Federal Telemedicine News

Health Policy Center Launched

2012-01-29T06:34:00.001-05:00

Philanthropic pioneers Gary and Mary West launched the West Health Policy Center in Washington D.C at the Health Care Innovations Summit held January 26th in Washington D.C. The goal is to save up to $100 billion in cumulative healthcare costs within ten years.

The event partnered by CMS, Office of the National Coordinator for Health IT, West Wireless Health Institute, and Health Affairs brought together health delivery systems, physicians, innovators, policymakers, academics, and investors to help find payment solutions already working in the marketplace.

“Healthcare costs are rising at an unsustainable rate and which has caused a national crisis, has threatened our economy and national security, weakens our global competitiveness, causes millions of jobs to be “offshored” and violates public trust,” said Gary West. “It is vital for the future of our country to begin immediately to focus on some common sense changes in healthcare reimbursement and regulation.”

Independently funded by a multi-year, multi-million dollar commitment from the Wests, the Policy Center is the only non-profit, non-partisan organization with the single aim of lowering healthcare costs.

The Policy Center will initially work to:

• Provide patients with the right care, at the right time, wherever they are, whenever they need it. This will be enabled by new models of care coordination powered by smart technology

• Provide timely, easily accessible, easily understandable and actionable price data that enables consumers and providers to fully understand the costs associated with diagnostic, therapeutic, and routine healthcare choices

• Advocate for reimbursement models that incentivize development and use of equally or more effective low cost high value alternatives to the status quo

• Provide research and analysis for clear regulatory pathways to expeditiously bring tools to enable infrastructure-independent low-cost care to consumers and clinicians

• Identify wasteful, costly, unnecessary, or duplicated healthcare spending

The Policy Center will establish a competitive fellowship program where five established researchers will be selected through a nationwide application and interview process each year based on their ability to identify at least $1 billion in actionable annual healthcare cost savings.

The Policy Center’s first fellow is Dr. Peter Neumann, an internationally renowned researcher on the use of cost effectiveness analysis in healthcare decision making. He currently serves as the Director of the Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy at Tufts Medical Center in Boston.

He will join the other fellows to identify opportunities for regulatory and reimbursement changes ensuring that the rules across CMS, FCC, and FDA are aligned with each other to allow for equal or better clinical outcomes at lower costs.

For more information on the West Health Policy Center, go to www.westhealthpolicy.org, for more information on the West Wireless Health Institute, go to www.westwirelesshealth.org and for more information on the Health Care Innovations Summit, go to www.hcidc.org.

State Legislative Issues

2012-01-29T06:33:00.001-05:00

The Commonwealth of Virginia spends $42.3 billion each year on their Medicaid program and this amount is expected to increase with the implementation of federal health care reform and spending requirements. Therefore, the state is looking at using telemedicine to help reduce Medicaid costs.

House Joint Resolution No. 171 introduced by State Delegate Daniel W. Marshall III (R-VA) on January 11, 2012 would establish a joint subcommittee to study how telemedicine could play a role in reducing Medicaid costs.

The joint subcommittee with a total membership of 15 members, would examine the current use of telemedicine in the Commonwealth and in other states, research methods that could be used to reduce Medicaid costs using telemedicine, and consider other new technological advances used in other states to help solve the problem.

In New York State, a roundtable discussion was held on January 9th with the Legislative commission on rural resources. The hearing was held to identify what state legislators and policymakers can do to eliminate the remaining barriers to using telemedicine.

At the roundtable, the Healthcare Association of New York State (HANYS) and other stakeholders identified issues related to telemedicine that need to be addressed:

• Encourage all private payers to recognize telemedicine and telehealth services including new models of care emerging at the state and federal levels

• Expand Medicaid support for telemedicine to include service provided from licensed providers and private physician offices, especially with the critical need for child and adolescent psychiatry needed in many areas of the state

• Expand Medicaid support for consultations provided to nursing home residents

• Identify and address areas of the state that still lack broadband access

• Allow for peer review responsibilities when a hospital is contracting with another entity for specialty telemedicine consultations since the receiving hospital may not have the specialists on staff to appropriately conduct quality assurance activities that are part of the credentialing and privileging process

Participants in the roundtable also identified barriers at the federal level that included discussion on Medicare support for telemedicine. For example, there is limited payment for services to patients located in designated rural Health Professional Shortage Areas.

Startups Receive Funds

2012-01-29T06:31:00.002-05:00

Technology developed by the Georgia Institute of Technology and Emory University to help deliver drugs and other therapeutics to specific locations in the eye is the foundation for a startup company. The startup “Clearside Biomedical” was formed with the assistance of Georgia Tech’s VentureLab program which helps obtain early-stage seed funding from the Georgia Research Alliance.

The technology was developed by the research team led by Mark Prausnitz, a Professor in Georgia Tech’s School of Chemical and Biomolecular Engineering in collaboration with Henry Edelhauser, a Professor in the Department of Ophthalmology at Emory School of Medicine. The research leading to the development of the technology was sponsored by NIH.

The Atlanta-based “Clearside Biomedical” received a venture capital investment of $4 million to develop the microinjection technology. The funding came from Hatteras Venture Partners, a venture capital firm based in Research Triangle Park, North Carolina that focuses on seed and early-stage investments in companies developing products in biopharmaceutical, medical device, diagnostic, and related human health areas.

The microinjection technology will use hollow microneedles to precisely target therapeutics within the eye. If the technique proves successful in clinical trials and wins regulatory approval, this technology could provide an improved method for treating diseases that affect the back of the eye, including age-related macular degeneration.

Drugs today can be delivered to the retinal tissues at the back of the eye in three indirect ways. One way is to inject using a hypodermic needle into the eye’s vitreous humor, the gelatinous material that fills the eyeball, or use eye drops which are limited in reaching the back of the eye, or taking pills that expose the whole body to the drug.

With the development of new the technology researchers are able to use a hollow micron-scale needle to inject therapeutics into the suprachoroidal space located between the outer surface of the eye known as the sclera and the choroid which is a deeper layer providing nutrients to the rest of the eye. Preclinical research has demonstrated that fluid can flow between the two layers where it can spread out to the entire eye, including to the retina that is difficult to reach.

So far, the technique has been tested only in animals. The funding will enable the company to conduct additional efficacy and safety testing needed to seek regulatory approval. The company’s first product is expected to address macular edema and retinal vein occlusion.

For more information, contact Holly Korschun at (401) 727-3990 or Joy Bell at (404) 778-3711.

In a project in Virginia, the Center for Innovative Technology (CIT) a nonprofit corporation has invested CIT Gap Funds of $50,000 in the University of Virginia’s based start-up Rivanna Medical, a company specializing in portable low cost, radiation free x ray replacement technology based on medical ultrasound.

Rivanna Medical’s ultrasound technology is set to create a pipeline of advance handheld ultrasound products. The company’s technology enables clear delineation of bone structures with 3D imaging capabilities all contained in low cost handheld devices. According to the company their devices provides sharper contrast, resolution, and reduced noise when compared with standard ultrasounds due to advance signal processing technology. The product is a smart phone sized device targeting the spinal anesthesia market as a replacement for fluoroscopy guided or blind needle insertion.

Markets for the technology include spinal anesthesia, the diagnosis of bone fractures, and guidance for orthopedic surgeries. The combined market size is approximately $664 million per year in the U.S. and for Rivanna Medical’s product alone, the U.S. market is estimated at $208 million per year due to a population of 41,000 anesthesiologists and the fact that 18 million spinal anesthesia procedures performed each year.

For more information, email Hap Connors at hep.connors@cit.org or Stephanie Boucher at Stephanie.boucher@cit.org.

CBO Discusses CMS Demos

2012-01-29T06:28:00.001-05:00

The Congressional Budget Office (CBO) released an issue brief on January 18th reviewing the outcomes on 10 major CMS demonstrations. The evaluations by independent researchers show that most programs have not reduced Medicare spending.

The report explained that the programs where care managers had substantial direct interaction with physicians and significant in-person interaction with patients were more likely to reduce Medicare spending than other programs, but on average, even these programs did not achieve enough savings to offset their fees.

Results from demonstrations of value-based payment systems were mixed. In one of the four demonstrations examined, Medicare made bundled payments that covered all hospital and physician services for heart bypass surgeries. In those cases, Medicare’s spending for those services was reduced by about ten percent under the demonstration. Other demonstrations of value-based payment appear to have produced little or no savings for Medicare.

The report recommends that future efforts focus on collecting better data, targeting resources at patients really in need, and encouraging care providers to work together.

According to Rick Gilfillan, Acting Director of the CMS Innovation Center, reports that today the Innovation Center is engaging doctors, hospitals, and other providers to try new approaches. This can be achieved by keeping patients healthy and out of the hospital by having:

• Health systems participate in the Pioneer ACO and ACO Shared Savings models
• The Community-Based Care Transition Program invest up to $500 million in organizations such as Area Agencies on Aging to help seniors as they leave the hospital, and include home visits
• The Demonstration to Reduce Hospitalizations of Nursing Facility Residents invest $134 million to provide additional care and supports to help reduce preventable hospitalizations among nursing home residents
• The Comprehensive Primary Care Initiative provide new support from both Medicare and private health insurers to make sure that participating primary care practices have robust care teams
• The Medicare-Medicaid Coordination Office and the Innovation Center is empower states to invest in new models targeted towards beneficiaries that are eligible for both Medicare and Medicaid
• The Innovation Center is testing several new payment models, such as the Pioneer ACO Model and the Bundled Payments for Care Improvement with no upfront payments to participating doctors and hospitals. These groups will be rewarded once their innovative approach is proven to have reduced costs and keep patients healthier

To view the entire document, go to www.cbo.gov/doc.cfm?index=12663.

Accuracy in Hospital Reports Questioned

2012-01-29T06:26:00.005-05:00

The HHS Office of Inspector General recently reported that 13.5 percent of hospitalized Medicare beneficiaries experience adverse events during their hospital stays. This lack of reporting by incident reporting systems has resulted in prolonged hospitalizations, sometimes causing required life-sustaining interventions, has caused permanent disabilities, and has even resulted in death.

All of the hospitals reviewed for the report had incident reporting systems designed to capture events and their hospital administrators indicated that they rely heavily on the systems to identify problems. However, hospital accreditors report that they do not investigate event collection methods such as incident reporting systems unless evidence of a problem emerges through the survey process.

OIG recommends that AHRQ and CMS collaborate to create and promote a list of potentially reportable events for hospitals to use. They further recommend that CMS provide guidance to accreditors regarding their assessments of hospital efforts to track and analyze events.

The report "Hospital Incident Reporting Systems Do Not Capture Most Patient Harm" published January 2012 suggests that when hospitals collect information they use AHRQ’s Common Formats. Additionally, CMS should scrutinize survey standards when assessing hospitals and their compliance with the requirement to track and analyze events. They should also reinforce the assessment of incident reporting systems to improve event tracking.

OIG received comments on the draft report from AHRQ and CMS. AHRQ concurred with the recommendations and stated that they will collaborate with CMS to create a list of potentially reportable events and provide technical assistance to hospitals that use the list.

CMS also concurred with OIG’s recommendations stating that strengthening hospital reporting systems and practices is essential to preventing patient harm. Also, using a voluntary list of adverse events could be highly beneficial for improving incident reporting practices and that CMS is developing draft guidance for surveyors regarding assessment of patient safety improvement efforts within hospitals.

The full report is available at http://oig.hhs.gov/oei/reports/oei-06-09-00091.asp.

Developing Low Cost Tech

2012-01-29T06:23:00.001-05:00

The biomedical device startup Praxis Biosciences LLC is the fifth company to move into the California Institute for Telecommunications and Information Technology (Calit2) technology business incubator called TechPortal. The firm founded in 2010, has been developing low-cost technologies aimed at the medical industry.

Their sinus-screening tool uses near-infrared light to illuminate patient’s sinus cavities when signs of blockage are indicated. The tool is intended for use in primary care settings and will be tested for efficacy alongside CT scans, which is the current and more expensive tool used for sinus scans

The sinus screening tool uses a light wand type device placed inside the patient’s mouth that emits near infrared light which is not absorbed by tissue. Instead, it scatters and lights up the whole face. “However, if you have blocked sinus cavities, the shape of the light pattern differs. A digital camera outfitted with special filters captures the images, which can’t be seen with the naked eye, and then automatically uploads the images wirelessly,” reports Chief Technology Officer Joan You.

Praxis is collaborating on this tool with researchers Bruce Tromberg and Albert Cerussi at the University of California at Irvine’s Beckman Laser Institute. Along with developing the light-wand device, Praxis plans to work on organizing and managing the data for seamless integration into patient care databases.

The company has already developed a cartilage-reshaping instrument that molds cartilage in the ears using electrical stimulation that can be used in a medical office setting. So far the instrument is in the early stages of development. Currently, the device is focused on ear reshaping to correct trauma or genetic defects, but the technology can also be adapted for other procedures such as rhinoplasty.

By using electric current to reshape the tissue, doctors would be able to perform their work incrementally while eliminating the need for costly surgical procedures. The process is relatively painless and a topical anesthetic can eliminate the discomfort entirely.

In other Praxis research, the “EarTrumpet” could be the answer for some of the approximately 36 million people in the U.S. who need hearing assistance but can’t afford expensive hearing aids. The iPhone, iPad, and iPod app features a self administered hearing test to identify user specific frequencies that require amplification, and then is able to deliver a personalized hearing aid program. The app is already available but Praxis seeks to refine it to the level of a medical device. The current device is being upgraded to include more testing options and better amplification capabilities.

“In addition to their collaborations with researchers at the Beckman Laser Institute, Praxis Biosciences seeks additional partnerships with Calit2-affiliated faculty in the areas of telemedicine, medical informatics, and micro-devices,” said CTO Joan You who also serves as the company’s business affairs officer.

For more information, email praxisbiosciences@gmail.com.

Army's Health Technology

2012-01-25T06:30:00.001-05:00

The Army lists soldier medical readiness as its number one priority and wants to do a better job of screening to keep today’s service members healthy. Currently, almost half of all non-deployable soldiers have suffered preventable musculoskeletal injuries. It has been found in studies, that those at risk for injuries can be identified by using an up-to-date screening process referred to as MP3.

The MP3 research team with faculty and students from the Army-Baylor University Doctoral Program in Physical Therapy and researchers from the University of Evansville, and Duke University are conducting a study through the Army’s Medical Department of Advanced Medical Technology Initiative (AAMTI) with TATRC providing $239, 547 in funds.

The Army by using hand held devices (Motorala MC75) and netbooks are able to speed up the assessments and screen 35-40 soldiers in less than 90 minutes. The soldier’s data is translated into a score and then sent to a computer that uses an algorithm to determine whether the soldier is at risk for musculoskeletal injuries and to what degree. If a soldier is found to be at risk for injury, prescribed corrective steps are taken under the supervision of an Army physical therapist to help decrease risk factors. With the data, the medical team is able to track the soldier’s performance throughout their career.

As for the development of other devices, Lt. Col Eric Drynan, Division Chief the Medical Information Systems Directorate at the AMEDD Center and School, reports that the Army is examining the future of several hand-held devices. Lt. Col Drynan is working with the IT system and radio platform experts to develop the operational architecture to enable a commercial hand-held device to be used in the field which would greatly help medics and behavioral health providers.

According to Drynan, the Army’s work on the next generation device seems to be moving in the direction of Android-based phones perhaps similar to the Android EVO that’s already available in the commercial market. The Army is setting up its own 3G network with mobile antennas which are now being tested.

Another initiative being studied is the Electronic Casualty Report (ECR). If a soldier in a convoy is hit by an IED, another soldier can provide buddy aid and then document the information in the ECR, which is part of the mission command system in every Army vehicle. The ECR is an electronic version of the Tactical Combat Casualty Care Card which is used to document care provided by first responders.

To meet the needs of telemedicine, a telehealth Integrated Process Action Team (iPAT) is looking at telehealth requirements and capabilities in the AMEDD from the operational tactical level to the generating force. The iPAT team is going to conduct a capabilities-based assessment to identify gaps in current capabilities document where telemedicine could provide solutions.

A Virtual Behavioral Pilot program initiated in 2009 tried several methods to provide behavioral care. These methods included face-to-face care, high bandwidth Video Tele-Conferencing (VTC), and low bandwidth Defense Connect Online. It was discovered that service members were really helped with VTC encounters.

As a result in December 2011, the Tripler Army Medical Center in Hawaii opened their Pacific Regional Medical Command’s Tele-Behavioral Health Center. So today, Tripler is providing healthcare VTC not only in the Pacific islands but as far away as Alaska, Texas, and Kansas.

Pilot Project Helping Veterans

2012-01-25T06:29:00.001-05:00

Many veterans with some types of blood clotting conditions need to take blood thinners or anticoagulants. Warfarin, an anticoagulant is one of the most frequently prescribed drugs in the U.S. with more than 17.8 million prescriptions dispensed annually to prevent strokes or heart attacks. Once warfarin therapy begins, the International Normalized Ratio (INR) must be tested periodically to ensure the proper warfarin dosing.

To address the problem, a pilot project was funded by the VA’s Office of Rural Health, enabling the West Texas VA Health Care System to create a Telehealth Anticoagulation Clinic to help veterans currently taking blood thinners. The goal is to improve the clinical care received by veterans in rural and highly rural areas while developing a program flexible enough to handle the population shifts at multiple locations.

About 600 veterans within the 55,000 square mile primary service area of the West Texas VA Health Care System are enrolled in the telehealth clinic. Veterans routinely report to the West Texas VA Medical Center or to one of the Community Based Outpatient Clinics to have regular blood draws to check the INR levels monthly with results available to Dr. Jason Cornish, the Clinical Pharmacist in Big Spring. Then the results are sent to the veteran’s provider within 24 to 48 hours.

The Clinical Pharmacist discusses the results with the veteran at a different location using a telehealth unit. The patient and Clinical Pharmacist both use a computer screen during this communication and then adjustments are made to the veteran’s medication immediately if needed.

Although the Pharmacist managed anticoagulation clinic has only been in full implementation at distant sites for a few months, the results have been very successful. Significant improvements in INR control have been demonstrated at all the clinics and significant improvements have been demonstrated in decreasing the number of critical INR values.

Tech Diagnostics Help Rural Areas

2012-01-25T06:27:00.002-05:00

The “Extractionator" device could bring high tech medical diagnostics to rural areas according to information posted at Vanderbilt University. The prototype could be the basis of an easy-to-use low-cost sample collection and preparation system that could help bring medical diagnostic testing to people in poor rural areas in the world.

The research and development on the device to be performed at Vanderbilt was funded with $1 million grant from the Bill & Melinda Gates Foundation. The researcher’s ultimate goal is to make sample collection and preparation so simple that it can be operated properly with people with little training and can be easily integrated with the other detection methods under development by other grantees.

The device consists of a length of clear plastic tubing filled with a series of liquid chambers separated by short lengths of air. At one end, the tube also contains a number of tiny magnetic beads.

The prototype works something like a miniature car wash. When a patient sample is introduced into the end of the tube, the operator of the device uses an external magnet first to coat the beads with the target material. The beads have special coatings that bind with the specific biological molecules needed for a given diagnostic test.

At this point, the operator drags the beads through the air spaces into the subsequent chambers. Each of the sequential chambers contains special chemicals that remove molecules that interfere with the accuracy of the test. As a result, when the beads reach the other end of the tube, they carry a purified and concentrated sample of the sort required for testing.

Researchers have explored how the system works with biomarkers for the RSV respiratory virus and for malaria and have found the system effective. They evaluated the extraction and concentration of the RSV biomarker in great detail and found that the “Extractionator” works as well as the commercial lab-based kits that are currently available.

The principal investigators on the “Extractionator” project include biomedical engineer Rick Haselton, biochemist Ray Mernaugh, and Chemist David Wright. For more information, email David Salisbury at david.salisbury@vanderbilt.edu.

State Telemedicine Challenges

2012-01-25T06:26:00.001-05:00

The Maryland Telemedicine Task Force is addressing the challenges to the widespread adoption of a comprehensive statewide telemedicine system in the state. The Task Force established a Leadership Committee to prepare specific recommendations on the use of telemedicine that was submitted to the Maryland Quality and Cost Council in December.

Key recommendations to improve the use of telemedicine in the state are for:

• State-regulated payers to provide reimbursement for healthcare services delivered through telemedicine to the same extent as healthcare services provided face-to-face, regardless of the location

• An interoperable telemedicine network to be built on existing standards and integrated into the state designated health information exchange. This would enable broad provider participation, allow networks to connect to other networks, and provide access to clinical information through the exchange

• Regulations to be aligned with revised CMS rules to permit privileging and credentialing by proxy, a process by which an originating-site hospital may rely upon the credentialing and privileging decisions made by distant site telemedicine entities. Future changes in licensure will be needed to enable reciprocity of licensure for physicians practicing in border states

Today 12 states covering over 106 million Americans have legislated mandates for the reimbursement of telemedicine. In most states, payers may not create barriers to care or reimbursement solely because the care is being provided via telemedicine.

In general, according to the Environmental Scan of Telemedicine Initiatives in Maryland, existing telemedicine initiatives are fragmented and oversight of the functions to render care at a distance using licensed providers and health IT rests within several state agencies. These agencies include the Maryland Board of Physicians, Maryland Health Care Commission (MHCC), Maryland Institute for Emergency Medical Services System (MIEMSS), and the Department of Health and Mental Hygiene, Office of Health Care Quality.

Some of the stakeholders involved feel that a state entity should be designated to be a lead agency with regard to telemedicine, a telemedicine Advisory Council should be established consisting of public and private representatives, the state should designate a not-for-profit private entity to provide expert guidance to telemedicine providers, and the barriers to telemedicine adoption need to be addressed.

Payment policies for telemedicine services were reviewed. Determining when telemedicine services are medically necessary or when clinically equivalent to face-to-face services are required still remains a significant challenge in setting payment.

To support adoption of telemedicine, payments must accurately reflect the cost of delivery for providers and the effectiveness of the treatments must be proven to payers and patients. Payment must be sufficient to cover actual costs but should not favor telemedicine over face-to-face services.

