Time Out

Enjoy the holidays and have a happy New Year. Federal Telemedicine News will begin posting again January 2, 2013.

FCC's Healthcare Connect Fund

The FCC is creating the Healthcare Connect Fund to reform and modernize its universal service program by expanding access to robust broadband healthcare networks. The new Fund will provide up to $400 million each year to support broadband nationally and particularly target providers in rural areas.

In 2006, the FCC launched its Rural Health Care Pilot program to learn how to more effectively support the networks and now funds some 50 active pilots. In the “Wireline Competition Bureau: Evaluation of Rural Health Care Pilot Program” report released August 2012, lessons were learned from these pilots. The report is available at http://hraunfoss.fcc.gov/edocs_public/attachmatch/DA-12-1332A1.pdf.  

Highlights in the report show that a South Carolina consortium saved $18 million in Medicaid costs by using telepsychiatry and a group of healthcare providers in the Midwest saved $1.2 million in patient electronic intensive care unit services. Lessons learned from the August report and from success stories will help the new Healthcare Connect Fund to expand access to high-bandwidth connections.

The new Healthcare Connect Fund will:

• Remove artificial limitations on technology and provider type that hampered legacy universal service healthcare support

• Encourage consortia between smaller rural healthcare providers and urban medical centers so that remote hospitals and clinics can draw on the medical, technical, and administrative resources of larger providers

• Increase fiscal responsibility by requiring participants to contribute 35 percent of the costs, while affording healthcare providers access to lower rates through group buying

• Support broadband services purchased from diverse communications providers, while also allowing healthcare providers to construct new broadband networks when it is cost effective

• Cover upgrades to higher speed service that is required for healthcare applications

In addition, the plan will establish a new competitive Pilot Program to test expanding broadband healthcare networks to skilled nursing facilities. Up to $50 million over three years will be available from the Fund for these competitively awarded Pilots

Savings achieved by group purchases through consortia and other increases in efficiency could cut the cost of robust broadband healthcare networks in half for both providers and the Universal Service Fund, based on the FCC’s analysis of successful Rural Health Care Pilots.

For more information, go to www.fcc.gov.

NIH Seeks Cutting-Edge Research

NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) posted a Funding Opportunity Announcement (FOA) on December 12^th. The FOA is looking for groundbreaking research to address the development of new technologies to integrate in a wearable, portable, automated, closed loop system for the physiological glucose control for individuals with Type 1 Diabetes.

Research in technologies may include but other ideas are welcome:

• Robust continuous glucose sensing devices
• Real-time detection platforms and miniaturized multi-sensor platforms
• Glucose monitoring technologies
• Devices able to be integrate sensing, control, and delivery components in one unit
• Glucose regulated insulin delivery systems
• Smarter  pump and infusion set technologies
• Remote monitory systems to optimize the performance of the integrated platforms

 Eligible applicants can include higher education institutions, non-profits, for-profits to include small businesses, governments, and others.

The award budget is slated to include direct costs for up to $2.5 million to be used up to five years. NIDDK expects that the requested direct costs will range from $1 million to $2.5 million based on the scope of the research.

A Letter of Intent is due February 28, 2013 with applications due March 28, 2013.

To view FOA (RFA-DK-12-021), go to http://grants.nih.gov/grants/guide/rfa-files/RFA-DK-12-021.html.

Joint Commission's Safety Guide

The Joint Commission released their monograph “Improving Patient and Worker Safety: Opportunities for Synergy, Collaboration, and Innovation” to draw attention to the need to create a culture that focuses on both the safety of patients and healthcare workers. The document describes barriers that exist to patient and worker safety issues and suggests strategies to use to overcome the barriers.

Intermountain Healthcare (IH) located in Salt Lake City presents a case study in the monograph based on the success of their “Safe Patient Handling” program and how their team created a system-wide safe patient handling program to prevent injuries related to transfers, lifting, and falls.

The IH team found that it was necessary to;

·        Implement a cultural change with the focus on the right mix of people and equipment

·        Establish lift and transfer standards for patient-care practices

·        Standardize employee education and training

·        Evaluate and recommend appropriate equipment for transfer and lifting tasks

It was found that safety assessments must be completed daily. One of the solutions is to use wall signs posted at the head of the patient’s bed and in staff rooms to provide visual safety reminders that depict the scoring process. In addition, charting forms were incorporated into the medical records for seamless documentation.

Staff education includes both hands-on-classes as well as computer-based training for new equipment, policies, assessment tools, and skills pass-off checklists. Patients also receive fact sheets with information on needed safety measures. Electronic reports for program analysis are available at the departmental, campus, regional, and system level.

By 2010, IH saw a 41 percent reduction in employee injuries compared to pre-system rates and a 49 percent reduction in patient falls related to lifting and transferring activities. The estimated cost savings for employee injuries system-wide is $500,000 per year across the 22 IH hospitals

Examples of other case studies on patient and worker safety included in the monograph were described by Ascension Health, St. Vincent’s Medical Center, Atlantic Health, Duke Home Care, Kaiser Permanente Mid Atlantic Region, Lancaster General Hospital, Lemuel Shattuck Hospital University of Missouri, and the Department of Veterans Affairs.

The monograph was developed in collaboration with the National Institute for Occupational Safety and Health (NIOSH), National Occupational Research Agenda, and the Healthcare and Social Assistance Sector Council under a contract.

For more information, go to www.jointcommission.org.

USAID's New Health Office

USAID’s newly established Office of Health Systems will be the hub for technical experts to strengthen health systems worldwide. This will enable USAID to work on country ownership and sustainability to broaden access to critical health services for the world’s most vulnerable populations.

According to USAID, developing economies are growing and they will continue to spend more on health. Without thoughtful organization of the system, there will be an explosion of unregulated private services paid for out-of-pocket that could lead to inefficiencies and added health bills.

As a result, USAID feels that it is important to work on health systems and universal health coverage now. To do this, countries will need technical assistance to help create and sustain an efficient and equitable health system. The agency thinks that the key to success is not adding more capital from donors but to increase local capacity to reorganize and manage growing domestic resources.

The new Office of Health Systems will enable the agency to examine and communicate successes, gaps, and plot a course for an end game where everyone has access to appropriate health services at a cost they can afford.

