Wednesday, June 29, 2011

Update on Robotics

The National Science Foundation (NSF) is taking the lead with NIH, NASA, and USDA to support the National Robotics Initiative (NRI). Investments in NRI from NASA, NIH, NSF, and USDA may reach $40 to $50 million in the first year with anticipated growth in funding as other agencies and industry partners take part.

On June 24, 2011, NSF released a Request for Proposals to advance the science and engineering of co-robotic systems and to use robots to work beside, or cooperatively with people to help with individual human capabilities, performance, and safety.

The plan is to encourage innovative collaborative research that combines computer and systems science with mechanical, electrical, and materials engineering, along with social, behavioral, and economic sciences to tackle the most important and challenging robotic problems.

For example, state-of-the-art technology such as the Intuitive Surgical daVinci robot is already assisting doctors with complex surgical procedures. The Independence Technology iBot safely propels wheelchairs over curbs and upstairs, and systems like Cyberdyne’s HAL is able to augment body movements and strength for construction workers with wearable robot exoskeletons.

So far, NIH has used robotics for DNA sequencing, the rapid screening of potential drugs, and the subsequent discovery of new drugs. Now NIH Institutes will be able to develop robotic applications to assist in surgery, prostheses, rehabilitation, behavioral therapy, personalized care, and wellness/health promotion. One important issue that needs to be studied involves the safety of robotics used in the home or in surgical settings where the integration of complex systems is required.

NIH is very interested because of the potential impact on healthcare in the future as human assistive devices will revolutionize healthcare in the next 20 years as much as personal electronics have changed daily lives in the past two decades.

Research will be pursued in topics ranging from cognition and knowledge representation, control mechanisms, perception, human-robot interaction, language understanding, multi-networked agents, mobility, and human-connected cognitive prosthetics.

There are other ideas for robotic research available through a joint agency FOA released in 2010 for both the SBIR and STTR programs. For these thoughts and ideas go to

In the future, NRI expects to establish open system robotics architectures and common hardware and software platforms, create a repository of software, hardware, and data to encourage sharing of results, sponsor a range of projects from one or more investigators to produce multi-faceted collaborative efforts, create test beds to integrate the output of multiple activities and their testing, establish competitions among funded projects for the best performance of tasks, and produce findings that will educate and contribute to knowledge about the use of robotics.

The letter of intent for the NRI program solicitation is due October 1, 2011 with full proposals due November 03, 2011.

NRI expects to fund two project sizes under this program solicitation:

• Small projects—Projects are expected to range from approximately $100,000 to $250,000 per year in direct costs with durations of one to five years
• Large projects—Projects are expected to range from $250,000 to $1,000,000 per year in direct costs for one to five years, not to exceed $1,500,000 in total costs per year

To view the solicitation, go to Public webinar briefings on the solicitation will be held beginning September 2011.

The program contact at NSF is Howard Wactiar at or Kishna S. Ford at For further information at NIH, email John Haller PhD, at NIH at or call (301) 594-3009.

SAMHSA Publishes Goals

The Substance Abuse & Mental Health Services Administration (SAMHSA) has published several documents addressing the need for technology and data collection in their future plans. The first draft document “National Behavioral Health Quality Framework” identifies national priorities to help improve the delivery of behavioral health services.

What really concerns the agency is the tremendous need for collecting and analyzing data. Today, the limited and often piecemeal information and data generated by existing approaches does not provide the comprehensive array of information on behavioral health needed to adequately inform federal, state, and local experts in term of budget development, policy-making, and managing program operations.

The agency is taking an initial step to address these challenges and will release their “Behavioral Health Barometer” later this year that will highlight key behavioral health indicators of national significance. The agency realizes that their plans are ambitious and will require further discussions with relevant stakeholders and partners.

To view the draft document, go to The document is open for comment until July 1, 2011 with comments to be sent to with “Quality” in the subject line.

The second document “Leading Change: A Plan for SAMHSA’s Roles and Actions 2011-2014”concentrates on SAMHSA’s behavioral health IT initiatives and stresses the primary role and goals that SAMHSA will need to accomplish to achieve their total HIT effort.

The document has four goals:

• Goal 1—Develop the infrastructure for interoperable EHRs, including privacy, confidentiality, and data standards
• Goal 2—Provide incentives and create tools to facilitate the adoption of HIT and EHRs with behavioral health functionality in general and in specialty healthcare settings
• Goal 3—Deliver technical assistance to State HIT leaders, behavioral health and health providers, patients and consumers, and others to increase the adoption of EHRs and HIT with behavioral health functionality
• Goal 4—Enhance the capacity to exchange and analyze EHR data to assess quality of care and to improve patient outcomes

The agency is working with Federal, State and Territorial partners to create a holistic HIT strategy to include comprehensive recovery-oriented programs. The agency has collaborated with the VA, IHS, CMS, and DOD on a number of HIT initiatives.

To further help their partners, SAMHSA awarded a $3.2 million per year, 5 year contract to incorporate behavioral health clinical data standards so that states, territories, and other government jurisdictions have viable EHR options to offer providers that treat safety-net populations

To view the document, go to The publication Number is (SMA) 11-4629.

Telemedicine Receives Award

The Balkans Telemedicine Program developed by the International Virtual e-Hospital (IVeH) Foundation, a not-for-profit organization, received the 21st Century Achievement Award on June 20th as a 2011 honors laureate. The award accepted by the President of IVeH Dr. Rifat Latifi, also Trauma Surgeon and Professor of Surgery at the University of Arizona, was presented by Computerworld in the Health Category for the development and implementation of telemedicine in the Balkans and other countries.

The Health Category recognizes organizations for their innovative use of information technology to conduct research, develop new diagnostic or treatment methods and services, improve the safety and quality of patient care, or improve access to, or the affordability of healthcare.

“The application of information technology and telemedicine and e-health in the Balkans is a powerful combination and strategy that is helping to reform and rebuild healthcare systems throughout the region. The work initially began in the aftermath of war in Kosova but has now become an integral part of healthcare and is being implemented in the region through collaborations and funding from donors such as USAID, Department of State, local governments, and industry,” reports Dr. Latifi.

IVeH was created to assist in rebuilding the public healthcare system in developing countries by introducing and implementing telemedicine, telehealth, and virtual educational programs through the concept of the IVeH Network.

IVeH has worked very hard to establish a fully functional and integrated regional telemedicine network and virtual education network in the Balkans using a strategy called “Initiative Build Operate and Transfer” (IBOT). This strategy combines the establishment of robust telemedicine network and infrastructure along with virtual educational programs through international collaboration.

In addition, work was undertaken to help others to independently manage telemedicine and telehealth programs, create an affordable model, and to ensure full sustainability for applications in developing countries worldwide.

For more information, go to

Portable Images Available 24/7

The NIH Clinical Center’s Radiology and Imaging Sciences is using an innovative new system to enable users to access scans anywhere/anytime there is an internet connection. Operating as a mobile viewing room, the system is designed to work with any browser-enabled device, especially portable wireless devices or tablets.

The new PACS is fast, portable, and user-friendly allowing users to take images with them to meetings, conferences, or even to the library for reference when doing research. Users can search for data by patient name and open and view scans without being tied down to a desktop system, enabling efficient communications between physicians, radiologists, and patients.

The system is easy to navigate and display massive amounts of patient image data very quickly. “Image PACS have previously been designed for expert radiologists, but we know that patient care occurs at the bedside, in the conference room, or in the clinic,” said Dr. David Bluemke, Director for Radiology and Imaging Sciences.

Physicians and researchers can access patient images using their NIH username and login in at

eHI Releases HIE Toolkit

The eHealth Initiative (eHI) just released the second phase of the third generation of their Health Information Exchange (HIE) Toolkit. The Toolkit an online resource empowers healthcare leaders to better manage the challenges associated with developing, adopting, operating, and sustaining an HIE.

Phase II of the new eHI Toolkit is now online and available to the public. This “primer” addresses the next steps needed for starting an HIE. The goal is to create a sustainable model, be able to work with the technical aspects of connectivity, track progress, and be effective at marketing and promoting HIEs. Phase I published in April addressed developing a governance model, drafting legal and information sharing agreements, protecting patient privacy and much more.

“Phase II of the Toolkit includes essential elements for successful health information exchange,” said Jennifer Covich Bordenick, Chief Executive Officer of eHI. “Sustainability is an elusive concept, therefore HIEs need to choose the right technical platform and market themselves in order to be sustainable. Phase II offers best practices on how HIEs can meet the demands of the future.”

Go to for more information on the Toolkit.

To further discuss HIEs and many other important timely topics, eHI will present their “2011 National Forum on Health Information Exchange on July 14, 2011 at the Omni Shoreham Hotel in Washington D.C. Specific topics to be covered include HIEs and Meaningful Use, HIEs and ACOs, Health Insurance Exchanges and HIEs, HIEs and the Direct Project, and HIEs and Public Health.

For more details and on how to register for the National Forum, go to or email

Call for Submissions

The European Association of Healthcare IT Managers and the European Association of Hospital Managers is encouraging all IT managers, healthcare organizations, hospitals, and individuals worldwide to participate in the IT @ NETWORKING AWARDS 2012. This is the world’s only open competition of fully implemented operable healthcare IT and medical technology solutions. Hospitals, research institutes and companies from all over the world are invited to showcase their excellent solutions with the aim to win.

