exhibit hall to run concurrently in one convenient location on September 26-28 at the Hilton in Baltimore MD. There will be many opportunities to network with the most influential movers-and-shakers in telemedicine and to discuss the future of healthcare and telemedicine.

Among many topics, the ATA Summit 2010 will discuss government funding for telehealth, private payers of telemedicine, answer questions on federal regulations, and discuss how academic medical centers are influencing telemedicine.

The ATA Meeting will identify the swift changes underway in healthcare delivery and specific opportunities provided by those involved in telemedicine. The exciting line-up of speakers at this meeting will share the challenges and opportunities of health reform and the important role that telemedicine can play.

The agenda includes a line-up of all star speakers to present many perspectives in healthcare. For the first time, senior management from CMS, HRSA, and other major federal programs will actively participate in the telemedicine meeting, signifying a significant shift in federal public policy. Also participating will be senior leaders from regulators and private payers.

So far, some of the speakers include:

• Marilyn Tavenner, Acting Administrator, Principal Deputy Administrator and Chief Operating Officer for CMS
• Reed V. Tuckson, MD, Executive Vice President, Chief of Medical Affairs, UnitedHealth Group
• Molly J. Coye, MD, MPH, CEO, Health Technology Center
• Mary Wakefield, PhD, RN, Administrator, HRSA
• Ronald C. Merrel, MD, FACS, Virginia Commonwealth University
• Dale Alverson, MD, Medical Director, Center for Telehealth, University of New Mexico Health Sciences and President of the American Telemedicine Association
• Jonathan Linkous, Chief Executive Officer, ATA
• Gary Capistrant, Senior Director, Public Policy, ATA

The 5th Annual Pediatric Telehealth Colloquium will be held at the Mid-Year Meeting to hear discussions on original research related to pediatric telemedicine, innovative pediatric telehealth applications, achieving sustainability, providing quality of care, financial impact on the field, novel technologies, and advancing telecommunications.

The meeting will also feature pre-meeting events and partner meetings to include a Telemedicine Basics Tutorial plus an ATA Leadership Development Seminar.

Don’t miss out on the 2010 Mid-Year Meeting Exhibit Hall. This is where healthcare professionals will be able to find, handle, and test telemedicine products and services. Dedicated exhibit hall hours and the controlled size of the exhibit will enable prospective buyers and sellers to connect in a relaxed environment. There are still exhibit spaces available, but the deadline to be included in the final program is September 1, 2010.

For more information on the meeting, to find out about exhibiting or to register, go to

Wednesday, August 4, 2010

HIE Scheduled for 2010

Funds for $4.5 million from ARRA are going to HealthInfoNet (HIN), Maine’s independent nonprofit statewide HIE. The funds will be used to help transition HIN later this year from a two year demonstration phase and move toward statewide implementation with full statewide implementation scheduled for the second half of 2010.

HIN’s secure clinical database now contains approximately half of Maine’s entire population of 1.3 million. This means that clinicians participating in HIN’s 2 year demonstration phase now have 24/7 access on a statewide basis.

HIN expects to add up to seven more hospitals to the statewide HIE over the next year bringing the total number of participating hospitals to 22. By 2015, HIN plans to include all of the state’s hospitals and approximately 80 percent of Maine’s physician practices. Over time, HIN will include small and rural unaffiliated providers, long term care, home health, behavioral health, and others.

Despite a substantial budget shortfall, the State of Maine has included $1.7 million in the 2010-2011 budget to enable HIN to go live this summer and to position Maine for federal matching funds that are expected to be available. Some $8 million has been raised so far to build HIN and another $12 million is needed to build out the statewide infrastructure. It is estimated that it will cost approximately $6 million to operate HIN on an annual basis.

Organized as a public-private partnership, HIN received funding support from a wide range of private foundations, provider organizations, and state and federal government agencies. The Board of Directors includes physicians, hospital leaders, consumers, employers, government officials, insurance executives and others.

HIN has retained 3M Health Information Systems and Orion Health to build and operate the statewide HIE. In addition, DrFirst, Inc has been retained to provide coordination in automating electronic prescribing services and to provide access to medication history information.

For more information email HIN Executive Director Devore Culver at or Project Consultant Jim Harnar at

Board Studying Changes

Proposed rule changes were presented to the Texas Medical Board in April and June, and published in the July 2010 Texas Register for a 30 day comment period. The proposed rule changes pertaining to telemedicine are listed in Section 174. These proposed rules will be presented to the Medical Board August 26-27, 2010 and there will be an opportunity for comment at that time.

