Telestroke Care Helps Patients

According to the National Stroke Association, stroke is the third leading cause of death in the U.S. resulting in $73.7 billion being spent on stroke related healthcare costs. During a stroke, 1.9 million irreplaceable brain cells are lost every minute—so time is of the essence. However, new developments in the telemedicine field have opened up opportunities for hospitals to save stroke patients brought to the hospital for treatment.

New telestroke programs are not only starting but also expanding. For example, C3O Telemedicine formerly C30 Medical Group is currently partnering with Community Memorial Health System in Ventura California. Both the medical group and health system are using telemedicine so stroke patients now have immediate connectivity to highly skilled neurologists and neurointensivists.

C3O Telemedicine offers not only telestroke care but also neurocritical care, telepsychiatry, critical care, and teleICU and other telemedicine solutions. The company has a new C3O website at http://c3otelemedicine.com/.

In 2010, to further telestroke services in rural areas, USDA’s Distance Learning and Telemedicine (DLT) program awarded a grant for $253, 260 to Providence Health & Services to add five rural critical access hospitals in Eastern and Central Oregon to the Providence Telestroke Network hub in Portland.

The funding was used to place mobile robot devices with human-like mobility in rural hospitals. Using two-way video cameras over a secure internet connection, Portland-based neurologists are now able to examine and talk to patients, family members, and clinicians.

Today, the Providence Telestroke Network connects stroke experts at the Providence St. Vincent Medical Center and Providence Portland Medical Center to 14 communities outside of Portland. Since 2010 the network has been able to evaluate more than 1,000 patients.

In another program reaching rural areas, Ochsner Medical Center the first hospital in Louisiana to use telemedicine is treating strokes in patients located in areas with smaller hospitals. In the last two and half years since being implemented, Oshsner is one of the fastest growing networks.

By utilizing Ochsner’s “Acute Stroke System for Emergent Regional Telestroke” (ASSERT), stroke neurologists are present virtually at a growing number of hospitals through secure wireless and video. Ochsner’s stroke team evaluates patients, directs care, and ensures that timely thrombolytic therapy is administered. With Ochsner Medical Center in New Orleans functioning as the hub, ASSERT links specially-trained vascular neurologists to spoke hospitals 24/7 for collaborative care. 

There are several recent ongoing clinical trials studying the use of telemedicine when treating stroke patients. For example, A National Stroke Association clinical trial “Advancing Telestroke Care: Prospective Observational Study” is currently recruiting participants. Other sponsors of the trial include Mayo Clinic, Swedish Medical Center, Renown Regional Medical Center, University of Utah, and the California Pacific Medical Center.

The trial is underway at the University of Southern California in Los Angeles, and estimates enrolling 600 patients. The objective for the clinical trial is to see if telemedicine consultations used for acute stroke patients will improve their care and to see if stroke patients are also helped at hub hospitals. For more information, contact Gene Sung MD at gsung@usc.edu.

Another clinical trial “Telestroke in Nordland Hospitals: A Study of a Telemedicine Network” for an 18 month observation period is being conducted. The clinical trial sponsored by the University Hospital of North Norway will investigate the potential outcome for stroke patients in small rural hospitals using a telestroke service.

In Norway, providing telemedicine services can be vital especially in the Northern part of the country since there is a high turnover of clinicians, technical support is not available 24/7, severe weather conditions exist, and long distances can affect transportation efforts.

The study conducted at rural hospitals will examine patient flow by analyzing hospital information system data as well as monitoring teleconsultations. Hospital data on diagnosis, thrombolysis frequencies, and stroke complications like hemorrhage will be used to analyze the process.

The study will:

·        Send videos and images using the RIS/PACS system

·        Conduct semi-structured interviews and then follow-up with phone calls to hospital staff after telestroke incidents

·        Observe patients and doctors during telestroke consultations

·        Form semi-structured focus groups interviews to take place with health personnel involved with stroke patients

Email Bettina Heermann M.D., at Bettina.Heermann@nordlandssykethuset.no for more information.  

Developing Rare Disease Therapies

The Senate Health, Education, Labor, and Pensions Committee approved Senator Whitehouse’s bill “Expanding and Promoting Expertise in Rare Treatments (EXPERT) Act of 2012”. The legislation would give patients and experts a role in the FDA’s review of new treatments for rare diseases.

As cited by Senator Whitehouse’s legislation, FDA would be able to take advantage of the wisdom and insights of rare disease experts that would speed up the development of therapies for patients with rare diseases. The bill also gives rare disease patients and their advocates a role in consulting with the FDA on the severity of a rare disease, discuss unmet medical needs, and discuss the benefits and risks of therapies to treat the disease.

“We’ve seen that when FDA gets the technical and scientific assistance it needs from rare disease experts, incredible progress can be made,” said Senator Whitehouse. He specifically cited the Cystic Fibrosis Foundation’s recent work with Vertex Pharmaceuticals.

At the end of January 2012, Vertex’s New Drug Application was approved by FDA for Kalydeco™. The drug is used to treat people with Cystic Fibrosis who have a specific genetic mutation.

According to Senator Whitehouse, the FDA was able to approve Kalydeco ™ in just three months. It was one of the fastest review times in FDA’s history and was aided by the input from the Cystic Fibrosis Foundation and experts on the disease.

The legislation is supported by 64 rare disease groups including the Rhode Island Rare Disease Foundation. The EXPERT Act will enable the FDA to have a more viable partnership with experts in the rare disease community who are most knowledgeable on treatments,” said Patricia Weltin, Executive Director of the Rhode Island Rare Disease Foundation.

Harris Awarded IT Contract

Harris Corporation has been awarded a multi-year $80.3 million contract by the VA’s Technology Acquisition Center to help integrate EHRs for the VA and DOD. The company will develop the system’s key Services Oriented Architecture (SOA) to be released in early 2014. The SOA Suite contract was awarded to Harris as part of the VA’s Transformation Twenty-One Total Technology (T4) contract aimed at streamlining VA operations.

The VA and DOD have several disparate healthcare information systems including VistA, CHCS, and AHLTA as well as two hundred local data centers. Under this award, Harris will provide a single architecture and joint execution strategy for the two agencies.

The SOA suite will serve as the standard platform to migrate legacy systems, applications, and sharing capabilities. Harris will deploy a common federated middleware as a secure, virtualized, intelligent infrastructure allowing best-of-breed “Cloud First” services for all members of the DOD and VA healthcare systems. Harris plans to work with DOD and VA to develop a demonstration site by September 2012, full site deployment slated for August 2013, and full SOA release by early 2014.

The VA/DOD EHR project promotes health information sharing across the full spectrum of military service from active to retired service duty,” said Jim Traficant, President of Harris Healthcare Solutions. “It will enhance the health status of millions of service members whose move from military healthcare to the VA or from one VA facility to another sometimes involves waits and duplicate diagnostic testing. The SOA Suite architecture will create an enabling platform for unprecedented integration and communications to ensure a continuum of care across a service member’s lifetime.”