The USAID’s “Applying Science to Strengthen and Improve Systems” (ASSIST) project is a new five year project funded by the Bureau of Global Health to operate within the Office of Health Systems. The goal is to build the capacity of host country systems to improve the effectiveness, efficiency, client-centeredness, safety, accessibility, and equity of the services provided.

The project will enable the team of scientists to improve the delivery of healthcare, test changes to determine whether they yield desired results, and share valuable workable data on improvements.

The scientists will study ways to improve outcomes in child health, maternal, and newborn care, study nutrition, family planning, reproductive health, research HIVAIDS, tuberculosis, non-communicable diseases, improve solutions for chronic care, develop the needed health workforce, and provide for the essentials for community-based healthcare.

The USAID ASSIST country programs will be designed with host-country leadership to ensure context appropriateness and local ownership and will be aligned with global initiatives.

For more information, go to www.usaid.gov  and for information on the ASSIST program, go to www.usaidassist.org.

DOD & VA Sharing Images

The “Health Artifact and Image Management Solution” (HAIMS) team working with DOD and the VA has made it possible for the agencies to share healthcare images and artifacts. Since October 31^st, HAIMS has enabled 2,738 images and artifacts to be shared through the interface.

Release I enabled the HAIMS to provide a web-enabled enterprise document management and image sharing solution enabling users to view radiographs, clinical photographs, electrocardiographs, waveforms, audio files, videos, and scanned documents.

In the coming months the HAIMS will enable 6,000 additional users to have access to the application through the AHLTA clinical workflow embedded mode. Additional capabilities will include the availability of bulk scanning which will allow the HAIMS to migrate data from disparate external repositories.

HAIMS will be able to interface with other external repositories such as the Theater Image Repository to enable Theater images to be available globally. Also, HAIMS will interface with Patient Administration Systems and Biostatistics to provide outpatient and inpatient scanned medical records generated during the Theater healthcare delivery process. In addition the system will interface with the Health Readiness Record to provide medical records for Army Reserve Component personnel.

Source: “The Beat” December 2012 newsletter available from the Defense Health Information Management System (DHIMS) at http://dhims.health.mil.

Collecting Cancer Cell Data

Johns Hopkins researchers are applying the concept of storing medical data in the cloud in hopes of predicting and improving cancer patient treatments and outcomes. The project is supported by a new $3.75 million National Cancer Institute grant to go to the Johns Hopkins Institute for NanoBioTechnology over a five year period.

The project was launched because researchers now realize that cancer cells affecting the same type of tissue can behave differently in different patients. The data collected will help doctors make better predictions on how a patient’s illness will progress and what type of treatment will be most effective.

To help doctors prepare a more personalized medical prognosis and treatment plan, Johns Hopkins has assembled experts in cancer and engineering to begin characterizing and storing cancer data collected through a process called high-throughput cell phenotyping. The software and hardware used in the high-throughput cell phenotyping process is protected by patents obtained through the university’s Technology Transfer Office

“We use scanning microscopy to take picture of the size and shape of cancer cells,” said Denis Wirtz, leading the research and Associate Director of the university’s Institute for NanoBioTechnology. He also directs the Johns Hopkins Physical Sciences-Oncology Center.

According to Wirtz, “Notes are made on the age and gender of the patient and any treatment received. Looked at as a whole, this information can help us identify a signature for a certain type of cancer which gives us a better idea of how it spreads and how it responds to certain drugs. The long-range goal is to make this data available through the internet to physicians who are diagnosing and treating cancer patients around the world.”

Typically information on the patient’s disease is obtained by averaging the results from trillions of cells that have been blended together. However, with the new scanning system, researchers will obtain views of individual cells retrieved from individual patients even from different parts of the same organ.

As Wirtz explained, “This ability to examine single cells is important because scientists have discovered that even cells that possess the identical genetic makeup can vary in other small ways that can affect the behavior of cancer.”

According to Anirban Maitra, Professor of Pathology and Oncology at Johns Hopkins, “This technology may provide a way to centralize specimen data, images, and analysis in a way that hasn’t been done before and we will be using the information to find better ways to treat disease.”

The Johns Hopkins team will soon collect similar data from other major U.S. cancer research centers also supported by NIH with the initial focus to be on pancreatic cancer. Other types of disease, including breast, ovarian, and prostate cancer will be addressed in the near future. Early data is being stored on computers at the Los Alamos National Laboratory under an arrangement funded by NIH.

For more information, go to http://inbt.juh.edu.

Vermont Seeks RFPs

The Office of Purchasing and Contracting for the State of Vermont on behalf of the Agency of Human Services (AHS) is soliciting bids from vendors for fixed price proposals. The RFP released November 16^th requests responses for the “Design, Development, Implementation, and Maintenance of a Health and Human Services Integrated Eligibility (IE) Solution”.

Currently, the State of Vermont’s AHS uses an IE solution known as ACCESS to process eligibility for most of its healthcare and human services programs. Also, ACCESS is used to process and manage benefit issuance for Medicaid and for a number of non-healthcare programs.

The envisioned new IE Solution will need to integrate all in-scope programs from ACCESS. The planned IE Solution will replace ACCESS with a modern flexible system capable of managing integrated eligibility business processes for Medicaid programs and for all the non-healthcare programs currently supported by the legacy ACCESS system.

The new IE Solution will need to integrate the current MMIS, plus the new MMIS solution that AHS is planning to acquire in the next few years, and continue in the foreseeable future to process Child Support Enforcement services. The IE Solution will also need to provide citizens, state workers, and external service providers with robust and secure access to information and functionality.

Proposals are due January 2, 2013 with the contract scheduled to be awarded March 1, 2013. All communications for information on this RFP are to be addressed to the Purchasing Agent, John McIntyre, at John.McIntype@state.vt.gov.

Go to, http://bgs.vermont.gov/sites/bgs/files/pdfs/purchasing/Final_Vermont_IE_RFP_11152012.pdf  to view the RFP. 

Telehealth Grant Opportunity Posted

HRSA is soliciting applications for their “Telehealth Network Grant Program” (TNGP) to help telehealth programs and networks improve access to quality healthcare services in rural, frontier, and underserved communities.

HRSA is looking for grant responses with innovative applications that meet new and emerging needs in a changing healthcare delivery system focusing on value and improved healthcare outcomes.

Even though grant activities must serve rural communities, the grantee may be located in either urban or rural areas. In addition, all applicants are required to identify the areas of telehealth that will be the focus of the project.