The Call for Submissions for the IT@NETWORKING AWARDS 2012 has just been announced. Have you recently implemented an innovative IT solution in your hospital or department? If yes, then reflect and build on your success. This is your opportunity to tell your story, and to show the global healthcare sector what your solution can do and why the technology deserves to win.

The IT @ NETWORKING AWARDS 2012 awards will take place on January 18-19 in Brussels, Belgium. On Day one, the MINDBYTE Session will take place by having each nominee for the award give a five minute presentation followed by a lively five minute Q&A. The audience will vote immediately after each presentation according to the voting criteria for each solution.

The WORKBENCH Session to take place on Day two will have eight top-rated nominees give a 25 minute in-depth presentation followed by a 15 minute Q&A discussion to provide the audience with a thorough understanding of the project.

IT @ 2012 is a real competition in which presenters are challenged by expert judges and participants. The competition is especially unique since each presentation is followed by a thorough questioning from the voters. CEOs, CIOs, CMIOs, hospital and IT managers will use the electronic voting system to support their preferred projects.

IT @ 2012 will identify some of the finest and most innovative departmental institutional local, regional, and national healthcare solutions. The top prize will be an Award Trophy plus a cash prize of 2,500 EUR around $3,615 in U.S. dollars. Additionally, the winning technology will be promoted in Europe’s leading healthcare management media which is valued at 47,500 EUR around $68,700 in U.S. dollars.

All entries must be implemented in at least one site and must be fully operable. Each submission must cover the importance of the technology, benefits, originality, difficulties, successes, and impact of the technology. Submissions need to be entered by September 16, 2011 so go to for more information.

Submissions without any commercial interest or any link to healthcare service providers are free. All other submissions are charged a one-time registration fee. For Federal Telemedicine News readers and subscribers, the rates are 160 Euros or around $225 in U.S dollars. When FTN readers are registering, choose group A. Then include the FTN blog website URL as your reference in the comments.

For more information, please visit or call +32/2/286-8501.

Sunday, June 26, 2011

CMS Awards $500 Million

CMS through the CMS Medicare Medicaid Innovation Center has made $500 million available for the new “Partnership for Patients” (PFP) program. The funding will help hospitals and healthcare provider organizations stop millions of preventable injuries and complications related to healthcare acquired conditions and unnecessary readmissions. The goal is to reduce harm in hospital settings by 40 percent and reduce hospital readmissions by 20 percent over a three year period.

On June 22, 2011, CMS released the pre-solicitation notice (APP111513) seeking a Patient Safety Hospital Engagement Contractor. The plan is to contract with large healthcare systems, associations, state organizations, and other interested parties to support hospitals in the hard work of redesigning care processes to reduce harm. CMS intends to award multiple firm-fixed price contracts by September 30, 2011.

The Contractors will be asked to do the following:

• Design intensive programs to teach and support hospitals to make care safer
• Conduct training for hospitals and care providers
• Provide technical assistance for hospitals and care providers
• Establish and implement a system to track and monitor hospital progress in meeting quality improvement goals

The funding can also address other areas such as adverse drug events, catheter-associated urinary tract infections, central one-associated blood stream infections, pressure ulcers, surgical site infections and, ventilator-associated pneumonia.

In addition to the Hospital Engagement Contractors, CMS will be working with other contractors to develop and share ideas and practices to improve patient safety. These efforts will include working with patients and families to improve patient safety and transitions between different healthcare settings.

In addition, CMS has planned an Industry Day that will include a webinar on July 6, 2011 from 1pm to 4pm EST to discuss the PFP program and solicitation. For more information, go to or call (877) 267-1577. The participant code is 5045.

For more information on the RFP, go to The primary point of contact for this solicitation is Richard B. Asher, Contract Specialist. Email or call (410) 786-4170.

NIH Seeks New Devices

The NIH Funding Opportunity Announcement (FOA) seeks small businesses through the SBIR program to develop new devices and instruments or find ways to improve existing equipment that will effectively monitor and treat newborn infants and small children. Despite major advances in biotechnology, R&D efforts so far have been limited.

This FOA hopes to foster the collaborations and partnerships needed between clinical and bioengineering research communities and small business concerns to move the field of pediatric device development forward.

The FOA (RFA-HD-12-192) was issued on June 14, 2011 by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Heart, Lung and Blood Institute (NHLBI). Up to $250,000 total costs per year may be requested by the proposer.

Studies need to be done to establish the accuracy and safety of devices under varied clinical conditions. Studies many range from concept to developmental phases but the goal is to develop accurate devices that can be marketed and used in clinical settings to help newborn infants of varying gestational age, postnatal age, and illness severity The major topic areas for the R&D effort include but are not limited to cardiovascular, pulmonary, hematologic, metabolic, infections, and hearing, speech, and swallowing functions.

The application for the FOA “Safe and Effective Instruments and Devices for Use in the Neonatal Intensive Care Units” (SBIR) (R43) is due September 19, 2011. Go to for more information or mail Tonse N. K. Raju M.D at

FDA Issues Draft Document

FDA issued a draft document to help advance the development and approval of an artificial pancreas system to treat Type 1 diabetes in the U.S. An artificial pancreas system is an automated, closed-loop system that combines a continuous glucose monitor, an insulin infusion pump, and a glucose meter for calibrating the monitor.

The draft document published on June 20, 2011 addresses an early version of an artificial pancreas system known as a Low Glucose Suspend (LGS) system which can help reduce or lessen the severity of a dangerous drop in glucose levels by temporarily reducing or stopping the delivery of insulin.

The release of the draft document clarifies information for manufacturers, investigators, and reviewers involved in developing an artificial pancreas system. The document provides information on how to submit an application for the LGS system intended for single patient use in the home environment. The document discusses safety and effectiveness goals that the FDA may require researchers and industry to meet when developing the LGS system.

FDA seeks input from industry, researchers, the clinical community, and other stakeholders on the draft document. Specifically, FDA is interested in the types of clinical studies that should be conducted and what the target outcomes should be to demonstrate safety and effectiveness. Comments and suggestions are due 90 days after the publication of the June 21st notice in the Federal Register.

FDA is working on a second draft guidance that will help manufacturers and researchers develop more autonomous artificial pancreas systems and this guidance document is expected to be issued by the end of the year.

To view the document “Draft Guidance for Industry and the FDA Staff: The Content of Investigational Device Exemption and Premarket Approval Application for Low Glucose Suspend Device Systems” go to

EHRs & Medical Decision-Making

Today, EHRs are not designed to support clinical decision-making since physicians are faced with information overload, time pressures, multi-tasking, and the need to aggregate and synthesize information from disparate sources. Today’s systems serve as a medium for information storage and retrieval but are rarely aligned with mental processes that underlie clinical decisions.

In doing research on decision-making, it has been found that expert medical decision makers mentally organize information in task-specific ways for efficient effective and safe diagnostic or therapeutic decisions.

To help address the barriers to effectively deal with health information technology, the National Center for Cognitive Informatics and Decision Making in Healthcare (NCCD) was funded by the Office of the National Coordinator for HIT under the SHARP program.

NCCD a consortium of nine institutions led by the University of Texas Health Science Center at Houston (UTHSC-H) is going to do research on “Patient-Centered Cognitive Support”. The program brings together a collaborative interdisciplinary team of researchers from a number of fields such as biomedical and health informatics, cognitive sciences, clinical sciences, industrial and systems engineering, and health services.

UTHSC-H researchers will examine human information processing, medical decision-making, medical artificial intelligence, and clinical comprehension. By analyzing the research, scientists will come up with decision models to serve as a basis for the design of “Cognitive Support Systems” along with a suite of tools that will be able to gather and organize clinical information in a problem specific manner.

To further develop the program, on May 26, 2011, UTHSC-H issued an RFP to find assistance on how to design, implement, and evaluate cognitive support to provide the EHR with the intelligence to organize task-specific information in a way that supports the cognitive processes of decision-making both in critical and primary care.

The winning contractor will work closely with these researchers in the School of Biomedical Informatics to help design, develop, implement and support a series of medical applications based on research generated by the “Cognitive Support Systems” project.

To view the RFP “Cognitive Support for Medical Decision-Making”, go to then go to the search box and search for RFP No. 744-1122. The bid submittal deadline is June 28, 2011. For more information, email Michael K. Ochoa, UTHSC-H Purchasing Contracts Administrator at

State to Publish RFP

The Minnesota Department of Human Services (DHS) intends to publish a Request for Proposals (RFP) by July 1, 2011 for “Health Care Delivery System” (HSDS) demonstration projects to be launched pending federal approval in 2012. In 2010, the Legislature mandated the Minnesota DHS to develop and implement demonstration projects to test alternative and innovative healthcare delivery systems including Accountable Care Organizations.

The state agency will seek proposals from providers for the demonstration projects to improve care and to lower costs for the state’s publicly funded healthcare programs which include Medical Assistance and MinnesotaCare.