The proposed changes and new rules pertaining to Section 174 related to telemedicine are:

• Section 174.2 would establish uniform definitions for those who practice telemedicine in Texas. The section defines distant site provider, face-to-face visits, patient site locations, patient site presenters, amends the definitions for physician patient email, telemedicine medical services, and deletes the definition for telepresenter

• Section 174.7 concerns telemedicine services provided at sites other than at an established medical site such as in the patient’s home. The new section will establish standards for the use of telemedicine medical services at non-medical sites. The proposed rule will accommodate developing trends in healthcare delivery as well as changes in the Health and Human Services Commission’s rules for Medicaid telemedicine reimbursement. Also the proposed changes authorize the types of telemedicine that are currently being practiced in both rural and urban areas in Texas

• Section 174.8 would establish the requirements to maintain medical records for telemedicine medical services and the documents needed to be considered part of the medical records.

• Section 174.9 would establish requirements relating to technology and security while providing telemedicine services and physician-patient communications through email.

• Section 174.11 concerns on-call services and enables the physicians in the same specialty who provide reciprocal services to be able to provide on-call telemedicine medical services for each other’s patients

• Section 174.12 provides that persons who treat and prescribe using advanced communications technology and are engaged in the practice of medicine must have appropriate licensure unless otherwise exempt.

For more information, go to or email or call (512) 305-7016.

Expanding Dental Care

HHS has announced a joint initiative to expand oral health services, education, and research in America. The joint effort will be lead by HRSA with support from the U.S Public Health Service Oral Health Coordinating Committee, and the HHS Office of Minority Health.

Other HHS agencies involved in developing a systems approach to create dental programs include ACF, CDC, CMS, and the Indian Health Service. These agencies are working to provide education, monitor oral diseases, develop innovative strategies to increase access to care, and developing a national surveillance system for American Indians/Alaskan Natives.

In addition, the NIH National Center for Research Resources (NCRR) is funding development of a web accessible clinical research dental network toolkit so that researchers will be able to standardize dental research and develop a national dental research consortium infrastructure.

Using the dental network toolkit will enable researchers to have a secure and uniform way to collect patient information and biological samples. The web-based resource will allow dental researchers to use standard but customizable forms to collect and compare clinical trial data across multisite studies. It will also enable the storage of medical and dental records as well as patient samples in a single web accessible data-encrypted platform.

Using the technical informatics expertise at the University of North Carolina’s CTSA and building on its established biomedical informatics infrastructure, developers of the dental network toolkit have been able to create the resource quickly and provide a way to support large complex studies.

Connecting researchers with patients who could not otherwise take part in a large study, the dental network toolkit will also serve as a clinical data management system to support dental clinical trials, patient registries, and longitudinal and observational studies, allowing researchers to easily store, analyze, and share clinical research data.

Telemedicine Pilot Launched

The Illinois Department of Corrections (IDOC) and the University of Illinois at Chicago are partnering on a new telemedicine pilot program to bring healthcare to inmates with HIV and Hepatitis C. This interagency pilot program was successfully rolled out at Danville, Lincoln, and Robinson Correctional Centers.

Three more prisons in the system will be piloting this program and the hope is to add three prisons each month until all of the facilities are using telemedicine technologies to treat the inmates. IDOC pilot sites scheduled to roll out next month include Logan, Moline, and Western Correctional Centers.

Each facility will have equipment installed and UIC will have a designated area where the physician can do their assessments. Each location has a screen along with medical instruments connected to the telemedicine unit at UIC. A medical staff member from the prison is with the inmate at all times and can be directed in the exam by the specialist at UIC. So far, the equipment has worked well, the clinic flow was smooth, and the patients were very receptive.

According to Assistant Professor at the University of Illinois at Chicago, in the Department of Medicine, Dr. Jeremy D. Young, he hopes to provide evidence-based, up-to-date subspecialty care for offenders. He also foresees the program not only providing medical care but also intensive case management services for offenders as they transition from the prison and go back into the community. The plan is to make this an academic program to help provide education and training to IDOC staff and UIC students, residents, and post-graduate infectious diseases fellows.

Bill Gates to Speak at Summit

Bill Gates, Co-Chair and Trustee of the Bill & Melinda Gates Foundation will address using mobile technologies to improve health outcomes in the developing world. He will present his keynote address at the 2010 mHealth Summit to be held November 8-10 in Washington D.C. at the Walter E. Washington Convention Center.