Paying for medical services via telemedicine is now being implemented by some states, federal programs, and private payers. A number of initiatives are underway and while there is some overlap, the initiatives are largely fragmented.

Medicare’s incremental approach to reimbursing for telemedicine was reviewed as a potential model for provider reimbursement in Maryland. Medicare’s FFS model includes reimbursement for limited professional services only and limits distant site practitioners eligible for reimbursement. Distant site practitioners are paid 80 percent of the appropriate Medicare Physician Fee Schedule amount while originating sites receive a small fee that is billed separately. Originating sites must be located in a rural Health Professional Shortage Area or in a county outside of a Metropolitan Statistical Area.

Some of the participants in the clinical advisory group identified the need to establish a demonstration project at MIEMSS to improve access to specialty center consultations for patients with time critical conditions such as acute stroke, heart attack, and trauma. The pilot program could reside in the 24/7 emergency medical resource communications center at MIEMSS and would be able to test the feasibility of providing immediate access to specialty consultants for patients with time critical conditions.

Potential benefits of the pilot would reduce unnecessary and costly transfers to tertiary care facilities, faster access to emergency interventions, and improved patient outcomes. A demonstration project might yield information around broadly deploying telemedicine that could be applied to a statewide telemedicine initiative.

Go to http://mhcc.maryland.gov/electronichealth/telemedicine/md_telemedicine_report.pdf to view the complete report prepared for the Maryland Quality and Cost Council in December.

Global Initiatives at JHU

2012-01-25T06:24:00.001-05:00

Johns Hopkins University recently established the Global mHealth Initiative (JHU-GmI) to provide for a university-wide community of excellence. JHU-GmI is connecting faculty, staff, and students across schools so they can collaborate in the field of mobile health according to an article appearing in the JHU December 2011 newsletter “The Globe” published by the Department of International Health.

In a project undertaken last summer, a student Nadi Nina Kaonga, JHU-GmI Intern, worked on the Ghana Telemedicine Project in the Millennium Villages Project site of Bonsaaso. She helped conduct an evaluation of the mobile phone intervention using social network analyses along with other qualitative and quantitative methods.

In Nigeria less than a third of the births are recorded and the capacity to obtain mortality and cause-of-death data is very weak. Because most births and many deaths occur at home or outside of health facilities, the majority of vital events are missed by existing civil registries and facility-based health information management systems. This can undermine efforts to make sound policies and to plan and evaluate programs.

Therefore, a two step process to identify and verify vital events has been initiated. When a child is born or a death occurs, trained community contacts will send SMS alerts to their local health authority which will trigger a home visit to be made by an outreach worker. This data is collected and sent by mobile phones to local governments, to the state level, and integrated into the existing HMIS and other vital registries.

The global mHealth initiative is exploring ways to combat chronic diseases and is focused on developing and evaluating easy-to-use personalized mHealth interventions to improve feedback loops. The researchers are now assessing the effectiveness of smartphones and text messaging platforms to help engage feedback to help prevent cancer and to help individuals manage weight. The next step is to apply technologies to help diabetics adhere to their medications.

Another JHU-GmI key project called “mCare” is an innovative community health worker scheduling and pregnancy monitoring system. This system is being used to help improve the delivery of antenatal and postpartum services in a short period of time between crisis and care in rural Bangladesh by using mobile systems

The eMOCHA project is a free open-source applications designed to assist health programs in developing countries and to help improve provider communication and education as well as patient care. This is being accomplished by using wireless devices with local server-based clinical training and patient care support services

A complete list of project and researchers affiliated with the program are available at www.jhumhealth.org.

Competition Awards Top Prize

2012-01-25T06:22:00.001-05:00

The European Association of Healthcare IT Managers and the European Association of Hospital Managers encouraged all IT managers, healthcare organizations, hospitals, and individuals worldwide to participate in the competitive IT@NETWORKING AWARDS held January 18-19 2012 at the General Secretariat of the EAHM in Brussels, Belgium.

Ian de Vega from the Medical Research Council in South Africa took home the IT@2012 Trophy and the $2,500 euro cash prize. In addition, the winning project is going to be featured in a number of Europe’s leading healthcare management publications.

The winning solution, “Successful Development and Implementation of a Primary Healthcare Information System” (PHCIS) is being implemented at all primary healthcare facilities in the Western Cape Province. Since the start of the project in 2006, PHCIS has been implemented in 103 facilities and has created electronic records for 3.75 million patients. PHCIS processes 130,000 patient visits a month and tracks 5.6 million folders. The system supports patient registration, appointment scheduling, clinical record keeping, reporting, and workload monitoring

Challenges since using PHCIS have overcome the shortage of funding, initial resistance and lack of buy-in, absence of adequate network infrastructure and connectivity, insufficient space for computers and printers, unstable electricity supply, and the need to create positions for information officers and data capturers.

Second place was awarded to the entry “Individualized Patient Disease Diagnosis and Treatment through Whole Genome Sequencing and Comparison” which was presented by Peter van de Spek. In this project, an Oracle Exadata server was installed as the initial component for the Erasmus Medical Center Translational Research Center’s personal cloud architecture.

The project’s objective is to provide scientists easy access to Next Generation Sequencing data, to provide access to the results of experiments performed at the Erasmus Medical Center, and to develop a Benelux reference to reference genomes with 3-4 million variations per individual genome.

Third place went to “eyeSmart EMR-Intelligent IT Solution for Eyecare” presented by Anthony Vipin Das. eyeSmart is an Ophthalmic Electronic Medical Record and Hospital Management System developed in house by L. V Prasad Eye Institute in India.

eyeSmart enables clinical data entry, generates instant medical reports, and provides information on prescriptions, refractions, and surgical records. The EMR provides complete patient records which are handed out to patients at every visit. So far the system is in place in seven centers ranging from tertiary, secondary, to primary centers which are now running totally paperless.

For more information, email HITM General Secretariat at awards@hitm.eu or call +32/2/286 8501 or go to www.itandnetworking.org.

MVP's Vast Amount of Data

2012-01-21T17:32:00.001-05:00

The amount of data to be collected through the Veterans Administration’s “Million Veteran Program” (MVP) is enormous. The MVP program launched earlier this year with 15,000 veterans enrolled is on target to build the world’s largest database of health and genetic information according to the VA publication “VA Research Currents”.

A team at the Boston VA Healthcare System has designed an ambitious project called the “Genomic Information System for Integrated Science” (GenISIS) to maintain the data. Backed by huge clusters of servers housed in two locations, the system links de-identified patient DNA samples and health information with a multitude of VA and non-VA databases, and links to a call and mail center that manages MVP enrollment, appointments, and gathers information.

Genetically speaking, each person’s cells carry within them some 3.2 billion bits of data since many pairs of nucleotides or chemical bases are in the human genome. This figure represents tens of thousands of protein-coding genes, plus large amounts of other DNA. The scientists are trying to determine the precise role for just one stretch of DNA versus another stretch of DNA. There are countless possible variants that could affect health, and scientists have yet to learn about most of them.

According to Leonard D’Avolio, PhD, Associate Director for Biomedical Informatics at VA’s Massachusetts Veterans Epidemiology Research and Information Center and Manager of the MVP Project, “Each patient has hundreds if not thousands of relevant pieces of information such as current and past medical conditions, laboratory data, information on prescriptions, family histories, lifestyle issues, plus environmental exposures.”

Some veterans who take part in MVP can have a VA EHR going back two decades. Multiply the billons of data points for each person by the million veterans that are expected to take part in MVP and the figure is in the quadrillions.

However, the larger the figure, the easier it is for meaningful patterns to emerge. With a study on 500 or 1,000 people, the association between a gene variant and a certain trait would have to be quite striking to catch the attention of the researcher.

“To detect meaningful patterns, researchers will need to analyze samples numbering in the tens of thousands. These connections are going to be discovered only by looking across many data points to make that possible”, said D’Avolio.

In the future, researchers will be able to access GenISIS remotely, ask questions, and then move the data with appropriate permissions into a secure environment that will be needed to deal with the huge amounts of storage required. The system through its nexus with various VA and non VA databases, could also gather specific data relevant to a researcher’s question even of the data is not retrieved and brought over to the MVP on a routine basis.

D’Avolio reports the first scientific contribution of MVP will likely deal with mental health illnesses which today affects some 170,000 veterans using VA care. The study is recruiting thousands of veterans who have schizophrenia or bipolar disorder. “It’s no small thing to get up to 10,000 patients with schizophrenia or bipolar disorder but then you have to match that with another 10,000 who don’t have either disease”, says D’Avolio.

For more details, go to www.research.va.gov/currents/dec11-jan12/dec-jan12-01.cfm.

Monitoring Rheumatology Conditions

2012-01-21T17:29:00.001-05:00

Rheumatologic conditions are common, debilitating, and costly but close monitoring could help to reduce disease activity, joint damage, and improve patient functionality without involving additional costs. However, even today, relatively few organizations have systems in place that can give providers usable easy-to-access information at the point-of-care to allow for effective monitoring and support as needed.

Geisinger and the American Institutes for Research together developed a proposal for AHRQ”s “Accelerating Change and Transformation of Organizations and Networks” (ACTION) program to address the ability to monitor rheumatology conditions. The two organizations were able to secure AHRQ funding for $339.999 to develop a portion of the costs for system development and implementation as well as the total costs associated with evaluating the project.

Geisinger was very interested in developing a system to provide the information needed, as they operate three rheumatology clinics including a large clinic in Danville and two smaller clinics in State College, and Wilkes-Barre. The impetus to develop the Patient-Centric Electronic Redesign” referred to as the PACER system came from leaders in the Danville clinic. Clinic leaders wanted to investigate how to develop a parallel software-based system that could pull relevant information from multiple sources.

To begin to address the problem the system pulls data from a separate EMR and a patient touch screen questionnaire is completed at the start of each visit gives clinicians easy access to all relevant information. Clinicians are now able to systematically analyze the patient’s progress and condition right before the visit allowing them to focus scarce visit time on solving problems and provide the support needed.

Early results show that PACER has been widely adopted by physicians and has generated improvements in providing needed services, having patient symptoms reported, patients adhering to recommended care processes, and patients self reporting symptoms.

So far, data on the upfront development and implementation costs are not available. However, creating a similar system from scratch could be prohibitively expensive for many organizations, consequently, organizations wishing to adopt this system may decide to build on the existing PACER system and customize the system to the organization’s specific needs.

The system is separate from the EMR and can be used with multiple EMR systems. The program developer at Geisinger is in the process of developing mechanisms to allow PACER to be licensed for adaptation, implementation, and to be used in other settings.

For more information on the project titled “Rheumatology Clinics Leverage Technology and Redesign Care Processes to Provide Physicians Relevant Patient Information, Improving Symptoms and Adherence to Recommended Care” go to www.innovations.ahrq.gov.

The contact at the Geisinger Medical Center is Eric Newman M.D at enewman@geisinger.edu and the contact at the American Institute for Research is Lauren Smeeding at lsmeeding@air.org.

Using Wireless in HF Cases

2012-01-21T17:27:00.001-05:00

Heart failure affects 5.8 million in the U.S. alone and is responsible for nearly 1 million hospitalizations each year. Most hospitalizations result from a build-up of body fluid in the lungs and other organs due to the heart’s inability to pump effectively. UCLA researchers want to see patients with heart failure closely tracked in order to avoid hospitalizations and researchers also think that home-monitoring interventions along with patient follow-up would be especially useful.

Today, it is possible to use a number of home monitoring strategies to identify and manage heart failure early. These strategies include obtaining daily weighing and information on medications, phone calls from a nurse or automated response system, home health visits, and the use of telemedicine along with remote monitoring devices.

Several researchers have just published a paper appearing in the online edition of the “Journal of the American College of Cardiology” that discusses the importance of heart failure disease management and monitoring that can be done in the home. Their research was funded by the Ahmanson Foundation and AHRQ.

One of the authors of the research paper, Dr. Gregg C. Fonarow, UCLA’s Eliot Corday Professor of Cardiovascular Medicine and Science, Director of the Ahmanson-UCLA Cardiomyopathy Center, and Co-Chief of Cardiology at the David Geffin School of Medicine at UCLA, sees new promising devices on the horizon to track heart-ventricle and pulmonary artery pressures.

UCLA is currently testing wireless monitoring in a trial referred to as the “Heart Failure in their Better Effectiveness After Transition-Heart Failure” (BEAT-HF) study. The trial is comparing using wireless remote monitoring combined with structured telephone monitoring versus current care provided.

The researchers are studying and hoping to learn if using wireless remote monitoring will improve the care for heart failure patients at six medical centers that include UCLA, Cedars-Sinai Medical Center, UC Davis, UC Irvine, UCSD, and UCSF.

During the trial, approximately 1500 patients of both genders 55 or older hospitalized at any of the six medical centers with a principal diagnosis of heart failure will be educated on their condition. They will be taught to use a wireless remote monitoring device from their home on a daily basis for six months following their hospital discharge. Information will be gathered on weight, heart rate, blood pressure, etc and transmitted daily by their remote wireless monitoring device.

Patients will receive structured telephone calls from a centralized call center nurse at least once a week for the first month after their discharge and monthly calls for the remainder of the six month study period. Patients may receive additional calls depending upon the information gathered during the scheduled call center phone calls on their health status.

North Carolina's HIT Initiatives

2012-01-21T17:25:00.001-05:00

According to the recent quarterly legislative report prepared by the North Carolina Department of Health and Human Services, health IT partners have received grants totaling about $630 million across all federal HIT funding categories. This figure includes funding for EHR incentive payments to individual eligible hospitals and providers over the next four years with the total funding approaching $1 billion in federal investments to support HIT in the state.

The state is involved in a number of HIT initiatives such as their Health Information Exchange where the state received $12.9 million in a Federal grant plus $1.7 million from a supplemental Challenge Grant to enable the secure exchange of patient health information between providers and hospitals statewide.

So far, the selection of the vendor and development of the core HIE infrastructure continues under the North Carolina HIE (NC HIE) and Capgemini/Orion Healthcare Consortium. The NC HIE is scheduled to launch during the first quarter of 2012.

The state has $144 million in federal dollars available for Broadband Technology Opportunities Program for Round 1 and Round 2, $40 million available in a private match, $7.7 million available from MCNC Endowment, and $24 million is available from the Golden Leaf Foundation. The funding is being used to expand the North Carolina Research and Education Network and is expected to be completed by July 2012.

In 2011, Blue Cross and Blue Shield of North Carolina (BCBSNC) working with the North Carolina HIE and Allscripts launched the “North Carolina Program to Advance Technology for Health” (NC PATH). This program was created to equip 750 North Carolina independent physicians including over 150 physicians in 39 free clinics with Allscripts EHR software to connect healthcare providers across the state through the North Carolina exchange.

For in-network providers, BCBSNC will cover 85 percent of the software, maintenance costs, and the NC HIE connectivity and membership fee for a period of 5 years while the provider is responsible for the remaining 15 percent.

The NC Area Health Education Center’s Regional Extension Centers (NC AHEC REC) program at the University of North Carolina, Chapel Hill received an award for $13.6 million over 2 years and presently has enrolled over 3700 primary care providers. The NC REC was designated one of five vanguard states by ONC.

The North Carolina Beacon Community Grant operating with the lead agency Southern Piedmont Community Care Plan, is working with funding of $15.9 million. The overall goal is to leverage Community Care of North Carolina’s patient-centered medical home model, health IT, and innovative interventions to improve care coordination, encourage patients to be involved in their medical care, and to improve health outcomes.

The Cabarrus Health Alliance has scanned all of their medical records to prepare for EMR implementation. They have implemented a child health module and have incorporated a new evidence-based program “Bright Futures” into their EMR.

The Rowan County Health and the Stanly County Health Departments are also upgrading their EMR software and scanning medical records in preparation for EMR implementation. The next phase is to develop a public health portal to view demographic and community health data.

The lead agency for telehealth is the North Carolina Telehealth Network which was awarded a federal grant of $12.1 million through the FCC Rural Healthcare Pilot Program. They were also awarded $125K in one time state dollars in 2008 from the North Carolina Division of Public Health for the initial development for telehealth.

So far, the NC Telehealth Network has been successful in building up broadband telehealth capacity particularly in rural and underserved communities in the state. Phase 1 has completed telehealth connectivity to virtually all public health sites and free clinics in North Carolina. Phase 2 will focus on small public and non-profit hospitals in cooperation with the North Carolina Hospital Association.

In the field of pediatrics, Community Care of North Carolina is working with CMS and the American Academy of Pediatrics on developing and evaluating a Pediatric EHR model. North Carolina and Pennsylvania are the only two states selected for this pilot grant program.

The CHIPRA Category-D Pediatric EHR Consultant has been meeting with vendors, practices, and stakeholders since late August 2011 to introduce the Pediatric Electronic Health Record model. The state is evaluating the model among smaller independent healthcare providers and across a variety of EHR vendors. So far four vendors have conducted Pediatric content-specific product demonstrations for the project team.

The evaluation design phase in this grant project is well underway and five areas of quality improvement have been selected to be the primary focus and include obesity, oral health, developmental and behavioral health, early periodic screening, diagnosis and treatment, and asthma.

Go to www.ncdhhs.gov/healthit/quarterly_report_2012January.pdf to view the complete quarterly legislative report distributed January 1, 2012.

Genetic/Genomic Testing Creates Jobs

2012-01-21T17:23:00.001-05:00

Driven by rapid innovation made possible in large part by the mapping of the human genome, genetic and genomic clinical laboratory testing generates 116,000 U.S. jobs and contributes $16.5 billion annually to the U.S. economy, according to a new report by the Battelle Memorial Institute.

The report titled “The Economic and Functional Impacts of Genetic and Genomic Clinical Laboratory Testing in the United States” was sponsored by the American Clinical Laboratory Association, and their educational arm “Results for Life.” Because this industry sector is still in the early stages of development, much future growth is expected.

It was found that the industry sector’s ability to innovate and produce cutting-edge genetic testing services and products supports about 44,000 direct jobs and generates another 73,000 jobs in key supplier industries such as real estate, food services, and wholesale trade businesses, as the result of consumer spending by laboratory employees. Together, the genetic and genomic laboratory testing sector-related workforce received nearly $6 billion in wages and benefits in 2009. It also generated $657 million in estimated state and local tax revenue and nearly $1.2 billion in federal taxes in 2009.

“The fact that genetic and genomic testing has created 116,000 jobs and $6 billion in personal income for U.S. workers in the middle of one of the country’s worst recessions should be noted by U.S. policy leaders. This industry is one of America’s true economic success stories.” said Alan Mertz, ACLA President. “It is also important to recognize that a significant amount of that amount is coming from the small innovative start-up labs throughout the U.S.”

Battelle reports that comparatively high levels of wages and salaries are provided within the industry, along with sound benefits packages. It was found that the annual average personal income of a worker in this sector was about $57,000 in 2009 which is a significant wage premium as compared to roughly $45,000 in the overall U.S. economy.

In addition to fueling the economy, innovative genetic tests are enabling a revolution in medical care and genetic testing by identifying the genetic nature of a disease or condition that enables physicians to better target treatments. Significant improvement is occurring as a result in a range of conditions such as childhood leukemia, HIV, heart disease, cervical cancer, blood clotting, melanoma, and colorectal cancer.

For example, physicians use these clinical laboratory genetic tests to target cancer therapies to an individual’s unique genetic fingerprint, which has improved survival rates in many types of cancer. Genetic tests are used to diagnose certain genetic diseases, such as cystic fibrosis in babies, so treatment can begin early and minimize the disease’s impact. Genetic tests are also used to improve patient safety by preventing underdosing, overdosing, or misdosing medications which can cost more than $100 billion annually in human suffering.

“This report provides a much clearer understanding of the real-world impact in terms of jobs, economic growth, and health cost savings and in terms of rapid innovation in genetic and genomic testing” said Mertz. “This information can help guide strategic economic development and regulatory efforts at both the state and national levels as decision makers look to nurture high growth economic sectors.”

To view the report, go to www.acla.com or to www.labresultsforlife.org.

AHRQ Seeks Survey Participants

2012-01-21T17:21:00.001-05:00

The Agency for Healthcare Research and Quality (AHRQ) seeks input from researchers and implementers who have experience using the AHRQ Health IT Survey Compendium. The Compendium is a tool for health IT researchers and implementers looking for Health IT related surveys to help support their implementation and evaluation needs.

If you are a health IT researcher or implementer with prior experience using the Compendium and you are interested in participating in this AHRQ research effort, please email Westat at AHRQ_HIT_Tool_Eval@westat.com or call Westat toll-free at 888-789-8869 but you will need to contact Westat by February, 2, 2012 to schedule a call.

Westat will then contact you for some additional information. If you are selected to participate, Westat will schedule time with you and then send you a confirmation in advance. Your participation will include participating in an online interview and will take approximately 60 to 90 minutes of your time and does not require any travel. No advance preparation is required and you will receive a payment of $75 to thank you for your time.

Modernizing Lifeline Program

2012-01-17T06:32:00.001-05:00

FCC Chairman Genachowski is proposing changes to eliminate waste, fraud, abuse, and sees the need to modernize the Universal Services Fund’s “Lifeline” program so that all Americans can have access to basic communications services. As the Chairman has stated “Lifeline” a vitally important program for over the past 20 years has helped tens of millions of low income Americans afford basic telephone service.

According to the FCC, the Lifeline program is faced with a number of problems. Some carriers are providing Lifeline services to individuals that already have Lifeline service from another carrier. Currently, there is no database of recipients that carriers can check against before signing up a new customer.

The FCC has received reports that some unscrupulous carriers are abusing the program by supporting consumers who did not sign up for Lifeline by mailing them phones already set up for the service, or signing people up for Lifeline who aren’t eligible for the program. Finally the program is outdated and only focuses on phone service and not the internet.

The proposed reforms are projected to save the program up to $2 billion over the next few years:

• Eliminate waste, fraud, and abuse by creating a National Lifeline Accountability Database to prevent multiple carriers from receiving support for the same subscriber
• Set a budget for Lifeline while acknowledging that the size of the program should fluctuate as the economy improves or worsens
• Establish national eligibility criteria to ensure low income consumers access to Lifeline service who meet the federal standards for participation in the program
• Conduct independent audits every two years on every carrier that receives more than a specified annual amount of support

Lifeline needs to be modernized from just a telephone service to being able to support broadband. To accomplish these goals, the FCC is going to establish a Broadband Adoption Pilot Program to determine how Lifeline can be used to increase broadband adoption among Lifeline-eligible consumers. Starting this year, the program will solicit applications from broadband providers and select a number of projects to fund.