The primary goal for the demonstration is to not only encourage providers to innovate to deliver higher-value care, also to support robust primary care, and improve care coordination via healthcare at home or equivalent efforts. The demonstration will also test payment models to increase provider accountability, implement projects in different parts of the state, allow both larger and smaller provider groups to participate, and create alignment with similar initiatives across payers.

In April 2011, a Request for Information was issued to solicit comments from interested stakeholders on the subject of the demonstration. These comments are now being used to identify areas of concern and to form the details needed to initiate the demonstration projects.

For more information, go to or email Ross Owen at or call (651) 431-4228.

Wednesday, June 22, 2011

Brain Research & Computers

At the Department of Energy researchers using powerful computers have generated a promising lead that may effectively treat patients with Parkinson’s. At least half a million people in the U.S. are believed to suffer from Parkinson’s with about 50,000 new cases diagnosed each year according to the National Institute of Neurological Disorders and Stroke.

A team of researchers at the Supercomputer Center at the University of California at San Diego used the Blue Gene/P supercomputer at the Department of Energy’s Argonne National Laboratory to simulate how proteins called alpha-synucleins damage neurons. Proteins are the cell’s workhorses carrying out vital maintenance and metabolic functions. Clumps of alpha-synucleins in the brain have long been associated with Parkinson’s and other degenerative diseases, but by the time clumps appear, the damage has already been done.

The simulation shows in much detail how alpha-synucleins actually join into ring-like structures penetrating cell membranes and creating pores long before clumps appear. In the case of Parkinson’s disease, the pores can lead to death in the brain’s dopamine-producing cells causing loss of mobility and other symptoms that worsen over time.

Researchers are also developing compounds that can stop alpha-synucleins aggregation in cell cultures. This is a first step toward developing a drug to treat and slow Parkinson’s progression. The information gained from this research is being applied to finding medical answers to Alzheimer’s disease, kidney diseases, and some cancers.

Research scientists at Argonne National Laboratory are also using their lab’s supercomputer to probe other secrets of the brain and find better treatments for patients with blood flow complications. In this study, researchers are mapping exactly how red blood cells move through the brain.

For example, healthy red blood cells are smooth and elastic since they need to squeeze and bend through tiny capillaries to deliver blood to all areas of the brain. By using the supercomputer, researchers were able to discover how the malaria parasite makes its victims red blood cells 50 times stiffer than normal. These malaria-infected cells stiffen and stick to the walls, creating blockages in arteries and vessels. Malaria victims die because their brain tissues are deprived of oxygen.

What is needed is a more complete picture of how blood moves through the brain so that doctors will be able to understand the progression of diseases that affect blood flow, like not only malaria but also diabetes, and HIV.

“Previous computer models haven’t been able to accurately account for the motion of blood cells bending or buckling as they ricochet off the walls,” said Joe Insley, a Principal Software Developer at Argonne who is working with the team. “So far the research data from the Argonne supercomputer is providing an extra level of detail to see how the brain actually works.”

Another part of the study is looking at the relationship between cerebrospinal fluid and blood flow in the brain. “Since blood vessels expand if blood pressure is high and since they are located between brain tissues, this can put dangerous pressure on the brain,” said Leopold Grinberg, a Brown University Scientist on the team.

In healthy people, spinal fluid can drain to relieve pressure on brain tissues, but occasionally the system breaks down—leaving the brain vulnerable to damage. Researchers are spending many hours trying to understand how the system interacts so that doctors will more accurately be able to treat and protect the brain.

Military's 1st Mobile MRI

The Naval Medical Logistics Command (NMLC) awarded a contract to Philips Healthcare for two mobile MRI systems to help diagnose and treat soldiers with traumatic brain injuries in Afghanistan. The Navy has been working with the Army and Air Force to develop unprecedented MRI capabilities to help the deployed forces.

The procurement of the MRI systems has been a joint initiative between NMLC’s partners that includes the Bureau of Medicine and Surgery, Army Medical Material Agency, Chief of Mobility Command, the VA, and the Army’s Rapid Equipping Force.

According to James B. Poindexter, Commanding Officer of NMLC, MRI systems going to Afghanistan are unlike anything commercially available. These specific units have to be self-contained and require that the system be designed from the ground up to account for the many unique and challenging working environments that will be encountered in combat theater. These factors can include vast temperature differences, fine blowing sand, and power issues, so in addition, the MRIs need to meet size and weight requirements to be capable of being airlifted into war zones.

NMLC headquartered at Fort Detrick Md., provides logistics expertise, healthcare services strategies, medical equipment and logistics for Navy Medicine and designs and administers individualized state-of-the-art solutions to meet healthcare needs.

NMLC operates as the technical manager for the Navy’s Healthcare Services Contracting Program and has formal agreements with the Marine Corps, and the Coast Guard to provide medical logistics and materiel management information plus medical mobilization planning assistance.

Hawaii Issues RFP for HIE

An RFP issued on June 6, 2011, is looking for contractors to provide the goods and services needed to establish the Statewide Hawai’i Health Information Exchange (Hawai’i HIE). RFP responders will need to submit a proposal in a written format on July 5, 2011 and be able to provide vendor demonstrations starting in August 2011.

Section 4 of the RFP outlines the services that the vendor will need to provide. In Phase 1, the vendor is required to provide secured messaging services to go from certified EHR applications to providers on another healthcare system.

Phase 2 requires authorized users and systems to easily connect to information through the HIE. There will be two options to help providers access the HIE. The first is with a direct connection to the HIE generally through an integrated EHR system. Integration is expected with specific EHR products such as Epic, Cerner, Allscripts, Wellogic, Med-Media, and GE Centricity.

The Phase 2 second option would be through a web-based portal provided by the HIE. It is estimated that 700 authorized providers either have no clinical data system or have a clinical data system but the system is ready to provide a direct connection to the statewide HIE.

Go to to view the RFP and for more information, email

Benefits from EHRs on the Rise

A Robert Wood Johnson Foundation issue brief reports that 51 percent of patients with diabetes treated at local practices using EHRs in Cleveland Ohio received all the care they needed, as opposed to only seven percent in practices with paper records. These outcomes were recorded across all insurance types whether the patients were on Medicare, Medicaid, a commercial plan, or if they were uninsured.

In 2009, President Barack Obama declared his commitment to invest in EHRs with the hope that they would improve healthcare quality. The RWJF issue brief is the first in a series demonstrating how providers in communities are responding positively.

Significant headway is being made by “Better Health Greater Cleveland” (Better Health) in leading RWJF’s “Aligning Forces for Quality” (AF4Q) initiative in the region to lift the overall quality of healthcare in one of the 16 targeted communities. The program is helping to move beyond improving care in one clinic, one hospital, or one disease at a time, and instead the AF4Q initiative takes a community-based approach.

Better Health has been able to promote high-quality and equitable care especially for the growing populations of people with chronic conditions but yet Cleveland situated in Cuyahoga County still struggles with a burgeoning population faced with a fragmented and uncoordinated healthcare system in the region.

Better Health worked with local doctors to help doctors obtain government incentives to help them adopt EHRs through a series of summits and trainings held in 2010. Today, physician practices across the region are able to report on how often patients with diabetes receive tests to check blood sugar levels, have eye exams, and receive important vaccinations. Today, through Better Health’s bi-annual “Community Health Checkup” report, doctors are able to see how often their diabetic patients received all of the recommended care.

Just this last May, RWJF announced that new grants for $1.3 million would be awarded to 16 additional healthcare collaborations through AF4Q. So far, RWJF has committed $300 million for projects in the program and has managed to lift the overall quality of healthcare in communities as well as reduce racial and ethnic disparities.

For more information, go to

CAPF Funding Grants

The University of Wisconsin School of Medicine and Public Health announced the availability of “Community-Academic Partnership Fund” (CAPF) grants. These grants are made available through the Wisconsin Partnership Program to provide funding to Wisconsin community-based organizations to improve the health of the public through a competitive Request for Partnerships.

Funds totaling $2.5 million will be made available for prevention and wellness projects to promote Wisconsin’s health plan “Healthiest Wisconsin 2020” during the 2011 funding cycle. Through CAPF, the Wisconsin Partnership Program is supporting efforts by state community-based organizations and government agencies to work together with an academic partner to improve the health of residents in the state.

There are two types of grants available:

• Implementation Grants have up to $400,000 for three year projects that either employ or test evidence-based health interventions
• Development Grants have up to $50,000 for two years to develop new partnerships, demonstrations or pilot projects, or smaller implementation projects

Funding priorities will be somewhat limited to programs that are aimed at eliminating health disparities, address the needs of rural and urban underserved, and programs targeting healthy weight, physical activity, and good nutrition.

So far in previous funding cycles, 100 grants have been awarded totaling $24 million to community organizations. For example in 2010, The Wisconsin Primary Health Care Association worked with the UW Madison School of Human Ecology to develop additional FQHC sites in Wisconsin to help provide access to healthcare in rural and underserved populations.

Full proposals are tentatively scheduled to be submitted in mid to late August. For more information, email Mary Jo Knobloch at

Minority Communities & EHRs

HHS in the Office of Minority Health (OMH) and Quest Diagnostics based in Madison N.J. are working together to help minority communities adopt EHRs. Quest Diagnostics will donate EHR software and services to physicians in small practices serving minority populations in Houston, Texas.