TNGPs may provide services in any variety of settings including long-term care facilities, community health centers or clinics, physician offices, hospitals, schools, and assisted living facilities to demonstrate how telehealth networks can meet the goals of the program. Applicants need to have a successful track record in implementing telehealth technology and have a network of partners in place committed to the project.

Projects selected for funding must provide clinical services where performance measures can be developed. HRSA strongly recommends emphasizing clinical services that focus on one or more chronic disease states of high priority such as CHF, cancer, strokes, chronic respiratory disease and/or diabetes.

Grantees will be required to participate in the Office for the Advancement of Telehealth’s data collection and evaluation efforts as a condition for accepting TNGP funding. The data collected must include six month progress reports, annual reports, information for the grantee directory, and a final grant project report.

The grant notice was posted on December 13, 2012. Estimated amount of funding for this competition (HRSA 13-166) will be $2,250,000 with nine awards estimated. The average size of the awards is estimated to be $250,000. The application deadline is February 13, 2013 with the anticipated award date to be September 1, 2013.

For more information, go to www.grants.gov. 

FCC Accelerating Text-to-911

FCC Chairman Julius Genachowski announced that four of the largest wireless carriers including AT&T, Verizon, Sprint, T-Mobile have agreed to step up Text-to-911 with major deployments expected in 2013 and nationwide availability by May 2014. 

This will mean that over 90 percent of the nation’s wireless consumers, including millions of consumers with hearing or speech disabilities will be able to access emergency services by sending a text message to 911where local 911 call centers will be prepared to receive the texts.

Text-to-911 will enable consumers to have greater access to emergency communications in case a voice call could endanger the caller or if a person with disabilities is unable to make a voice call. Text-to-911 will complement but not be a substitute for voice calls to 911 services.

To help eliminate consumer confusion while Text-to-911 capability is being phased-in, the carriers are going to provide an automatic “bounce back” text message to notify consumers when their attempt to reach 911 via test message is unsuccessful. Such a message would instruct the recipient to make a voice call to a 911 center. The four carriers expect to fully implement the “bounce back” capability across their networks by June 30, 2013.

The FCC is continuing to work with all stakeholders, including 911 authorities, local 911 call centers, Emergency Access Advisory Committee, public safety organizations, disability organizations, consumer groups, and industry.

The FCC is going to take additional steps next year that will include closely monitoring carriers and their compliance but the FCC will also see that they address other aspects of Next Generation 911 such as the ability to transmit photos and videos to 911 centers.  

Texas Issues RFP

The State of Texas through the Texas Health and Human Services Commission (HHSC) wants to work with HIEs. The goal is to help local HIEs with planning, funding, and implementation by having HIEs bid on HHSC grant funding. HHSC posted the RFP No. (529-13-0009 on November 27, 2012 looking for applicants to submit proposals for the state’s “Health Information Exchange Infrastructure Development Initiative”.

The State is seeking solutions that will provide but are not limited to chronic disease surveillance, state immunization registry reporting, electronic lab reporting, developing prescription drug program, monitoring interoperability, and facilitating communication between providers and independent and/or hospital laboratories.

The HHSC oversees and coordinates the planning and delivery of health and human service programs in Texas and oversees all of the Texas HHS agencies.  Under contract with HHSC, the Texas Health Services Authority (THSA) developed the Texas HIE Strategic and Operational plan.

One item in the approved Strategic and Operational plan requires HHSC and THSA to develop a grant program to provide partial funding for the planning, implementation and operations of local HIE initiatives and networks.

As a result, in 2010, HHSC started the initial procurement process and identified several local HIEs that qualified for planning funds under the grant program. After the completion of the local HIE planning period in 2011, twelve HIEs from around the state amended contracts with HHSC to implement their local HIE plans. The existing contracts for the local HIE Grant Program are anticipated to continue through the end of 2013.  

HHSC’s reason for this procurement is to locate a pool of eligible and qualified HIE organizations capable to bid on HHSC grant projects. Possible projects may support partnerships between one or more HIEs and support one or more outside organizations to develop policies, procedures, technical specifications, and other tools necessary to address HIE priorities.

Applicants are eligible for this RFP if their organization is receiving implementation funds under the Local health Information Exchange Grant Program. Also, other organizations that are providing HIE services to practitioners and providers in Texas communities will be considered.

Proposal responses are due January 8, 2013 with the anticipated contract to start on February 8, 2013. Any contract resulting from the RFP is subject to the availability of state and federal funds. As of now, HHSC anticipates that budgeted funds will be available to reasonably fulfill the project requirements.

To view the RFP, go to www.hhsc.state.tx.us/contract/529130009/rfp.shtml. The point of contract for information is Richard Blincoe, HHSC at (512) 206-5468 or email Richard.Blincoe@hhsc.state.tx.us.

Joining to Help Patients

Rock Health located in San Francisco is the first seed accelerator for digital health startups to help entrepreneurs and experts understand the complicated digital health landscape. Rock Health’s latest class of startups will help companies develop consumer and enterprise tools plus help to develop consumer mobile apps.

Kaiser Permanente has joined Rock Health as a new sponsor to provide financial support and work closely with Rock Health’s network. Kaiser joins Rock Health’s other partners the Mayo Clinic, Kleiner Perkins, Mohr Davidow, Aberdare Ventures, GE, Genentech, United Healthcare, UC San Francisco, Harvard Medical School, and Nike.

In another partnership effort, the Care Connectivity Consortium (CCC) was created by five health systems to include Kaiser Permanente, Mayo Clinic, Group Health Cooperative, Intermountain Healthcare, and Geisinger Health System. The CCC goal is to connect doctors electronically so that CCC partners can exchange information across all five organizations in select geographic and specialty areas.

For example, a retired couple living in Herron Island Washington has experienced the benefits first hand. They are able to travel each December from Herron Island to Desert Hot Springs California for several months and this would not be possible without the collaboration between their primary care physician at the Group Health Cooperative and their Kaiser physician in Palm Springs, California.

In another case, the State of Washington, the Everett Clinic Group Health Physicians, and Group Health Cooperative have formed a new alliance aimed at providing high quality and affordable health care for patients in Snohomish County. This county is located on Puget Sound which is the 13^th largest county in total land area in the state of Washington.

The joint venture is going to:

• Develop a commercial accountable care organization to deliver coordinated care at the local level and potentially to a larger geographic market
• Advance existing care quality initiatives for Medicare enrollees
• Identify joint clinical programs to improve quality and reduce costs
• Identify innovative ways to help patients avoid unnecessary emergency room visits and hospital admissions.