The Commission will discuss Lifeline issues at a meeting scheduled to be held in Washington D.C. on January 31, 2012 and will consider the many changes and reforms needed to modernize the program to meet the needs of the consumers.

Monitoring Health on the Move

2012-01-17T06:31:00.001-05:00

Ford, Microsoft Corp, and Healthrageous announced at the Digital Health Summit, that they plan to work together to develop connected devices to help people monitor and maintain health and wellness while in their cars. Since trends show that people are spending more time in their cars, researchers will examine how to extend health management into the personal vehicle in a nonintrusive way while people are on the move.

“With the tremendous growth in mobile healthcare solutions, Ford is dedicated to understanding the value of connecting to health and wellness-related services while driving,” said Gary Strumolo, Manager of Infotainment, Interiors, Health and Wellness at Ford Research and Innovation.

As Strumolo explained “Our connectivity platform Ford SYNC provides easy voice-controlled access to mobile devices such as smartphones and tablets and it makes sense to research areas that are important to our customers. Customer research and societal trends suggest that there is a strong business case for Ford to explore opportunities in health and wellness technology.”

A prototype system being developed by BlueMetal Architects is leveraging Ford SYNC® technology, Microsoft HealthVault, Windows Azure, and the interactive services Healthrageous provides in conjunction with compatible biometric measurement devices.

The prototype system would capture biometric and vehicle data as the basis for real-time health and wellness advice and monitoring. The driver can provide voice inputs plus other details on their health routine such as the number of glasses of water consumed during the day or what pills they take.

The data would then be uploaded into the HealthVault cloud, at which point, the data would be transferred to Windows Azure. Then the information would be processed with other health data to create graphical reports that drivers can access after leaving the vehicle.

Since last year, medical and healthcare was the third-fastest growing category of smartphone apps, with more than 17,000 available for download. By 2015, this market is expected to reach $392 million according to a new Frost and Sullivan report and 500 million people are expected to use mobile healthcare apps. As Strumolo explained, “These trends point to a natural role for the automobile in the emerging digital health and wellness field.”

For more details, email Alan Hall at ahall32@ford.com, Mike Werner at mikewe@bluemetal.com or Emily Rosen at Emily.Rosen@hkstrategies.com.

Companies Receive Funding

2012-01-17T06:29:00.001-05:00

The Maryland Technology Development Corporation (TEDCO) awarded 12 Maryland researchers $485,000 through their University Technology Development Fund (UTDF) and TechStart programs. The aim of the UTDF program is to help researchers develop and assess the commercial viability of new technological inventions, test prototypes, and optimize principle research designs.

So far, since 2001, 95 projects have been completed and 43 have been licensed or optioned to private companies with 35 of these companies located in Maryland. Of these licensees, 29 were startup companies in the state, 13 received follow-on funding through TEDCO’s Maryland Technology Transfer and Commercialization Fund program, and 7 through TEDCO’s TechStart program.

Of the $485,000 awarded, researchers from Johns Hopkins Applied Physics Laboratory, Johns Hopkins University, Salisbury University, and Towson University received up to $50,000 each in UTDF funding. The University of Maryland Baltimore, University of Maryland College Park and JHU, each received up to $15,000 in funding from TEDCO’s TechStart program. Five startup companies were launched as a result of the funding and include BOSS Medical, CervoCheck, Clear Guide Medical, Lifelong Technologies, and Neximmune.

A.J Khanna M.D., JHU Associate Professor of Orthopedic Surgery and Biomedical Engineering was awarded $50,000 to develop a minimally-invasive bone tissue harvesting device to be able to collect of more bone tissue, provide safer autograft, and reduce pain. The resulting technology is the core for the startup company BOSS Medical LLC.

Robert H. Allen, PhD, JHU Associate Research Professor of Gynecology and Obstetrics, received $50,000 to develop a technology to enable obstetricians to more accurately diagnose early preterm labor, prescribe interventions to prolong the pregnancy, and to improve fetal development. This device by bypassing the maternal abdomen to measure contractions in the cervix and vagina enables a more accurate diagnosis. The startup company CervoCheck, LLC resulted from the development of the device.

Emad Boctor, PhD, JHU Assistant Professor of Radiology received $50,000 to develop a needle tracking and intervention guidance device using ultrasound imaging. This enables needle-guided interventions to be done without the need for expensive, cumbersome, and external tracking devices currently used. This device will allow the physician or ultrasound expert to find small or deep tumors which cannot yet be easily spotted by ultrasound. This technology is the core for the startup company Clear Guide Medical, LLC.

Angelia Crawford entrepreneur and graduate of the ACTIVATE program, UMB Robert O’Toole, M.D, Assistant Professor of Orthopedics, and Nancy Cowger, M.D, Office of Technology Licensing at UMB were awarded $8,000 from Tech Start to develop the Step Activity Monitor (SAM) a walking aid. SAM provides data on the patients’ physical activity to physicians. LifeLong Technologies, LLC was formed around the technology.

Mathias Oelke, PhD, JHU Assistant Professor of Pathology, Kenneth Carter, PhD, entrepreneur, and Daniel Potvin PhD Senior Licensing Associate received $15,000 from TechStart to develop a technology to destroy tumor cells. The technology developed is an easy-to-assemble system where different immunological signals can be attached to a bead or smaller quantum dot and activate Natural Killer T-cells (NKT) that can stimulate cells outside the body in culture and also be injected into patients. The startup company Neximmune, Inc. was formed around the technology.

Other technologies under development include the development of a therapeutic technology known as a mimetic peptide to treat cancer. This technology showing promise in inhibiting metastatic breast cancer and other breast cancers that are not responding to current treatments, is being researched by Aleksander Popel, PhD at JHU.

An award was also made to a JHU researcher Brendan Canning PhD to further develop a treatment to limit coughing. The ongoing research has discovered cough receptors that play an essential role in regulating the cough reflex and a group of compounds have been discovered that are more effective in selectively targeting these receptors.

In addition, JHU Researcher Clifford Weiss M.D. is working on a device to make dialysis more effective. His team has designed a device to access naturally high blood flows in the leg, as opposed to the artificially created ones in the arm that cause stenosis. This subcutaneous device provides two ports for access to the femoral vein and a third port for controlling a valve which closes access to the vein when the patient is not in dialysis.

For more information, go to www.marylandtechco.org or www.MarylandTEDCO.org.

New Telehealth Alliance Formed

2012-01-17T06:27:00.001-05:00

MedApps, Inc., a mobile telehealth innovator is aligning with MedMinder a company helping chronically ill seniors and those with disabilities maintain their independence. The Alliance is going to improve the ability to deliver connected and remote medication management. Both companies have led the way in their respective areas of expertise within the telehealth market by providing affordable, easy to use, patient-centered remote monitoring solutions.

According to Kent Dicks, Founder and CEO MedApps, “The challenge with any prescribed therapy for patient care is compliance whether that means a patient is taking their blood pressure or glucose readings on a daily basis or taking their medication when they are supposed to so that the caregiver can effectively manage their conditions.”

MedMinder offers their smart cellular pillbox referred to as “Maya” complete with innovative features to enable medication management. Maya can track the dosage activity of patients, deliver optional medication reminders or alerts if the medication is not taken within an assigned timeframe, or report if an incorrect medication compartment is inadvertently accessed.

MedMinder not only keeps detailed records of patient medication activities but also can provide access to reports for the user, the family, and caregivers via the internet, email, and by text notification. MedMinder’s capabilities with MedApps supply of consistent near-real time biometric data will be able to deliver a coordinated solution for medication management.

“We are very excited about partnering with MedApps and integrating into their remote health monitoring platform,” said MedMinder Founder and CEO Eran Shavelsky.

In addition, MedApps Cloud Care™ enables health information delivery to allow a variety of manufactured devices to be integrated into a remote monitoring program very quickly with a minimum of coordination time. CloudCare is the first in the telehealth field to deliver “Plug & Play” platform.

For more information, go to www.medapps.com or go to www.medminder.com.

Texas Upgrading Systems

2012-01-17T06:26:00.001-05:00

The state of Texas hired Public Consulting Group (PCG) a privately held consulting firm, to conduct a comprehensive analysis of their public behavioral health system as required by Texas 2011 legislature. PGC will conduct a comprehensive study of the current behavioral health system and provide short and long term recommendations to upgrade the system. The main purpose is to provide future direction on behavioral health services in the state.

To accomplish the study, the Texas Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) are currently holding six public stakeholder forums conducted by PCG that started in December 2011 and continuing through January. Stakeholders are providing feedback on topics such as access to services, service delivery models, current services available, general strengths and weaknesses of the system, and funding issues.

One of the key topics under discussion includes the integration and coordination of care in the state. The people in Texas people want to see better coordinated care between physical, mental health, and substance abuse issues. Issues under discussion include barriers to receiving coordinated care within the current service delivery system and what strategies are needed by the state to achieve high quality and efficient coordinated care.

In-depth discussions are focusing on the various service delivery models in the state. Texas is a large state where behavioral health services are provided through various service delivery models across the state through mental health authorities, substance abuse providers, and NorthSTAR. To make it more complicated, Medicaid benefits are managed both through a traditional Medicaid Fee for Service model and numerous Medicaid managed care programs.

The stakeholders ideas and thoughts will be reviewed and PCG will do an in-depth review of the financial structure of the current behavioral health system to understand the current and existing sources of funding to pay for the services. In addition, PCG will look at other states and how their behavioral health systems operate in order to identify potential options on how Texas can improve their system.

Information from the initial discussions at the forum will be analyzed thoroughly and a comprehensive report will be made to DSHS. At this point, PCG will work on the second phase of the analysis to provide recommendations on how to effectively improve access, service utilization, patient outcomes, and system efficiencies, and how to accomplish these goals with the funding available now and in the future.

According to the Texas HHSC newsletter, ‘InTouch”, the state is embarking on a modernization project to upgrade the state’s eligibility system to meet the needs of the future and to provide the software and hardware that the local offices will need to implement the system.

The first step is to obtain feedback on the project and then develop ideas for improvements based on best practices from other states and from within HHSC. The second step will be to undergo further scrutiny by the HHSC staff and the third step will be to try out the new processes and technology tools in a nonproduction environment. These steps are needed to make sure that the project’s vision actually plays out successfully in high volume use often incurred in eligibility offices.

To keep up with the needs of eligibility offices, the network infrastructure will be built around state-of-the-art hardware and software capable of running multiple virtual server processes simultaneously. This means that if one data-serving process goes down or needs to be serviced, the work can temporarily be shifted to others without affecting the ability to work.

Survey Shows Benefits for HIT

2012-01-17T06:24:00.001-05:00

Doctors that are routine users of health IT obtained significant more benefits in healthcare delivery, according to a new Accenture online survey of 3,700 doctors across eight countries. These countries included the U.S. Australia, Canada, England, France, Germany, Singapore, and Spain. Five hundred physicians were interviewed per country and 200 physicians were interviewed in Singapore between August and September 2011.

Global findings show that doctors agree that HIT improves clinical data by 70.9 percent, coordination of care by 69.1 percent, and reduces medical errors by 66 percent. In general, doctors in Singapore and Spain perceive a more positive impact compared to their counterparts in the U.S. and Australia.

Specifically, U.S. physicians rate the benefits of EMRs and HIEs lower than their international colleagues, and the U.S has the lowest number of doctors (45 percent) who think health IT will improve diagnostic decisions as compared to 61 percent globally. Only 47 percent of U.S. doctors reported that healthcare technology has improved the quality of their treatment decisions as compared to 61 percent globally.

The survey showed an age divide and a statistically significant contrast in attitudes among doctors above or below 50 years of age. The study found that doctors under 50 are more likely to believe that health IT has a positive impact across a wide range or perceived benefits. But more than 72 percent of doctors under 50 think EMRs and HIEs will improve care coordination across settings and service boundaries and 73 percent believe that these technologies will offer better access to quality data for clinical research.

Accenture is a global management consulting technology services and outsourcing company. For more survey information, call Jenn Francis Accenture Health at +1-630-338-6426, or email Jennifer.francis@accenture.com.

Resource Center Events Coming

2012-01-17T06:20:00.002-05:00

The Mid-Atlantic Telemedicine Resource Center Summit in conjunction with the Virginia Telehealth Network is presenting a premier event on March 15-16, 2011 at the University of Virginia’s Darden School of Business. Leading telehealth resources plus experts and programs throughout the mid-Atlantic region and the nation will be on hand for presentations and discussions.

There will be opportunities to hear from national leaders on telehealth policy and resources, to explore a broad range of innovative new technologies and approaches to telehealth, to formulate strategies to remove barriers to application, and to collaborate with experts in a broad number of areas.

Featured keynote speakers are:

• Marilyn Travenner, Acting Administrator for CMS
• Aneesh Chopra, Assistant to the President & Chief Technology Officer and Associate Director for Technology within the Office of Science & Technology Policy

Go to http://terzettocreative.com/clients/MATRC to register and for more details, email MATRC@virginia.edu, or Ladi Carr at Ladicarr@virginia.edu, or call Eric Swensen at (434) 924-5770.

The Northwest Regional Telehealth Resource Center will present a Conference on March 19-20 in Billings Montana. Several keynote speakers will be featured such as Glen Hiemstra, Founder of Futurist.com and the Founder and Curator of DoTheFuture.com, Ron Rabou with expertise on how to improve communication skills to achieve better relationships, Peter Yellowlees, M.D. Professor of Clinical Psychiatry at UC Davis Health System, and Steve Bahmer, a former award-winning journalist, leader of a technology company, and founder of his own public affairs company.

One free registration will be given away for the Conference which will run through January 25th. For more details, go to the NRTRC blog post “NRTRC Telemedicine Conference Giveaway”. For more details on the Conference, go to www.nrtrc-conference.com.

Updated 2012 Health Technology Report Released

2012-01-10T16:22:00.002-05:00

Bloch Consulting Group’s Federal Health Technology Report has just been revised for 2012 and is available for download at http://www.federaltelemedicine.com.

The report, “Activities in Telemedicine Telehealth and Health Technology” contains key details on Federal government activities in telemedicine, telehealth, eHealth, health technology and related areas at 24 cabinet level and independent federal agencies.

The download also includes “Selling to HHS,” a guide to navigating and taking advantage of many relevant programs at HHS.

“The growing use of health information technology is becoming the routine way to deliver healthcare in the U.S. and other parts of the world” according to Editor Carolyn Bloch. “To keep up with Federal activities, it is essential to understand not just what funding may be available, but also current and future innovative federal movements and policy changes.”

The 260-page edition of the “Activities in Telemedicine Telehealth and Health Technology” contains information on how government agencies are organized, describes ongoing activities relevant to the field, and points out numerous grant and contract programs useful for ongoing business development.

The 45 page report “Selling to HHS” specifically helps individuals and companies market their technology products and services, secure grants, and locate good possibilities for funding within this agency. This report is included free with all orders for the 2012 Federal Activities report.

The reports are available as digital downloads in PDF format. More information is available at the Bloch Consulting Group web site at http://www.federaltelemedicine.com.

Handheld Can Save Lives

2012-01-10T16:20:00.002-05:00

Researchers at the Army Medical Research and Materiel Command at Fort Detrick Maryland are successfully working on a handheld telemedicine device referred to as “TEMPUS-Pro” in the article “The Business Side of Saving Lives” authored by Jeff Soares, a Communications Specialist with USAMRMC. The handheld device is an advanced compact telemedicine system that can be used on combat casualties happening in forward areas.

The “TEMPUS-Pro” resulted from a collaboration formed with TATRC, MC4, Defense Health Information Management Systems, Army Aero-Medical Research Laboratory, Army Institute of Surgical Research, Army Medical Materiel Agency, Air Force Medical Evaluation Support Activity, and the Joint Forces Command Surgeon’s Office.

Three devices incorporated into one handheld device is able to provide real-time audio and video capability plus the device houses a transcription feature to use when voice free input is available. The handheld allows for immediate communication, pre-hospital monitoring of patient vital signs and telemetry data, and is able to receive instructions from other medical providers.

The device is designed to be lightweight, mobile, rugged, and can be used with tactical communication radio networks supporting internet protocol-based transmission. This enables signals to be sent digitally over both classified and non-classified systems.

According to Dr. Gary Gilbert, Chief of the Knowledge Engineering Group for USAMRMC’s TATRC, “The patient’s medical data is always with the patient and goes with the patient everywhere.”

Medics can also quickly assess severe injuries and send real-time images along with live telemetry data, plus the Tactical Combat Casualty Card (TCCC) to experienced surgeons offsite for instructions. The physician mentor can talk with medics over the built-in voice-over IP capability. With ultrasound and laryngoscope capabilities in the works, use of the device will lead to more accurate diagnoses and treatment.

Personnel can transfer data from one device to another, from the ground to the helicopter, to the hospital, and can transmit information via radio or tactical internet in advance of the patient’s arrival at the next stop in the evacuation. The patient’s vital records can be exchanged wirelessly between various systems and eventually inserted into the patient’s permanent medical record.

The “TEMPUS-Pro” is requiring the military to upgrade the current limited capability to transmit data digitally between air and ground units. “The military’s helicopters currently do not all have compatible high tech radio systems necessary to transmit information digitally from helicopters to the ground, Gilbert says. “One of the biggest challenges is to get the TEMPUS-Pro integrated properly to be used in the medevac helicopter.”

Currently, the device is awaiting approval under the Department of Defense Information Assurance Certification and Accreditation Process. However, about 25 units have been distributed to various Special Operations commands for trial use and so far the results have been positive.

The “TEMPUS-Pro” has been selected for the Army’s Network Integration Evaluation exercise to be held at Fort Bliss Texas beginning April 2012. The device will be field tested for two months to determine its operational effectiveness within Infantry Brigade Combat Teams. Also, the device will be tested in a Marine Corps Warfighting Lab Limited Objective Experiment scheduled for August 2012. Gilbert believes that these tow rigorous tests should help to validate the applicability and usefulness of the handheld device.

Artificial Pancreas Advancing

2012-01-10T16:18:00.001-05:00

Advancing the development and use of an artificial pancreas, developing anti-obesity drugs, and exploring immune-based diabetes treatments will spearhead the Decade of Discovery’s research programs in coming months. Last year, the Minnesota Partnership for Biotechnology and Medical Genomics launched the “Decade of Discovery” to conquer diabetes.

The goal is to optimally treat and ultimately cure Type 1 and Type 2 diabetes through a multi-sector, coordinated initiative that will draw on Minnesota’s expertise in research, care delivery and public health. The Decade of Discovery along with leaders from the University of Minnesota and Mayo Clinic announced awards totaling $1.86 million in state funding for three projects under the auspices of the Minnesota Partnership.

Advancing the artificial pancreas is one of the research projects. The artificial pancreas works by combining a continuous glucose monitor and an insulin pump complete with sophisticated computer software to provide automatically the right amount of insulin at the right time.

Funding for $500,000 was awarded for a project called “The Chip” to explore and develop a specialized electronic chip that will improve glucose monitoring and provide a critical component to the artificial pancreas being developed by Mayo Clinic.

The chip will be a new type of sensor to transmit data wirelessly and be able to function in more locations in the body than current sensors. It may also last longer than current sensors and because it is made from grapheme may also be useful in detecting other diabetes factors such as lactate or ketone molecules. Based on a device concept invented at the University of Minnesota, the new sensor should be more reliable, stable, accurate, and make the artificial pancreas possible.

The other two research projects awarded will do research to develop an anti-obesity drug but this means that the researchers will need to discover new molecular targets for the drugs. The other research project will target insulin-specific T cells in an effective way to cure Type 1 diabetes in mice. In the coming year, the research team will test and validate mouse models containing human diabetes cells against various factors.

Another research project is ongoing with Boston University and Massachusetts General Hospital (MGH) to find the cure for Type 1 diabetes and make automated blood glucose control a reality. So far, engineers from Boston University have develop a closed-loop artificial pancreas blood glucose control system that uses frequent measurements of blood glucose concentration along with subcutaneous delivery of both rapid-acting insulin and glucagon as directed by a computer algorithm.

Previous artificial pancreas designs did not include the capability to administer glucagon. The artificial endocrine pancreas automatically makes a new decision about insulin and glucagon dosing every five minutes. The system is being tested in people with Type 1 diabetes at MGH with results recently published in “Science Translational Medicine”.

JDRF, researchers, clinicians, policymakers, and patients have called on the FDA to advance the development of an artificial pancreas. Also, over 100,000 people in the diabetes community signed JDRF’s petition which urged the FDA to adopt clear guidance. In addition, leading clinical organizations specializing in diabetes care are urging FDA to ensure that the development of an artificial pancreas is not delayed by unnecessary regulatory roadblocks.

On the regulatory front, on December 1, 2011, FDA issued draft guidance designed to help investigators and manufacturers as they develop and seek approval for artificial pancreas device systems to treat Type 1 diabetes. To facilitate development of the device, the draft guidance provides flexible recommendations for design and testing that meets statutory requirements for safety and effectiveness. When final, the guidance will help manufacturers and investigators assemble submissions for clinical trials as well as product approval submissions.

DOD Funds Brain Studies

2012-01-10T16:14:00.003-05:00

The Department of Defense awarded BrainScope® Company, a Bethesda Maryland medical neurotechnology company, a $7.5 million contract to use their BrainScope technology to help medical teams effectively treat head injuries in the emergency department.

BrainScope’s Ahead™ M-100 is a handheld non-invasive non-radiation emitting medical device under development to use at the point-of-care to aid in triage or use for patients where TBI is suspected. The device capable of assessing structural brain injuries and impairment from TBI and concussions, and can rapidly assess brain injuries based on patterns identified in brain electrical activity.

The company also received $250,000 in funds through the Maryland Department of Business and Economic Development made through the Maryland Venture Fund. This came about because earlier this year, the state was awarded $23 million in federal funding to invest in businesses and to disburse funds through existing state finance programs that included the Maryland Venture Fund.