For more information, go to http://www.harris.com/.

CIT Invests in Technology

The Commonwealth of Virginia’s Center for Innovative Technology (CIT) in their Gap Fund program has invested $125,000 in a company called iTi Health Inc., whose proprietary technology is able to identify a protein biomarker in the early stages of pancreatic cancer.

iTi Health is very interested in the at-risk population for this disease that comprises an estimated 900,000 individuals per year in the U.S. Tom Weithman, CIT Vice President and GAP Funds Managing Director, said, “Pancreatic cancer of one of the deadliest cancers. With a 5 year survival rate of less than 5 percent, a prognosis has not improved in 40 years.”

iTi Health’s technology PHAGEMARK™ is able to rapidly identify novel disease and drug response targets. The company is focusing on the validation of its imaging product Plectiscan™ to detect the target for pancreatic cancer known as plectin.

In studies on over 100 human pancreatic tumors, there is a 100 percent correlation between cancer presence and the expression of plectin. Plectin is also detected in nearly two-thirds of advanced precancerous lesions, but not in other benign inflammatory conditions of the pancreas such as pancreatitis.

iTi Health Co-Founder and CEO Greg Fralish said, “We see Plectiscan as a transforming diagnostic tool that primary care physicians, surgeons, radiologists, medical oncologists, and gastroenterologists can use.”

The CIT GAP Funds make seed-stage equity investments in Virginia-based technology, clean technology, and life science companies that have a high potential for achieving rapid growth and generating significant economic return for entrepreneurs, co-investors, and the Commonwealth of Virginia.

For more information on CIT GAP Funds, go to http://www.citgapfunds.org/.

Dental Network Consolidating

NIH’s National Institute of Dental and Craniofacial Research (NIDCR) awarded $66.8 million in a seven year grant to consolidate their dental practice-based research network initiative into a unified nationally coordinated effort. The network initiative is headquartered at the University of Alabama at the Birmingham School of Dentistry, and has been renamed the “National Dental Practice-Based Research Network (NDPBRN).

A dental practice-based research network operates as an investigative union of practicing dentists and academic scientists. The network enables practitioners to propose or participate in research studies that address day-to-day issues in oral healthcare.

According to NIDCR Director Martha Somerman, D.D.S, Ph.D, the initial seven-year Regional Dental PBRN grants proved to be extremely productive. The networks enrolled 1,719 practitioners in 43 states. In collaboration with the Dental PBRN academic faculties and staff, the practitioners organized and conducted 51 research studies, generated 87 journal articles on topics ranging from preventive and restorative dentistry to pain management and smoking cessation.

The NDPBRN plans to expand the number of participating practitioners to 5,000. Another goal is to extend practitioner participation across the country. “With today’s advanced communications tools, no rural community is too remote for participation in the national network,” said Gregg Gilbert, D.D.S, M.B.A, the NDPBRN National Network Director and Chair of the UAB School of Dentistry’s Department of General Dental Sciences.

For more information, go to http://www.nidcr.nih.gov/.

ACS Exhibiting at ATA

Attention Control Systems (ACS) located in Mountain View California is exhibiting their Planning and Execution Assistant and Trainer (PEAT), a handheld computer system at ATA 2012 from April 29 to May 1, 2012.

PEAT is a unique Android-based application that aids individuals and soldiers with TBI and PTSD and other individuals with memory, attention, and cognitive disorders. PEAT provides cues over an Android-based smart phone to support individuals through daily activities while monitoring their progress and is able to adjust schedules in response to changing situations.

The new release of PEAT is integrated with an advanced version of AFrame Digital’s MobileCare Monitor™ system. This system provides real-time continuous health and safety monitoring for seniors, patients managing chronic conditions, and other at-risk individuals. The system includes a wristwatch-based personal monitoring device embedded with a patent-pending heart rate sensor design.

“The integrated application of PEAT with MobileCare Monitor is due to the successful collaborative research conducted under a contract for DARPA and the Office of the Secretary of Defense,” explains ACS CEO Rich Levinson.

AFrame Digital COO Bruce Wilson says, “Promoting the independence and engagement of injured soldiers has been a long standing research objective of AFrame Digital under SBIR contracts from DARPA dating back to 2005.”

To see PEAT, go to booth #1135 located on ATA’s Virtual Exhibit Hall. For more information on ACS, go to http://www.brainaid.com/ and for more information on AFrame Digital located in Reston Virginia, go to http://www.aframedigital.com/.

Healthcare Issues on the Agenda

HHS Secretary Kathleen Sebelius views the surge to form the healthcare of the future as truly transformative. According to the Secretary, innovative and effective changes are being made not only at the federal level but also at the state and local levels. As a keynote speaker at the Atlantic’s Fourth Annual Health Care Forum on April 19^th held in Washington D.C., she touched on the efforts being made to reduce healthcare-associated infections.

According to the just released HHS updated National Action Plan to eliminate healthcare-associated infections, everyday one in 20 patients has an infection related to their hospital care. These infections cost the U.S. healthcare system billions of dollars each year and lead to the loss of tens of thousands of lives. Public comments are now requested on the plan.

In a new state-by-state breakdown by CDC, current data shows that central line- associated bloodstream infections have declined by 33 percent saving 1,250 lives and saving $82 million. Also, surgical site infections have declined by 10 percent with catheter-associated urinary tract infections declining by 7 percent.

Secretary Sebelius stressed how the HHS “Partnership for Patients” program is going to stop millions of preventable injuries and complications in patient care over the next three years. This is to be accomplished by establishing structured learning collaboratives to support hospitals nationwide adopt proven interventions. The hope is that the proven interventions become the standard of care and 60,000 lives could be saved and thereby reducing costs by millions.

Farzad Mostashari, National Coordinator for HIT, at the opening panel discussion commented “In the past two years, we have made as much progress on the adoption of health IT as we have in the past 20 years. There is an entirely new level of interest in using technology by young providers.”

He mentioned three trends that are not going to go away and will affect the growth of health IT. For one, doctors will need to have EHRs, the system can’t continue to pay for care based on volume, and smart phones are really affecting how people relate to connected health and medical information.

As he pointed out, there are new financial incentives being studied along with new care models. For example, the medical home will be used to manage chronic care and is expected to produce an amazing transformation in care across the country. 

Atul Grover, Chief Policy Officer for the Association of American Medical Colleges opened the next panel to discuss the enormous shortage of primary care physicians facing this country. As he said, “Primary care is the foundation for the healthcare system but with long hours, too many patients to see, not enough time to spend with patients, physicians enticed financially to move into other specialties, and physicians not having financial incentives to go into primary care, a shortage is occurring now and in the future.” 