“The U.S. healthcare system as we know it is hurting families with wide variations in price, volume, and intensity of services,” said Group Health Physicians President and Chief Medical Executive Michael Soman, MD. Duplicative uncoordinated care is wasteful at a time when healthcare costs for families are too high, so physician groups believe collaborative efforts are needed to fix healthcare community by community.”  

Mobile Devices: Protect the Information

At the December 2012 ONC Annual Meeting, HHS announced that a new education initiative and website at www.HealthIT.gov/mobiledevices has been launched complete with a set of online tools to provide healthcare providers and organizations practical tips on protecting health information when using mobile devices.

Some tips offered:

• Use strong passwords—Passwords should include at least 6 characters, a combination of upper and lower case letters, at least one number, and one punctuation mark. Change your password quarterly and prevent people from seeing it. Install automatic log off features on the device
• Install and enable encryption—Mobile devices can have built-in encryption capabilities or you can buy and install an encryption tool on your device
• Install and activate remote wiping and/or remote disabling—Remote wiping enables you to erase data on a mobile device remotely. If you enable the remote wipe feature permanently then data will be deleted on a lost or stolen mobile device. Remote disabling means that if a mobile device is lost or stolen and if the mobile device is recovered, you can unlock it
• Disable and do not install or use file sharing applications—File sharing is software or a system that allows internet users to connect to each other and trade computer files. However, file sharing can also enable unauthorized users to access your laptop without your knowledge. By disabling or by not using the sharing applications, you can reduce a known risk to data on your mobile device
• Install and enable a firewall—Firewalls can intercept incoming and outgoing connection attempts and block or permit them based on a set of rules
• Install and enable security software—The software can protect against malicious applications, viruses, spyware, and malware-based attacks
• Keep your security software up to date—When you regularly update your security software, you have the latest tools to prevent unauthorized access to health information
• Research apps before downloading—Before you download and install an app on your mobile device, verify that the app will perform only functions that you have approved
• Maintain physical control of your mobile devices—Mobile devices are easily lost or stolen and may enable the use of unauthorized health information. If the mobile device is stolen, be sure to report the incident and take decisive steps to deal with the loss by developing an incident reporting plan when you initially start using your mobile device
• Be careful when using adequate security to send or receive health information over public Wi-Fi networks—Don’t send or receive secure health information when connected to a public Wi-Fi network unless you use secure encrypted connections
• Delete all stored health information before discarding or reusing the mobile device—ONC has issued guidance that discusses the proper steps to take to remove health information and other sensitive data stored on your mobile device before you dispose or reuse the device

Caring for Veterans with CHF

The Veterans Administration’s Quality Enhancement Research Initiative (QUERI) released their Strategic Plan in November describing how the VA is improving care for veterans with Chronic Heart Failure (CHF). Heart Failure (HF) currently affects nearly five million Americans with hospital admissions for this condition increasing six-fold in the U.S. since 1970, due in part to an aging population. Also heart failure is the number one reason why veterans are discharged from the VA healthcare system.

The VA realizes several factors in delivering care to HF patients. For example, a significant portion of outpatient care for heart failure for veterans is delivered by Patient Aligned Care Teams (PACT). It has also been found that at least a third of patients with HF going to primary care providers do not see a cardiologist either at a VA facility or at a non-VA facility. It is also a fact that another third of patients receive dual care with VA primary care and non-VA cardiology care. The VA is now examining the impact of dual care provided by VA primary care and by non-VA specialty care.

According to the recent published QUERI “Strategic Plan for CHF”, the VA is planning to expand their focus on PACTs by evaluating several interventions that will have local pharmacists providing lists of patients to PACT teams for care changes.

In partnership with VA’s Office of Care Coordination, CHF-QUERI completed a standardized Disease Management Protocol (DMP) for HF. This protocol has been beta-tested and all four vendors are installing it into their systems. All veterans at all of the VA facilities enrolled in the Coordination Home Telehealth (CCHT) program will use this standardized DMP for HF.

CHF QUERI has initiated the “Heart Failure Provider Network” a network of over 900 VA providers and staff interested in improving heart failure care throughout the VA’s healthcare system. The goals are to share evidence-based HF program data, understand and help resolve barriers to care, establish collaborations and networking opportunities, and implement quality improvement projects. The HF Network also solicits QUERI funded proposals to establish new affiliations and collaborations with network members.

CHF-QUERI has developed a comprehensive web-based HF Provider Toolkit by collaborating with the members of the HF Provider Network as well as other non-VA organizations. Providers are encouraged to review the toolkit to determine where the tools will be helpful in their practice.

In addition, VA’s CHF-QUERI is implementing the “Hospital-to-Home” (H2H) initiative. As part of the initiative, all facilities have been provided toolkits, along with active support such as web-based meetings, consultations, and emails.

In the future, the VA will examine the HF specific impact of SCAN-ECHO and e-consults each in terms of survival, rehospitalizations, and quality measures. The VA plans to continue to examine disparities in care based on race, gender, age, rural location, and mental health diagnosis.

For more information on CHF-QUERI, email Theresa Marsh-Daniels at Theresa.Marsh@va.gov. Go to www.queri.research.va.gov/about/strategic_plans/chf.pdf to review the Strategic Plan for CHF.

Help for the Underserved

Funding for $18.8 million was awarded to the State of Illinois under the HITECH Act in 2010 to implement the State HIE. Recently, Pat Quinn Governor of Illinois announced that $1.3 million of the federal funding is being awarded to three Illinois not-for-profit organizations to help them upgrade health information technology services in underserved areas of the state.

The federal funding has enabled the Illinois Office of Health Information (OHIT) to award the funding to connect providers in the Metro-Chicago area, Central and Southern Illinois. The OHIT anticipates that the grants will enable more than 1,600 individual providers to connect with more than 48 healthcare organizations serving hundreds of thousands of patients each year.

The three grants awarded:

• The grant amount of $495,120 goes to Heartland Health Outreach which is the healthcare arm of the Heartland Alliance of Community Health Services to provide primary care, mental health, and dental treatment along with grant funding going to the Chicago Health Information Technology Regional Extension Center in Chicago
• The grant amount of $338,600 goes to the Illinois Critical Access Hospital in Princeton
• The grant amount of $500,000 goes to Southern Illinois Healthcare in Carbondale including Memorial Hospital of Carbondale, Herrin Hospital, and St. Joseph Memorial Hospital

 The grants were made possible by OHIT as part of its White Space Grant Program that fills in gaps throughout the state and connects organizations to health information exchange services that would not otherwise be able to connect.