Quest Diagnostics and its subsidiary MedPlus will donate 75 EHR licenses, including subscription fees for 12 months to help integrate information technology components within participating physician practices. QUEST will collaborate with the Regional Extension Center at the University of Texas Health Science Center at Houston on staff education and training and OMH will be responsible for the evaluation of the program.

Data from the 2005-2006 “National Ambulatory Medical Care Survey” and the “National Hospital Ambulatory Medicare Survey” shows that EHR adoption is lower among providers serving Hispanic patients who are uninsured or have patients relying on Medicaid. It has been shown that adoption is lower among providers serving uninsured and non-Hispanic black patients than among providers that serve privately insured non-Hispanic white patients.

Other partners include the National Health Information Technology Collaborative for the Underserved (NHIT), HIMSS Latino Initiative workgroup, and Medic Success, located in New Jersey. These groups will assist in physician recruitment.

A healthcare provider who wished to participate must:

• Practice in a Medically Underserved Area (MUA) or in a Health Provider Shortage Area (HPSA) as designated by HHS
• Have an internet connection and use an electronic billing system
• Be a small practice group of one to five providers or a FQHC within a MUA or HPSA
• Be eligible to receive “meaningful use” incentives
• Complete an initial application and submit monthly reports.

For more information, email Dr. Meera Kanhouwa at or Marcia Thomas-Brown at

Sunday, June 19, 2011

Universities Receive $200 Million

As announced on June 14th, five new centers at major universities will receive $200 million over five years from NIH as part of the expansion of the national “Clinical and Translational Sciences Awards” (CTSA) Consortium. This program led by NIH’s National Center for Research Resources (NCRR) is now in its fifth year. The CTSA Consortium has been able to generate a searchable database of potential industry partners to aid scientists seeking public-private partnerships to help take their research to the next level. At the same time, they have been able to develop a secure web application to help scientific teams collect and share research data.

“The CTSAs support the innovation and partnerships necessary to bridge the traditional divides between basic research and medical practice,” said NIH Director Francis S. Collins, M.D., Ph.D. “The combination of resources and collaboration made possible by these awards is essential for developing and delivering new treatments and prevention strategies.”

With these new awards, NIH is funding a total of 60 CTSA institutions in 30 states and the District of Columbia. The five new Clinical and Translational Science Institutes that received the current funding are:

• Penn State Clinical and Translational Science Institute ($27.3 million)—To expand collaborations beyond the boundaries of biomedicine informatics and develop new software solutions to study genetics, epigenetics, and systems biology. Partner with industry, and capitalize on novel tools in information technology to collect, share, mine data, and disseminate new knowledge

• UCLA Clinical and Translational Science Institute ($81.3 million)—To develop ways to retain, recruit, and empower scientists to work together across disciplines, language barriers, cultures, departments, institutions, and geography to improve the health status of the people in Los Angeles

• University of Kansas Heartland Institute for Clinical and Translational Research ($20 million)—to promote innovative public and private partnerships to develop new drugs and devices and integrate patient-centered health and health systems outcomes into evidence-based risk models to help physicians in clinical care

• University of Kentucky, Lexington Center for Clinical and Translational Sciences ($20 million)—To promote collaborations to develop novel drugs and medical devices, to do joint pilot studies, and develop strong programs in community-based participatory research.

• University of Minnesota, Twin Cities ($51 million)—The Biomedical Health Informatics initiative at the university will provide networked clinical data and biospecimen resources while training future informatics scholars

For more information on these CTSA awardees go to The CTSA consortium web site with information on the consortium, current members, and new grantees, can be accessed at

Technology to Fight Fraud

HHS Secretary Kathleen Sebelius has announced that CMS will begin using new predictive modeling technology to help crack down on fraudulent Medicare claims before payment is made. Plans are for the new technology to roll out this year in ten states with the highest levels of waste, fraud, and abuse. By the third year of implementation, predictive modeling software will be incorporated into Medicare claims processing systems nationwide.

The initiative builds on the new anti-fraud tools and resources provided by the Affordable Care Act to help CMS move beyond its former “pay & chase” recovery operations. Medicare will adopt the state-of-the-art technology in predictive modeling systems that are currently used by the credit card and banking industries to identify potentially fraudulent claims and billing patterns before taxpayer funds are spent.

Northrop Grumman, a global provider of advanced information solutions was selected through a competitive procurement to develop the CMS national predictive model technology format. The company has partnered with National Government Services and Federal Network Systems, LLC, a Verizon company to fight healthcare fraud.

Northrop Grumman, through the use of proven predictive models and other advanced analytics, will move rapidly to implement the new technology. The company will deploy algorithms and an analytical process that looks at CMS claims by beneficiary, providers, service origin, or other patterns to identify potential problems and then assign alert and risk scores for those claims. The problem alerts will be further reviewed to allow CMS to both prioritize claims for additional review and then if necessary assess the need for investigative or other enforcement actions.

State Issues RFP for HIE

On June 15, 2011, the Virginia Department of Health (DOH), Office of Information Management and Health Information Technology issued RFP (VDH-2011-00520) for “Project Management Services” for the “Statewide HIE”. The Governor’s HIT Advisory Commission created the strategic and operational plans for the HIE were approved by the Office of the National Coordinator. The Commonwealth of Virginia received $11.6 million for the project.

Virginia’s DOH intends to contract with a private, not-for-profit organizations to create and manage the HIE’s operations on an ongoing basis. This means that the awardee of the contract will need to establish the governance body, the management structure, business operations, and technology infrastructure for the HIE. DOH also expects that the not-for-profit HIE contractor will also subcontract with a private sector firm or firms to operate the technology infrastructure for the HIE.

To view the RFP, go to The deadline to submit questions is June 28, 2011 with RFP responses due by 3 pm July 20, 2011. All inquiries for information should be directed to Sylvia Mitchem by email at or email

Legislation to Monitor Newborns

New Jersey Governor Chris Christie signed the first-in-the-nation legislation to protect the health of newborns from potentially life-threatening congenital birth defects. The legislation requires all inpatient or ambulatory healthcare facilities licensed by the New Jersey Department of Health and Senior Services to perform pulse oximetry screenings that must be done a minimum of 24 hours after birth and on every newborn at a facility.

Pulse oximetry is a non-invasive, low-cost test used to identify congenital birth defects in newborns. It measures the percent of oxygen in the blood of an infant and whether a baby’s heart and lungs are healthy. The screening involves taping a sensor to the newborn’s foot that beams red light through the foot to measure blood oxygen content.

According to the HHS Advisory Committee on Heritable Disorders in Newborns and Children, congenital heart disease affects approximately seven to nine of every 1000 live births in the U.S. and Europe. About 100 heart defects are detected in a year in New Jersey.

“Before they leave the hospital, the 102,000 babies born in New Jersey each year will now have a simple, painless screening test to ensure that any hidden but potentially life-threatening heart defects will be detected, We expect the pulse oximetry test to detect about 100 congenital heart defects in infants each year, enabling early treatment and preventing life-threatening injury or death,” according to Health and Senior Services Commissioner Mary O’ Dowd.

Health Technology Bill Introduced

Representative Albio Sires (D-NJ) introduced the “21st Century Global Health Technology Act” (H.R. 2144) to enable USAID to develop technologies for global health. The legislation would encourage public-private partnerships as a way to leverage federal government resources with private-sector investments in order to create the next generation of lifesaving drugs, vaccines, and devices.

The legislation provides for USAID to establish a health technologies program capable of developing, advancing, and introducing affordable, and appropriate and primarily late-state technologies.

The health technology program would improve the health and nutrition in developing countries, reduce maternal, newborn, and child mortality worldwide, and improve the diagnosis and prevention of diseases especially HIV/AIDS, malaria, tuberculosis, and other infectious diseases.

The legislation requires USAID’s annual reports to Congress to have information on the use of research funds, collaborations with federal departments and agencies how these joint ventures and investments complement their work, investments made in science, technology, and innovations, and any information on the technologies and available research products that are undergoing field trials or are currently being used.

Wednesday, June 15, 2011

Senator Introduces Several Bills

North Dakota Senator Kent Conrad Chairman of the Senate Committee on the Budget, has long been a champion for telehealth to enable veterans to receive appropriate care in rural areas. Recently, he introduced both the “Veterans Telemedicine Act of 2011” (S 1124) which expands the use of teleconsultations teleretinal imaging, telemedicine and telehealth at veteran’s healthcare facilities and the “Veterans Rural Health Improvement Act of 2011” (S 1127).

As Senator Conrad reports, the VA Health Care Network serving North Dakota would expand the use of telehealth technologies at the VA’s Community-Based Outpatient Clinics by creating financial incentives to support the use of telehealth. The legislation also calls for additional telemedicine programs to focus specifically on mental health and TBI treatments.

The second piece of legislation introduced would create “Rural Centers of Excellence” to conduct research and education with the goal to improve the outcomes and the quality of life for rural veterans. These centers would be required to develop innovative clinical activities and systems of care for rural veterans along with providing education and training on rural health issues for healthcare professionals.