The panel was moderated by Derek Thompson, Senior Editor, The Atlantic. Panelists included Carolyn Clancy M.D., Director of AHRQ, Jill Rubin Hummel, Vice President, Payment Innovation, Well Point, Inc., Steve Miller, Senior Vice President and Chief Medical Officer, Express Scripts, and Marci Nielsen, Executive Director, for the Patient-Centered Primary Care Collaborative.

All of the panelists were in agreement on several critical issues related to the lack of patient care doctors such as:

·        Practicing in underserved and rural areas can be difficult when dealing with so many chronic illnesses among the elderly

·        The lack of health IT in rural areas to meet the needs of so many chronically ill patients

·        Lack of financial incentives along with an effective business model

·        Lack of appropriate team training in medical schools needed to provide coordinated care

·        The need to resolve the debt issue for this specialty which could include financial incentives to practice in underserved areas

·        Lack of medical homes pilots and in general the ability to provide coordinated care in rural and isolated areas

·        The temptation for medical students to go into research to further their career

The panelists were all in agreement that health IT is needed to help meet the needs of primary care physicians. All agreed that it would be easier for smaller practices to be networked in order to help coordinate care for patients with chronic illnesses especially the elderly, health IT would help to support the flow of data, and new technology would help primary care physicians, patients, laboratories, and pharmacies to operate more as partners with each other. As Dr. Clancy emphasized, primary care is all about relationships and for the right person; the field can be terribly exciting.

 

Helping Cancer Survivors

Nearly 80 percent of children treated for cancer are now cured of their original disease due to vast improvements made over decades past, according to the National Cancer Institute. However, the survivors of pediatric cancers are also more likely to have long-term health complications.

To assist these patients, Emory researchers created “SurvivorLink”™, at http://www.cancersurvivorlink.org/ for pediatric cancer survivors, their families, and physicians. Currently, SurvivorLink has 225 registered users, contains patient, provider, and research portals, along with educational materials on survivorship, and helpful links. 

Primary care physicians might have only two or three patients who are pediatric cancer survivors, and almost always with different diagnoses. “Doctors tell us that what they need are patient case summaries that are quickly and easily accessible”, said Ann Mertens, PHD, Developer of SurvivorLink, Pediatric Endocrinologist, and Medical Director of the Cancer Survivor Program at Children’s Healthcare of Atlanta.

Due to their original disease and harsh treatments such as chemotherapy and radiation, pediatric cancer survivors can suffer late effects such as osteoporosis, heart disease, lung problems, and secondary cancers. About 70 percent of pediatric cancer survivors experience chronic health conditions late in life.

Funded by a three year grant of more than $1 million from the Agency for Healthcare Research and Quality within HHS, the database connects patients and their families with the ability to virtually consolidate their medical histories, records, and follow-up care as they age and provide valuable information to their doctors.

In another move to help cancer survivors, University of Kansas (KU) research has led to the creation of a new startup company that will develop online curriculum for healthcare professionals involved in managing the care of cancer survivors. The goal is to create e-learning solutions to keep healthcare providers current on issues of importance to cancer survivors.

Cancer Survivorship Training Inc. (CST) has finalized a licensing agreement with KU to commercialize the research done by Dr. Jennifer Klemp, a researcher in the university’s departments of internal medicine, nursing, and psychology. According to Klemp, most cancer patients lack guidance on the healthcare they require for common late and long term effects of cancer or its treatment.

“More than one-third have unmet psychosocial needs. Also, many cancer patients do not receive adequate health promotion, cancer screening, and the proper coordination of care needed for post treatment and for long term survivorship.”

CIT will provide online and mobile resources to healthcare professionals to help them better treat and provide advice to cancer survivors. CST plans to officially launch its suite of online and mobile solutions to healthcare professionals in May.

Bills Introduced in States

Recently, New York, Connecticut, South Carolina, and Louisiana have introduced bills related to telemedicine and telehealth. In New York, two companion bills one in the House and one in the Senate includes reimbursement for telemedicine services for home health agencies, long term home health care programs, AIDS home care programs, and licensed home care services agencies. If services are covered for hospital, medical and/ or surgical care then telemedicine services would be covered.

The state of Connecticut is considering a bill to deal with the coverage of telemedicine services under Medicaid. If it is deemed appropriate, an in-person contact between healthcare providers and patients would not be required when services can be provided using telemedicine and the telemedicine services would be eligible for reimbursements under the state Medicaid plan.

In addition, the Department of Social Services (DSS) in Connecticut may establish a demonstration project to offer telemedicine as a Medicaid-covered service at Federally-Qualified Community Health Centers.

Connecticut’s Commissioner for Social Services in consultation with the Commissioner of Public Health could establish rates for cost reimbursement for telemedicine services provided to Medicaid recipients. The Commissioner may also apply if necessary to the federal government for an amendment to the state Medicaid plan to cover telemedicine services.

Legislation to enact the “South Carolina Telemedicine Insurance Reimbursement Act” would help expand telemedicine services. The Act would require insurers, hospitals, and medical, service corporations, healthcare corporations, HMOs, preferred provider organizations, provider-sponsored healthcare corporations, and managed care entities that provide health insurance policies in the state to include reimbursement for telemedicine.

State representative Scott M Simon from Louisiana has made a request to the Louisiana state legislature urging the Department of Health and Hospitals (DHH) to study ways to expand access to telehealth services to residents of the state. To conduct the study, DHH would need to engage, collaborate, and obtain information and perspective from stakeholder groups.

Some of the universities and organizations that need to be included as stakeholders are the healthcare services division within the Louisiana State University System, Tulane University School of Medicine, Louisiana State Medical Society, Louisiana Primary Care Association, and the Louisiana Health Care Quality Forum. The study’s findings would need to be reported to the State House Committee on Health and Welfare and the State Senate Committee on Health and Welfare by December 31, 2012. 

Illinois Seeks Proposals

The State of Illinois is soliciting proposals to help coordinate care for seniors and adults with disabilities. The Solicitation referred to as the Phase I Innovations Project/2013-24-002, was issued by the Office of the Governor and several other health related departments within the state.

The state wants to hear from experienced and qualified Care Coordination Entities (CCE) and Managed Care Community Networks (MCCN) along with community partners that have the capability to provide coordinated quality care to seniors and adults with disabilities. They must be able to work across provider and community settings, offer new risk-based funding incentives, and able to measure delivery system effectiveness and efficiency.

CCEs may propose options for care coordination fees and options for shared savings models or other financial structures. CCE partners must include participation from hospitals, primary care providers, and behavioral health and substance abuse providers.

MCCNs a provider sponsored organization that contracts to provide Medicaid covered services through a risk-based capitation fee and must be owned, operated, managed, or governed by providers, state funded medical schools, or county governments.

Phase I of the Innovations Project, a three year award consisting of several phases is looking to redesign the state healthcare delivery system to make it more patient-centered with a focus on improved health outcomes, enhanced patient access, and patient safety.