“Illinois health information exchange network is only as strong as the volume and geographic diversity of providers connected to it,” OHIT Director Laura Zaremba said. “Through these projects, we are connecting providers in communities that need our assistance the most.”

RWJF Announces $200,000 Challenge

The Robert Wood Johnson Foundation (RWJF) just announced that winning software developers will receive $200,000 in cash awards to create game applications to improve personal and community health. The developer of the winning game app will receive $100,000, the second place winner $50,000, and the third place winner will receive $25,000.The games challenge is the second in a series of app competitions sponsored by the Foundation through their Aligning Forces for Quality initiative.

The first “app challenge” focused on creating applications to improve patient access to healthcare quality information. In this new Game Challenge, competing developers will build upon data from RWJF’s “County Health Rankings & Roadmaps” program, and other databases to create game applications that engage patients and health providers in generating new quality data.

“Gamification” has been an increasingly hot topic in the health space. The features of computer and video games, with advanced graphics, stunning realism, immersive interactivity, and structured challenges offer unique solutions to a variety of health and healthcare issues.

Early research consistently indicates that well-designed and well-implemented games can motivate and support wellness, lifestyle behavior changes, self-care, clinical care, adherence to treatment plans, and self management of chronic conditions.

The Games Challenge requires participating developers to provide a means for the data generated to be directed toward healthcare improvement. In playing the developed game applications, participants will be competing or collaborating to improve personal health while simultaneously contributing to the overarching goal of maximizing their community’s health.

The Game Challenge will be conducted in two phases. Phase one is to come up with ideas for interested developer teams and then submit application concepts. In phase two, the top five developer teams from phase one will build upon their initial proposals and create working game applications. 

Winners will be announced in September 2013 and the first place winner will present at the annual Fall Health 2.0 Conference to be held later that month. Developers can learn more and register for the challenge at www.health2con.com/devchallenge/?p=12074. The deadline for entry submission for phase one is January 27, 2013.

Spotlight on mobiHealth Wallet

“Diversinet launched the mobiHealth Wallet because the healthcare industry works with fragmented healthcare data and patients are faced with suboptimal care coordination,” according to the company’s CEO, Dr. Hon Pak.  “Essentially, mobiHealth Wallet with Blue Button connectivity puts the patient in the driver’s seat in terms of managing and sharing information.” Diversinet unveiled mobiHealth Wallet at the mHealth Summit at Washington D.C area’s Gaylord National Resort and Convention Center December 3-5, 2012.  

An important feature of mobiHealth Wallet allows patients to use the Web or mobile devices to create and update unique health profiles, including preferences, lifestyle characteristics, and social determinants of health over time.

A patient can choose a primary language and preferred methods of communication with providers or caregivers, via voice calls, email, or text messages. Patient profiles along with data sent from interoperable mobile applications such as medication adherence and mood trackers, allow providers to understand a patient’s adherence and behavior patterns and to customize health interventions.

The company plans to market mobiHealth Wallet to application developers and to healthcare organizations, including providers, payers, population-health companies, and medical device makers. The company will further develop mobiHealth Wallet by expanding patient-generated preferences and social determinants of health. 

In October, Diversinet’s mHealth platform became the first to have its encryption technology awarded Federal Information Processing Standards (FIPS) 140-2 validation. This is the only mobile health solution that can store, parse, and share Blue Button data on a mobile device with FIPS 140-2 certification.

 For more information, go to www.diversinet.com.

Healthcare News from Iowa

Providing care for veterans with HIV in the U.S is top priority for the Veterans Health Administration. According to the November issue of the “The Rural Connection” www.ruralhealth.va.gov published by the VHA Office of Rural Health (ORH), the ORH supports care for veterans with HIV but has found that 18 percent living in rural areas delay entry into HIV care because of the distance needed to travel for care. With the delay entry into HIV care, these veterans very often receive care when they are at an advanced stage of the disease.

OHR supported the development of the Iowa City VA Healthcare System’s Telehealth Collaborative Care (TCC) program for rural veterans living with HIV. During the past two years ending May 2012, there were 32 veterans with HIV who lived more than a one hour drive from the Iowa City HIV clinic and who were geographically closer to a Community Based Outpatient Clinic.

Thirty of these veterans chose TCC over traveling to Iowa City for their HIV care. An evaluation found that TCC maintained high quality of HIV care in the Iowa City system and improved the average travel time for care.

The Iowa Department of Health (IDPH) has recently been actively involved in several public health programs. For instance, IDPH is expanding their newborn screening program to include screening for Severe Combined Immune Deficiency (SCID), a rare inherited disorder caused by a deficiency or absence of cells that help fight infections.

If untreated, most infants with SCID die before their first birthday. The incidence of SCID is estimated to be one in 50,000 to 60,000 live births. Nearly 40,000 Iowa babies are screened shortly after birth through the newborn screening program.

SCID screening began as an implementation pilot to ensure that the screening process met standards, ensure that all the babies were being screened, and any baby with an abnormal result would receive appropriate interventions.

In other screening news in the state, more than one million babies have been screened as part of Iowa’s Neonatal Metabolic Screening Program. With one small blood sample, more than 50 diseases can be detected. Most of these life-altering and life threatening disorders are completely undetectable at birth without the newborn screening.

The IDPH with funding from CDC has just launched their Environmental Public Health Tracking (EPHT) Network at www.idph.state.ia.us/EHS/EPHT.aspx. The tracking system is expected to be a valuable resource as counties develop their Community Health Needs Assessment and Health Improvement Plans. The data will help the state develop effective public policy.

Public health officials in the state have relied on the state’s Immunization Registry Information System (IRIS) at www.idph.state.ia.us/InmTB/Immunization.aspx?prog=Imm&pg=IRIS to ensure that patients at the recommended vaccines at the right times throughout their lives. Before clinic and hospital staff could only use certain computers that had been installed with special software. Recently, IDPH adopted new software for IRIS and now hospitals and clinics have immediate access to the database via laptops or tablet computers.