More than 20 percent of the veterans in this country live in rural areas and it is difficult sometimes to receive treatment. To handle the veterans with problems in rural America, the VA established the Office of Rural Health which in turn, established three Rural Health Resource Centers on a temporary basis but the new legislation would make these resource centers permanent.

Both pieces of legislation have been referred to the Senate Committee on Veterans Affairs.

Upgrading Army Medical Training

Engineering & Computer Simulations (ECS) a company located in Orlando, received a contract to continue the build-out of the High Fidelity Physiology Model (HFPM) to integrate with medical simulation training systems to provide a real-time representation of human physiology.

Last year, ECS began R&D for HFPM to provide the medical training community with an open-source, stand-alone, and interoperable model capable of simulating multiple patients in real time. Since then, ECS has been able to integrate the physiology model with their “Virtual Medic™” (vMedic) and NEXUS virtual world.

The vMedic application combines the Army’s Tactical Combat Casualty Care Simulation (TC3Sim) and the USMC’s Computer Based Corpsman Training System to create a single application to help meet the needs of the military’s medical first responders. vMedic has the capability to use game engine-based simulations and state-of-the-art instructional strategies that immerse students into scenario-driven events.

The ECS long term vision is to enhance HFPM and make it available to all real-time simulation systems. ECS is working on various avatar-based learning technologies to distribute to meet the Army’s training and education requirements by combining 3D virtual worlds, immersive learning environments, virtual classrooms simulation-based training, and collaborative online knowledge repositories.

In another training gain, the Army’s Medical Communications for Combat Casualty Care (MC4) system is making it possible for soldiers to train on EHRs and medical command and control apps using their personal or approved iPhone, iPad, or Android devices.

Version 2.0 of the “Army Training Network 2 Go” (ATN2GO), a stand-alone mobile application includes tools to guide users of the MC4 system. This helps the military staff document and track patients and their care, digitally manage medical supplies, and conduct health surveillance in the combat zone.

ATN2GO operates through iTunes which is not authorized for use on government computers. Soldiers can download the application to a personal computer from the Army Training Network (ATN) website via a common access card or with Army Knowledge Online credentials. Tutorials and resources on the ATN website guide users through the installation process.

MC4 is continuing to work with ATN to expand application training and to build upon the soldiers’ proficiency with the MC4 system. In the next year, MC4 will extend its training materials to Army distributed learning sites to enable commanders to assign soldiers training paths as well as to evaluate and sustain their unit’s readiness with the MC4 system.

For more information on ECS, go to or to For additional information on Army mobile training, go to

Addressing Patient Safety & Quality

Johns Hopkins Medicine has established the Armstrong Institute for Patient Safety and Quality with a $10 million gift from C. Michael Armstrong, Chairman of the Board of Trustees of Johns Hopkins Medicine and retired Chairman of Comcast, AT&T, Hughes Electronics, and IBM World Trade Corporation.

The Armstrong Institute will oversee all of the current patient safety and quality efforts throughout JHU medicine. It is designed to rigorously apply scientific principles to the study of safety for the benefit of all patients, not just those at Hopkins.

The focus will be on eliminating preventable harm for patients, eliminating health disparities, ensuring clinical excellence, and creating a culture that values collaboration, accountability, and organizational learning. Hopkins will serve as a learning laboratory to test the best that the researchers have to offer in the fields of patient safety and quality improvement.

Patient safety expert Peter J. Pronovost, M.D. PhD, a Professor of Anesthesiology and Critical Care medicine at the JHU School of Medicine has been named the Director for the Armstrong Institute. Pronovost is internationally known for his work using a simple five step checklist coupled with a program of culture change to dramatically reduce the number of central-line associated bloodstream infections in ICUs and virtually eliminating them at the JHU Hospital and throughout Michigan.

Pronovost’s program now in place in nearly every state, the District of Columbia, Puerto Rico, and in many nations around the world, is believed to have saved thousands of lives and millions of healthcare dollars. Pronovost says he wants to build on the success of his checklist and bring the same focus to other areas of medicine where preventable harm continues unabated.

Pronovost currently heads Johns Hopkins Quality and Safety Research Group and is the Medical Director for the Hopkins Center for Innovation in Quality Patient Care. Both groups as well as other partners throughout the university and health system will be folded into the new Armstrong Institute.

Pronovost expects to bring a multidisciplinary approach to the new Armstrong Institute because as he says, “There are different types of safety problems that require different theories and different methods to solve. More importantly, we need to listen to and partner with clinicians.” He plans to tap the expertise of psychologists to assist in improving teamwork, sociologists to help with organizational culture and human factors, and bring in systems engineers to improve the interaction between staff members and new hospital technologies.”

Diagnosing Heart Disease

Innovative UK technology using a revolutionary digital stethoscope will make it easier for GPs to spot the first signs of heart disease. A University of London research team funded by the Engineering and Physical Sciences Research Council has developed a computer-based technology synchronizing the various sounds making up a human heartbeat collected by the new stethoscope.

Like a conventional stethoscope, the new stethoscope captures four sounds one after another. What is exciting is that the new computer-based technology than turns these separate sounds into one combined signal which an existing technique called Independent Component Analysis (ICA) can then process.

The sounds analyzed by ICA are then transferred wirelessly to a laptop or desktop computer in easy-to-understand graphs. These graphs provide a visual representation of the heartbeat and any anomalies. Currently, such anomalies can be missed by doctors who aren’t experts in cardiac care.

With the new system, doctors can compare the visual graphs, produced with normal readings while the patient is there, or save the graphs and study them at a later time. Also, it is easier to obtain a second opinion via the internet from another doctor located miles away.

The new stethoscope called the “DigiScope” is not only suited for GPs to use, but is also ideally suited to be used in outpatient clinics, accident and emergency units, and other hospital departments where doctors are not necessarily cardiac specialists.

The DigiScope is designed to be used by doctors in exactly the same way as they use a conventional stethoscope. The doctor positions the end piece in turn on four different places on the patient’s chest.

Listening to internal sounds within the body via a stethoscope is a hard skill to master since heart sounds are of low frequency and the intervals between events are in the order of milliseconds, requiring the doctor to be able to distinguish between a normal and pathological heart sound.

The digitally enhanced stethoscope can be used to train physicians to improve their basic skills in diagnosing and treating heart conditions or used as a tool for the worldwide screening of specific heart pathologies.

The overall stethoscope development project is an international collaboration led by Portugal’s University of Porto and Centro Hospitalar Alto Ave, Guimaraes and benefiting from additional cooperation from Brazil’s Real Hospital Portugues in Recife.

For more information, go to

Save the Date: Partners Symposium

Partners Healthcare 2011 Connected Health Symposium promises to be a premier opportunity for healthcare executives and key thought leaders to have in-depth discussions and debates on the tough healthcare issues that not only this country but countries all over the world face in the 21st century. Save the date for the Symposium to be held at the Boston Park Plaza Hotel on October 20-21, 2011.

The theme for the Symposium “Driving Quality Up and Costs Down: New Technologies for an Era of Accountability” will provide vital information for over 1,100 health technology leaders, community-based practitioners, health plan executives, large employers, government policy makers, and investors.

The two day event will be filled with top plenary speakers such as Brent James M.D., Chief Quality Officer, Intermountain HealthCare and the subject of the New York Times Sunday Magazine article “If Health Care is Going to Change, Dr. Brent James Ideas will Lead the Way”

Also presenting is Kate Pickett, PhD, Professor of Epidemiology, University of York in the UK and the author of “The Spirit Level: Why Greater Equality Makes Societies Stronger”.

Other keynoters include Atul Gwande, M.D. Surgeon, Brigham and Women’s Hospital in Boston, New Yorker Magazine staff writer on healthcare, and Director for the World Health Organization’s Global Challenge for Safer Surgical Care.

Attendees will want to hear from Janet Dillione GM for Healthcare, Nuance and how she developed healthcare uses for “Watson” IBM’s Artificial Intelligence System. “Watson “was the star computer system that beat two human champions on Jeopardy.

Also on the agenda are many breakout sessions with vital information on accountable care organizations, innovative ways to provide wireless for poor communities, ongoing developments in gaming psychology, entrepreneurship, enhancing decision making skills, dealing effectively with the marketplace, meeting future goals, and how to work effectively by using today’s expanding social media.

The Symposium will be filled with drill down interviews, cut-to the chase debates, and many other great opportunities and events to help attendees have easy conversations with experts in the field. Don’t miss out on meeting all of the exhibitors and viewing their products and be the first to see rapid fire demonstrations of products and services that will help you or your organization stand out and surge ahead to reach new heights in the healthcare field.

Go to for more information on sponsorships, exhibiting, and registering for this major opportunity in order to have the most current information in the connected-health field. The full price to attend the Symposium is $1095. A discount of $100 is being offered to Federal Telemedicine News readers of the blog/newsletter. The code to use when registering is "Telemed News".

For further details, email Joe Ternullo Organizing Chair at or email Margaret Spinale at

Sunday, June 12, 2011

ONC Introduces i2 Initiative

The Office of the National Coordinator for HIT has announced a new program called “Investing in Innovations (i2) Initiative” to spur innovations in health IT. The program will award prizes and conduct competitions to accelerate the development of solutions around key challenges in health IT.