The care needs to include a medical home with a primary care provider, provide for specialist services, diagnostic and treatment services, mental health and substance abuse services, inpatient and outpatient hospital services, rehabilitation, and long term care services.

A separate solicitation for children with complex and/or multiple chronic medical needs is anticipated for release this spring. A solicitation for Phase 2 of the Innovations Project will be issued for dual-eligibles also in spring 2012 and in the summer, Phase 2 will include a solicitation for expanded priority populations.

The proposal is due May 25, 2012. For more information, email HFS.carecoord@illinois.gov. Go to www2.illinois.gov/hfs/PublicInvolvement/cc/Documents/Innovations%20Solicitation.pdf.

For a list of the companies and individuals that have submitted Letters of Interest as of March 20, 2012, go to http://www2.illinois.gov/hfs/PublicInvolvement/cc/Documents/cc_solicloi.pdf.

Challenge Finalists Announced

The Alzheimer’s Challenge Initiative provides an entrepreneurial springboard and $25,000 to each finalist to help harness new thinking and approaches to help improve Alzheimer’s care. The goal is to use the funding to help further develop methods to use to assess and track changes in memory, mood, thinking, and activity levels over time that will help improve diagnose and monitor the disease.

The Alzheimer’s Challenge Initiative is presented by the Alzheimer’s Immunotherapy Program of Janssen Alzheimer Immunotherapy and Pfizer, Inc. together with the “Geoffrey Beene Gives Back®”. Recently, the five finalists for the “Alzheimer’s Challenge 2012 were announced.

Each of the five finalists will be eligible to participate in a “Design & Behavior Boot Camp” hosted by Luminary Labs where they will receive mentorship and hands-on experience to refine their concepts into market offerings. Then the finalists will present a prototype of their idea to a panel of judges in June 2012 at a Finalist Event being led by InnoCentive. The winner will receive an additional $175,000.

The five winning systems of the “Alzheimer’s Challenge 2012 includes:

• The Digital Clock Drawing Test (dCDT) applies cutting-edge technology and innovative software to a familiar test—the clock. The test produces a screening test for Mild Cognitive Impairment and Alzheimer’s disease that is user and patient-friendly, rapid, inexpensive, and portable. The test automatically measures variables that are found in traditional clock drawing tests, but also detects subtle behaviors, previously not measurable that appear to be very early diagnostic markers for pre-symptomatic Alzheimer’s disease

• The ICHANGE system continuously and coincidently monitors signature activities and behaviors of people with Alzheimer’s disease that are readily assessed without the need to remember to wear or charge a device. An array of inexpensive sensors is used to unobtrusively measure key functions where change has been associated with the progression of cognitive decline. The data is aggregated and analyzed with prediction algorithms that are then streamed to interested stakeholders providing real-time reports of change

• The Ginger.io platform is a combination of a mobile phone application and web-based dashboard. The platform passively tracks Alzheimer’s patients’ behavior relevant to their mood, memory, and functional status. Then the system administers standard Alzheimer’s cognitive assessments to provide healthcare providers with a dashboard to measure patient health status, easy-to-interpret scores, and novel data analytics

• BrainBaseline uses Apple’s iPad tablet computer to provide a brief, comprehensive assessment of memory, attention, language, and processing speed over time, while minimizing the logistical constraints currently associated with collecting longitudinal cognitive performance data. The tool aggregates lifestyle and cognitive performance data to give patients and caregivers customized information regarding how these factors interact with cognitive function and can be used to enhance quality of life. Also, the data can be used to understand how specific demographic and lifestyle factors contribute to the incidence and progression of Alzheimer’s

• The VF-meter, a non-invasive computerized instrument measures and monitors subtle cognitive changes over time that may indicate early Alzheimer’s disease. The test automates the administration and results analysis of a standard verbal fluency task, and then stores the results on several platforms including computers and mobile devices. The automated measurements are used to evaluate a subject’s current cognitive state, monitor cognitive change over time, and to predict the relative likelihood and rate of progression to dementia.

For more information, email Alyssa Bleiberg at ABleiberg@Biosector2.com or call (212) 845-5628.

CapeNet Moving Ahead on Fiber Network

CapeNet LLC selected Ciena Corporation and Integration Partners to increase bandwidth from 10G to 100G and beyond for the fiber optic OpenCape Network that is scheduled to be completed January 2013. Ciena Ethernet solutions will provide the fiber optic network being constructed in Southeastern Massachusetts and on Cape Cod.

The network is being funded through a Broadband Technology Opportunity Program (BTOP) grant made possible by ARRA. So far, there have been several federally-funded BTOP recipients also using Ciena that includes DC-CAN, Navaho Tribal Utility Authority (NTUA), U.S. Unified Community anchor Network (U.S. UCAN) and NetworkMaine (MaineREN).

The OpenCape Network will be able to provide high speed broadband connectivity to improve public safety, health, social services, and emergency care as well as help local government and administration offices deliver distance learning, telemedicine, security monitoring, and other advanced applications not currently possible with the present infrastructure.

On Cape Cod, the network will provide high-speed broadband connectivity to community anchor institutions, to include 30 libraries, 5 colleges, 15 town network hubs, and 6 research institutions. The network will offer opportunities to hundreds of additional anchor institutions, and nearly 62,000 businesses.

Stephen B. Alexander, Ciena Senior Vice President and CTO, reports that “Ciena’s WaveLogic™” Coherent Optical Processors will vastly expand capacity without disrupting existing networks and will provide cost effective upgrades from 10G to 40G or 100G with a clear path to 400G.”

For more information, go to http://www.ciena.com/.

DOD & VA Sharing Information

Both DOD and the VA are involved in several interagency electronic health data sharing activities according to Dr. Jo Ann Rooney, Acting Under Secretary of Defense for Personnel and Readiness appearing before the Senate Committee on Veterans Affairs. As she explained, several systems are transferring information between the agencies.

For example, when a retired or separated service member leaves active military status, currently the Federal Health Information Exchange (FHIE) provides the only one-way electronic exchange of historic healthcare information from DOD to the VA.

On a monthly basis, DOD sends inpatient and outpatient laboratory results, radiology reports, outpatient pharmacy data, allergy information, discharge summaries, consult reports, admission/discharge/transfer information, standard ambulatory data records, demographic data, pre-and post-deployment health assessments, and post-deployment health reassessments via FHIE. To date DOD has transmitted health data on more than 5.8 million retired or separated service members to the VA.

To help shared patients being treated by both DOD and the VA, DOD maintains the jointly developed Bidirectional Health Information Exchange (BHIE) implemented in 2004. Unlike the FHIE, which only provides a one-way transfer of information; the two way BHIE interface enables clinicians in both DOD and the VA to view health data in text form from DOD’s existing health information systems.