The company will use this funding to develop and conduct clinical trials for Ahead™ M-100. In addition, the company also participated in MEDICA 2011 in Germany with the help of a DBED MD Export grant for $5,000.

In another DOD funding effort, researchers at the University of Southern California’s Institute for Creative Technologies, (ICT), New York-Presbyterian Hospital/Weill Cornell Medical Center, and Emory University School of Medicine were awarded an $11 million, four year grant from the Department of Defense to test different ways to treat PTSD including the use of virtual-reality exposure therapy developed at ICT.

The study will involve 300 military and civilian personnel who have been diagnosed with PTSD that occurred after their service in the Iraq and Afghanistan wars. The researchers will look at personal and genetic factors that may impact an individual’s chances of developing PTSD as well the individual’s future response to therapy.

JoAnn Difede, Director of the Program for Anxiety and Traumatic Stress Studies at New York-Presbyterian/Weill Cornell reports, “Combat-related PTSD is notoriously difficult to treat. Our study will conduct a large-scale head-to-head investigation of virtual reality as compared to tradition exposure treatment for PTSD. This could answer decisively which intervention is most effective, and for whom.”

Patients using virtual reality will use a headset with goggles and earphones as the therapist controls the digital scenes. Sensory cues will be added such as chair vibrations that simulate an explosion.

Difede began using virtual reality with burn unit patients in the 1990s and in 2001, she did research at the University of Washington which resulted in the creation of the Virtual World Trade Center System that was used to treat 9/11 survivors.

For more information email VRatl.orgBeach@gmail.com or visit www.scire-lb.org/ptsd.html or for information about the study sites email Brittany Mello at brm2016@med.cornell.edu.

Technologies at Harvard

2012-01-10T16:12:00.001-05:00

To repair damage and defects within a heart, doctors currently use stopped-heart and open-chest surgeries. These procedures are highly invasive and incur a significant risk to the patient from neurological impairment to possible death. The “Motion Compensating Catheter for Beating Heart Surgery” (#3719) a device developed at Harvard, now enables surgery to be performed within a heart while it is beating with the same accuracy as in open-chest surgeries.

The technology is a fast motion compensating mechanical device using image guidance and a sophisticated software package that is able to anticipate and react to the rapid movement of the cardiac tissue. The device can either be a handheld tool or it can be a standard cardiac catheter, enabling the surgeon to perform very delicate surgeries such as mitral valve repair without the need for heart stopping techniques. The technology takes advantage of real-time 3-D ultrasound images and a Radon transform-based algorithm for processing.

In another technology developed at Harvard “A Second Skin Pressure Sensor for Large Area, Form-fitting Wearable Applications” (#3788) a flexible form-fitting pressure sensor capable of registering location and intensity of pressure acts as a “second-skin” to create a range of never before possible body monitoring applications. The sensors can improve motion for use in physical therapy and long term healing, can be used in wearable sensors, in peripheral input devices, special effects hardware, and for battle field monitoring.

The sensors can be built into a new class of “smart” orthotic braces to give real-time feedback based on need. When used as a peripheral input device, these sensors can provide body movement data that can be translated into commands.

Both available technologies have U.S. Utility Patent Applications pending.

For additional information on Harvard Case #3719 go to www.techtransfer.harvard.edu/technologies/tech.php?case=3719 and for Harvard Case #3788, go to www.techtransfer.harvard.edu/technologies/tech.php?case=3788 or contact Sam Liss, Director of Business Development at (617) 495-4371.

Rural Healthcare Grants Available

2012-01-10T16:11:00.001-05:00

The Colorado Rural Health Care Grant Council requests applications for the fifth cycle of their grant program. The grant program is designed to help expand access to healthcare for rural residents and to help improve the health infrastructure and primary care services in the state.

The grant program, a collaborative effort between the State of Colorado and UnitedHealthcare will end up providing a total of $7.5 million to healthcare organizations in the state starting in 2008 and end in 2012. For 2012, the Council will award up to $1 million with the maximum award to be $50,000 per applicant. The program is administered by the Colorado Rural Health Center.

Organizations located outside of the state’s urbanized areas that provide outpatient primary care services that includes medical, oral, and mental health services are eligible to apply. Grants will fund projects to support the rural health infrastructure and strengthen the capacity of rural entities to enable adequate outpatient primary care services to be provided not only now but in the future.

The Intent to Apply forms are encouraged to be submitted by January 13, 2014 with applications due February 15, 2012. For more information, go to www.coruralhealth.org or contact Shelly Collings at (800) 851-6782 or by email at sc@coruralhealth.org.

FDA's Recent Actions

2012-01-07T16:25:00.001-05:00

Recently, FDA approved a medical device that can support the weakened hearts of children with heart failure so they will live until a donor for a heart transplant can be found. The mechanical pulsatile cardiac assist device called the EXCOR Pediatric System made by Berlin Heart comes in graduated sizes to fit children from newborns to teens.

Heart failure in children is much less common than in adults. Heart transplantation offers effective relief from symptoms, however, there are far fewer pediatric-sized donor hearts available for transplantation than for adults. For infants, the average waiting time for a donor heart is 119 days. Overall, a reported 12 to 17 percent of children and 23 percent of infants die while on the waiting list for a heart transplant.

The EXCOR was designated as a Humanitarian Use Device by the Office of Orphan Products Development at FDA. This designation is made for medical devices intended to benefit patients in the treatment or diagnosis of a disease or condition that affects fewer than 4,000 individuals in the U.S. annually. FDA’s Orphan Products Grant Program supported the U.S. clinical trials for the EXCOR Pediatric System with grants of $400,000 per year for three years.

In another FDA action, FDA now allows the marketing of the first hand-held device intended to aid in the detection of life-threatening bleeding in the skull called intracranial hematomas using near-infrared spectroscopy. The device called the “Infrascanner Model 1000” manufactured by InfraScan Inc. of Philadelphia, can help healthcare providers identify patients with critical head injuries who need an immediate brain imaging study. Intracranial hematomas occur when blood from a ruptured blood vessel collects within the brain or between the skull and the brain.

The scanner directs near-infrared light which is a wavelength of light that can penetrate tissue and bone into the skull. Blood from intracranial hematomas absorb light differently than from other areas of the brain. The scanner is able to detect differences in light absorption and then transmit this information wirelessly to a display on a hand-held computer.

By comparing the optical density from a series of scans for specific areas on both sides of the skull, a trained healthcare provider can use the information provided by the device, in conjunction with other clinical information to determine the likelihood of an intracranial hematoma and the need for further diagnostic procedures such as a CT scan.

“As a result, this portable device can offer emergency room physicians a non-invasive mechanism to aid in assessing whether an immediate CT scan is needed”, according to Christy Foreman, Director of the Office of Device Evaluation at FDA’s Center for Devices and Radiological Health.

NASA Selects 300 SBIR Projects

2012-01-07T16:24:00.001-05:00

NASA selected 300 small business proposals to negotiate for possible contract awards through NASA’s SBIR and STTR programs. The SBIR program selected 260 proposals for a combined value of $44 million to negotiate for Phase I feasibility study contracts. In addition, the STTR program selected 40 proposals with a combined value of $5 million to negotiate for Phase I contracts.

Ionu Biosystems in Somerville Massachusetts proposed an SBIR project (11-1X13.01-9659) to develop a fluorescent smart phone blood analyzer that can measure important physiological concentrations from a drop of blood. The approach is to develop fluorescent optode sensors to detect the concentration of the components of basic metabolic and blood gas panels.

Using wireless optode sensors removes the need for wired connection of the sensors, sample preprocessing, and microfluidics for sample handling. Fluorescence emission from the sensors will be directly measured by the built-in phone camera and the data process that can occur on the phone itself.

This smartphone will present commercial applications for NASA to enable NASA to self- monitor key physiological parameters during long flight missions and enable non NASA applications for a fluorescence-based smart phone blood diagnostics device. This technology will also be useful in communities since the device can be used in rural settings, for home health monitoring, and used in developing countries.

For more information, contact John Dubach at (617) 460-4003.

CFD Research Corporation located in Huntsville Alabama proposed STTR project (11-1T1.02-9940) to develop a novel miniaturized point-of-care (POC) device to diagnose disease pathogens. The device after development will be compact, lightweight, fully integrated, automated, highly cost effective, and power efficient.

In its final phase of development, the sensor will be integrated with a compact handheld instrument for data collection, analysis and processing, and will interface with existing NASA space instrumentation to use for both terrestrial and microgravity environments.

The device in a non NASA commercial application could provide a new type of electrochemical sensor or diagnostic technology and provide no-cell culturing based pathogen detection for a variety of applications in healthcare, life sciences, in hospital settings, and for monitoring.

The researchers will work to develop in-situ analytical tools for the preparation, detection, and analysis of low level pathogens obtained from biological fluid and or water samples. Also, the device may also be used in drug discovery, to study human diseases, to do clinical and preclinical diagnosis, as well as be used in the areas of cellular biology, microbiology, and homeland security.

For more information contact Jianjun Wei at (256) 327 0672.

Go to http://sbir.ssfc.nasa.gov then click on “SBIR 2011 Phase 1 Selection Announcements dated 11/29/2011.to view the research proposal abstracts.

HHS Releases Solicitation

2012-01-07T16:21:00.002-05:00

HHS is awarding a total small business set-aside to acquire a “Software-as-a-Service” (SaaS) System to support data modeling and simulation involving health and healthcare. The system will support research, analysis, and evaluation in a wide variety of applications across HHS.

In addition, the contract will supply materials, training, and education in the use of the technology. Also, additional capabilities will require consultations and ways to adapt the system to meet specialized needs.

Across the operating and staff divisions of HHS, there is a growing need to analyze research and policy issues. There is a need for HHS to have access to existing modeling and simulation systems to be able to evaluate variables related to disease conditions, healthcare settings, medical product interventions, and in other areas.

The use of modeling and simulation software will enable improved capability and reliability of results from the research and analysis efforts. The insights gained from the use of modeling and simulation may be used in policy formulation, design of research projects, support new hypothesis generation, promote construction of new analytic frameworks, inform survey design, plus there are other applications.

The solicitation “Health Data Modeling and Simulation Software as a Service”(#12-233-SOL-00090) published December 29, 2011 will be a single award Indefinite Delivery, Indefinite Quantity firm fixed price contract valued at $5,000,000. The due date for proposals is January 16, 2012.

For information, email the primary contact Wendy C. Cruz at Wendy.Cruz@psc.hhs.gov or call (301) 443-3086.

New Partnership Enables Teleaudiology

2012-01-07T16:18:00.001-05:00

UC Davis in a new partnership with the State of California and Mercy Medical Center in Redding will enable infants located throughout Northern California to be seen by a pediatric audiologist at UC Davis via telemedicine. The program is funded with a three year $354,242 grant by HRSA and by the Child Health Bureau through the Department of Health Care Services, Children’s Medical Services. Participation in the program comes from referrals from the state Health Coordination Center.

This teleaudiology program is unique because rather than consulting with audiologists or other clinicians at the remote location who then diagnose and treat the patient, the UC Davis audiologists actually perform the hearing screening and make the diagnosis.

Early identification of deaf and hard-of-hearing infants before 3 months of age and starting early intervention services before 6 months of age are the most important factors in developing age-appropriate language skills, whether families communicate using sign language or spoken language.

“Driving three to four hours to a medical center with a four week old baby may not be possible for many families”, said Anne Simon, Senior Pediatric Audiologist in the UC Davis Department of Otolaryngology.

The program focuses primarily on infants living inland in the far northern counties in California adjacent to Shasta County where Redding is located. The program works when an EEG technician in Redding places electrodes on an infant’s head and earpieces in the ears. The audiologist then controls the screen equipment remotely from Sacramento.

The telemedicine connection allows the technician to switch camera views in order to see the infant and the parents as well as the technician and the screen room. It is also possible to view the child’s ear canal and eardrum with the information being recorded by the device during the two to four hour testing period.

In the auditory brainstem response test, an electrical signal is evoked from the brainstem as a response to an auditory stimulus, the child is tested and it has been found that many have a conductive hearing loss, which may be caused by obstruction of the middle, ear, sensory loss in the cochlea, or by neurological issues.

Then the next step is to use otoacoustic emissions to test inner ear health which can indicate the site of a lesion for hearing loss in infants. Also, typanometry can test the health of the middle ear and the mobility of the ear drum.

“We are very excited about providing this program, because central Northern California has the highest lost-to-follow-up rate in the state for newborn hearing screening,” said James Marcin M.D, Professor of Pediatric Critical-Care Medicine and Director of the US Davis Pediatric Telemedicine Program.

For more information, go to www.children.ucdavis.edu.

CDC Releases FOA

2012-01-07T16:16:00.001-05:00

CDC is looking for proposals to design and test a surveillance system to incorporate data for congenital and inherited conditions that have low prevalence but have a high health and economic impact in the U.S. population. CDC wants to see this surveillance system in place so that agencies and organizations will be able to inform, evaluate policies, and intervene to improve health services and health outcomes.

At the present time, approximately 7,000 people have low prevalence/high impact conditions in the U.S population collectively affecting about 25 million people. In the U.S., a condition is considered low prevalence/high impact when the number of cases at any given time does not reach 200,000. In comparison, the number of cases for a common disease such as diabetes amounted to nearly 26 million for the U.S. in 2010.

Healthcare for individuals with low prevalence/high impact conditions can be costly and labor intensive. For example, the 2006 average annual medical expenditure for people with actively managed cystic fibrosis ages below 65 years was about $48,000 which is 22 times as much as the average medical expenditure of a person without the disease. The cost of treatment for some low prevalence/high impact diseases can be as high as $400,000 per year.

To address the problem, CDC released a FOA on January 4, 2012 titled “A Pilot Surveillance System for High Impact/Low Prevalence Congenital and Inherited Conditions” (RFA-DD-12-002) looking for applicants to design a surveillance system to focus on spina bifida a neurological condition affecting mobility, muscular dystrophy a neuromuscular condition, and fragile X syndrome a condition affecting cognition and behavior. The project will develop a prototype surveillance system that in the future may be able to serve as a model for other low prevalence/high impact conditions.

Research objectives are to identify gaps and deficiencies in existing local, regional, and national data sources and existing surveillance systems for the three target conditions, develop and execute a plan to integrate all major data sources into a functional surveillance system for the three target conditions simultaneously, and then pilot test the surveillance system.

Eligible applicants can include higher education institutions, nonprofits, for-profits, small businesses, and state and local governments. Estimated total program funding for the Cooperative Agreement is $800,000 with one expected award. The award ceiling is $400,000.

The Letter of Intent is due February 2, 2012 with applications due March 2, 2012. For further information, go to www.grants.gov or phone the contact center at 800-518-4726 or email support@grants.gov.

IHI Seeks Qualified Candidates

2012-01-07T16:14:00.001-05:00

The Commonwealth Fund’s Commission on the High Performance Health System Scorecard and Research Project located at the Institute for Health Care Improvement (IHI) in Cambridge Massachusetts, seeks qualified candidates for an important research position.

The Senior Research Associate position is responsible for conducting analytic work to update the ongoing series of health system scorecard reports. The successful candidate will report to the Senior Analyst and Project Manager David Radley, PhD.

The position requires that the Senior Research Associate be able to manage data collection and analysis and serve as a coauthor and key analyst on the scorecard reports. This position includes assisting with the scorecard report in the design, production, and dissemination activities that includes web site tools and information.

The Associate will also assist and advise on the compilation of data and the development of issue briefs for insurance markets and provider organizations and participate in any analytic work required to produce trend and policy reports.

In addition, the Senior Research Associate supports the day to day management of the IHI unit, and will coordinate research efforts and communication among the unit, Commonwealth Fund staff, and external collaborators.

The successful candidate will have a master’s degree and five to seven years of work experience or the equivalent. Preference will be given to applicants with prior research experience and/or formal education in economics, statistics, mathematics, or public policy. A demonstrated interest in healthcare policy or health services research is a plus.

If qualified and interested, contact IHI, VP Human Resources, 20 University Road, 7th Floor, Cambridge MA 02138, or email employment@IHI.org.

NY OMH Releases RFP

2012-01-07T16:11:00.001-05:00

The New York State Office of Mental Health (OMH) issued RFP (C009999) seeking technical and professional services to implement an EMR system. This system is based on a solution available using the Department of Veterans Affairs VistA software at 26 state operated psychiatric centers, 310 OMH outpatient locations, and at OMH’s Central Office.

OMH recognizes that the VA’s VistA system does not fully meet OMH requirements for an OMH EMR. This means that in order to create OMH’s VistA Solution, bidders will need to propose additional software that can be the contractor’s existing proprietary software, software developed by the contractor during the project, and/or third party software.

OMH’s vision for New York State mental healthcare includes developing and supporting a coordinated, comprehensive, community-based public mental health system. OMH wants to improve the tracking of individual mental health records, the flow of EMR data among OMH facilities and outpatient locations, and improve the efficiency and effectiveness of the OMH mental health services.

The bid proposal submission is due April 27th 2012. The pre-bid conference form is due January 23rd 2012. The mandatory pre-bid conference OMH demos Day 1 will be held February 6th, 2012 with the Demos Day 2 to follow on February 7th, 2012.

To be eligible for the contract award, the bidder must demonstrate:

• Five years experience in implementing a VistA-based EMR solution at multiple facilities within a single hospital entity or state agency
• Five years experience in using commonly accepted project management best practices to successfully manage and implement the system
• Five years experience and technical capability in software design, development, testing, configuration, customization, and integration with third party software
• Have a relationship with the VA FOIA office to ensure that all future plans, software development, corrections and modifications to VistA by the VA will be immediately available to OMH
• Capability to deploy a web-based product when it is available from the VA

Go to www.omh.state.ny.us/omhweb/rfp/2011/emr to view the RFP and supporting documents. For more information, email Sheila Long, Scott Derby, or Joel Rubin at EMR-RFP@omh.ny.gov.

Updated 2012 Health Technology Report Released

2012-01-03T06:32:00.002-05:00

Bloch Consulting Group’s Federal Health Technology Report has just been revised for 2012 and is available for download at http://www.federaltelemedicine.com.

The report, “Activities in Telemedicine Telehealth and Health Technology” contains key details on Federal government activities in telemedicine, telehealth, eHealth, health technology and related areas at 24 cabinet level and independent federal agencies.

The download also includes “Selling to HHS,” a guide to navigating and taking advantage of many relevant programs at HHS.

“The growing use of health information technology is becoming the routine way to deliver healthcare in the U.S. and other parts of the world” according to Editor Carolyn Bloch. “To keep up with Federal activities, it is essential to understand not just what funding may be available, but also current and future innovative federal movements and policy changes.”

The 260-page edition of the “Activities in Telemedicine Telehealth and Health Technology” contains information on how government agencies are organized, describes ongoing activities relevant to the field, and points out numerous grant and contract programs useful for ongoing business development.

The 45 page report “Selling to HHS” specifically helps individuals and companies market their technology products and services, secure grants, and locate good possibilities for funding within this agency. This report is included free with all orders for the 2012 Federal Activities report.

The reports are available as digital downloads in PDF format. More information is available at the Bloch Consulting Group web site at http://www.federaltelemedicine.com.

NIH Establishing NCATS

2012-01-03T06:30:00.001-05:00

In a move to re-engineer the process for translating scientific discoveries into new drugs, diagnostics, and devices, NIH is establishing the National Center for Advancing Translational Sciences (NCATS). The funding in the FY 2012 spending bill establishes NCATS with a budget of $575 million to act as a catalyst for innovations in translational science and also work with partners in the regulatory, academic, nonprofit, and private sectors.

According to NIH Director Dr. Francis S. Collins, M.D., PhD, “Patients suffering from debilitating and life threatening diseases do not have the luxury to wait the 13 years it currently takes to translate new scientific discoveries into treatments that could save or improve the quality of their lives.”

An example of an innovative NCATS project is the new initiative between NIH, the Defense Advanced Research Projects Agency, and FDA to develop cutting-edge chip technology. The new technology will enable researchers to screen for safe and effective drugs far more swiftly and efficiently than current methods.

These programs will be part of NCATS:

• Bridging Interventional Development Gaps—to make critical resources available as needed for the development of new therapeutic agents
• Clinical and Translational Science Awards—to fund a national consortium of medical research institutions to work together to improve the way clinical and translational research is conducted nationwide
• Cures Acceleration Network—to enable NCATS to fund research in new and innovative ways
• FDA-NIH Regulatory Science—to form an interagency partnership to accelerate the development and use of better tools and approaches
• Office of Rare Diseases Research—to coordinate and support rare diseases research
• Components of the Molecular Libraries—to provide researchers with access to the large-scale screening capacity necessary to identify compounds that can be used as chemical probes to validate new therapeutic targets
• Therapeutics for Rare and Neglected Diseases—to encourage and speed the development of new drugs for rare and neglected diseases

For more information, go to www.nih.gov/about/director/ncats/index.htm.

Veterans Administration Issues RFI

2012-01-03T06:28:00.001-05:00

The Department of Veterans Affairs Technology Acquisition Center issued a Request for Information (RFI) on replacing the VistA “Medical Scheduling Package” (MSP). The VA’s existing MSP is more than a quarter century old, is highly inefficient, no longer can effectively support the multiple linkages needed to engage patients, clinicians and ancillary services, and no longer can support new models of clinical care delivery.

The VA envisions:

• A scheduling system which is standards-based, modular, extensible, and scalable
• A new veteran-centered medical scheduling system that relies on web and mobile devices
• A new system that will build a foundation to build scheduling functions to support new models of care and new ways of engaging veterans and clinicians
• A phased approach to mitigate some of the risk of developing a complex and expensive process
• A procurement that is based on specific, tested, and mutually agreed upon outcomes not just best efforts.

In 2011, the VA created an open source custodial agent to enable a structured and predictable migration path from custom and proprietary VistA software to an openly designed, standards-based, modular, scalable, and extensible platform. The Open Source Electronic Health Record Agent (OSEHRA) is the custodial agent for the VistA open source codebase.

For more information on the RFI, go to www.fbo.gov (posted December 21, 2011) with the response to the RFI due on January 31, 2012.