The i2 initiate is made possible by funding from the America COMPETES Reauthorization Act of 2010. As part of the initiative’s rollout, ONC has awarded nearly $5 million to the Capital Consulting Corporation (CCC) and Health 2.0 LLC to fund projects supporting innovations in research and to encourage health IT development through open innovation mechanisms like prizes and challenges.

Examples of health IT competition topics developed in consultation with CCC and Health 2.0 LLC, includes:

• Applications that allow an individual to securely and effectively share health information with members of their social network
• Applications that generated results for patients, caregivers, and/or clinicians by providing access to rigorous and relevant information that can support real needs and immediate decisions
• Applications that allow individuals to connect during natural disasters and other emergencies
• Tools that facilitate the exchange of health information while allowing individuals to customize the privacy allowances for their personal health records

Another component of the i2 Initiative will support analysis of the current health IT environment in an effort to track and model clusters of innovation. All of this will be done while simultaneously identifying connections between disparate innovator communities. This effort will identify technology development trends in a fast-moving sector to provide information on future advisory and policy-making activities.

The i2 initiative will consult with hospitals, doctors, consumers, payers, states, employers, advocates, and relevant federal agencies to obtain direct input on execution and to build partnerships. CCC and Health 2.0 LLC along with other contributors will help provide detailed and up-to-date analysis of relevant emerging innovations and associated trends to help ONC and other HHS agencies better understand these developments as well as the issues that surround them.

Go to for more information available on the ONC homepage.

Software Licensed to HDT Robotics

The Johns Hopkins University Applied Physics Laboratory (APL) located in Laurel Maryland recently licensed Large Motor Control (LMC) software to HDT Robotics. The agreement grants HDT the right to incorporate the software into robotic limbs that the company intends to sell in the commercial market.

The LMC software was originally developed for the Defense Advanced Research Project
Agency’s “Revolutionizing Prosthetics 2009” (RP 2009) program. This program was an APL-led effort that developed the Modular Prosthetic Limb (MPL), an advanced upper-extremity prosthesis that promises to restore full motor and sensory capability to upper extremity amputees.

The MPL is currently being used in a non-human primate clinical trial that includes LMC software in the shoulder and elbow joints as well as to control wrist movements. “The software controls the motors in the arm that allows prosthetic users to use the mechanical upper arm to perform everyday tasks such as picking up an object or opening a door,” explains Kapil Katyal, a biomedical software systems engineer in APL’s National Security Technology Department.

“We are pleased to have a long standing relationship with Johns Hopkins APL and to have been a part of the DARPA Revolutionizing Prosthetics project where the technology was developed, reports Tom Van Doren, Chief Operating Officer at HDT Robotics. “Our continued partnership with APL will enable HDT to bring products to market quickly.”

For more information, email Paulette Campbell at

White House Establishes Rural Council

President Obama signed an Executive Order to establish the first White House Rural Council to address the many challenges that rural communities face in the U.S. today. The Council will be in place to coordinate programs across government, to encourage public-private partnerships, and to promote further economic prosperity and quality of life in rural communities nationwide.

The Rural Council will by chaired by Secretary of Agriculture Tom Vilsack and not only be responsible for recommending investments in rural areas, but also to coordinate the activities and thoughts of a variety of stakeholders that will include agricultural organizations, small businesses, plus state, local, and tribal governments.

In the coming months, the Rural Council will focus on job creation and economic development by increasing the flow of capital to rural areas, by promoting innovations, and expanding digital and physical networks. Key items open for discussion will center on health technology systems, how to increase broadband opportunities in rural areas, and how to coordinate the critical infrastructure needed in communities.

Collaborative Approach to Telemedicine

Sprint is partnering with healthcare and wireless companies to deliver care more efficiently by sharing its network and expertise in embedded mobile computing and Machine to Machine (M2M) communications. To meet the demand for developer support and network certification, Sprint recently opened their new M2M Collaboration Center in Burlingame California.

The Center a hands-on interactive environment is working to facilitate ideas, knowledge, and technology to produce wirelessly enabled M2M concepts, products, and solutions. This means that Sprint engineers and their partners are teaming up to rapidly bring new M2M ideas to the marketplace.

To further collaborative efforts, Sprint has attracted the attention of many entrepreneurial healthcare companies who understand that chronically ill patients recover faster and are more comfortable at home than in hospitals. For example, American TeleCare (ATI), Inc powered by Sprint 3G and 4G has the capability to use a remote stethoscope at 9.6 kbps in clinic-to-patient home settings and uses an interactive video technology to access more patients at lower bandwidths. Sprint and ATI are also working very hard to find connectivity solutions in patient’s homes to better care for chronically ill patients.

In another case, the company Reflection Solutions offers a product called “Reflection” powered by AFrame Digital that provides wireless personal health monitoring. A device worn as a wristwatch wirelessly connects patients and their caregivers to monitor the patient’s health and physical activity.

The watch has a traditional PERs panic button and can even automatically send an alert in the event of a fall, even if the user is unable to activate the PERs button. Boosted by the Sprint network, Reflection is able to extend care beyond traditional limitations while working in conjunction with the caregiver’s mobile phone and PDA.

A sampling of other companies shows how Sprint’s wireless solutions are helping these companies:

• AirStrip Technologies has developed remote patient monitoring applications to deliver real-time vital waveform and other critical patient data directly from hospital monitoring systems to mobile devices. This enables providers to continually monitor vital signs wherever the provider is located

• BodyMedia provides a holistic weight-management system consisting of an armband monitor, online activity manager, optional display and free smartphone apps. It automatically tracks the calories burned during daily activities, and even monitors the quality of sleep. In April, the companies launched the “Sprint BodyMedia ID Pack”, a customized bundle of widgets, applications, wallpapers, ringtones, and wellness content for selected Sprint smartphones

• Calgary Scientific has developed an application called “ResolutionMD” Mobile powered by PureWeb to provide advanced visualization of critical medical images such as MRIs and CAT scans directly to Sprint devices such as the “HTC EVO” 4G and Samsung Epic 4G. Attending or acute care physicians are able to have real-time access to specialists such as neurologists, regardless of where the physicians and patients are located

• IDEAL LIFE manufactures in-home health monitoring equipment for individuals with chronic conditions such as congestive heart failure, hypertension, diabetes, asthma, and obesity. Their system works wirelessly using the Sprint network to transmit medical data to healthcare providers.

• Omnilink tracks individuals who have been diagnosed with Alzheimer’s or some other form of dementia. With Omnilink, the family can be assured that the Alzheimer’s patient is being well-cared for even while away from a doctor’s office or care facility

For more information on these projects, email Randy Spolter at or call (703) 592-8507 or cell (703) 930-2671.

Grant to Help Active Aging

AHRQ awarded a five year $10 million grant to do community-based participatory research on the use of communication and information technologies to improve the health and healthcare services for older adults. The funding will be used to create a “Center of Excellence” to bring together research teams from institutions.

The research will focus on:

• The use of IT to extend independence and functioning of older adults and reduce unnecessary healthcare utilization
• The expansion of service networks that place individuals and their families at the center
• The development of innovative approaches to translate evidence into practice

Grant (1P50 HS 019917 was awarded to David Gustafson PhD and his team from the University of Wisconsin in Madison Wisconsin, The project will run from June 1, 2011 to May 13, 2016. Go to for more information.

Call for Submissions

The European Association of Healthcare IT Managers and the European Association of Hospital Managers is encouraging all IT managers, healthcare organizations, hospitals, and individuals worldwide to participate in the IT @ NETWORKING AWARDS 2012. This is the world’s only open competition of fully implemented operable healthcare IT and medical technology solutions. Hospitals, research institutes and companies from all over the world are invited to showcase their excellent solutions with the aim to win.

The Call for Submissions for the IT@NETWORKING AWARDS 2012 has just been announced. Have you recently implemented an innovative IT solution in your hospital or department? If yes, then reflect and build on your success. This is your opportunity to tell your story, and to show the global healthcare sector what your solution can do and why the technology deserves to win.

The IT @ NETWORKING AWARDS 2012 awards will take place on January 18-19 in Brussels, Belgium. On Day one, the MINDBYTE Session will take place by having each nominee for the award give a five minute presentation followed by a lively five minute Q&A. The audience will vote immediately after each presentation according to the voting criteria for each solution.

The WORKBENCH Session to take place on Day two will have eight top-rated nominees give a 25 minute in-depth presentation followed by a 15 minute Q&A discussion to provide the audience with a thorough understanding of the project.

IT @ 2012 is a real competition in which presenters are challenged by expert judges and participants. The competition is especially unique since each presentation is followed by a thorough questioning from the voters. CEOs, CIOs, CMIOs, hospital and IT managers will use the electronic voting system to support their preferred projects.

IT @ 2012 will identify some of the finest and most innovative departmental institutional local, regional, and national healthcare solutions. The top prize will be Award Trophy plus a cash prize of 2,500 EUR around $3,615 in U.S. dollars. Additionally, the winning technology will be promoted in Europe’s leading healthcare management media which will be valued at 47,500 EUR around $68,700 in U.S. dollars.