Use of the data from BHIE continues to increase. As of January 2012, data from BHIE is available on more than 4.3 million shared patients including over 293,340 theater patients. Recent 2011 improvements to BHIE include the completion of hardware, improvements to the operating system, and performing security upgrades.

The exchange of pharmacy and allergy data is accomplished through the Clinical Data Repository (CDR) and the Health Data Repository (HDR) interface referred to as CHDR. CHDR supports interoperability between AHLTA’s CDR and the VA’s HDR enabling bidirectional sharing of standardized computable outpatient pharmacy and allergy data. So far, both DOD and the VA have exchanged pharmacy and allergy data on over 1.4 million patients receiving healthcare from both systems.

The transferring of images for the most severely wounded and injured is very important especially when service members are transferring to the VA Polytrauma Rehabilitation Centers for care. Today, DOD is able to send radiology images and scanned paper medical records electronically to the VA.

Both departments are focused on sharing health data with the private sector through the Nationwide Health Information Network (NwHIN) and the Virtual Lifetime Electronic Record (VLER). NwHIN will enable the departments to view a beneficiary’s healthcare information not only from DOD and the VA but also from other NwHIN participants.

DOD and the VA are working jointly on the Integrated Electronic Health Record (iEHR). Both departments anticipate that iEHR capabilities will evolve from existing service oriented architecture compliant capabilities and from commercial off-the-shelf, open source, and custom systems.

Maryland's Telemedicine & HIT Actions

On April 17^th, the Maryland State Legislature approved HB 1149 and SB 781 mandating that health insurers pay for telemedicine services. Governor O’Malley is expected to sign the bill into law in May and upon signing, Maryland will join 12 other states that have passed similar legislation.

Leaders in the telemedicine field including Jennifer Witten, Government Relations Director for MD-DC, for the American Heart and Stroke Association, Gary Capistrant with the American Telemedicne Association, and Dr. Karen Rheuban Medical Director for the Office of Telemedicine at the University of Virginia, Senator Catherine E. Pugh, Delegate Susan C. Lee, and a number of other advocates and experts have worked very hard to pass the legislation. 

Important and specific steps are also taking place to move HIT forward at a rapid rate in the state. According to an update provided for the March Maryland Health Care Commission meeting, the Center for Health Information Technology is continuing to evaluate the responses received from the “2011 Hospital HIT Survey” from all 46 acute care hospitals in Maryland. The survey was administered at part of the “Maryland Freestanding Ambulatory Surgical Center Survey.”

Questions were included on adoption of technologies such as CPOE, EHRs, eMARs, infection surveillance software, e-prescribing, electronic data interchange, and for the first time telemedicine. In general, health IT adoption increased in all nine HIT categories with the highest increase in the adoption of CPOE at around 63 percent and e-prescribing which increased by roughly 58 percent.

The Center’s staff is in the preliminary stage of working with the Maryland-National Capital Homecare Association to explore opportunities to advance HIT with home healthcare agencies. The staff has also collaborated with the University of Maryland-Baltimore County, Department of Information Systems to assess the current HIT implementation activities among home healthcare providers. They are identifying ways to improve care delivery and coordination, reduce costs, and improve access to care using technology.

Over the next three months, the staff plans to convene focus groups, conduct interviews, and evaluate literature to identify a framework for advancing HIT in home health. A webinar was held on the use of telemedicine within an HIE for chronic disease management.

The Center’s staff has evaluated strategies to assess progress achieved toward the adoption and meaningful use of EHRs in the state. The staff is also making recommendations for any changes in state law that may be necessary to achieve optimal adoption and use as required by House Bill 706. A report on this issue is due to the Governor and the General Assembly in October 2012.

The Center’s staff is also working with state designated Management Service Organizations (MSO) and EHR vendors to continue discussions on interface development with the statewide HIE as interfaces are required to connect EHRs to the HIE infrastructure.

So far, the staff has met with five vendors and the staff thinks that the MSOs, are well positioned to serve as the technology hub to connect EHRs to the HIE. Over the next month, the staff plans to continue meeting with EHR vendors to develop timelines and affordable pricing models for HIE connectivity.

A quote was requested to identify a vendor to implement a Direct Pilot in regards to the statewide HIE “Chesapeake Regional Information System for Our Patient” (CRISP). A Maryland-based vendor, Secure Exchange Solutions was selected to complete the work.

CRISP and the Abell Foundation are sponsoring a contest to find ways to identify innovative and practical ideas for using clinical information on a patient population to drive advances in public health. The contest is trying to stimulate innovations on potential data sources, both within and outside the healthcare domain, and find new solutions to address public health challenges. The winning applications for the $5,000 prize will be selected in May 2012.

Last month the staff participated in the Finance Committee meeting to discuss HIE connectivity pricing models for ambulatory providers. In the near future, the staff plans to meet with nearly 50 ambulatory practices to identify barriers to HIE connectivity and make recommendations regarding pricing for ambulatory practice connectivity. Another committee, the Technology Committee discussed implementing a small demonstration project to exchange diagnostic images.

Go to http://mhcc.maryland.gov/mhccinfo/cmsmtgs/updates/0312.pdf for more information.

New Devices for Dialysis Patients

Treating patients with End Stage Renal Disease or chronic kidney failure costs the nation almost $40 billion each year for treatment. The most effective treatment is kidney transplantation but those organs are in short supply and last year only 16,000 kidneys were available for transplant leaving many patients on the waiting list, according to the Organ Procurement and Transplant Network. 

Researchers at the University of California at San Francisco are developing an implantable artificial kidney for dialysis patients. The research project has been selected as one of the first research projects to undergo more timely and collaborative review at FDA.  The research at UC San Francisco combines nano-scale engineering with the most recent advances in cellular biology to create an implantable Renal Assist Device (iRAD).

Shuvo Roy, PhD, leading the artificial kidney research at the university has met with possible investors and granting agencies seeking funds expected to be $20 million for artificial kidney clinical trials that are targeted for 2017.

To help researchers and companies cope with regulatory hurdles, FDA launched the “Innovation Pathway” program, a pilot program to address innovative device development for ESRD. FDA selected ESRD as a topic because management of the disease is largely dependent upon medical device technology including hemodialysis equipment.

To begin the selection of research projects, on April 9^th, FDA chose the UC San Francisco product and two other products from 32 product applications that were submitted ranging from an artificial kidney to devices that assist kidney function. The majority of the 32 applications came from small, start-up businesses, or academic institutions.

To be selected, the product had to involve an innovative technology, use a novel approach to solve a technological problem, and very importantly, further FDA’s in-house technical/clinical expertise.

FDA’s subject matter experts, management, and members of the innovation subcommittee of the Center Science Council discussed each application internally, held an initial teleconference with each candidate to better understand the device technology, the impact on public health, the possible regulatory impact, and the product’s stage of development.