The state has taken another step forward so that in 2013, the Iowa Health Information Network (IHIN) will be established. In the meantime, Iowa is testing their direct secure messaging system. To prepare for the direct secure messaging pilots, Iowa e-Health at www.iowaehealth.org  is partnering with the state’s HIE vendor, Xerox.

Xerox is working with several sub contractors including Informatics Corporation of America, Genova Technologies, and LightEdge Solutions. In addition, Iowa e-Health has conducted a webinar to educate providers about direct secure messaging in cooperation with Iowa Medicaid Enterprise, and Iowa’s HIT Regional Extension Center, Telligen at www.telligenhitrec.org. .

Once the direct secure messaging pilot projects are complete, enrollment will be open to all provider types and offered without charge to providers through 2012. Fees following this period will be assessed and published in the Iowa e-Health Business and Financial Sustainability Plan.

mHealth Helping Caregivers

Several companies demonstrated their technology solutions to help seniors and people dealing with chronic conditions obtain real-time in-home patient care at the mHealth Summit held December 3-5 at the Gaylord National Resort and Convention Center in the Washington D.C area.

One of the companies at www.ecaring.com involved in senior technology issues and needs called eCaring was chosen by mHIMMS, AARP, and Aging 2.0 to showcase their system in the EngAGE Pavilion at the mHealth Summit.

“eCaring fills a care coordination gap by providing healthcare providers and caregivers with real-time, comprehensive behavioral and clinical data form a patient’s home,” says Robert Herzog, CEO of eCaring. This unique platform improves care quality, lowers healthcare costs, and reduces hospital admissions so that seniors and people with chronic conditions are able to remain at home longer.”

eCaring demonstrated their cloud-based care management system that enables users to access data from any web-enabled device. Their cloud-based platform enables hospitals, family caregivers, and care providers, to spot changes in a patient’s normal patterns. It is possible to receive alerts when problems arise so that small problems in the home don’t become big problems in the hospital.

By using the system, readmission rates can be reduced. The technology also enables accountable care organizations, medical homes, and managed long term care program to reduce the individual and population costs of their patients which is vital for organizations reimbursed under capitated rates.

As part of the demonstration, eCaring introduced a suite of new features for eCaring 2.0. These upgrades included customizable text and email alerts, a comprehensive dashboard to view reports, free text notes, and easy-to-use vital sign entry. The system has also been optimized for use on tablet devices.

mHealth can be especially valuable when serving Alzheimer’s patients. For example ‘BeClose” at http://beclose.com, a company headquartered outside of Washington D.C, exhibited their remote home monitoring system at the mHealth Summit. Their system is designed to allow people to age in place independently while giving family members and caregivers peach of mind.  By going to a secure web site, caregivers can see the in-home activity of an elderly family member.

The BeClose system is a network of wireless sensors showing activity throughout the home that can be customized for many activities. BeClose initiated a research and development partnership with Alarm.com which serves more than 500,000 homes and businesses nationwide.

BeClose used in a successful pilot program in group homes was deployed in New Brunswick N.J. The objective was to assess efficacy in saving long term care costs and to help seniors remain safely in their home. The pilot showed that older adults can stay in their own home at greatly reduced cost to families and payers.

Another company, Royal Philips Electronics released their new mobile app “CarePartners Mobile” www.carepartnersmobile.com at the mHealth Summit that is now available on iTunes and Google Play. The app is designed to help family caregivers coordinate healthcare. The free app available for iPhone and Android streamlines care coordination and enables caregivers to:

·        Communicate in a private secure online community

·        Create, manage, and view upcoming caregiving tasks using a shared to-do list

·        Assign tasks to individuals

·        Sync task responsibilities directly into their smartphone calendars.

CHCF Invests in Telemedicine

The California HealthCare Foundation (CHCF) is investing $500,000 in Direct Dermatology, a Palo Alto telemedicine company using low-cost technology to bring high-quality dermatology care to rural and underserved patients in the state.

“Skin problems account for approximately 25 percent of all visits to office-based Primary Care Physicians (PCP),” said Margaret Laws, Director of CHCF’s “Innovations for the Underserved” program that manages the CHCF Health Innovation Fund. “For many of these visits, the patient and physician would benefit from a consultation with a dermatologist, but the current shortage and the unequal geographic distribution of dermatologists often prevents or delays these consultations.”

The new funding brings CHCF’s total investment in Direct Dermatology to $740,000 made through the CHCF Health Innovation Fund. The fund supports business models that have the potential to lower the total cost of healthcare and significantly improve access to care for the people of California.

“Direct Dermatology uses digital cameras and secure internet access to enable medical dermatologists to review patient skin conditions remotely,” said Raj Gupta, MD, PhD, and Co-Founder of Direct Dermatology. “Within 48 hours of receiving a picture from a provider or patient, we are able to diagnose and recommend treatment options.”

To use the services, clinics only need a digital camera, computer, and internet connection. Patients can use the service by visiting their primary care provider or by uploading images to the Direct Dermatology platform. In both cases, patients are able to receive a diagnosis and a prescription if needed.

Since 2010, the company’s board-certified dermatologists have provided more than 4,000 virtual consultations to referring PCPs. Recently, the company opened its online service directly to consumers that make it possible for patients to have access to skin specialists without a doctor’s referral.

For more information, go to www.directdermatology.com or go to www.chcf.org.

Companies Receive FDA Clearance

At the mHealth Summit, AliveCor, Inc announced that the company received FDA 510(k) clearance on their mobile Heart Monitor as well as CE Mark conformity. This clinical-quality, low-cost mobile ECG heart monitor, compatible with the iPhone 4 and 4S, enables doctors to evaluate patient heart health easily, quickly, and remotely.

Clinical studies of the device indicate that a high quality single-channel ECG can be rapidly and simply recorded using an iPhone with the AliveCor application and device to accurately screen for cardiac arrhythmias including atrial fibrillation.

Additionally, AliveCor’s founder Dr. David Albert along with co-founders Bruce Satchwell and Kim Barnett were granted U.S. Patent No. 8,301,232 for the device and technology. The three colleagues began working on the heart monitoring device in 2008.

The Heart Monitor is available for pre-sale to medical professionals in the U.S. through the company website at www.alivecor.com.

In November, AFrame Digital received FDA 510(k) clearance to market its MobileCare Monitor system as a Class II device. The device has been cleared as a Class I device since 2009. The MobileCare Monitor services offer a scalable, hosted platform for care professionals to support patients across the continuum of care.