Integrated Care for Duals

2012-01-03T06:26:00.001-05:00

The “Alliance for Health Reform” founded by Senator Jay Rockefeller of West Virginia held a briefing December 12th on Capitol Hill to foster a discussion on the issues facing dual eligible beneficiaries. Under the CMS funded “State Demonstrations to Integrate Care for Dual Eligible Individuals”, fifteen states are in the process of designing new approaches to better coordinate care. Each state will receive $1 million to develop a model that will work in their state.

According to Suzann Gore, Director of Integrated Care for Dual Eligibles at the Center for Health Care Strategies, it is very important to keep stakeholders engaged to meet the needs of dual eligible beneficiaries, to learn how care can be improved, and to understand what is working.

To find solutions to integrating care for dual eligibles, Lindsay Barnette, a member of the Models and Demonstrations Group in the Medicare-Medicaid Coordination Office at CMS described how focus groups held by CMS in 2011 were productive. The focus groups held in five states helped to gain insight as to how Medicare-Medicaid enrollees make enrollment decisions, their experiences with the various types of Medicare and Medicaid service delivery combinations, and how to improve communications with enrollees.

The focus groups enrolled 156 people in 21 groups mostly 18 to 64 but three groups had participants 65 years old and older. People were in the group with physical disabilities, serious mental illness, developmental disabilities, multiple chronic illnesses, long term care needs, and individuals with no particular conditions were represented. In addition, there was one Chinese speaking group and one group with Navajo majority.

Basically, the participants are concerned with the physician and/or psychiatrist in the network that they will work with, understanding benefits, making the right dental and eye care choices, and understanding their prescription drug needs and costs.

Most enrollees find the information confusing and overwhelming as to what is covered, what is not, and the overall cost for their healthcare. They also want up-to-date provider directories with information as to whether the providers are taking new patients. Most participants have poor access to the internet and are frustrated with automated phone information.

Most participants in the groups are much more focused on coordination of benefits than on the coordination of care. The participants want better coordination of benefits, easier time in getting authorization for services, and they do not want to get the run-around between Medicaid and Medicare.

Lynda Flowers a Senior Strategic Policy Advisor for the Health Team in the Public Policy Institute at AARP, described the insights obtained from AARP focus groups that discussed what older adults want from their care.

The participants in the AARP focus groups were 65 or older, enrolled in both Medicare and Medicaid, receiving care through one of the specified delivery models, had no cognitive impairments, currently managing multiple chronic conditions, and roughly one-half of the participants had a recent interaction with a hospital.

The AARP heard that most of the participants in the focus groups were generally satisfied with their care although duals in this study group strongly preferred having the freedom to select their providers but most were willing to make trade-offs. However, some duals in some of the care models reported having problems accessing some services.

Most of the dual eligibles in the focus groups saw value in care coordination. They like having someone look out for their best interests and take care of billing issues. The things that they appreciated the most included frequent phone calls from their care managers, phone calls alerting them as to the availability of special health programs, and having people check to make sure that they had the things they needed to manage their conditions. It also gave most of the duals a measure of comfort knowing that their providers communicated with each other.

The focus groups talked about effective strategies to educate beneficiaries on the billing system and benefits, the options available, and how or whether to develop a single, laminated ‘smart” card that combines Medicare Parts A, B, and D for beneficiaries in fee- for- service.

Also needed are peer-to-peer discussions among duals with similar health conditions, a study to examine whether social isolation increased healthcare costs, and if and how the use of pharmacy transition coordinators could be an effective strategy to improve medication management.

Massachusetts was one of the fifteen states awarded a $1 million planning contract from CMS to help develop a design proposal for a state demonstration plan to integrate care for duals. The state’s target population is 115,000 dual eligibles ages 21 to 64 with full MassHealth and Medicare benefits.

Corrine Altman Moore from the MassHealth/Executive Office of Health and Human Services in the Commonwealth of Massachusetts recounted how the four focus groups assembled in 2011 felt about current benefits and an integrated model. From feedback gathered, the focus groups and other stakeholders want to see some improvements in benefit design especially related to dental services and eyeglasses and want more peer support related to nutrition and wellness provided by community health workers.

As for the enrollment process and outreach, they believe a neutral and impartial enrollment broker is needed along with sufficient time and clear information on how to make good choices for their care and they want to see current providers connected to their caregivers.

The Commonwealth of Massachusetts Executive Office of Health and Human Services (EOHHS), Office of Medicaid in December 2011, released a draft proposal that went to the CMS Center for Medicare and Medicaid Innovation on how the state could conduct a state demonstration to integrate care for duals.

The draft proposal gives ideas on how the demonstration would be managed, provides leadership under the leadership of the state EOHHS, and how the Integrated Care Organization (ICO) manager would oversee the daily program. The ICO contracting unit would handle routine contracting and procurements for managed care plans.

One of the major challenges would be to provide the specific information on the technology needed to enroll members, make global payments, collect and manage encounter data, manage federal reporting activities including MA-21 for enrollment and eligibility, MMIS for capitation payments, and provide a data warehouse to collect and analyze data. Data analysts would also be needed to aggregate, analyze, and report on encounter, quality, and financial data to be used for quality control and other purposes.

Go to www.mass.gov/eohhs/docs/eohhs/healthcare-reform/state-fed-comm/111207-draft-demo-proposal.pdf to view the draft proposal.

For more information on the briefing and the Alliance, go to www.allhealth.org.

Chinese Visit Western University

2012-01-03T06:24:00.001-05:00

In December, officials from Shijiazhuang Kidney Disease Hospital in China visited Western University of Health Sciences located in Pomona California to learn more about osteopathic medicine and to lay the groundwork for future collaborations.

The Hospital located 150 miles south of Beijing has more than 1,000 beds and specializes in kidney disease and specifically in Micro-Chinese Medicine Osmotherapy. This type of therapy treats kidneys by understanding the root of the problem and determining the cause. This treatment is able to expand local blood capillaries and promote blood circulation. The hospital is known for another specialty referred to as Stem Cell Transplant Techniques plus a program to apply blood purification before and after stem cell transplantation.

Dr. Xitong Cao, President and CEO and Dr. Ke XU, from the hospital’s Dialysis Center met with several Western university administrators and faculty members from the College of Osteopathic Medicine of the Pacific (COMP), with Western University researchers, and with representatives from other colleges.

Dr. Cao reports that China is developing quickly which has caused a high demand for scientific and technical skills. He said,” We came to the U.S. to learn how to develop a successful management and educational style and then take this knowledge back to China. The doctors are looking for high quality professional people so that these professionals will be able to adapt to a fast developing county like China. There is great interest in an exchange program since it would enable Chinese students to learn about Western University’s innovative methods”.

“Also, Western University has a lot to learn from colleagues in China,” said Edward V. Barnes II, M.D who is a COMP Assistant Professor of Internal Medicine in the Division of Nephrology and Hypertension. “The fact that a kidney hospital in China does things a little differently than we do in the U.S. might bring different perspectives and produce new innovations to increase our knowledge.”

Barnes continued to say, “It would be good to collaborate. They may have a different approach to research which might allow us to do a little more in-depth research on curative treatments for the kidneys rather than just managing chronic diseases. I think that we can both learn from each other by discussing models that we have here versus models that they have in China.”

CMS Creates New Programs

2012-01-03T06:22:00.001-05:00

CMS has created a new demonstration program for chronically ill Medicare beneficiaries to test a payment incentive and service delivery system. The CMS Independence at Home (IAH) Demonstration is directed towards home-based primary care teams aimed at improving health outcomes and reducing expenditures. Participating practices must be available 24/7 to care out the care needed. Practices must use electronic health information systems, remote monitoring, and mobile diagnostic technology.

Services will be provided to high cost, chronically ill Medicare beneficiaries in their homes. Participating practices will need to provide comprehensive, coordinated, continuous, and accessible care to high-need populations at home and coordinate healthcare across all treatment settings. Participating practices may share in savings under the demonstration if specified quality measures and savings targets are achieved.

CMS is interested in finding practices that can provide home-based primary care and work as multidisciplinary teams composed of physicians, nurse practitioners, physician assistants, pharmacists, social workers, and other supporting staff.

Each participating practice must provide services to at least 200 applicable beneficiaries during each year of the demonstration. A practice’s enrollment may vary over each year but must reach at least an average of 200 applicable beneficiaries during the first year and not drop below that average for the remainder of the demonstration. There are three options available for practices when applying for the demonstrations. Practices may apply as a sole legal entity, consortium, or become a part of the national pools.

Applicable beneficiaries are defined as Medicare fee-for-services patients, who have at least 2 chronic illnesses, need assistance with two or more functional dependencies requiring the assistance of another person, have had a non-elective hospital admission within the last 12 months, and have received acute or sub-acute rehabilitation services within the last 12 months.

The demonstration is effective December 21, 2011 with provider applications to participate due February, 2012. For more information, contact Linda Colantino (410) 786-3343 or Jennifer Brown (410) 786-4036.

In another move, 32 healthcare organizations both rural and urban groups representing 18 states will participate in the new Pioneer Accountable Care Organizations (ACO) initiative. Through this program, the CMS Innovation Center will reward groups of healthcare providers within ACOs based on how well they are able to improve the health of their Medicare patients and lower their healthcare costs.

The initiative will test the effectiveness of several innovative payment models and how experienced organizations can provide better care for beneficiaries, work in coordination with private payers, and reduce Medicare cost growth. These payment models will enable organizations if they are successful to lower cost growth and to move away from a payment system based on volume under the FFS model and move towards one where the ACO is paid based on the value of care it provides.

State to Issue RFP

2012-01-03T06:19:00.001-05:00

The California Health Benefit Exchange in collaboration with the Department of Health Care Services, and the Managed Risk Medical Insurance Board are soliciting proposals for a new Exchange system. The system is referred to as the “California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS).

The Draft Solicitation released December 20, 2011 seeks comments due December 30, 2011 to enable the public and vendors to provide input in advance of the final solicitation to be released January 18, 2012. The final proposal submission is due February 24, 2012.

According to the Draft Solicitation, the vendors are expected to:

• Design, develop, test, and deliver a fully integrated automated system delivering services through a web format in English and Spanish to be used by persons with disabilities and provide for feedback regarding ease of accessibility
• Enable customers to access consumer accounts via the CalHEERS web portal using role-based security
• Enable individuals to create an account, submit applications, update case information, appeal an eligibility determination, allow application processing across affordability programs, enable users to browse anonymously, provide for seamless and timely transition between health programs with no gap in service, and enable individuals to be able to shop and compare health plan options
• Provide capabilities to determine real-time eligibility for all Exchange Health Services Programs, Healthy Families, and for Med-Cal income-based eligibility
• Promote transparency and accountability through compliance with federal guidelines
• Build on existing systems where appropriate and build on an architecture that is scalable, flexible, modular, and dynamic
• Build on a single comprehensive and integrated security and privacy framework that implements multiple federal and California state security and privacy policies and protects consumer information
• Operate and maintain the automated system for the life of the contract and provide for administrative maintenance and case maintenance tasks
• Implement the automated system statewide with minimal business disruption, prepare CalHEERS user groups and facilitate their implementation, deliver training, equipment, materials, organization, logistics, and staffing

It is expected that vendors will need to proactively monitor other States and their exchange developments and implementations and be able to incorporate public domain software in their proposed solutions to the solicitation.

Go to www.healthexchange.ca.gov/Solicitations/Pages/Default.aspx to view the draft solicitation then click on “Draft CalHEERS Solicitation for Development and Operations Services”.

Time Out

2011-12-20T13:45:00.002-05:00

We want to wish you a very happy holiday season and best wishes for the New Year. The next “Federal Telemedicine News” will be published January 4th, 2012.

Improving Neonatal Care

2011-12-20T13:43:00.001-05:00

The American Telemedicine Association (ATA) developed a legislative proposal to expand the use of telemedicine for Medicaid enrollees with high-risk pregnancies and neonatal care needs. If adopted, the plan would improve care delivery for an at-risk population and create significant long term savings for the government and tax-payers.

Commissioned by ATA to appraise the proposal, Avalere Health determined that using telemedicine would generate a savings of up to $186 million over the next 10 years and estimates modest participation by states, managed care organizations, and individual providers over the ten year period. The estimated savings take into account changes in Medicaid enrollment expansion as a result of the Recovery Act as well as higher proposed Federal Medical Assistance Percentage rates.

The proposal uses a shared savings approach to encourage provider adoption, as well as a 90 percent contribution from the Federal government in the first two years to encourage state adoption. Participating providers in the birthing network would be eligible for shared savings if Medicaid spending associated with eligible individuals in the program was below a baseline expectation.

The proposal would provide Medicaid coverage of telemedicine for maternal-fetal and neonatal care via a comprehensive care “birthing network”. These networks could leverage telemedicine technologies to more effectively treat major conditions associated with high-risk pregnancies, including pre-term labor, gestational hypertension, mild preeclampsia, and gestational diabetes mellitus. HHS would ensure the quality of care through performance reporting.

This innovation builds on the successful experience of the University of Arkansas ANGELS Program, which has cost-effectively managed a birthing network in that state for nearly ten years. The program is also grounded in findings from the Institute of Medicine.

“This is a win-win for both patients and Federal taxpayers,” said Jonathan Linkous, ATA CEO. “We urge Congressional leaders to quickly adopt this proposal and realize the savings.”

For more information, email Benjamin Forstag at bforstag@americantelemed.org or call (201) 223-3333. Go to www.americantelemed.org/MedicaidProposal for the complete Avalere memorandum on ATA’s proposal.

NIST's Call for Proposals

2011-12-20T13:40:00.002-05:00

NIST located within the Department of Commerce is looking for research grant proposals to meet the needs of their Measurement Science and Engineering (MSE) Research Grant program. Some of the research programs within the MSE grant program support healthcare from clinical diagnostics to tissue engineering, plus the more efficient manufacturing of biologic drugs. This research enables physicians to make more accurate diagnoses and better monitor the effectiveness of new drug therapies.

MSE’s program has grants available through the Information Technology Laboratory (ITL) Grant Program to support research in the areas of advanced network technologies, cloud computing, complex systems design, computer forensics, information access, cybersecurity, health information technology, smart grid, software testing, computational biology, interactive systems, mobile platform security, device mobility among heterogeneous networks, and virtual measurements.

The ITL Grant Program in FY 2012 anticipates funding individual projects in the $10,000 to $500,000 range. In FY 2011, the ITL Grant Program funded 23 new awards totaling $4,500,000.

In addition, the NIST Measurement Science and Engineering (MSE) Research Grant Program has other grant funding programs within their research activities that present possible places to seek grants related to the health technology field.

The NIST Office of Special Program has jurisdiction over the Office of Law Enforcement Standards (OLES) Grant Program. OLES oversees the Public Safety Communication Research (PSCR) Grant Program which does research, development, testing, and evaluation to foster nationwide communications interoperability. Specific research is conducted on improving patient safety and response and to help responders make decisions on the job utilizing performance standard measurement tools.

The PSCR Program provides insight to wireline and wireless standards committees on how to develop standards for voice, data, image, and video communications. Specific areas of interest include land mobile radio technology, broadband technology, interim interoperability devices, and emerging public safety communications technologies.

FY 2012, the Office of Special Programs (OSP) Grant Program anticipates limited funding for individual projects related to environment issues for $25,000 to $1,500,000 however, the PSCR grant program may not release grant funding at this time. For more information email Dereck Orr at dereck.orr@nist.gov.

The Physical Measurement Laboratory (PML) Grant Program in their Sensor Science Division conducts research on optical properties, and standards. For further information email Carl J. Williams at carl.williams@nist.gov.There is funding for PML of $5,000 to $250,000 for FY 2012. In 2011, PLM funded 19 new awards that amounted to $982,733.

The Engineering Laboratory (EL) Grant Program performs research on intelligent systems and information system integration for applications in manufacturing. The Systems Integration Division performs research on state-of-the-art information technology-based solutions to manufacturing systems integration problems. For FY 2012, $5,000 to $500,000 is available. In FY 2011, the EL grant program funded 11 new awards at $2,200,000. For more details, email Vijay Srenivasan at vijay.srinvasan@nist.gov.

The Standards Services Group (SSG) Grant Program studies topics related to health, safety, and the environment as well as supports specific standards-related activities including the development of web-based information systems. Funding for FY 11 is available for $5,000 to $25,000. In FY 2011, the SSG Grant Program did not fund any new awards.

All of the programs in this call for proposals will be considered on a continuing/rolling basis. However, for proposals received after 5 PM on June 1, 2012, proposals may be processed and considered for funding under this current fiscal year or in the next fiscal year unless there is a new posting in www.grants.gov.

For more details on the MSE Research Grant Program announced on December 7th, go to www.grants.gov or go to www.nist.gov/director/mse-121311.cfm and click on Measurement Science and Engineering Research Grant Programs.

EU/U.S eHealth Collaboration

2011-12-20T13:38:00.001-05:00

ARGOS formally called the “Transatlantic Observatory for Meeting Global Health Policy Challenges” was created to provide dialogue and enable collaboration on important health policy issues. The goal to promote eHealth understanding, learning, and collaboration among EU and the U.S is supported by several partners such as the European Institute for Health Records (EuroRec), Empirica, Instituto Ortopedico Rizzoli, AMIA, and the University of Buffalo. Other organizations contributed such as the UC San Diego, CCHIT, European American Business Council, and AHIMA.

A Conference held November 2011 enabled leaders in the field to present their ideas and thoughts along with recommendations on important global eHealth issues. The presenters pointed out that it is essential for the U.S. and EU care about the challenges since citizens are traveling and migrating globally and face new health issues, EU and U.S. want to produce better products to penetrate global markets, both the U.S. and EU want to be able to support large scale eHealth infrastructure, the U.S and EU need to support eHealth R&D, and the experiences and lessons learned globally concerning eHealth are useful both in Europe and the U.S.

George De Moor, PhD, President of EuroRec, a speaker at the Conference reported that the goal is to coordinate research efforts, to integrate all electronically captured data and information, and obtain knowledge on modeling the human physiome in both health and disease. The EU and U.S. have already invested large amounts in resources by working to develop the Virtual Physiological Human (VPH) framework.

The leaders agree that EU and U.S need to agree on common policies, standards, and realign all VPH-type research efforts towards the creation of a global VPH cyber-infrastructure. This would ensure that all data repositories and models as well as all developed tools and techniques would be interoperable. It is estimated that there are more than 100 VPH related projects worldwide resulting in the early diagnosis of Alzheimer’s disease, prevention of fractures, prevention of the rupture of cerebral aneurysms, and help in cardiac and liver modeling.

The leaders feel that the way to move eHealth forward is by doing community building and social networking on the issues, provide user support and training, test and use models in clinical decision support systems, develop clinical trials, and establish a multi-stakeholder advisory group to address the main issues and work to accomplish a common vision.

To provide new ideas on how to achieve collaborative solutions and meet eHealth challenges, ARGOS just recently released the proceedings “Transatlantic Cooperation Surrounding Health Related Information and Communication Technology” a collection of eight policy briefs addressing key topics and solutions in eHealth informatics. Information on The ARGOS proceedings, published by IOS Press in the Netherlands is available at www.iospress.nl.

Digital Divide Still Exists

2011-12-20T13:37:00.001-05:00

The Department of Commerce’s Economics and Statistics Administration and NTIA recently released the report “Exploring the Digital Nation: Computer and Internet Use at Home” presenting an in-depth analysis of broadband internet adoption in the U.S. Overall, approximately seven out of ten households in the U.S. subscribe to broadband service.

However, the report finds a strong correlation between broadband adoption and socio-economic factors such as income and education, but maintains that these differences do not explain the entire broadband adoption gap that exists along racial, ethnic, and geographic lines. Even after accounting for socio-economic differences, certain minority and rural households still lag in broadband adoption.

The report analyzed data collected through the Current Population Survey of about 54,300 households conducted by the Census Bureau in October 2010. Earlier this year, NTIA released initial findings from the survey showing that virtually all demographic groups have increased the adoption of broadband at home since the prior year, but historic disparities still exist among demographic groups.

Overall the report found:

• Sixty-eight percent of American households used broadband internet in 2010 which was up from 64 percent in 2009

• Approximately 80 percent of American households had at least one internet user

• Cable modems and DSL were the leading broadband technologies for home internet adoption

However, there were still differences in household broadband adoption in households. Hispanics, people with disabilities, and rural residents were less likely to have internet services at home. This compares to 81 percent of Asian households and 72 percent of white households that have broadband at home as compared to 57 percent of Hispanic households and 55 percent of black households.

Other factors were found in household broadband adoption such as the percentage of usage was higher for urban households, households with school-age children, and for the 93 percent of households with incomes exceeding $100,000. The research also found that home mobile broadband adoption was more widespread in households reporting use of handheld devices.

Go to www.ntia.doc.gov/report/2011/exploring-digital-nation-computer-and-internet-use-home to view the document.

Studying Medication Use & Safety

2011-12-20T13:35:00.001-05:00

Today an important barrier to effective medication reconciliation is the unreliability of the patient’s own reports concerning their own medication use. Today, the James J. Peters VA Medical Center (JJP-VA) a facility in the Bronx is using VA grant support for the project “Implementing a Regional Data Exchange Tool to Improve Medication Use and Safety”.

The researchers will use data obtained from the Bronx RHIO to examine transitional drug risks, adverse drug events, and total inpatient costs. They want to examine how the information available to providers from the Bronx RHIO that houses information on both VA administered medications and medications issued from outside the VA, is being used. To be effective, this information needs to be reconciled in order to go into the patient’s medical record.

The VA also wants to identify system and provider factors that may be impeding the adoption of the information in the RHIO by VA providers. The objective is to find out what impedes or would help the adoption of the RHIO for routine use by providers and also to find ways to improve the RHIO.

The plans are to conduct a controlled trial to study the medication reconciliation process at the time of hospital admission to see if the information is either enhanced or not enhanced with data from the regional health information exchange. They are also going to examine the effects on transition drug risk, adverse drug events, and total inpatient costs.

The study set up in two inpatient units at the JJP-VA has assigned the first group of patients to a group to receive the usual medication reconciliation. The second group is assigned to a group where the RHIO enhanced medication reconciliation information is also available and if applicable, the patient’s non-VA medications will be studied.