Blood Purification Technologies Inc. (BPTI) in Beverly Hills also selected has developed a Wearable Artificial Kidney (WAK). The company has exclusive worldwide rights to the technology and plans to move quickly to commercialize it. BPTI seeks to raise $20 million to complete product development and design, testing, and final approval. 

The third product selected was the Hemoaccess Valve System (HVS) designed by CreatiVasc Medical located in Greenville, South Carolina. HVS has undergone extensive testing and FDA has approved CreatiVasc’s system for human clinical trials which are now underway.

Applicants from the ESRD Innovation Challenge are now going to participate in FDA’s Center for Devices and Radiological Health (CDRH) “Innovation Pathway 2.0” program set to deepen the collaboration between FDA and innovators earlier in the process prior to pre-market submission. The program will also serves as a living laboratory to test new tools and methods for breakthrough devices that may also be applied to other technologies.

CMS Selects 27 ACOs

CMS selected the first 27 Accountable Care Organizations (ACO) to participate in Shared Savings Program where ACOs providing high quality care measured by 33 quality measures may share in the savings to Medicare.

The Shared Savings Program to serve an estimated 375,000 beneficiaries in 18 states brings the total organizations participating in the program to 65. This includes the 32 Pioneer Model ACOs announced last December and the six Physician Group Practice Transition Demonstration organizations started in January. 

Of the 27 ACOs, five are participating in the Advance Payment ACO model an initiative developed by the CMS Innovation Center. Through the Advance Payment ACO Model, selected participants in the shared Savings Program will receive advance payments that will be repaid from the future shared savings they earn. ACOs participating will receive three types of payments to include upfront fixed payment, upfront variable payments, and varying monthly payments depending on the size of the ACO.

In April, the CMS Innovation Center selected seven geographic markets to pilot the Comprehensive Care initiative, a new multi-payer approach that aims to strengthen the primary care system with better healthcare and lower costs.

The markets were selected based on applicants that included private health plans, state Medicaid agencies, and employers that support comprehensive primary care coordination in partnership with Medicare.

The markets include:

·        Arkansas—Statewide

·        Colorado—Statewide

·        New Jersey—Statewide

·        New York—Capital district-Hudson Valley Region

·        Ohio—Cincinnati-Dayton Region

·        Oklahoma—Greater Tulsa Region

·        Oregon—Statewide

Once the participating payers in each market have agreed to the terms and conditions to participate in the initiative and have a Memorandum of Understanding with CMS, the Innovation Center will provide the application for primary care practices to participate in each market. Approximately 75 primary practices will be selected to participate in each designated market.

Addressing Rural Healthcare

The healthcare delivery system is undergoing dramatic changes with financial incentives changing from volume-based to value-based services. Most early adopters of technology have been large urban-based integrated delivery systems.

As a result, there isn’t much known about how technology changes and environmental factors will affect rural healthcare delivery systems. Early pilots and demonstrations supported by private foundations or CMS have focused largely on providers paid under traditional administered pricing systems.

Since rural healthcare providers are often paid outside of the traditional prospective payment systems and fee schedules, there is less known about how new and emerging models might function in rural communities. As a result, policy makers and rural providers need to better understand the implications of new and emerging models for low-volume rural settings.

In addition, rural providers need to be supplied with technical assistance and information to take part in new pilots and demonstrations. To address these issues, HRSA is soliciting applications for the “Rural Health System Analysis and Technical Assistance (RHSATA) Cooperative Agreement” to research and assess the distinct characteristics of the current rural healthcare delivery system.

Applicants must have experience in analyzing rural health issues particularly in identifying emerging policy issues and developing rural delivery systems. The objective is to also analyze recent rural and non-rural national, regional, state and local demonstrations, and pilots to obtain any key lessons learned that may help future rural health policy development.

Eligible applicants include public, private, and nonprofit organizations, including faith-based and community organizations as well as Indian tribal governments and organizations. The estimated amount for this competition of $6,000,000 is expected to be available annually to fund one awardee during FY 2012-2014.

The estimated project start date is September 01, 2012 with the end date to be August 31, 2015. For more information on HRSA-12-176, go to http://www.grants.gov/ or contact Aaron Fischbach at afischbach@hrsa.gov or call 301-443-5487.

DOJ Grant Announcement

The Department of Justice in their Office of Justice Program’s Bureau of Justice Assistance (BJA) has released their FY 2012 Competitive Grant funding. The grant is available to states and Indian tribal governments under the “Harold Rogers Prescription Drug Monitoring Program (PDMP).”

PDMP provides the resources to prevent and reduces the misuse and abuse of prescription drugs and also to aid in investigations of pharmaceutical crime concerning controlled substances. Thirty six states now have operational PDMPs with an additional 12 states and Guam in the process of establishing PDMPs but they are not yet fully operational.

Under the BJA grant program, 12 awards were made in FY 2011 for states to use to implement or enhance a PDMP. Since the beginning of the grant program in FY 2001, grants have been awarded to 49 states and one U.S. territory to implement or enhance a PDMP. In FY 2012, the program is expanding to provide funding to Indian tribal governments. Grant funds can be used to: 

Build a state-level data collection and analysis system • Enhance existing programs and use the data to identify drug abuse trends 

• Participate in national evaluation efforts to assess the efficiency and effectiveness of the PDMP • Encourage states to make improvements and implement programs
• Encourage collaboration with law enforcement, treatment professionals, the medical community, pharmacies, and regulatory boards
• Enable Indian tribal governments to share technological infrastructure in order to share PDMP data available from healthcare facilities

Go to www.bja.gov/Funding/129DMPSol.pdf for more information. The deadline to submit applications is May 8, 2012. Call the hotline at 1-800-518-4726 or email support@grants.gov.

Developing a Successful HIE

Joy Duling, Interim Executive Director for the Central Illinois Health Information Exchange (CIHIE) speaking at a April 3rd webinar shared some of the strategies used to prepare for their HIE implementation.

CIHIE an independent non-profit organization covers a dense, urban population of 1.3 million with 20 counties in the region. The area includes 27 hospitals, 20 health departments, 2,800 physicians, 280 pharmacies, 12 laboratories, plus imaging centers. Since 2010, CIHIE has raised nearly $400,000 in seed money, plus annual service contracts with seven hospitals and four clinics were in place to kick off the HIE rollout.

A few of the organizations that have recently joined CIHIE include the Institute of Physical Medicine and Rehabilitation, a non-profit medical rehabilitation center with 18 locations across Central Illinois, the Community Health Improvement Center, and the Macon County Health Department.

Duling explained that in 2009, the state was ranked 49th in the country in terms of readiness for an HIE. People weren’t talking about an exchange at the community level and there was fierce competition among local hospital systems that made the likelihood of an HIE appear unrealistic.