Someone wearing AFrame Digital’s wireless wristwatch-based health monitor can press a button to request help. Also, if that person experiences a fall or has vital sign reading outside their personal baseline or target range, the system will generate an alert in real-time to caregivers through their mobile communications device of choice.

The monitoring device offers a patented method for non-intrusively and continuously gathering data about a person’s activity when combined with vital signs and gait data to create individualized baselines of wellness. Vital sign data is obtained wirelessly from Class II FDA cleared devices such as Bluetooth-enabled glucometers, pulse oximeters, weight scales, and blood pressure cuffs.

For more information, go to www.aframedigital.com.

Foundation Assisting with HIT

The Verizon Foundation is investing nearly $12 million in grants and in-kind technology to fund and equip four non-profit healthcare organizations with new health information technologies. The focus will be on children, women, and senior citizens.

The non-profit organizations include the Children’s Health Fund, Society for Women’s Health Research, National Association of Community Health Centers, and the University of California, San Diego. The program will expand in 2013 to include additional partnerships.

The foundation’s support of these organizations will help them use the technology to improve self-management, increase access to care, and improve quality along with care adherence. In addition, the foundation in collaboration with Verizon Enterprise Solutions, will give each organization access to Verizon’s health information technology solutions.

“For the first time at Verizon we are integrating our technology solutions and philanthropy to accelerate change in healthcare and improve patient outcomes,” said Rose Stuckey Kirk, President of the Verizon Foundation. “We are deploying our technology together with behavior modification programs to empower people to take control of their health.”

In addition, the Verizon Foundation is especially interested in the development of new mobile device technology to improve tuberculosis (TB) patient care. TB is the leading cause of death among persons with HIV, the second leading cause of infectious disease deaths worldwide, and claims 1.4 million lives each year. TB is a chronic and fatal disease but it is treatable as long as the daily intensive regimen is adhered to strictly.

In order for the daily regimen to take place, “Directly Observed Therapy” (DOT) is required which meant that patients needed to visit their practitioners every day to be observed taking their medications. Today, with the support of the Verizon Foundation and with the work of Dr. Richard Garfein, TB patients are using their cell phones to receive treatment from anywhere. 

Also, Dr. Garfein one of the foremost experts in the study of DOT is testing a new mobile device enabled Video DOT (VDOT) to enable patients to video their treatment sessions using their mobile devices and provide the record to their providers remotely.

For more information, go to www.verizonfoundation.org.

FDA's New Partnership Efforts

FDA is taking part in the first public-private partnership to promote medical device regulatory science with the focus on speeding the development, assessment, and review of new medical devices. Regulatory science works to develop new tools, standards, and approaches to assess the safety, efficacy quality and performance of FDA regulated products that are critical to the medical device industry.

Advancements in regulatory science could not only improve how products are developed and evaluated but also reduce the cost and time it takes for a promising device to come to market.

The new Medical Device Innovation Consortium (MDIC) is an independent, nonprofit corporation created by LifeScience Alley (LSA), a biomedical science trade association that provides insights into current trends, regulations, research, and emerging technologies.

MDIC membership is open to representatives of organizations that are substantially involved in medical and/or medical device research, development, treatment, education, promoting public health, or have expertise in regulatory science 

MDIC will receive input from industry, government, and other nonprofit organizations and then prioritize the regulatory science needs of the medical device community. The next step will be to fund projects to help simplify the process of medical device design and the last step will be to look at commercialization possibilities.

The output from MDIC will:

• Ensure innovative technology is readily available to patients
• Provide industry and government with methods and tools that can be used to expedite medical device development and the regulatory process
• Reduce the risk and expense of clinical research
• Reduce the time and cost of medical device development

“By sharing and leveraging resources, MDIC may help industry to be better equipped to bring safe and effective medical devices to market more quickly and at a lower cost,” said Jeffrey Shuren, M.D., J.D., Director for FDA’s Center for Devices and Radiological Health.

For more information, go to www.deviceconsortium.org.

Reaching Out to Partners/Customers

At the 2012 mHealth Summit held December 3-5, Qualcomm Life announced that their 2net Platform and Hub already available in U.S. and Europe is now available in Canada. The newest collaborative technology partners and customers to join the growing 2net ecosystem include Ingram Micro, HealthyCircles, Valued Relationships Inc (VRI), Tri-City Medical Center (TCMC) ActiveCare, and MD Revolution.

Companies will Use the 2net Platform and Hub to:

• Ingram Micro’s expertise in logistics and distribution will enable the 2net ecosystem collaborators to achieve scale quickly and efficiently
• HealthCircles, will leverage the 2net platform to enable patients and providers to easily monitor vital health information with data that is readily accessible and shareable
• VRI and TCMC will use 2net Hub to further reduce hospital readmissions by delivering the 2net Hub to TCMC patients within 48 hours of discharge
• Active Care will now be able to quickly capture and analyze patient data using the 2net Platform
• MD Revolution will use the 2net Platform to enable MD Revolution’s SaaS solution RevUp  to aggregate genetic and health data plus mobile device data and automate the diagnostic process to provide personalized treatments and wellness plans 

 The mHealth Summit was an opportunity for Qualcomm Inc. to be joined by three Wireless Reach partners collaborating on wireless applications to improve healthcare in underserved communities. The partners came from RTI International, the Flagstaff Medical Center, and the International Community Foundation.

The first project the RTI “Wireless Access for Health” is a public/private collaboration to streamline the reporting process at clinics and hospitals in the Philippines and improve access to accurate and timely patient information for clinicians and decision-makers. As a result, midwives, and other health workers now have mobile access to the Community Health Information Tracking System (CHITS) developed by the University of the Philippines in Manila on a 3G-enabled tablet.

The second project “Care Beyond Walls and Wires” launched at the Flagstaff Medical Center (FMC) in Flagstaff Arizona is Northern Arizona’s only regional referral center caring for more than 85,000 patients each year.

The project provides mobile broadband tools to Congestive Heart Failure (CHF) patients to improve their coordination of care following a discharge from the hospital. The goal is to engage patients in their own healthcare, decrease hospital readmission rates for CHF within 30 days, and increase patient satisfaction.

The third project with assistance from the International Community Foundation is working to help to curb the current diabetes epidemic in northern Mexico and around the world. The “Dulce Wireless Tijuana” project is doing a bi-national multi-sector study to examine how the chronic care model together with 3G wireless internet access can better manage diabetes.