The Summit is being organized by the Foundation for the National Institutes of Health in partnership with NIH, and the mHealth Alliance and is expected to attract more than 2,000 attendees from around the globe, plus feature over 150 exhibitors.

“We are honored to have Bill Gates join the mHealth Summit. The event has quickly become the premier meeting place for leaders focused on research and the delivery of health services through the implementation of mobile technologies,” said Richard Scarfo, Director of the mHealth Summit and Director of Strategic Alliances at the Foundation for NIH.

Gates will be keynoting an interactive discussion on November 9, at 1:00 p.m. EST during the Summit. The event will connect leaders in health, government, academia, philanthropic organizations, and the private sector to discuss new ideas and thoughts on how mobile technology will affect health practices, research, and policy in the U.S. and abroad particularly in low and middle income countries.

Mobile Health or “mHealth” is rapidly becoming a transformative solution for improving quality healthcare services in poor and remote regions around the world. With over 5 billion mobile subscriptions globally, cell phones are becoming a tool to help close the digital divide and increase access to a range of services, including healthcare.

“We are delighted that Bill Gates is speaking to advance the discussion on how modern mobile and computing technologies can save lives and promote healthier communities in even the world’s poorest places,” said David Aylward, Executive Director of the mHealth Alliance whose founding partners include the Rockefeller, United Nations, and Vodafone Foundations, PEPFAR, and the GSM Association.

Verizon Wireless, the partnering sponsor will be joined by other sponsors including Abbott Labs, American Telemedicine Association, CTIS, McKesson Foundation, Microsoft Research, Pfizer, Qualcomm, Robert Wood Johnson Foundation, Skype, and the West Wireless Health Institute.

Be sure to visit the 2010 mHealth Summit web site for registration and conference details at

For more information, contact Kate Barrett at, call (301) 436-2611, or contact Ingrid Madden at, call (202) 887-9040.

Sunday, August 1, 2010

U.S./India to Develop Devices

The National Institute of Biomedical Imaging and Bioengineering (NIBIB) awarded funds to help the U.S. and India develop low-cost diagnostic and therapeutic medical technologies to use in underserved communities worldwide. The supplemental funding announced at the U.S. India Science and Technology Joint Commission Meeting held in June in Washington D.C. is an initiative between NIBIB and the Department of Biotechnology (DBT) of the Ministry of Science and Technology in India.

Some of the technology needed includes:

• Glucose monitoring for diabetes
• Low-cost platform technology for multiple diagnostic tests
• Point-of-care technologies especially to use to screen infants
• Diagnostic tests for early detection of cardiovascular disease
• Networked and mobile technology for diagnostic devices
• Non-invasive or minimally invasive screening technology
• Low-cost diagnostic imaging devices

Applications are now being accepted. Funding amounts will vary and are limited to 25 percent of the direct costs of an existing NIBIB grant. The funding opportunity closes on September 1, 2011. More information and examples of other potential low-cost technologies can be found at

To provide for collaboration between U.S. and Indian researchers, NIBIB and DBT have established an online networking group at For more information, go to Scientists, engineers, and clinicians are encouraged to participate in the Indo-U.S Coalition for Low-Cost Medical Technologies LinkedIn group.

For more information, email John Haller, PhD at

USDA Seeks Comments

USDA is providing a virtual web discussion for individuals, organizations, and professionals interested in the field of telemedicine. The “Power of Telemedicine” web discussion is an extension of the USDA’s Open Government effort and Rural Development’s effort to encourage a more widespread use and understanding of telemedicine.

The web discussion encourages comments, feedback, new information and ideas, innovations, and success stories involving the uses of telemedicine. The Rural Development program is examining the Distance Learning and Telemedicine program in order to improve the program for telemedicine practitioners, patients, and institutions. Since 1993, the Distance Learning and Telemedicine grant program has funded more than 900 projects in 48 states and several U.S. territories, with awards totaling more than $300 million.

For more information and to access the discussion site, go to

HIT Helps Small Community

Frank Vozos, M.D., Executive Director of the Monmouth Medical Center located in Long Branch, New Jersey, appeared on July 27th before the House Energy and Commerce’s Subcommittee on Health to highlight how the medical center’s use of HIT is helping in Long Branch, a small community on the Jersey shore.

He told the Committee that the Monmouth Medical Center (MMC) a 527 bed community teaching hospital provides a full spectrum of services from neonatology to geriatric care. The Center has more than 800 medical and dental staff members admits more than 22,000 adult and pediatric inpatient, as well as cares for over 120,000 outpatients annually.