All entries must be implemented in at least one site and must be fully operable. Each submission must cover the importance of the technology, benefits, originality, difficulties, successes, and impact of the technology. Submissions need to be entered by September 16, 2011 so go to for more information.

Submissions without any commercial interest or any link to healthcare service providers are free. All other submissions are charged a one-time registration fee. For Federal Telemedicine News readers and subscribers, the rates are 160 Euros around $225 in U.S dollars. When FTN readers are registering, choose group A. Then include the FTN blog website URL as your reference in the comments.

For more information, please visit or call +32/2/286-8501.

Wednesday, June 8, 2011

NIBIB Releases Draft Plan

Researchers are developing new medical technologies and accelerating the application of biomedical technologies at the National Institute of Biomedical Imaging and Bioengineering (NIBIB). Their plans were spelled out in the release of their May 2011 draft Strategic Plan which showed a number of projects underway showing major results.

Following strategic planning retreats and group discussions, a working group of senior staff identified goals for the next five years and the strategies needed to achieve these goals. At that point, the NIBIB staff in close consultation with the NIBIB National Advisory Council developed the 2011 draft strategic plan. The plan is open for comment through June 17, 2011 and comments should be submitted to nibib_sp@mail.nih.govv.

NIBIB provides grants to perform ongoing work in imaging, engineering, health informatics, and interdisciplinary sciences. The main objective is to develop low-cost state-of-the-art technologies to apply to the treatment of specific diseases by collaborating with other NIH institutes and centers. In addition, NIBIB is studying how telecommunications and mobile health technologies can broaden the accessibility and affordability of healthcare in remote environments.

A number of projects are underway. For example, researchers at Stony Brook University are working on the use of ventricular assist devices to save lives resulting from heart failure. The researchers are studying the need to use anticoagulants when patients with mechanical devices are required to follow a difficult regimen of anticoagulant therapy. The problem is that if the blood flows inefficiently through these mechanical devices then at some point, blood clots can sometimes occur.

To study the problem, researchers are doing virtual wind tunnel testing of ventricular assist devices by simulating blood flow through the devices to understand what causes blood clots to form. They will use this information to improve the design of the implanted devices.

Researchers at Massachusetts General Hospital are working on point-of-care devices to use for the early detection of cancer. So far, they have developed a disposable microchip capable of detecting and separating rare circulating tumor cells from whole blood samples at concentrations of less than one cell in a billion.

These microfluidic devices have been successfully used to track the number of circulating tumor cells in cancer patients with the devices correlated to the treatment of their tumors. Individual cells that are captured need to be identified to understand where they came from in the body for follow-up studies. The team is currently working to integrate their microfluidic chips with single cell analysis to analyze genetically the captured cells.

Globally, research to advance technologies in global health is ongoing. Researchers in the “Program for Appropriate Technology in Health” (PATH) in collaboration with the University of Washington are working to develop advance point-of-care diagnostics technology to use globally.

In addition, researchers from PATH and mBio Diagnostics ™ have developed a low-cost disposable cartridge system that can simultaneously test blood samples for multiple infections including HIV, syphilis, and Hepatitis B and C. The disposable cartridge system is currently being field tested.

Go to to view the NIBIB draft Strategic Plan.

EHRs to Include Work History

Workers on the job are at risk for illnesses and injuries because of long hours, changing shifts, lifting and repetitive tasks, stress on the job, and exposure to infectious diseases and hazardous chemicals. Because of the many work-related health factors that exist, the National Institute for Occupational Safety and Health (NIOSH) and the Institute of Medicine (IOM) are conducting a study to examine the rationale and feasibility of incorporating work history information into patient EHRs by 2015.

“Inclusion of occupational information into EHRs is vital to accurately diagnosing and providing appropriate treatment for an individual,” said NIOSH Director John Howard M.D. “ As the Nation moves toward a 21st century system of interoperable electronic record systems, NIOSH appreciates having IOM as a partner to study the challenges and opportunities for incorporating work history information into such systems.”

Today, leaders in the healthcare field are beginning to realize how important it is to incorporate occupational information into EHRs to not only increase efficiency, reduce costs in healthcare, but to most importantly arrive at the correct medical diagnosis.

To discuss the issues, a public workshop was held on June 2, 2011 to discuss the following questions:

• What are the potential benefits to individual and public health for incorporating occupational information in EHRs?
• Are there any current systems that incorporate work history into EHRs that support clinical decision making and public health reporting
• What are the technical barriers to incorporating work history information into the patient’s EHR
• What steps are needed to advance this effort?

At the June 2nd workshop, James Tacci, MD, JD, MPH, Global Corporate Medical Director and Manager of Medical, Health, and Wellness Services for Xerox Corporation presented several case scenarios describing factors that can be missed simply because the work information is not included in the medical record.

To show how important it is to include occupational information in medical records, the correct diagnosis based not only on information in the medical record but also based on occupational information for the following cases would have saved the patient, doctor, and the employer valuable time and money.

A 45 year male came to the doctor due to a new onset of wheezing, coughing, with chest tightness and shortness of breath The diagnosis could be any one of a number of conditions, including asthma, bronchitis, COPD etc. The accurate diagnosis was new onset occupational asthma related to his new job. It turned out that the patient was working in a local supermarket bakery and was exposed to new air contaminants. He was working in the bakery temporarily to tide his family over, because he lost his engineering job. WHO and NHLBI estimate there are 300 million cases of asthma are reported worldwide and it is estimated that 15 to 23 percent of all new cases of asthma are work-related.

A 20 year old man came to the doctor due to a new onset of redness, swelling, and scaling of his hands. The patient told the doctor that his wife was using a new type of scented liquid soap so the doctor told him to switch back to the old soap. The real fact was that the man was developing new onset occupational contact dermatitis related to specific mechanical solutions he used while working on the job in a specialty metal-working shop. It is estimated that 3000 chemicals are well-documented causes of allergic contact dermatitis with 25 chemicals accounting for half of the cases.

A 60 year old male came to his doctor complaining about his hearing loss and was fitted with hearing aids by an audiologist. Without occupational data available, the doctor and the audiologist both thought that the man’s hearing loss was simply age related. It was found that the man actually has occupational noise induced hearing loss due to his occupation as a carpenter and his lifelong significant exposure to power tool noise on the job. NIOSH estimates that over 22 million U.S. workers are exposed to hazardous noise in the workplace.

A 36 year old female came to the doctor with excruciating low back pain after a fall on her front steps. The doctor prescribed anti-inflammatory medications, muscle relaxants and sent her to physical therapy. Actually, she was employed as a sales representative for a solar energy company where her job requires her to cover a three state territory and she spends up to five to six hours a day driving in her car plus making many trips by air which was not easy on her back. However, the real problem was that in her job, she had to lift demonstration solar panels weighing up to 35 pounds and roll a carry case with three panels and other equipment weighing up to 100 pounds to demonstrate products to her clients. This is what really caused her back pain.

A 45 year old male is three months post a myocardial infarction and balloon angioplasty. He has undergone a cardiac rehabilitation program, is following a new diet, and taking an anti-hypertensive and cholesterol-lowering drugs. He was permitted to go back to work with a release signed by his doctor but the release did not require the man to have any restrictions at work. Without occupational data, the doctor failed to realize that the patient was an interstate commercial truck driver and required some restrictions included in public safety laws when he returned to work.

A 50 year old female with a family history of adult-onset diabetes having failed a trial of diet and exercise as well as two trials of oral hypoglycemic agents was placed on insulin by her physician. Without her work medical history, her physician did not realize that the patient worked as an air traffic controller and worked different twelve hour shifts sometimes during the day and sometimes at night. Her irregular hours made it very difficult for her as a diabetic to exercise, adhere to a diet, and adhere to her medication schedule. The doctor needed to take all of this information into consideration when treating her diabetes.

HIT Barriers for Small Practices

Finding ways to deal with financial and legal issues and technology barriers in adopting HIT is a major problem for small medical practices. To discuss the issues, the hearing “Not What the Doctor Ordered: Health IT Barriers for Small Medical Practices” was held on June 2nd by the House Small Business Committee’s Subcommittee on Healthcare and Technology.

As Chairwomen Renee Ellmers (R-NC) pointed out in her opening statement almost 60 percent of office-based physicians work in practices with less than ten doctors. Sasha Kramer, M.D., a board-certified dermatologist presented an in-depth view of the difficulties facing smaller practices in terms of selecting and purchasing the right technology needed for their practices.

Dr. Kramer a small solo practitioner sees an average of 100 to 125 patients per week and generates 40 to 45 percent of the practice’s revenue from Medicare and Medicaid patients. The practice located in Olympia Washington serves the metro area population and beyond with many individuals in the area having limited access to practicing dermatologists.

Two years ago, Dr. Kramer’s practice purchased an EHR system at a cost of $41,349 part of which was funded by a grant of $19,964 through the Washington Health Information Collaborative for HIT. Cash reserves paid for the remaining amount. The selection of the system required Dr. Kramer to spend over 80 hours selecting the vendor and the system. At that point, another 80 hours was added dedicated to training.