A few years ago to actively begin the development process, an Executive Council consisting of regional councils formed workgroups to look at governance, financial sustainability, communications, legal/privacy issues, how to handle clinical data, and how to develop the infrastructure.

The power of the people’s voice and their personal stories were shared when preparing to implement the HIE. Duling spoke about her own personal cancer treatment and how important it is to exchange information. She explained how during her treatment period, she went to a number of hospitals and doctors, however, none of the providers involved in her case actually had access to all of her records. She understands how important it is to have electronic records when treating a complex medical situation.

She also commented on how use cases can be a key component to getting people excited about participating in an HIE. Also, the HIE team worked very hard to get media interest by writing and talking about human interest stories, involving many senior groups in conversations, and worked very hard to present new ideas and thoughts on consumer-oriented radio shows.

CIAN won the 5 year multi-million dollar contract to implement the Software-as-a-Service (SaaS) model. CIAN will also provide consulting, design, implementation, and the operation foundation for the CIHIE.

To help further HIE development, the National eHealth Collaborative (NeHC) released their “Health Information Exchange Roadmap: The Landscape and a Path Forward” which is available at www.nationalehealth.org. The Roadmap offers stakeholders a clear picture of efforts being undertaken by both the public and private sectors to create and implement the building blocks for widespread deployment of interoperable HIE.

The Roadmap covers ONC-led efforts to develop nationally recognized standards that can be leveraged by local HIE initiatives, major steps that communities can follow to accelerate progress toward realizing a widespread and successful deployment of interoperable EHRs, connected health IT tools, and real-time information sharing through an HIE.

The release of the HIE roadmap kicked off the launch of NeHC’s new “HIE Learning Network” that includes a series of workgroups. Some of the topics to be discussed in the workgroups include business models, measures of success, governance and technology, best practices, patient consent model, secondary uses for data, payer and employer engagement in the HIE, and the role and function of an HIE to support accountable care.

Telehealth Reaching More Vets

According the April newsletter “The Rural Connection”, published by the Veterans Health Administration’s Office of Rural Health (ORH), the elderly rural veteran population is rapidly growing. The reality is that rural veterans are on average older than their urban counterparts and have trouble finding primary care physicians with the training or experience to manage complex older adults with multiple chronic diseases.

“ORH is taking a multi-pronged approach to home health care, telehealth, chronic disease management, transportation, and care giving initiatives”, according to Dr. Mary Beth Skupien ORH Director.

To meet the veterans’ needs, ORH is rapidly expanding home telehealth into rural areas. The VA’s Home Based Primary Care (HBPC) program is now available at 140 VA Medical Centers and 53 Community-Based Outpatient Clinics. The VA Office of Geriatrics and Extended Care in partnership with ORH started HBPC to provide comprehensive, longitudinal primary care by interdisciplinary provider teams for veterans at home with complex and chronic disabling conditions.

HBPC provides medication management, wound care, pain management, collection of specimens for laboratory analysis, monitoring of symptoms through telehealth, and provides care coordination between the VA and community providers.

ORH is providing nearly $43 million to support the HPBC effort in an additional 50 rural areas and in FY 2013, ORH will continue to support rural HBPC expansion. ORH is also funding demonstration projects and equipment purchases to help expand home telehealth initiatives to help more homebound veterans with chronic conditions.

One of the major medical issues affecting veterans is dementia since the VA has to treat the elderly veteran population. ORH supports the VA Proactive Dementia Care Pilot program taking place in rural areas. The program combines educating the rural Community-Based Outpatient Clinics (CBOC) staff on screening for memory disorders, providing telehealth technology to help veterans receive specialty care from neuropsychologists, and coordinating care with providers to form a comprehensive management plan.

Telehealth is not only helping rural veterans but also helping the total veteran population in new ways. Today, the VA is using telehealth to meet specific medical concerns in managing pain. The “Resilient Coping with “Chronic Pain” program is offered both in-person and via telehealth to veterans. By using videoconferencing, veterans not only receive education and support but are also able to learn practical techniques to help improve their ability to cope with pain on a daily basis as well as how to manage flare-ups.

The VA is helping veterans with spinal cord injuries by enabling spinal cord telehealth visits to take place. Telehealth is used to link veterans to specialists that can help them consult with physicians, consult with physical and occupational therapists, receive post-operative follow-up care, and address complex psychosocial concerns.

Sharing Electronic Information

Even though primary and behavioral healthcare fall under the healthcare umbrella, these specialties can provide vast differences in terms of cultures, funding streams, philosophies, and overall approaches to treatment. The goal is to promote the needs of people with mental health and substance use conditions whether they obtain medical attention from a primary care or from a behavioral healthcare provider.

To address the issue of blending primary care electronic data with behavioral health, the Substance Abuse and Mental Health Services Administration (SAMHSA) and HRSA have joined together to form the “SAMHSA-HRSA Center for Integrated Health Solutions” (CIHS). The Center is operated by the National Council for Community Behavioral Healthcare under a cooperative agreement from HHS.

CIHS provides training and technical assistance to 64 community behavioral health organizations that collectively received more than $26.2 million in Primary and Behavioral Health Care Integration Grants. Grant awards were made to community health centers and other primary care and behavioral health organizations. The training helps to improve the effectiveness, efficiency, and sustainability of integrated services.

One success story includes Weber Human Services a behavioral health provider and the Midtown Community Health Center together forming the “Wellness Center” located in Ogden Utah. They now share clinical information, share registries, and provide continuity of care documents.

In another case, the Rhode Island Quality Institute (RIQI) a not-for-profit organization, was recently awarded $600,000 subcontract to extend access to “Currentcare, the statewide HIE to the behavioral health community serving 54,000 individuals.

Since “currentcare” went live in 2011, more than 200,000 Rhode Islanders have enrolled and more than 4,000,000 health records from the state’s largest medical laboratories, eight hospitals, and several small practices have been processed. Under the subcontract, nine community mental health organizations will be added to the first group of “currentcare” users.

RIQI’s subcontract will fund the development of the necessary infrastructure and initiatives such as:

• Drive voluntary enrollment in “currentcare” among behavioral health patients
• Roll out the system to behavioral health providers to enable them to view clinical information on enrolled patients along with their laboratory results and medication histories
• Securely exchange data between practice-based EHRs and “currentcare”
• Connect behavioral health and other providers through Direct Messaging, a secure email service

Rhode Island is one of only five states to receive funding under this program. The other states to receive funds from CIHS are Illinois, Kentucky, Maine, and Oklahoma.

Helping Medicaid Enrollees

Assurance Wireless, a federal Lifeline Assistance program operating as part of the Low Income Program of the Universal Service Fund is partnering with OmniCare Health Plan Inc. to enable OmniCare’s enrollees in Michigan learn how the Assurance Wireless program via Sprint can help to provide low-cost cell phone service.