He explained that the hospital is the leading healthcare provider in Long Branch, a multi-ethnic enclave of residents who are disproportionately poor, young, uninsured, and members of minority groups. More than 35% of the city’s population lives at or below the Federal Poverty Level. There are four census tracts within the city that have been federally designated as Low Income Medically Underserved Populations.

Although there are 40 primary healthcare providers located in the area, most do not accept Medicaid or offer charity care. As a result, the medically indigent population in Long Branch and the surrounding communities use low income clinics provided through a FQHC and the Emergency Department at MMC as their only source of healthcare.

However, the 150 acres that includes the Long Branch oceanfront has added more than 1,300 high end residential properties and 600,000 square feet of commercial space in the near vicinity of the medical center. Residents in the oceanfront area are mostly “empty nesters” and as they grow in both numbers and age, they will place an increased demand on both emergency and other health services in the area.

Dr. Vozos told the Committee that MMC installed their first electronic clinical information system in 1988. Since that time, the Emergency Department has invested significant resources and installed sophisticated IT components. For example, the hospital has a direct electronic interface between the ER clinical information system and hospital charts using the EDIMS computer framework. All records and tests link to the hospital EHR system.

MMC’s clinical information platform connects data from devices that comes from either local or remote workstations. The data goes to the EMR and to providers to enable telemedicine to be used so that better patient care can be delivered. This interconnectivity allows data to be sent and received as well as safely stored based on CCHIT HIE specifications. The medical center is very focused on CPOE and is trying to encourage the physicians to enter orders into a computer instead of handwriting them.

MMC is encouraging physicians to take advantage of EHR systems in their own practices and to be able to interface with MMC so that by 2011 there will be active physician connectivity. The medical center is looking into the costs associated with linking physicians to the medical center by examining what can be subsidized, what can be funded by the medical center, or funded by physicians to work towards connectivity.

According to Dr. Vozos, the Medical Center along with two other hospitals in N.J are beginning a CMS funded 21 month pilot project to test a model to be able to transition Medicaid patients who come to the Emergency Department with non-emergent care needs to the appropriate primary care setting through collaboration with the FQHC. This data driven pilot will integrate electronic referral systems and EHRs, improve the infrastructure, and coordinate the pilot in N.J and in 19 other states.

IBM & UPMC Teaming

IBM and the University of Pittsburgh Medical Center (UPMC) are teaming to bring “smarter” hospital rooms to patients nationwide and bring technology that will bring the right patient information to the bedside when the information is needed. The new high-tech Smart Room now features new capabilities such as a system for automatically organizing and prioritizing the work of nurses and other caregivers.

The SmartRoom solution tackles everyday problems such as simplifying the workflow and making the documentation easier so that nurses can have more quality time at the bedside,” said Michael Boroch, Chief Executive Officer of SmartRoom, a company wholly owned by UPMC and jointly funded by IBM. “It’s estimated that only 30 to 40 percent of a nurse’s time is spent on direct care and we believe that that number can be raised to benefit caregivers and their patients.”

IBM’s funding for the SmartRoom system comes from a $50 million co-development fund created by UPMC and IBM in 2005, when they entered into an eight year agreement to transform UPMC’s IT infrastructure while developing and commercializing clinical solutions.

SmartRoom capabilities are in use in 24 rooms at UPMC Montefiore in Pittsburgh. Using small ultrasound tags from Sonitor Technologies, the SmartRoom system identifies healthcare workers wearing the tags as they walk into a patient’s room displaying the person’s identity and role. This information is on a wall mounted monitor and easily visible to patients.

At the same time, the SmartRoom automatically provides the clinician with relevant, real-time patient information pulled from the electronic medical record, including allergies, vital signs, test results, and any medications that are due.

Software has been developed to help determine which tasks should be completed and in which order to most effectively and safely care for patients. Unexpected interruptions from new physician orders to lengthy discussions with a patient’s family are factored into the dynamically changing priority list.

The information shown on the caregiver’s monitor is tailored to the needs of the specific worker. A hostess who delivers meal trays, for example, will see only dietary orders and allergy information. A doctor will see different information than a nurse.

Using a simple touchscreen interface on a monitor in the patient’s room, a nurse or aide can document the completion of tasks in just a few seconds, rather than writing the information down and waiting to enter it into a computer later. SmartRoom technology provides real-time links to key clinical systems, including pharmacy and lab services. Patient email, testing schedules, education and other features, are also offered through the SmartRoom technology.

For more information, go to