For more information on the project (IIRIO-146) starting 2011 and ending 2014, email Kenneth Boochvar at the James J. Peters VA Medical Center at Kenneth.boochvar@mssm.edu or call (718) 584-9000.

Hemophilia Funding & Research

2011-12-17T16:11:00.001-05:00

HRSA is looking for applicants to develop the “National Hemophilia Program Coordinating Center” (NHPCC). The Center’s goal is to provide for an integrated and collaborative Regional Hemophilia Network (RTN) to help individuals with hemophilia and related bleeding disorders or clotting disorders such as thrombophilia.

The NHPCC will evaluate the activities of the RHN grantees, provide technical assistance to RHNs on standards, examine accessibility to care, resources available, and make information on genetics and public health as it relates to hemophilia available. Advances in genetic medicine and services will be included since they directly influence the health of individuals with hemophilia or other bleeding or clotting disorders.

About $800,000 is expected to be made available for FY 2012-2014. An annual cooperative agreement will fund one awardee with $300,000 specifically for projects to be undertaken with RHN grantees. Eligible applicants can include public and nonprofit entities, including faith-based and community-based organizations, Tribes, and tribal organizations

Applications for announcement (HRSA-12-135) to develop the NHPCC are due December 30, 2011. For more information, email Kathryn McLaughlin at kmclaughlin@hrsa.gov or call (301) 443-6829. To view the announcement, released November 16th go to www.grants.gov.

In addition, NIH funding has been provided for gene therapy research to help patients with Hemophilia B. Hemophilia B is less common than hemophilia A with 1 in 5 hemophilia patients having hemophilia B while the other four have hemophilia A.

The problem is that Hemophilia B patients are unable to produce enough human clotting Factor IX also referred to as FIX, which is essential for normal blood clotting. Liver cells are the only cells in the body capable of producing a form of FIX that is active in the clotting process.

Researchers working on an experimental gene therapy technique have boosted the production of a vital blood clotting factor in six people with hemophilia B. Today, researchers are joining the FIX gene to a virus that targets liver cells.

Research teams from the University College London Cancer Institute and St. Jude Children’s Research Hospital in Memphis Tennessee have examined the effects of delivering the FIX gene to patients. Scientists inserted the FIX gene into a virus which served as the delivery vehicle for the gene therapy.

“Results from this study represent a promising step toward making gene therapy a viable treatment option for hemophilia B”, said Susan B. Shurin, M.D., Acting Director of the National, Heart, Lung, and Blood Institute (NHLBI) within NIH.

The research was partly funded by NHLBI, Howard Hughes Medical Institute, the ASSISI Foundation of Memphis, and the American Lebanese Syrian Associated Charities. Organizations in the United Kingdom such as the National Health Service, National Institute for Health Research, Department of Health, and the Royal Free Hospital are also providing funding for the research.

The research results are online in the New England Journal of Medicine and will appear in the December 22nd print edition.

Patient-Centered Care Discussed

2011-12-17T16:09:00.001-05:00

The ECRI Institute’s 18th Annual Conference “Patient-Centeredness in Policy and Practice” co- organized by FDA was held late November in Silver Spring, Maryland. The conference attendees gathered to hear presentations and panel discussions centered on defining patient-centeredness, what programs are currently working, and does patient-centeredness have staying power?

Presenters including leading policy makers such as Margaret Hamburg, MD Commissioner FDA, Carolyn Clancy, MD, Director AHRQ, Jeffrey Shuren, MD, JD, Director for Devices and Radiologic Health at FDA, Janet Woodcock, MD, Director, Center for Drug Evaluation and Research, at FDA, and Joe V. Selby, MD Executive Director for the Patient-Centered Outcomes Research Institute.

Joel Kuppersmith MD, Chief R&D Officer at the Veterans Health Administration presented a comprehensive picture of how patient-centered care is helping the veteran population. As Dr. Kuppersmith noted, the VA is a large system with 8 million enrollees and treats 6 million patients per year at 1200 sites of care.

He reported that the VA is meeting the need for patient-centered care through the use of telehealth technologies, through community-based clinics, and via secure messaging. He described how in general our current care model should transition to patient-centered care by focusing on the person’s, culture, preferences, and lifestyles.

Kuppersmith discussed how the VA’s assets are being utilized to move to patient-centered care. This is being achieved through the use of the VA’s Electronic Health Record to provide computerized decision support, the VA’s ability to access sophisticated national databases containing clinical and administrative data, the VA’s extensive experience in working with quality and performance measures, and the fact that the VA research program is embedded in the healthcare system.

To better manage care, veterans need to have a primary point of contact within the healthcare system using a team approach to manage their care, assist in coordinating their care including transitions in and out of hospitals, and provide more proactive care management if needed.

One of the VA’s assets is the Quality Enhancement Research Initiative (QUERI) that studies and facilitates the transfer of new treatments, tests, and models of care into routine clinical practice. QUERI is looking specifically at what is needed to provide patient-centered care, how to increase the options for access and empowering patients to manage their own health care and make individual treatment decisions, how to make systems and clinical improvements to support the veterans care, and determine the research needed to address specific unanswered issues.

Just recently, QUERI and the Office of Specialty Care Transformation have been funded to develop a model that emphasizes specialty care support for the “Patient Aligned Care Team” assigned to the veteran to help manage their chronic diseases.

Looking down the road, the VA wants to help veterans obtain the best and most complete care. To meet this need, the VA developed the “Million Veteran Program” (MVP) to create a genomic database over 5-7 years to provide genetic information for one million veterans in the healthcare system.

MVP is in place to provide genomic customization or treatments and treatments based on gene expression. The program’s database will have DNA specimens and link to tissue specimens, provide access to the VA EHR system, have IT capability to identify patients for a variety studies, and have the use of the latest analytical tools.

Go to www.ecri.org/Conferences/Pages/Annual_Conference_2011.aspx for more information on the Conference.

Interim CEO Appointed

2011-12-17T16:08:00.001-05:00

Diversinet Corp. has just appointed Dr. Hon Pak, a healthcare IT innovator and former American Telemedicine Association President as its interim CEO to succeed Albert Wahbe who has retired as CEO but is Chairman of the Board of Directors until March 31, 2012.

Pak, the Army’s first Chief Medical Information Officer, recently retired as CIO of the U.S. Army Medical Department, an $11 billion healthcare system with more than 60,000 employees. He also headed the Advanced Information Technology Group within TATRC. Pak a graduate of the U.S. Military Academy has a medical degree from the Uniformed Services University of Health Sciences and completed a fellowship in dermatology at Walter Reed.

Pak is recognized for the design and development of a health IT strategy around patient-centered care and as an innovator who helped transform Army Medicine into a systems-based organization. He also shaped a federal investment in EHR exchanges and HIT for active military, veteran, and civilian populations.

“Healthcare is starting to undergo significant changes, becoming more outcome-based and patient-centered,” Pak said. “Mobility will be critical for healthcare organizations to achieve this transformation.”

Pak’s military experience is especially pertinent as Diversinet is working with the Army to expand deployment of the company’s MobiSecure® technology to support the mCare telehealth program for wounded soldiers.

Screening to Protect Human Health

2011-12-17T16:06:00.001-05:00

A high-speed robotic screening system to protect human health from chemicals is being tested in the U.S. NIH, EPA, and FDA are collaborating on the project and are beginning to test 10,000 compounds for potential toxicity. Evaluating chemical toxicity has the potential to revolutionize the assessment of new environmental chemicals and enable the development of new drugs for therapeutic use.

“The robotic screening system referred to as Tox21 can rapidly assess drug toxicity and will become a powerful safety tool for protecting the American public. The system also has the potential to help bring innovative drugs to market by allowing drug developers to identify unsafe candidate drugs early,” said Janet Woodcock, M.D, Director or the FDA Center for Drug Evaluation and Research.

Scientific testing will be able to evaluate chemicals to see if they have the potential to disrupt processes in the human body to an extent that could led to adverse health effects. The compounds will be tested in the Tox21 system at the NIH Chemical Genomics Center (NCGC) which is part of the NIH Center for Translational Therapeutics housed at the National Human Genome Research Institute.

The project referred to as the National Toxicology Program (NTP) is administered by the National Institute of Environmental Health Sciences (NIEHS). A portion of the 10,000 compounds contained in the library of information will focus on pilot testing several formulations or mixtures of compounds. Each test compound will undergo a thorough chemical analysis to verify the chemical’s identity to determine the chemical’s purity, concentration, and stability. The Tox21 robot originally was purchased with funds provided by the NTP, but since that time, the robot has undergone rigorous testing since it was unveiled earlier this year.

All testing results will be available to the public through NIH and EPA chemical toxicity databases. In addition, the NIH Center for Translation Therapeutics has created a Tox21 chemical inventory browser available at http://tripod.nih.gov/tox21chem to provide additional information on the chemicals.

Go to www.niehs.nih.gov/health/assets/docs_p_z/ntp-tox21.pdf for more information about Tox21.

DOD's Private Sector Opportunity

2011-12-17T16:04:00.001-05:00

The National Defense Authorization Act (FY 10) Public Law 111-84 authorizes DOD to establish a pilot program for the Temporary Exchange of IT Personnel or referred to as the “Information Technology Exchange Program” (ITEP) pilot. The pilot enables DOD to enhance the IT and cybersecurity competencies of employees from the DOD civilian IT workforce or from their peers in the private sector. The program enables private sector employees to come on board to learn more about defense IT programs and initiatives and to share business best practices and expertise. Areas of interest include cloud computing, cybersecurity, IT consolidation, network services, IT project management, data management, and enterprise architecture.

Private sector participants may complete 3 to 12 month details at DOD with salary costs paid by their private sector employers. Since this is a pilot, participation is limited to 10 individuals enrolled in the program at any given time. At least 20 percent of the ITEP pilot participants must be from small businesses.

For more information, go to http://dodcio.defense.gov/sites/itep. The Office of the DOD CIO Management Services serves as the DOD ITEP Pilot Program Administrator. Requests to take part in the program should be submitted to askitep@osd.mil.

Improving Hospital Care

2011-12-17T16:03:00.001-05:00

The HHS sponsored “Partnership for Patients” initiative, a nationwide public-private collaboration to improve the quality, safety, and affordability of healthcare has awarded $218 million to 26 state, regional, national, or hospital system organizations to establish Hospital Engagement Networks.

The “Partnership for Patients” program has more than 6,500 partners, including over 3, 167 hospitals, along with 2345 physicians, nurses, patient advocates, 892 consumers and consumer groups, and 256 employers and unions. Plus the program includes health plans, area agencies on aging, state and federal government officials to work together to reduce the number of hospital-acquired conditions by 40 percent and reduce hospital readmissions by 20 percent by the end of 2013.

To achieve this goal, Hospital Engagement Networks funded from the CMS Innovation Center via funding from the Recovery Act will develop collaborative learning for hospitals and provide a wide array of initiatives and activities to improve patient safety.

The Networks will help to identify solutions already working to reduce healthcare acquired conditions and then spread the information to other hospitals and healthcare providers. In other words, these organizations will serve as mobile classrooms.

The Networks will be required to establish a secure web-based data collection and management portal. Through this portal, the networks will have access to hospitals measurement data and will use that information to evaluate progress and focus attention on efforts or hospitals that have yet to see improvements.

The Networks will be required to provide reports to CMS describing their activities and progress in their quality improvement efforts. These reports will be operational reports, improvement reports, and a final report to CMS at the end of the 24 month work period detailing the successes, failures, and unintended consequences, and areas of improvement in each of the ten core areas.

The funding went to the 26 Hospital Engagement Networks and include AHA, Ascension Health, Carolinas HealthCare System, Catholic Healthcare West, Dallas-Fort Worth Hospital Council Foundation, Georgia Hospital Association Research and Education Foundation, Healthcare Association of New York State, Hospital & Healthsystem Association of Pennsylvania, Intermountain Healthcare, Iowa Healthcare Collaborative, Joint Commission Resources, Inc., Lifepoint Hospitals, Inc., Michigan Health & Hospital Association, Minnesota Hospital Association, National Public Health and Hospital Institute, New Jersey Hospital Association, Nevada Hospital Association, North Carolina Hospital Association, Ohio Children’s Hospital Solutions for Patient Safety, Ohio Hospital Association, Premier, Tennessee Hospital Association, Texas Center for Quality & Patient Safety, UHC, VHA, and Washington State Hospital Association.

In addition to the Hospital Engagement Contract awards, HHS has also awarded $10 million to three firms to help the “Partnership for Patients” program achieve their goals. One of the companies Econometrica was selected to create a curriculum in patient safety and to provide support for culture change and operational implementation.

The company will develop an organizational assessment to help the participating hospitals identify their opportunities for improvement, help to set goals, and help to connect the best practices of the participating hospitals with a national faculty of leaders.

The company WeberShandwick was selected as the Beneficiary and Medical Professional Engagement Contractor. Under this contract, the company will engage Medicare, Medicaid, and CHIP beneficiaries along with their families and caregivers and others on specific activities supporting the aims of the “Partnership for Patients” program. The plan is to raise awareness of patient safety and ways to seek improvement by developing and deploying tools to help patients and families achieve smooth care transitions.

Health Services Advisory Group was selected as the Evaluation Contractor to evaluate the impact and effectiveness of the Partnership for Patients program. In this capacity, the company will be conducting an analysis of the impact of the overall program and provide an ongoing assessment of the program.

DLT Grants for Rural Healthcare

2011-12-14T06:30:00.001-05:00

USDA has just awarded their “Distance Learning and Telemedicine Program” grants for $30,172,607 to 34 states and one territory. The grants administered by USDA’s Rural Utilities Services will help fund 100 distance learning and telemedicine projects to improve access to healthcare and educational services in rural areas.

The grants for rural healthcare range from $50,000 up to two awards for $500,000. For example, the Sisters of Mercy Health System received a $500,000 telemedicine grant to provide much needed access to healthcare in some of Mercy’s most rural communities in Arkansas, Kansas, Missouri, and Oklahoma,

The grant will enable Mercy to hardwire facilities in these areas with telemedicine technology so that round-the-clock emergency coverage can be provided to hundreds of Mercy medical specialists. Earlier this year, USDA awarded Mercy a $495,926 telemedicine grant for a three-year telehome project to provide medical care to 900 people in hard-to-reach rural areas.

Other examples include funding for $108,820 awarded to the Maine Sea Coast Missionary Society to buy video equipment for a ship-based medical examining room. In Sac City, Iowa Loring Hospital was awarded $262,742 to purchase video conferencing equipment to connect their emergency room, outpatient and inpatient centers with local schools and area nursing homes.

For more information and the list of grantees, go to the December 8th USDA news release at www.usda.gov.

D.C to Be 1st 100 Gigabit City

2011-12-14T06:28:00.001-05:00

Washington D.C. Mayor Vincent C. Gray and officials from the District’s Office of the Chief Technology Officer (OCTO) announced that the first link in the D.C. government’s new high speed fiber network called D.C Community Access Network (D.C-CAN) is now live. The network link is operating with 100-gigabit-per-second (100G) service which means that the ultra-high-speed link enables last mile service providers who provide internet access to end users can take immediate advantage of low-cost services via DC-CAN.

DC-CAN the first city owned 100G network in the country was funded through an NTIA infrastructure grant as part of ARRA. The network was made possible by using Baltimore-based Ciena’s 100G technologies.

“With this 100G connection, we are making history by providing state-of-the-art network capacity that will serve the District’s economic growth well into the 21st century”, said Mayor Gray.

This network milestone makes the District the first city in the nation to build a network that is 10 times faster than typical service-provider networks available today. The network’s capacity surpasses that of other municipal networks in the country, including those in California’s Silicon Valley and other major tech hubs.

DC-CAN is positioned to deliver cost-effective “middle-mile” services at ultra-high capacity to government entities and private-sector internet service providers well into the future.
“As internet use moves toward video and other data-intensive applications, this network is well positioned to support such next-generation apps without the need for further infrastructure upgrades for at least a decade,” said D.C Chief Technology Officer Rob Mancini.

The link is bringing affordable high-speed broadband services to residents and businesses in the underserved areas of the District with adoption rates of less than 40 percent. These areas include 24 community anchor institutions such as healthcare, education, and public safety facilities where DC-CAN connectivity is operational. The 100G backbone links are expected to be complete in Wards 5, 7, and 8 within the next six months and will extend to every ward in the district by June 2013.

Improving DOD Program Coordination

2011-12-14T06:26:00.001-05:00

More than 200 programs available through DOD help military members and their families with psychological health and TBI issues, but according to a new RAND Corporation study, better coordination is needed between programs.

The report “Programs Addressing Psychological Health and TBI Among U.S. Military Service Members and Their Families” compiles a catalog of programs sponsored or funded by DOD. The research was done by the RAND Center for Military Health Policy Research as a joint effort with RAND Health and the RAND National Defense Research Institute.

Between 2001 and the end of 2010 more than 2.2 million military members were deployed in Iraq and Afghanistan. Despite the recent drawdown in Iraq, the high operational tempo of the past decade has included longer and more-frequent deployments resulting in significant mental health problems.

The RAND study is the first to fully catalog all support programs for psychological health and TBI as well as assess how such efforts compliment traditional service providers and routine care. The study identified 211 programs but found no single source with DOD or service branches that maintain a list of these programs or track new program developments.

RAND researchers say DOD should conduct a comprehensive needs assessment to identify how many service members and their families require services, what their characteristics are, what types of assistance they need, where they are located, and detail the clear and strategic relationships between programs and existing clinical care systems. DOD should then identify how well these programs are meeting those needs, what opportunities exist to improve current programs, and where the need exists to develop new programs.

The RAND study also recommends that DOD identify a central authority to be responsible to coordinate programs between service branches and within the Office of the Secretary of Defense. This central authority would also handle efforts to evaluate program effectiveness and would also continue to track these programs.

“The effectiveness of these programs is not being consistently evaluated,” said Carrie Farmer, a study co-author and a RAND associate policy researcher. “Less than one-third of the programs in any branch of service have reported having an evaluation to assess their effectiveness in the past 12 months.”

For more information on the study, go to www.rand.org.

Wireless Technology to Help Seniors

2011-12-14T06:25:00.001-05:00

Independa introduced Artemis™ a collection of wireless health, safety, and activity sensors that are part of the company’s integrated telecare solutions to help the elderly remain independent longer with greater health and well-being. Artemis was introduced at the 2011 mHealth Summit recently held in the Washington area.

Artemis will be fully integrated with and complement Independa’s Caregiver Web App and Angela™. Artemis connects sensors to monitor vital signs, safety and home conditions via a wireless hub to Independa’s cloud solution. Care providers will use the Caregiver Webb App to create automatic reminders to track care recipients remotely. The Independa Angela, a personal interaction device for the care receiver will also be used

Independa’s new integrated monitoring solution is tailor-made for the non technical elderly. Running as an out-of-the box power and play suite of home sensors, Artemis will support a custom package of monitors preconfigured to the individual’s activities and daily challenges.

Artemis will offer wireless sensors and connectivity to the internet where Independa will aggregate information collected from the in-residence sensors. Users won’t need to worry about pairing or matching devices with a wireless hub or computer because the sensors will be paired prior to shipment.

“Independa Artemis, in conjunction with other cloud-based integrated telecare offerings, delivers on our vision of providing Independa customers and channel partners the most integrated solution for supported independence,” said Independa CEO Kian Saneii.

To support the project, Independa is going to partner with Boston Life Labs LLC and Artemis will include the Boston Life Labs Smart Medical Home Hbox Hub and other plug-and play wireless telehealth sensors.

Independa Artemis is scheduled for beta testing in February 2012 and will be available in the second quarter of 2012 and will be sold through Independa partners.

For more information, go to www.independa.com/artemis.

RFP Seeks Proposals in D.C Area

2011-12-14T06:22:00.001-05:00

Quality Health Foundation (QHF), the mission arm of Quality Health Strategies (QHS), seeks applications for their 2012-2013 grants from organizations in Maryland and the District of Columbia. QHS subsidiaries Delmarva Foundation for Medical Care and Delmarva Foundation of the District of Columbia located in the area are quality improvement organizations for CMS. The main objective is to help underserved and vulnerable populations in the region.

Over the last three years, the Foundation has awarded $700,000 to 20 organizations and in 2011, $392,438 was awarded to twelve organizations in Maryland and D.C. QHF will award grants totaling $400,000 to eligible organizations that can demonstrate improved healthcare delivery, quality, and measurable outcomes from a consumer perspective.

This year grants for up to $50,000 will go to faith-based groups, healthcare providers, educational institutions, community-based non-government organizations plus other organizations and individuals

Specifically, the projects should increase healthy lifestyles and quality of life, increase access to culturally and linguistically appropriate care, implement consumer-centered care and decision-making, improve disseminate health-related information, and improve patient safety.

Applications are available at www.qualityhealthfoundation.org and will be accepted through January 18, 2012 with awards to be announced June 2012.

Free App to Improve Patient Care

2011-12-14T06:20:00.001-05:00

Silicon Valley’s El Camino Hospital, an acute-care 542 bed, not-for-profit and locally governed organization located in Mountain View and Los Gatos, California, has launched its first mobile application. The free app created for healthcare decision makers also known as Family Medical Officers (FMO) to use in the home and provides FMOs with accurate medical information anywhere, anytime to help make decisions. The app can be downloaded for free on Android devices, on Apple iPhones, iPod Touches, and iPads.

The app has several features:

• Wait Times in ERs—The app provides current wait times for El Camino Hospital’s emergency rooms in Mountain View and Los Gatos. Users can dial 911 with the touch of a button, as well as view a checklist of things to bring with them to the ER

• Locating a Doctor—Users can search for an El Camino Hospital physician by name, specialty, or location

• Track medical histories—FMOs can keep track of their families medical histories for diagnosis and for information purposes with a password protected tool

• Information on hospital resources—Offers access to a comprehensive health library, plus a drug reference and health encyclopedia

• Visits to the hospital—Provides access to turn-by-turn directions to the hospital, provides campus maps, visiting hours, and other useful information

• Information on news and events—The tool provides access to the most up-to-date news via the hospital’s RSS feed, Facebook page, YouTube page, and Twitter feed

To further the use of technology in the hospital setting, the hospital’s Center for Technology Integration (CTI) created in 2008, is always looking for new technologies, new inventions, and new ways to use established technologies.