Treating Undiagnosed Diseases

Rare and yet-to-be described disorders are difficult for patients, families, and their physicians. The NIH Office of Rare Disease Research notes that about 6 percent of patients seeking their assistance have an undiagnosed disease and as many as 15 percent had persistent symptoms without diagnosis for at least five years.

The NIH Undiagnosed Disease Program (UDP) began in 2008 and over a four year period has received 6,300 inquiries where eventually 2,300 medical records were evaluated and 450 patients were admitted to the NIH Clinical Center for thorough one-week evaluations.

On November 30, 2012, NIH issued Funding Opportunity Announcement (RFA-RM-12-020) “Coordinating Center for an “Undiagnosed Diseases Network” (UDP) which is to be developed as a Common Fund initiative.

The plan is to build upon the NIH UDP. The NIH Director’s Office of Strategic Coordination is looking to establish a Coordinating Center for a planned Undiagnosed Diseases Network that would include new clinical sites. The funds available for the award are approximately $1.5 million for FY 2014 and one award is anticipated.

The establishment of the Coordinating Center for the UDP will bring more visibility and increase the efficiency of the program. A major goal is to establish an integrated and collaborative research community across the scientific community to share standardized high quality clinical and laboratory data. This data would include genotyping, phenotyping, and documentation on environmental exposures.

NIH expects that the project data sets and associated genotyping data from the Network will be shared widely with the scientific community for research. Study protocols, descriptions, bioinformatic tools, and publications are expected to be available through an open access section of the dbGAP database, through public web sites, and scientific publications. Also, investigators will need support in preparing abstracts, presentations, and publications and the Network leadership will need help to make the public award of the program.

Eligibility for applicants includes higher education institutions, nonprofits, for-profits that including small businesses, governments, and others. A Letter of Intent (LOI) is not required but if a LOI is submitted, it must be submitted by  January 2, 2012. The application is due February 1, 2013.

Go to http://grants.nih.gov/grants/guide/rfa-files/RFA-RM-12-020.html for more information.

Telehealth Executive Summit Coming

Insightful discussions on virtual care models across a variety of specialties including diabetes management, tele-ICUs, ocular, pediatrics, and telemental health will take place at the World Congress Telehealth Executive Summit January 28-29, 2013 at the Hilton San Diego Resort and Spa.

Attendees will have the perfect learning environment while examining all of the issues involved in actively pressing forward to effectively use telehealth in today’s healthcare system.

Clinicians, administrators, and case managers will benefit from relevant case studies examining patient outcomes in active telemedicine initiatives as well as expert-led panel discussions on Credentialing, Grants and Funding, Technology and Vendor Selection, and Virtual Care Communication and Management Models.

Attendees will be able to listen to in-depth discussions on:

·        Aligning incentives and reimbursement models to support telehealth programs

·        The impact that the Affordable Care Act and SCOTUS decision will have on the future of telemedicine

·        How to overcome legal and regulatory barriers such as state licensing and credentialing

·        Ways to expand specialty telehealth initiatives to create an enterprise wide strategy

·        Determining ROI and how to improve outcomes from evidence-based case studies

·        Ways to reduce re-admissions and keep patients in their homes using remote monitoring technologies

·        Integrating disparate data sources to achieve interoperability

·        Ways to engage physicians and adapt clinical and workflow efficiently

Keynoter Jay H Sanders, MD, President and CEO, for the Global Telemedicine Group and Professor of Medicine at Johns Hopkins University School of Medicine will present his vision on how to transform healthcare delivery through telemedicine to effectively meet the needs of the 21^st century.

Some of the other speakers include:

·        Dale C. Alverson MD, Professor Emeritus of Pediatrics and Regents, Medical Director of the Center for Telehealth and Cybermedicine Research, University of New Mexico

·        Nina M Antoniotti R.N, PhD, Telehealth Director for the Marshfield Clinic

·        Ronald S Weinstein MD, Founding Director for the Arizona Telemedicine Program

·        Mario Gutierrez, Executive Director for the Center for Connected Health Policy

·        Nancy Vorhees, Chief Operating Officer for the Inland Northwest Health Services

·        Yael Harris, Director, Office of Health IT and Quality, Office of Special Affairs at HRSA

·        Lisa Robin, Chief Advocacy Officer, for the Federation of State Medical Boards

Plus many more speakers from hospitals, colleges, industry, state organizations will provide their knowledge and insight on the vital and critical issues involving the use of telehealth.

For more information or to register, go to www.telehealthsummit.com/events/HL13014. Federal Telemedicine News readers and friends can save an additional $300 off the current registration fee by using Promo Code FTN912 when registering.

For more information on other World Congress Conferences, go to www.congress.com.

New Bill Introduced

On December 5^th, Representative Mike Honda (D-CA) introduced the “Healthcare Innovation and Marketplace Technologies Act” (HIMTA) (H.R. 6626) to foster more innovation in the healthcare industry by developing marketplace incentives, offer challenge grants, and provide more workforce retraining.

First, the bill would establish an “Office of Wireless Health” at FDA that would coordinate with other governmental agencies and private industry to provide recommendations to the FDA Commissioner on developing and maintaining a consistent, reasonable, and predictable regulatory framework on wireless health issues.

The bill would also establish a mHealth developer support program at HHS to help mobile application developers build their devices in line with current privacy regulations. This program would provide a national hotline, an educational website, and a yearly report that would help translate the wide array of privacy guidelines into common English.

To foster greater interest in developing health IT, the bill mandates the creation of a prize program and small innovator challenge grants to incentivize risk-taking and attract outside investment. The “Disruptive Technologies Prize Program” would create a commission of private industry, patient safety/privacy advocates, medical professionals, and government officials that would recommend three major areas of health IT where there has not been enough innovation.

Then the commission would create a competitive prize program (similar to the X-Prize Foundation competition for private manned space flight) to attract private investment. In addition, the challenge grant program would provide grants to small innovators working in garages and home offices around the nation and develop the critical seed funding necessary to make their ideas a reality.

Since lack of capital is one of the biggest barriers to purchasing health IT, the bill would create a low-interest small business loan program for clinics and physician offices to purchase new health IT technologies and services. It would also create a tax incentive program to enable medical care providers to deduct costs related to non-EHR healthcare information technology. Finally, the bill would establish two year grants to assist medical care providers in retraining their employees into new positions that use health information technology.