Reduction of the patient volume was a major problem during the implementation of the system and it took almost four weeks before the practice was able to return to the normal routine of 4 to 6 patients per hour.

Another major unexpected problem was that the practice was forced to reinvest in a completely new HIT system two years later after the initial system had been in place for one and a half years. The software company sent out a notice that their company had been acquired by another company and that the new vendor’s products would not support Dr. Kramer’s current network platform.

Therefore, the practice looked for an alternative vendor but even so found out that the new system would cost the practice in excess of $27,000 with $6,000 in annual charges which would have to come out of cash reserves. Aside for the money involved to purchase the new system, Dr. Kramer was annoyed that again, the practice had to take time away from their patients to implement and train the entire practice on the new system.

Even with all of the issues, Dr. Kramer fully supports the infusion of HIT into physician practices as she feels strongly that HIT is a critical component in improving the healthcare delivery system in this country. Specifically, she noted that the practice benefits from HIT in a number of ways such as:

• Each patient’s chart and information is available to the physician for each encounter and helps to accurately track drug interactions, medication refills, and past medical history
• HIT makes it much easier to communication with other providers and the practice operates more efficiently with less employee time spent pulling and organizing charts
• At the conclusion of each visit, the staff is able to send charges to the clearinghouse immediately for processing claims and also payments are quickly applied to accounts using electronic remittance

In general, as Dr. Kramer explained, dermatology practices shifting from paper to electronic records or transitioning from one vendor’s platform to another platform will have to address:

• Large patient loads requiring fast-turn around during the record transfer
• Hardware and software initial and upkeep cost issues
• By converting, there is the potential for creating even longer waiting periods for patient appointments
• There may be an additional need for specialized software to accommodate the practice

She also thinks that the Physician Quality Reporting System (PQRS), e-prescribing, and the development of ACOs will all require reporting of various disparate quality metrics. Simply understanding and implementing all of these different programs is difficult and very often overwhelming to small practices

Another important issue is the fact that in 2015, physicians will possibly face financial penalties. Physicians who do not adopt certified EHR systems to meet the definition of “meaningful use” or use e-prescribing, or participate in the PQRS, can face phased-in penalties that overall can reduce Medicare payments.

Dr. Kramer along with the American Academy of Dermatology urges the Committee to provide sufficient financial and other resources to help physicians have the resources to select and implement HIT systems, consider delaying the penalties associated with HIT adoption until such time that a functional integrated system is in place, consider grandfathering physicians of a certain age to make them exempt from financial penalties, and lastly, provide a “safe harbor” for early adopters to protect them from financial penalties related to the “meaningful use” requirement.

Switching to eRX

A team of physician-scientists from Weill Cornell Medical College in a study funded by AHRQ tracked 19 physicians in an adult ambulatory clinic in the process of switching to a new eRX system to see if prescription errors were being made. They followed the physicians again after 12 weeks after the switch and once again a year later.

The study’s researchers analyzed nearly 4,000 prescriptions for more than 2,000 patients and noted mistakes in abbreviations, usage directions, dosage, quantity of medications to be dispensed, and several other factors. They conducted a survey to assess how the physicians viewed the switch with the results published in the “Journal of General Internal Medicine.”

The researchers found:

• The rate of prescription errors dropped by two-thirds, from about 36 percent to about 12 percent one year later
• The rate of improper abbreviations, such as the outmoded “QD” used once daily fell by three-quarters from about 24 percent to about 6 percent one year later
• The rate of non-abbreviation errors rose from about 9 percent to about 18 percent 12 weeks later but did not decline to the baseline level after one year

“Averting these types of errors will likely result in fewer callbacks from pharmacies”, said Senior author Dr. Rainu Kaushal, Chief of the Division of Quality and Medical Informatics in the Department of Pediatric and Public Health at the Medical College.

The physicians had their own thoughts on the implementation of the new system:

• Forty percent of the physicians weren’t satisfied with the implementation of the new system
• Only one-third thought it was safer than the old system
• Sixty percent reported that the alerts weren’t useful
• Two-thirds indicated that the new system slowed down drug orders and refills

To further the transition and reduce prescription errors, the researchers suggested that the systems should be designed to detect and fix the most typical mistakes as well as focus on the most clinically important mistakes so that providers don’t begin to ignore alerts wherever they appear. It was also thought that physicians should receive individualized instruction and close follow-up attention as they have substantial requirements for training and support.

For more information, contact Andrew Klein at

Modernizing the Medicaid System

In March 2011, an RFP was released to find an organization to develop a visionary plan for New Mexico’s Medicaid Program. Just recently, the New Mexico Human Services Department signed a contract with Alicia Smith & Associates to advise the state as to how to redesign and modernize the Medicaid program serving more than a quarter of New Mexico’s population.

The current Medicaid programs currently serve more than 550,000 New Mexicans in which the majority of the 335,000 served are children. The FY 2012 budget is $3.75 billion including state and federal funds. By 2014, it is estimated that an additional 130,000 to 175,000 will qualify for the program with the implementation of the federal healthcare reform act.

The transformation of the Medicaid program will meet the state’s goals by:

• Combining all of the services for low-income, aged populations, blind, and disabled population into a single comprehensive approach to managing care
• Requiring health plans to work together to develop multiple health home models
• Changing and updating Medical reimbursement methodologies
• Encouraging Medicaid members to take a more active role in managing their healthcare and how to use the resources wisely
• Helping the Tribal communities and organizations come together under a common framework to advance best practices in tribal medicine

Public and legislative input is requested for new ideas on how to redesign Medicaid. Input sessions are now being scheduled for several cities across the state and will be announced soon.

For more information, go to

New Demo to Coordinate Care

The “Federally Qualified Health Center Advanced Primary Care Practice” (FQHC-APCP) demonstration project will pay an estimated $42 million over three years to up to 500 FQHCs to coordinate care for nearly 200,000 Medicare patients. The new demonstration will be operated by CMS in partnership with HRSA and will test the effectiveness of doctors and other health professionals working in teams to improve care.

The demonstration will show how the patient-centered medical home model can improve quality of care, promote better health, and lower costs. Participating FQHCs must implement EHRs, and help patients manage chronic conditions, as well as actively coordinate care for patients.

To help participating FQHCs make investments in patient care and infrastructure, they will be paid a monthly care management free for each eligible Medicare beneficiary receiving primary care services.

The recruitment period began on June 6, 2011 and applications for the demonstration will be accepted until August 12, 2011. The demonstration will be conducted from 9/1/11 until 8/31/14. For details go to or to the CMS Innovation Center web site at

Sunday, June 5, 2011

Telemedicine Working in Mississippi

A fourteen year old boy involved in an accident in Mississippi was fighting for his life after being the victim of an accidental gunshot wound to the chest. Most of the time, these victims don’t survive. The boy and his brother were on their property for a family outing when he was hit by a rifle’s bullet. His father had given the boy’s brother the rifle for Christmas and they had gone hunting together many times. But his brother’s accidental shot caused the incident.

An article appearing in the May 16th issues of “CenterView”, a University of Mississippi Medical Center (UMMC) publication, explained how saving the boy’s life began with a nurse practitioner at Perry County Hospital began by using the services of the TelEmergency network.

The nurse communicated via video and talked to the emergency medicine doctors at the University of Mississippi Medical Center. They decided that the boy should be flown to Forest General Hospital in Hattiesburg by the UMMC’s helicopter service Air Care. At that point, the boy received emergency open heart surgery to stop the bleeding but during the surgery he lost 34 units of blood and almost died three times.

In addition, the doctors felt that since the bullet from the rifle had entered the chest and came out the right side, it probably had done some damage to the major vessel controlling the arm’s blood supply. The doctor’s thought he would probably lose his arm and also feared that he would have brain damage because no one knew how long his brain had been without oxygen.

Dr, Kristi Henderson, Director of the Training Program for Nurse Practitioners in TelEmergency, reports that because of the initial fast action in contacting TelEmergency and the expertise of the medical team, the boy not only survived but he is living a normal life because every person and the TelEmergency system worked efficiently and effectively to save his life.

The system is particularly valuable in rural hospitals since they can easily connect with board-certified emergency medicine physicians in the UMMC emergency department via video. Rural hospitals in Mississippi simply can’t afford to staff their emergency departments with emergency medicine doctors. Grant funds provided by the Bower Foundation provided the needed start-up funds for equipment to provide the service.

In treating stroke patients, Dr. Alexander Auchus, Chairman of the Department of Neurology uses the TelEmergency network to consult either by phone or by video to help determine if the patient at a rural hospital is a candidate for thrombolytic drugs to remove the clot.

“Sometimes, the patients still have to come to UMMC after thrombolytic drugs, because they may need a catheter-based procedure to manually remove the clot”, Auchus said. “We see this as a way to provide an additional level of expertise for the people all over the state.”

In addition, the UMMC Department of Psychiatry links to sites in the Mississippi Delta using grant funding from the Delta Health Alliance. Since, there are few resources except for the state run mental health centers in the Delta, video is used to teach mental health professionals all across the Delta and provides video connections from the Mississippi State Hospital to mental health centers.