Today more than 417,000 Michigan residents are without a job and more than 24 percent are living below the federal poverty line. The number of Michigan residents eligible for Assurance Wireless has increased by 1.2 million people in the last two years.

The objective is to provide low income eligible residents in Michigan and in a number of other states and the District of Columbia with a free phone plus 250 minutes of free wireless service provided on a monthly basis to eligible low-income customers. The list of states providing the service is continually expanding.

Eligibility for Assurance Wireless varies by states and may include participants in Medicaid Supplemental Nutrition Assistance Program, SSI, TANF, Federal Public Housing Assistance, Low Income Home Energy Assistance Program (LIHEAP), and the National School Lunch Program’s Free Lunch Program. Customers may also qualify based on low household income on a state-by-state basis.

This partnership will enable OmniCare to help their enrollees by strengthening channels of communications with members that will help promote preventive healthcare and provide a means to have regular check-ups with their doctors. OmniCare members will have unlimited access to their primary care physician’s office and to the health plan via voice calls and text messaging without impacting their free minutes.

OmniCare has more than 47,000 members and still growing, a network of more than 2,600 doctors, 37 hospitals, and 47 urgent care centers offers programs for Medicaid and MI Child eligible members in Wayne, Oakland, Macomb, Kalamazoo, Hillsdale, Cass, and St. Joseph counties.

People who don’t quite qualify for Assurance Wireless but are struggling to stay within a budget can take advantage of “payLo” by Virgin Mobile available at more than 40,000 retail stores. “payLo” offers plans for as little as $20 per month for 400 minutes or 90 days of service for $20 at a rate of less than $7 per month. For more information, go to “payLo” at www.virginmobileusa.com/cell-phone-plans/paylo-plans.jsp#.

“Phone service is essential in nearly every household in the country and even more so when you factor in the need for emergency services,” said Gary Carter, Manager for National Partnerships for Assurance Wireless. “This partnership will allow us to reach more Michigan residents who are eligible for program while at the same time provide a means for OmniCare to promote better healthcare among its members.”

Eligible residents can apply for Assurance Wireless by calling toll free 800-395-2171 or going to www.assurancewireless.com. Go to www.OmniCarehealthplan.com for more information on OmniCare’s health plan.

Device to Fight Cancer

A new microdissection device is able to produce DNA samples for genetic testing from slide-mounted tissue samples to help diagnose and treat cancer. The inventors say the microdissection device is an effective and a more reasonably priced method for removing tissue samples from microscope slides when the samples are needed for genetic testing.

Co-inventor Katherine Geiersbach, M.D., Assistant Professor in the University of Utah’s Department of Pathology identified the need for the device while working in molecular oncology at the Associated Regional and University Pathologists (ARUP) reference laboratory that performs laboratory testing for University Healthcare and for other hospital systems across the country. She was frustrated by the lack of a method that was more precise than hand-scraping.

The Salt Lake City Utah startup company AvanSci Bio is selling the microdissection device called “MESO-1”. The company was formed in 2011 and has attracted significant funding including a $50,000 grant from the University of Utah, more than $500,000 from private investors, and recently, a $213,000 SBIR grant. The company sees additional funding on the horizon.

MESO-1 falls in between two competing methods by providing a more accurate sample than scraping slides by hand, while being much less expensive than laser methods. The company expects to sell the device for a base price of $20,000.

“Their device addresses a need in clinical laboratories for a slide microdissection system that is semi-automated, precise, and convenient to use for the pathologist,” said Beth Drees, a manager at the university’s Technology Commercialization Office (TCO) that assisted AvanSci Bio in a number of ways. “A growing number of molecular tests require that specific cells of interest, such as tumor cells be dissected out from slide-mounted tissue samples.”

The company believes their device will be helpful to as many as 500 clinical labs, ARUP, and 2,500 research labs. The company projects a 20 percent annual market growth rate due to its unique capabilities and the rising popularity of genetic testing. In addition, the company anticipates developing more versions of the device for different levels of accuracy and higher volumes of testing.

Getting the device ready for market was a collaborative effort, with ARUP playing an integral role in its development by providing the mechanical engineering expertise, AvanSci Bio developed the early prototypes of a specialized bit called the xScisor, led the biochemical testing, supervised the development process, and was involved in the instrument and software design.

TCO provided resources to secure patient protection and guided the project through the SBIR grant application process. The University of Utah’s Software Development Center assisted faculty inventors in developing the MESO-1 imaging software. TCO also provided marketing resources through an affiliated program called PoleVault Media, a student media company that supplies everything from business cards to web design.

For more information, go to www.avanscibio.com or go to the University department Technology Venture Development at www.techventures.utah.edu.

Army SG Appears on the Hill

Lieutenant General Patricia D. Horoho, Surgeon General of the Army and Commander of the Army Medical Command, appeared March 21, 2012 before the House Armed Services Committee’s Subcommittee on Military Personnel to give some insight into Defense Health Programs.

Lt. Gen Horoho discussed some of the Army’s major programs such as Patient-Centered Medical Homes (PCMH), and Community-Based Medical Homes, but also how the Army is providing care for returning soldiers and veterans with TBI, and for soldiers with behavioral health issues.

The Army’s 2011 investment in patient-centered care is $50 million and the Army is in the process of transforming all of its 157 primary care practices to PCMH practices. It is expected that all Army primary care clinics will be transformed to Army Medical Homes by FY 2015 and should increase the capacity within Army military treatment facilities for over 200,000 beneficiaries by FY 2016.

The Army has also established Community Based Medical Homes (CBMH) operating clinics in leased facilities located in off-post communities closer to beneficiaries. Currently, the Army has approval to open 21 clinics and is actively enrolling beneficiaries at 13 facilities.

Today the Army is faced with the growing problem in treating concussion care. To meet the urgent need to address TBI, the Army relies on the Medical Research and Materiel Command (MRMC) TBI Research Program. Today, there are almost 350 studies funded by DOD to look at all aspects of TBI.

One of the problems in studying TBI is that so far the TBI studies lack objective diagnostic tools. MRMC is going forward with research on diagnostic biomarkers and other definitive assessment tools in order to better identify and manage these injuries.

The Army is partnering with the VA, the Defense and Veterans Brain Injury Center, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, academia, civilian hospitals, and the National football League to improve the ability to diagnose, treat, and care for those affected by TBI.

To further help soldiers with behavioral health and emotional resiliency issues, the Comprehensive Behavioral Health System of Care (CBHSOC) was created. The Army’s goal is to develop an integrated coordinated and synchronized behavioral health service delivery system.

The long term goal for the CBHSOC is to restore the psychological health of soldiers and families to prevent adverse psychological and social outcomes like violence, drinking and driving, and suicide.
The Army wants to make the CBHSOC effective and is working to develop a common behavioral health data system, further develop and implement surveillance and data tracing capabilities, coordinate behavioral health clinical efforts, provide for telebehavioral health activities, and study pain management.