CTI in working with companies in the communities surrounding the hospital and acts as a single point of contact for companies developing new technologies. CTI can also help to identify opportunities for partnerships.

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

Save the Date March 15-16

2011-12-14T06:18:00.002-05:00

The Mid-Atlantic Telemedicine Resource Center Summit in conjunction with the Virginia Telehealth Network is going to present a premier event on March 15-16, 2012 at the University of Virginia’s Darden School of Business. Leading telehealth resources plus experts and programs throughout the mid-Atlantic region and the nation will be on hand for presentations and discussions.

There will be opportunities to hear from national leaders on telehealth policy and resources, to explore a broad range of innovative new technologies and approaches to telehealth, to formulate strategies to remove barriers to application, and to collaborate with experts in a broad number of areas.

Featured keynote speakers are:

• Marilyn Travenner, Acting Administrator for CMS
• Aneesh Chopra, Assistant to the President & Chief Technology Officer and Associate Director for Technology within the Office of Science & Technology Policy

Go to http://hosted-p0.vresp.com/981175/d6768dede5/ARCHIVE for more details or contact Eric Swensen at (434) 924-5770.

FCC's Future Health Strategies

2011-12-11T06:28:00.001-05:00

Julius Genachowski FCC Chairman speaking at the 2011 mHealth Summit Keynote Luncheon stressed the need for productive partnerships and continued innovation in connected health. Just six weeks ago, the FCC acted to modernize the Universal Service Fund, the federal program used to support communications networks in rural areas.

As reported, the multi-billion dollar program was transformed to the new “Connect America Fund” to support universal broadband. The result is that over the next six years, seven million more rural Americans will be connected to broadband.

An important issue involves effectively and efficiently managing spectrum. The FCC’s National Broadband Plan set a goal to unleash 500 megahertz of spectrum for mobile broadband by the year 2020. To help reach that goal, the FCC has proposed voluntary incentive auctions.

Under this plan, spectrum licensees like broadcasters would voluntarily supply spectrum into an auction. The broadcasters would get a share of the proceeds from the auction and mobile providers would get large blocks of beachfront spectrum to use to deploy mobile broadband.

As Genachowski noted, unlicensed spectrum is important for devices that are surgically implanted in the body to treat disorders such as pancreatitis and enables mobile devices to function more efficiently. In addition, FCC has been looking for ways to harness the benefits of unlicensed spectrum including TV “white spaces”, which could enable new technologies like Super Wi-Fi to cover larger areas than traditional Wi-Fi.

Another issue involves helping mobile app or device developers find new ways to use spectrum either through new technologies like sensing and dynamic spectrum access or by allowing the expanded use of spectrum on a secondary basis.

Last week, the FCC adopted rules to provide access to spectrum for medical micropower networks that promise to dramatically help individuals who suffer from spinal cord injuries, TBI, strokes, and various neuromusculoskeletal disorders.

The FCC recognizes that certain types of medical devices need access to specific parts of the spectrum under provisions that are specifically tailored for them. For example, the FCC has provided spectrum for wireless medical telemetry devices that are used to monitor patients in critical care units. Spectrum is also provided for implanted medical devices where radio is used to reprogram cardiac pacemakers and defibrillators and for medical communications services.

The Chairman reports that the FCC plans to adopt rules to provide access to spectrum for medical body area networks in the 2360 to 2400 MHz band. These networks can be used to wirelessly interconnect a network of extremely low-powered sensors on the body so that patients will no longer be hooked up to a set of wires that anchor them to monitoring equipment.

The FCC is moving ahead on several issues. The plans are to improve and expand the experimental licensing program, propose easing testing restrictions on universities and research organizations, and develop a new program to speed development of new health-related devices.

CHCF to Help Labs Exchange Orders

2011-12-11T06:25:00.002-05:00

The California HealthCare Foundation (CHCF) has $300,000 available for six to eight grant awards to implement and test the exchange of laboratory orders using the EHR-Lab Interoperability and Connectivity Specification (ELINCS) Orders.

At the end of the grant period, CHCF expects participating organizations to have fully implemented ELINCS Orders and to be delivering real-time electronic lab orders from ambulatory EHRs to lab information systems. CHCF also expects to demonstrate the impact of the real-time communication of lab data on patient care processes and ideally on clinical outcomes.

CHCF’s goals for this initiative are to:

• Implement the ELINCS Orders specification to deliver laboratory orders to close the communication loop between ambulatory EHRs and laboratories
• Receive feedback from ELINCS Orders pilot implementations to improve the specification enable widespread adoption
• Facilitate adoption of ELINCS Orders by organizations nationally
• Demonstrate models for adoption in diverse settings
• Demonstrate the benefits for communicating lab data electronically
• Support national efforts to standardize the electronic exchange of lab data

Applicants for the grants can be ambulatory care provider organizations, community clinics, clinical laboratories that service ambulatory care provider organizations, HIEs, Health IT vendors, health plans, local initiatives, and county-organized health systems.

As this project will require significant collaboration between provider organizations, clinical information system vendors, and laboratories, CHCF anticipates that organizations will partner on their RFP applications.

The RFP was released December 5, 2011 and a Conference call is scheduled for December 19, 2011 at 10AM. Questions must be submitted by December 30, 2011 with proposals due on January 17, 2012.

To view the RFP, go to www.chcf.org/rfps/2011/rfp-elincs-orders?view=print. For more information, email Glen Moy, Senior Program Officer CHCF at gmoy@chcf.org or call (510) 587-3134.

Aventyn Announces Clinical Study

2011-12-11T06:22:00.001-05:00

The Cleveland Clinic estimates between 500,000 and 900,000 new cases of heart failure are diagnosed each year in Medicare patients leading to 200,000 deaths and one million hospitalizations annually. Readmissions for heart failure patients occur at a rate of over 27% after the first 30 days of discharge with more than half of that percentage readmitted over the course of the next 180 days to 12 months with overall costs estimated at $20 billion.

A study announced at the recent 2011 mHealth Summit will help to more effectively manage heart failure. Aventyn® a provider of remote patient monitoring and chronic disease management solutions is conducting a Remote-HF-1 Mobile Heart Failure Clinical Study.

The study is geared to help heart failure patients use “Vitalbeat” a specially designed patient adherence and monitoring software available in standard mobile devices. The study is being sponsored at international heart centers in collaboration with BMS Hospital Trust in India, AT&T Healthcare, University of California, and Zephyr Technology.

This international multi-center study is uniquely positioned to assess different health systems and infrastructures across nations on three continents for the very first time. It is also the first study aimed at testing the feasibility of mobile device monitoring in a representative sample of at-risk patients that does not involve paper, telephone, or web based technology that uses mobile-based remote monitoring. The patient-entered data and vital signs captured from medically certified devices and biosensors are instantaneously available on the software monitored at the physician’s end.

A total of 65 patients have been recruited from five centers across three continents. The patients at each center have been provided with mobile smartphone devices activated by a local mobile service provider. Additionally, clinicians and study coordinators are able to use tablet computer monitoring that provides immediate access to the information. Automated blood pressure monitoring apparatus, weight scales, and Bioharness™ wearable monitors are being used by patients to send vital sign data along with diet, medication adherence, and activity levels to the monitoring clinician.

The primary objective for Phase1 is to evaluate the study in terms of reliability and to provide seamless data transmission. Principal Investigator Dr. Satish Govind, MD, PhD reports that Phase 2 to take place in 2012 will be an interventional trial with a significantly larger patient enrollment, use more sophisticated vital sign sensor devices, plus the next phase will use cloud data sharing to manage long term preventive and wellness programs.

For more information, contact Puja Chandler at +1.858.232.2698 or email puja@aventyn.com.

Attaining Security Milestone

2011-12-11T06:20:00.001-05:00

Today, there are growing issues related to mHealth security and how healthcare organizations can overcome the challenges. The technology underpinning Diversinet’s MobiSecurity® applications supporting mobile healthcare has passed a security key milestone on the way toward earning a governmental stamp of approval for safeguarding highly sensitive patient information.

Diversinet’s technology has been placed on an important list that qualifies and evaluates the technology for how stringently it can protect patient records and mobile correspondence via secret encoding of information.

The company’s implementations of the cryptographic algorithms already have been successfully validated by NIST in the US. As a result, the Java cryptographic modules used in MobiSecure are now on a list for the Federal Information Processing Standards Publication (FIPS) 140-2 Security Requirements for Cryptographic Modules specifying the requirements used to protect sensitive information.

The Cryptographic Module Validation Program the accreditation program validating cryptographic modules is a joint effort between NIST and the Communications Security Establishment in Canada.

Cryptographic modules validated through the program are subjected to rigorous testing by independent and accredited Cryptographic Module Testing Laboratories. FIPS-2 validation is particularly important for government agencies, medical device manufacturers, and pharmaceutical companies to achieve since validation is required for any cryptographic product to be used in a U.S. government agency network.

Diversinet’s inclusion in FIPS 140-2 is very important since the organization provides patented and proven secure products to enable healthcare organization to rapidly deploy HIPAA-compliant mobile health applications to anyone, anytime, and anywhere, on mobile devices

“Our inclusion in FIPS 140-2 reaffirms that the technology underlying our MobiSecure mHealth application meets stringent government requirements for storing and sharing sensitive personal health information via mobile devices,” said Albert Wahbe, Diversinet Chairman and CEO.

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

AMIA Holds Health Policy Meeting

2011-12-11T06:18:00.001-05:00

AMIA an association for informatics professionals addressed the shortcomings of clinical data capture and documentation at their 6th Annual Health Policy Meeting in Washington D.C Today, users often experience significant frustrations with data overload, documentation redundancies, and data entry inefficiencies.

Edward H Shortliffe, MD, PhD and AMIA President and CEO emphasized that from personal experience, he can attest that entering patient data and often following non-intuitive series of screens or clicks can be a source of tremendous frustration and inefficiency for busy clinicians.

More than 80 participants including leaders from various Federal government agencies and private sector organizations involved in expanding the use of informatics and health IT attended AMIA’s invitational health policy meeting. The participants presented their vision for achieving the ideal future state of technology enabled data capture and documentation. Participants also worked on AMIA’s proposed guiding principles for clinical data capture and documentation and proposed attributes for high-quality clinical information.

The meeting participants took into consideration multiple new policies, regulations, and initiatives that exist in our current Federal environment that affect data capture and documentation. Some of these recent initiatives include state health information exchanges, regional extension centers, beacon communities, state-based health insurance exchanges, meaningful use incentives implementation, developing standards and certification criteria for EHRs, ONCs Query Health initiative, and FDA’s proposed guidance of mobile medical apps.

AMIA Board Chair-Elect Gil Kuperman, MD PhD and Director for Interoperability Informatics at New York-Presbyterian Hospital noted that it is very important to consider the strengths and weaknesses of current approaches to clinical documentation and data capture from multiple stakeholder perspectives in order to identify knowledge gaps and research priorities.

As a result of this meeting, AMIA plans to compile the information from the meeting and produce a summary report with policy and research recommendations. The next step is to develop a short range action/research plan of two to three years and then disseminate the findings and work products through various channels.

Go to www.amia.org/meetings-and-events/2011-annual-health-policy-invitational-meeting for more information. For questions, email Meryl Bloomrosen at meryl@amia.org.

Connecticut Calling for Pilots

2011-12-11T06:16:00.002-05:00

Connecticut’s Department of Public Health seeks pilot sites to participate in the early development of the Connecticut Health Information Technology and Exchange (HITE-CT). The plan is to find healthcare provider organizations capable of developing early deployment sites to help refine the HITE-CT. The funding request seeks pilot participants from a variety of hospitals and from both large group practices small group practices.

Priority awards will be made to organizations that can offer real-world interoperability use-cases and to stakeholders that will build out the HIE. Also needed is expertise on testing and deploying new and emerging health information technologies including standards in use by HITE-CT.

The candidates for the pilot sites must be able to help the HITE-CT establish and test production connections, review operational workflow options and processes, review and refine security and privacy protections, provide feedback to HITE-CT, develop and test clinical use cases, and provide input to the Exchange on standard operating procedures.

Go to www.ct.gov/dph/cwp/view.asp?a=3936&q=462958&dphNAV=%7C46940%7C for more information. Proposals need to be submitted by December 21, 2011. For questions, email Lori Reed-Fourquet at lfourquet@ehealthsign.com.

HHS Secretary Touts Innovation

2011-12-07T06:30:00.002-05:00

HHS Secretary Kathleen Sebelius kicked off the “2011 mHealth Summit and Exhibition” held December 5-7 at the Gaylord National Resort and Convention Center located in the Washington D.C. area. She told the crowd, innovation must speed up to improve our capability to provide the right information at the right time to both patients and physicians. In the HHS report released November 30th, she reports that doctors adopting health IT has doubled in two years and is scheduled to triple in the future. She emphasized that the Obama Administration has been a catalyst in helping doctors achieve EMR adoption.

Secretary Sebelius focused on how the present administration has accelerated the use of health IT and how exciting it is to be able at this time to expand the use of mobile technologies and constantly see new products and apps in the marketplace.

The Secretary described some of the recent innovative apps that have been developed such as the National Cancer Institute’s app to help teens quit smoking by enabling teens to use their constant companion the mobile phone. SmokefreeTXT a free text message cessation service provides 24/7 encouragement, advice, and tips to teens to help them quit smoking.
D.C.,

Another app Text4Baby is helping pregnant women with data and information reports that women using their cell phones and the Text4Baby app are highly satisfied and 75.4 percent report that Text4Baby messages let them know at an early stage about medical warning signs.

Another innovative app is helping women in danger. The Secretary stressed that women face the highest rates of dating violence and sexual assault and many of these assaults occur when women are in college, As a result, the HHS program Challenge.Gov produced apps with possible solutions to the problem.

The winning app in the Challenge.Gov program developed “On Watch” an iPhone app enabling users to send emergency information by phone, email, by texting to their friends and by using social media. Another winning app was “Circle 6” a mobile app that makes it quick and easy to reach your circle of friends and let them know where you are or if you need help.

The 2011 mHealth Summit “Shaping the Future of Mobile Health” conference was presented by the Foundation for the National Institutes of Health in partnership with mHealth Alliance, mHIMSS, and NIH. For more information, go to www.FNIH.org.

HRSA Announces Demo

2011-12-07T06:28:00.001-05:00

HRSA has posted the funding announcement for the “Critical Congenital Heart Disease (CCHD) Newborn Screening Demonstration Program”. The demonstration will increase the number of newborns screened for CCHD prior to discharge from newborn nurseries by using validated screening protocols plus the demonstration will also improve the state newborn screening infrastructure. The plan is to create or build upon the state’s infrastructure to collect and use information from various hospitals within a HIE for the detection of CCHD and related patient follow-up and outcomes.

The funding announcement seeks to:

• Help state, local public health agencies, and hospitals provide screening and counseling and then link the results of CCHD screening to obtain needed follow-up healthcare services. Also perform the necessary quality assurance, outcomes analysis, and other public health surveillance functions

• Provide healthcare professionals and newborn screening program personnel with education in newborn screening and training in relevant new technologies for critical congenital heart disease

• Develop and deliver education programs on critical congenital heart disease, newborn screening, counseling, testing, follow-up treatments, and specialty services to parents, families, and patient advocacy and support groups

• Establish, maintain and operate a system to coordinate and assess screening programs and follow-up relating to critical congenital heart disease

If funding is available this program expects to provide funding during FY 2012 to 2014. About $2.1 million is expected to be available annually to fund up to seven grantees. Applicants may apply for a ceiling amount up to $300,000 per year.

Eligible applicants can include states or a consortium of two or more states, a territory, a health facility or program operated in connection with a contract or grant from the Indian Health Service, or any other entity with expertise in newborn screening.

The application deadline is January 17, 2012. For more information go to www.grants.gov or email Debi Sarkar at dsarkar@hrsa.gov or call (301) 443-0959.

HL7 & Regenstrief Working Together

2011-12-07T06:26:00.001-05:00

HL 7 the global authority on standards for interoperability for health IT with members in 55 countries and the Regenstrief Institute a healthcare and informatics research organization are working together to develop and extend standards in the industry.

LOINC is a universal code system developed by Regenstrief to identify laboratory and clinical observations. When used in conjunction with the data exchange standards developed by HL7, LOINC’s universal observation identifiers make it possible to combine test results, measurements, and other observations from many independent sources. Together, they facilitate exchange and pooling of health data for clinical care, research, outcomes management, and for other purposes.

LOINC began in the mid 1990’s when Regenstrief investigators, using their decades of experience with EMRs began the Indiana Network for Patient Care (INPC), the nation’s first citywide HIE. The researcher clinicians found that they could receive data from various INPC member institutions but that the clinical content was difficult to interpret because each used a different code for the same test or observation so it was like receiving messages in French, Spanish, and Italian when all they could understand was English.

LOINC was born from the desire to develop a working language. From the beginning, it has been a free and open system encouraging additions, comments, and feedback. Two new versions of LOINC are issued annually with more than 2,000 new terms for tests or clinical observations per release. These new additions are based on requests from end users.

“Rengenstrief has been a long-standing contributor to the standards developed by HL7 and LOINC has been enhanced by its adoption in HL7’s standards,” said Daniel Vreeman, Associate Director of Terminology Services at the Institute. “With this agreement, we look forward to an even closer collaboration with HL7 to improve the semantic interoperability of health data exchange worldwide.”

Qualcomm Announces Spin-Off

2011-12-07T06:24:00.001-05:00

Qualcomm in spinning off Qualcomm Life has launched the 2net ™ Platform to help medical device companies overcome some of the challenges experienced with wireless implementation. Qualcomm’s announcement was made at the 2011 mHealth Summit “Shaping the Future of Mobile Health” just concluding at the Gaylord National Resort and Convention Center.

Qualcomm’s Life’s 2net Platform and Hub are designed to interconnect wireless medical devices via cloud-based solutions so that biometric information is easily accessible by device users, by healthcare providers, and caregivers and able to transfer, store, convert, and display medical device data.

“Qualcomm Life’s 2net Platform will be able to provide a direct wireless connection within every home,” stated Richard Strobridge, Chief Executive Officer of Entra Health Systems. “Integration with the 2net ecosystem will open up new markets for MYGlucoHealth wireless blood glucose meter and diabetes management system within senior care, home health care, and help in assisted living facilities where there may be limited access to wireless technology.

Additionally, Qualcomm has formed a $100 million Qualcomm Life Fund managed by Qualcomm Ventures to accelerate wireless health technologies and services. The Fund will specifically focus on wireless health business initiatives that will help accelerate 2net Platform adoption and the adoption of other wireless health initiatives.

Qualcomm Ventures has already invested in five wireless health companies that includes Sotera Wireless, Telcare, AliveCor, Cambridge Temperature Concepts and WorkSmart Labs and now these companies are part of the fund.

Areas of specific interest to the Qualcomm Life fund range from personal wellness to disease management and include:

• Biosensors or devices for vertically focused applications like chronic disease care, medication compliance, and fitness or wellness

• Integrated system providers that provide remote diagnosis or monitoring or specialize in independent living

• Software health IT applications

• Health related informatics/analytics

To watch a video explaining the 2net Platform, go to www.qualcommlife.com.

Disabled Need Wireless

2011-12-07T06:23:00.001-05:00

Georgia Tech and the Shepherd Center were awarded $4.75 million for a five year grant from the U.S. Department of Education’s National Institute on Disability and Rehabilitation Research (NIDRR) to research and develop wireless technologies to help people living with disabilities. This grant award is the third consecutive five-year grant awarded to the team of researchers and will continue the ongoing research and engineering at the Wireless Rehabilitation Engineering Research Center RERC a collaborative effort between Shepherd Center and Georgia Tech.

“This funding will allow us to move into new and emerging areas and leverage our relationships with the wireless industry, disability organizations, governmental agencies, and other researchers and engineers to promote equitable access to wireless technologies and to develop new assistive technologies build on wireless platforms,” said Helena Mitchell, Executive Director of the Center for Advanced Communications Policy at Georgia Tech’s School of Public Policy and Principal Investigator and Co-Director of the Wireless RERC grant.

The Wireless RERC is going to launch a new incubator to develop software apps. The Apps Factory will fund innovative internal and external ideas on a competitive basis to provide apps to people with disabilities across a wide range of platforms. This research should help build new assistive tools based on “smart” wireless platforms.

In addition, the Wireless RERC will continue to work to find better solutions to provide better access to 911 emergency services. This research focusing on wireless use to help consumers with disabilities may also help shape the development of public policy primarily related to general accessibility and emergency communications.

“We are pleased that NIDRR continues to support the wireless RERC’s important work,” said Mike Jones, Director for Shepherd’s Crawford Research Institute and Co-Director for the Wireless RERC grant. “The rapid pace at which wireless technology has evolved over the past several years and is expected to accelerate in the future, requires ongoing efforts to ensure that the accessibility needs of people with disabilities are incorporated into new technologies.”

HP Streamlining State Process

2011-12-07T06:21:00.002-05:00

HP has been asked by the North Carolina Division of Medical Assistance (DMA) to integrate claims processing for the North Carolina Health Choice program with the State’s current Medicaid Management Information System (NC-MMIS). The integration will enable providers to use a single system to submit both Medicaid and Health Choice claims.

The plan is to make the claims processing for providers as well as for agency administrators easier to use. HP will be processing claims valued at more than $250 million annually for the 260,000 children enrolled in North Carolina Health Choice.

By integrating the systems, the state and providers will have several benefits:

• Enable providers to use a single system when submitting both Medicaid and Health choice claims, and also streamline oversight and administration for Health Choice

• Providers will have 24/7 access to Health Choice eligibility verification as well as provider remittance reports

• Pharmacists will have 24/7 access to an interactive, real-time pharmacy claims processing system along with drug alerts to protect patients

• Improved insight into claims data through the NC-MMIS

“States today must maximize the value of existing technology to improve cost and resource efficiency,” said Melissa Robinson, North Carolina Account Executive for HP Enterprise Services. “Dr. Gray, North Carolina Medicaid Director and the DMA have worked tirelessly with HP over the past six months to ensure the success of the NCHC integration, motivated by their desire to enhance the health of North Carolina’s children.

AHRQ Collaborating With NSF

2011-12-04T06:26:00.001-05:00

AHRQ in collaboration with the National Science Foundation (NSF) seeks “Advancing Health Services Through System Modeling Research” proposals as they relate to health services. Through this partnership, AHRQ and NSF will foster new collaborations with researchers along with industrial and systems engineers to support the role of health IT. Over the last several decades there has been particular interest in applying the tools and techniques in industrial and systems engineering to improve the system.

The Institute of Medicine and the National Academy of Engineering have recently called for increased application of industrial and systems engineering tools to improve the healthcare delivery system but so far there has been limited impact by industrial and systems engineering on health services research and practice.

AHRQ and NSF conducted a workshop in September 2009 in which experts in both health service research and industrial systems engineering convened to explore the critical areas of research at the intersection of both fields while trying to fully understand the role that health IT should play. The workshop produced a vision where both engineering and patient-centered care would emerge as an integrated system addressing a global multi-cultural growing and aging population by incorporating systems engineering concepts.

Proposals will be accepted from January 15, 2012 to February 15, 2012. The estimated number of awards will be 3 to 6 with total funding amount estimated to be $1,000,000 to $2,000,000.
Go to www.nsf.gov/pubs/2012/nsf12515/nsf12515.pdf for more information.

NITAAC Helps Buy IT

2011-12-04T06:25:00.001-05:00

The health IT market is going to provide great opportunities for government programs and the health IT industry over the next several years. The government health IT market needs products and services, IT/Security/Privacy professionals, subject matter experts, business process management consultants, and trainers to assist with the complexity of e-government services. Plus expertise in interoperability, data exchange, research, and management consulting will all be needed.

The “NIH Information Technology Acquisition and Assessment Center” (NITAAC) deals with two Government-Wide Acquisition Contracts called GWACs to help NIH buy IT faster. NIH labs and offices come to NITAAC when they need standard or customized IT products, services, and solutions. On the other end, NITAAC has pre-screened highly qualified companies that have already been verified for integrity and expertise.

Products and services can include computers, servers, IT-related products for the lab or office, routine or customized software, plus customized health IT solutions for laboratories and extramural programs.

The NITAAC program presently offers two GWACs that includes “CIO-SP2i” to be used for IT services/solutions requiring customized programming or applications such as data capture research analytics, cloud computing, or IT consulting. The other GWAC is ECS III is to be used for products/services such as hardware, software and peripherals or warranty services.

Using GWACs benefits NIH since the products are priced lower than in the open market and services are at competitive pre-competed prices and can be negotiated lower, awardees can be selected based on their best value criteria, customized terms and conditions relevant to the task or delivery order can be easily added, and no special “Delegation of Procurement Authority” is needed from NITAAC to use GWACs or online systems.

Also expected in early 2012 is the CIO-SP3 Small business award. The CIO-SP3, is a ten year multiple award, indefinite-delivery, indefinite-quality contracts with a $20 million ceiling that can be used by a federal agency to satisfy IT requirements that focus on small businesses.

The CIO-SP3 features ten tasks areas including IT services for biomedical research, health sciences, and healthcare, support for CIO, imaging outsourcing, IT operations and maintenance, integration services, critical infrastructure protection and information assurance, digital government, enterprise management systems, and software development.

NITAAC is planning ahead to find cloud-based solutions even though right now some of the agencies are struggling with an appropriate cloud strategy. Right now, NITAAC has information on their contract holders that have expertise and experience with cloud computing and therefore these contractors are in now in position to help agencies find cloud solutions and develop cloud strategies.

For more information on health IT services and products within NIH go to http://nitaac.nih.gov or email Mary Armstead, Program Director at ma19d@nih.gov.

FCC Initiating CAF

2011-12-04T06:22:00.001-05:00

The FCC is overhauling both the FCC’s outdated universal service and Intercarrier Compensations systems into a new “Connect America Fund” (CAF), to connect all Americans to broadband. CAF will put the country on the path to universal broadband and advance mobile coverage without increasing costs.

The CAF has an annual budget of no more than $4.5 billion, the same as the current universal service funding level and is expected to help connect 7 million to high-speed internet and voice in rural areas over the next six years. This FCC Order is taking into account the growing importance of mobile broadband and makes it an independent universal service objective for the first time. Support to expand mobile broadband nationwide to tens of thousands of road miles will be provided through a new Mobility Fund

At the same time, the FCC is phasing down antiquated and opaque regulated charges for the exchange of voice traffic among carriers known as Intercarrier Compensation. Now, there will be a simplified uniform “bill-and-keep” framework which removes hidden subsidies on consumers’ bills, increases efficiency, and eliminates impediments to the deployment of modern networks.

Company Receives FDA Clearance

2011-12-04T06:20:00.001-05:00

Aptus Endosystems, Inc, the developer of an advanced technology for Endovascular Aneurysm Repair (EVAR), has received 510(k) clearance for the Aptus EndoStapling System known as the HeliFX™ Aortic Securement System. The system enables independent endograft fixation and is designed to mimic the hand suturing performed during open surgical repair of Abdominal Aotic Aneurysms (AAA).

Each year, an estimated 200,000 people in the U.S. and 100,000 people in Europe are diagnosed with AAA. EVAR is an alternative to open surgical repair of AAA, when a minimally invasive catheter-based system is used to implant a metal and fabric endograft to isolate blood flow away from the aneurysm to prevent potential rupture and death.

The system provides physicians with a novel technology to repair endovascular grafts that have migrated away from the implant site, have developed endoleaks, or are at risk of developing these complications which are commonly seen after EVAR. In such cases, augmented fixation and/or sealing is required to regain or maintain effective aneurysm exclusion. The system can also be used during initial EVAR procedures to enhance an endograft’s inherent fixation and sealing mechanisms.

To make the decision, FDA reviewed the data available from 154 patients who were implanted with 810 EndoStaples and were monitored with routine follow-up CT scans. After a year, none of the EndoStaples had fractured and none of the patients experienced endograft movement, but one patient did need an additional intervention to address an endoleak.

“The FDA clearance of the system is a major milestone for Aptus and a significant technological advancement in the field of EVAR,” said Jeff Elkins, CEO for Aptus Endosystems. “The intuitive physician-directed implant technique and HeliFX’s ability to be used with market-leading endografts have the potential to clinically benefit a large number of patients who otherwise have few proven treatment alternatives.”

NIH's Device to Treat Eyes

2011-12-04T06:18:00.001-05:00

NIH has developed a prototype medical device to administer therapeutics into the eye to treat a variety of ocular diseases and is now looking for research collaboration and commercialization partners to further develop the medical device. The device will be able to treat diabetic retinopathy, retinal vein occlusion, and macular degeneration.

The device is a dual function needle that can inject and sample ocular fluid at the same injection site. The needle includes a hub portion in communication with a needle portion through a lumen that may be used as a conduit to inject a therapeutic into an injection site. A sample chamber, with an optional absorbent material is disposed in the lumen capable of absorbing intraocular fluid via a passive filling action into the sample chamber.

The research on the device was done by the National Eye Institute and the National Institute for Biomedical Imaging and Bioengineering inventors. The HHS Reference Number is E-233-2010/0 and the Provisional patent application number is 61/533,908 filed September 13, 2011.

For more information on licensing information, email Michael Shmilovich at shmilovm@mail.nih.gov or call (301) 402-0220. For collaboration opportunities email Alan E. Hubbs, PhD at hubbsa@mail.nih.gov or call (301) 594-4263.

Research to Help Children

2011-12-04T06:17:00.001-05:00

The Georgia Institute of Technology and IBM are working together on a new research initiative to apply advanced systems modeling and large-scale data analytics capabilities to integrate disparate health data. Partnerships with Emory University, Children’s Healthcare of Atlanta, Georgia Cancer Coalition, and the Georgia Department of Community Health will initially focus on children suffering from diabetes, asthma, and autism.

The project called “One Million Healthy Children” (1MHC) will focus on two specific challenges healthcare providers face. First, the current fee-for-service model in the U.S. means payment for action rather than for outcomes regardless of treatment effectiveness. 1MHC will adopt techniques from IBM’s services research portfolio to model economic, incentive, treatment, disease, and other factors that affect healthcare decisions to find practices and policies that will shift the focus of pediatric care from disease treatment to long-term wellness and disease prevention.

The second challenge is that healthcare can be affected by myriad factors such as transportation, health services, socio-economic status, food resources, educational attainment, but yet solutions aren’t always available due to the lack of information and specific data. The project will address these factors.

Another major factor concerns dealing with the necessary variety and the amount of data presented to the researchers. IBM and Georgia Tech’s “Institute for People and Technology” plus the Tennenbaum Institute will work together to integrate and analyze the variety of data needed to deal with the complex system of children’s health.

The ability to make sense of mountains of data with IBM’s analytics capabilities is the perfect pairing to Georgia Tech’s modeling expertise, according to Tennenbaum Institute Executive Director William B. Rouse Co-Chair of the National Academies Healthy America Initiative and a member of the National Academy of Engineering.

The 1MHC program will begin by integrating the types of anonymous healthcare data that is untraceable back to any single individual, but can be aggregated and analyzed. Data on care delivery and clinical practices will be obtained from a variety of participants in Georgia’s healthcare ecosystem.

In the first stage, health records for over 16,000 children will be analyzed, initially focusing on those suffering from diabetes and then focus on children suffering from asthma and autism. The objective is to optimize policies that support the highest quality pediatric care by aligning treatments, outcomes, and costs. Privacy and security of patient data and compliance with all current healthcare regulations will be addressed throughout all phases of the project.

Additional factors to be studied beyond financial issues and coping with massive amounts of data, will include urban planning issues, individual behavioral issues, disease transmission, clinical research, and how the media can influence the health of individuals.

For more information, contact Lisa Grovenstein at (404) 894-8835.

Europeans Support Telemedicine

2011-12-04T06:14:00.001-05:00

RENEWING HEALTH the largest European project to date with almost 8,000 patients in 9 European regions is evaluating the use and impact of ICT and innovative telemedicine services. The pilot will use a patient-centered approach to help patients suffering from chronic conditions such as diabetes, cardiovascular disease, and chronic lung problems to strengthen the evidence-based use of telehealth-based services in Europe and worldwide.

The RENEWING HEALTH pilot program has joined forces with the EU co-founders under the Information and Communication Technologies Policy support Program, (CIP ICT PSP), 9 European regions, 9 member states and some NGOs. These groups are advanced in the use and implementation of Personal Health Systems (PHS) along with telemedicine applications and services.

These 18 pilots have been running in parallel in 9 European regions for almost 4 years, and are expected to provide the hard evidence that decision makers need to make additional investments towards ICT. So far, Personal Health Systems used for a number of years, have mostly involved small numbers of patients, for short periods, and with the focus almost totally on clinical outcomes.

RENEWING HEALTH will evaluate the projects using a multidisciplinary evaluation method that will take into consideration more than just the clinical outcomes of the trials. The economic and organizational impact when using these services will be equally assessed since the economics of innovation cannot be ignored.

The evaluation of the large scale pilots will be done using the “Model for Assessment of Telemedicine (MAST). The objective is to produce a systematic and multidisciplinary assessment of the impact and outcomes of the integrated telemedicine services included in the RENEWING HEALTH pilots. MAST makes it possible to compare and aggregate data from different projects with similar interventions and is attracting major interest outside the RENEWING HEALTH consortium.

The results of the project will provide valuable information for the planning and design of future healthcare delivery in Europe and provide recommendations for large-scale deployment of telemedicine solutions.

In November, RENEWING HEALH held a Midterm Workshop to enable the sharing of information on the progress of the pilots and to enable the eHealth community to go beyond the geographical coverage of the projects and listen to other relevant experiences in deploying eHealth services.

Go to www.renewinghealth.eu for more information. For questions on RENEWING HEALTH, email Dr. Lorenzo Gubian Coordinator at lgubian@gmail.com or information on the workshop held in November, email the workshop organizer Marc Lange at marc.lange@ehtel.

HRSA Seeks Applications

2011-11-28T16:18:00.001-05:00

On November 16th, HRSA’s Office of Rural Health Policy (ORHP) issued a funding announcement seeking applicants capable of synthesizing and analyzing key policy issues and changes to support the work of the Rural Policy Analysis Program. This information is needed to enable public policy makers, providers, leaders, and decision makers to understand the challenges ahead for rural populations.

Just like the U.S. population as a whole, the rural population is aging, report poorer health and more physical limitations than urban residents, experience greater financial and geographic barriers to access to care, and less likely to have health insurance coverage than the metro population. Added to these facts, rural communities have fewer healthcare providers and services due to declining rates for family medicine residencies, redistribution of J1 Visa waivers, plus the shortage of allied and other healthcare professionals in the workforce.

In addition to these challenges, there are also significant changes taking place in Federal and State policies. The Affordable Care Act is going to have a profound impact on rural communities since the Act contains a wide variety of rural-specific provisions that are specific to rural populations.

Eligible applicants can include domestic public, private, non-profit or for-profit organizations along with state, local, and Indian tribal governments, institutions of higher education, and hospitals. Applicants must have knowledge of Medicare and Medicaid policies, rural delivery systems, and public health.

The program will provide funding during fiscal year 2012 to 2016. Approximately $225,000 is expected to be available annually to fund one award for up to five years. The application is due January 17, 2012. For additional information, go to www.grants.gov or email Nicole Comeaux at ncomeaux@hrsa.gov or (301) 443-5433.

NIH Streamling Tech Transfer

2011-11-28T16:16:00.001-05:00

NIH has just launched the “Electronic Research Materials” (eRMa) catalogue to streamline the agency’s technology transfer process. The new eRMa web site should reduce response time for unpatented materials from six months to a few days and can be found at www.ott.nih.gov/erma. eRMa was designed and developed by NIH’s Office of Technology Transfer (OTT) with support from the NIH National Cancer Institute’s Center for Cancer Research.

More than 6,000 researchers at NIH laboratories help to drive the research and discovery process. These NIH researchers make unpatented materials available to companies through internal use licenses executed by OTT. An NIH internal use license is a contract that governs the transfer of tangible research materials from NIH to a company for commercial research use.

The new system will streamline the licensing process by:

• Providing a website for companies to find and license unpatented materials using a ready-to-go contract

• Allowing a company to pay online through www.pay.gov and to receive the materials quickly from the labs

• Providing faster turn-around time and simplifying the process for companies to find research materials available from NIH labs

For non-profit research organizations interested in obtaining NIH materials through a material transfer agreement, NIH will launch the “Transfer Agreement Dashboard” in December. This web-based system will have a broad array of beneficiaries to include NIH scientists and technology transfer staff as well as researchers and technology transfer offices at universities and non-profit research institutions.

The NIH Office of Technology Transfer administers about $97 million annually in royalty payments from about 500 companies that have reported product sales of about $6 billion last year. OTT manages the patenting and licensing of the wide range of inventions made by NIH and FDA scientists as mandated by legislation.

For more information, go to the Office of Technology Transfer web site at www.ott.nih.gov.

California HIT Forging Ahead

2011-11-28T16:15:00.001-05:00

Both Linette T. Scott MD, Interim Deputy Secretary for HIT for the California Health and Human Services Agency, and Laura Landry, Interim CEO, for Cal eConnect spoke at the recent 2011 California HIE Stakeholder Summit. Both speakers updated the 300 attendees on major developments related to the transformation of healthcare in the state.

One recent development is the passage of the “Telehealth Advancement Act of 2011” that opens the door for the expansion of telehealth in the state. The Act will enable telehealth to provide a broader range of services and reach more providers and care settings.

To enable the delivery of telehealth, broadband must reach all of California’s rural communities. With help from the FCC Rural Health Pilot Project’s $22 million available over three years, the goal is to connect to over 800 sites. This funding will enable the Broadband Opportunities & Training Program to be executed by the California Telehealth Network (CTN) and the UC Davis Health System to provide $5 million in “Model eHealth Communities” awards to go to 15 communities.

In May, FCC granted a one year extension to the RHPP program and will accept applications through June 2012. Secondly the FCC has authorized CTN to provide subsidized low-cost broadband rates to RHCPP for an additional year.

Both Scott and Landry emphasized that the HIE landscape continues to evolve and develop. The big news is that San Diego Beacon Community plans to launch a Regional Health Information Exchange Infrastructure in December to connect hospitals, medical groups, public health, and emergency medical services. The selected sites for participating organizations include Children’s Primary Care Medical Group, Rady Children’s Hospital, UC San Diego Health System, Sharp Community Medical Group, and the VA San Diego Healthcare System.

The HIE is expected to be implemented to other sites throughout the San Diego healthcare community over the next 14 months. At that time, health IT will be integrated into care delivery, pre-hospital data will be available, immunization forecasting will be possible, medical device data on implantable wireless devices will be available to enable more effective treatments.

The HIE will help public health to improve with real-time syndromic surveillance available, enable bi-directional integration with the San Diego Immunization registry, make possible electronic reporting of notifiable conditions and laboratory results, and provide an emergency medical services hub.

The presenters at the meeting reported on the success of the EHR incentive programs in the state by pointing out that the Medicare EHR incentive program has enabled 224 providers to receive $4 million in incentives and the Medi-Cal EHR incentive program has 141 hospitals registered with CMS.

They also that reported the regional extension centers received $55,875,335 in federal dollars. This means that today, Cal HIPSO has 6,567 providers enrolled with 1, 935 EHRs installed, HITEC-LA has 2,950 providers enrolled with 850 EHRs installed, COREC has 800 providers enrolled with 405 EHRs installed, and the National Indian REC-CA has 148 providers enrolled with 148 EHRs installed.

Enabling Better Rural Healthcare

2011-11-28T16:12:00.002-05:00

Agriculture Secretary Tom Vilsack on November 18th announced grant awards to establish telemedicine and other rural healthcare projects in the Delta region. The grants will fund ten projects in six states to deliver health services to areas currently lacking adequate care and deliver services to 25 persistent poverty counties.

Some of the grants are going to:

• Delta Health Alliance Inc ($699,142) will finance the Delta Electronic Intensive Care Unit network to link five hospitals in the most rural and impoverished counties in the Mississippi Delta

• The Tombigee Health Care Authority ($384,742) to finance “Healthcare on Wheels” a totally independent unit to provide healthcare services, education, telemedicine, and outreach linkage to community resources

• Murray State University ($233,366) to finance the East Kentucky TeleCare Project by providing equipment and resources for telehealth infrastructure for five rural critical access hospitals, two small hospitals, and one acute care hospital in the Delta Region of western Kentucky. The project will link eight hospitals into the Kentucky Telehealth Network

• Building Healthy Communities, Inc. ($364,443) will finance the Louisiana Nursing Home Telehealth Project to provide healthcare consultations to five rural nursing homes in the Louisiana Delta,

• Ochsner Clinic Foundation ($270,254) will finance the Acute Stroke System for Emergent Regional Telemedicine to connect eight rural hospitals in Central Louisiana

Other funding for projects includes $519,924 for Connect SI Foundation Inc., City of Mound Bayou for $2,993,954, University of Arkansas for Medical Sciences for $162,002, Arkansas State University for $384,742, and Franklin Parish Hospital, Service District No. 1 for $62,870.

In other news related to helping Rural Health Clinics (RHC), Congressman Aaron Schock (R-IL) introduced HR 3458 to enable RHCs to become eligible for electronic health record incentive payments through the Medicare program.

Due to the unique reimbursement structure of RHCs, their healthcare providers are not eligible for EHR incentive payments through CMS. “RHCs should not be discriminated against simply because they bill Medicare differently than hospitals or other healthcare practitioners who practice in rural areas” according to Congressman Schock. He represents 20 counties in Illinois and several of these counties include health clinics that are being penalized by this accounting error. “This is a flaw in the system that needs to be fixed,” said Schock.

OPM Issues HIT Report

2011-11-28T16:10:00.001-05:00

The U.S Office of Personal Management (OPM) encourages the Federal Employees Health Benefits Program (FEHBP) to increase their use of health IT. Currently there are 207 health plan choices in the FEHB program with about 8 million Federal employees, retirees, and family members covered.

The FEHB carriers were asked to make PHRs available, provide healthcare costs transparency, provide incentives for e-Prescribing, and to protect the privacy of individually identifiable health information. To report on how these goals are being accomplished, OPM issued their fifth report on FEHBP relating to HIT.

This program-wide “HIT and Transparency Report” is based on individual reports collected from health plans participating in FEHBP. The report shows that 92 percent of FEHBP health plans have taken proactive steps to educate their members on the value of HIT.

This year’s findings include:

• 97 percent of plans representing 98 percent of total FEHBP enrollment have PHRs available to their members
• Members using PHRs vary widely. Some plans report about 6 percent of members use PHRs while others indicate that all members use them
• 59 percent of plans report that they have online physician or hospital cost estimators or comparison tools on their websites
• 75 percent of plans report that they have online tools to compare physician or hospital quality
• 75 percent of plans report that their physicians can order prescriptions online
• 100 percent of FEHBP plans indicate that they provide members with access to privacy policies describing their compliance with HIPAA

Go to www.opm.gov/insure/health/reference/hitreport2011.pdf to view the “HIT and Transparency Report for 2011”.

Efforts to Study Genomic Medicine

2011-11-28T16:06:00.001-05:00

In November, the New York Genome Center (NYGC) was established with $125 million from the City of New York as well as funds from private companies and foundations. NYGC’s eleven leading academic medical centers and research universities include Cold Spring Harbor Laboratory, Columbia University, Cornell University/Weill Cornell Medical College, Memorial Sloan-Kettering Cancer Center, Mount Sinai Medical Center, New York-Presbyterian Hospital, NYU School of Medicine, North Shore-LIJ Health System, the Jackson Laboratory, the Rockefeller University, and Stony Brook University. The Hospital for Special Surgery is an associate founding member.

Genomics are already a significant growth factor in the economy representing a $7 billion plus industry. NYGC will leverage existing strengths in genomics and attract new talent to create a hub where companies can develop applications for research. By 2025, the economic impact associated with commercial spin-off activities of NYGC is expected to represent the largest component of the total impact associated with the Center.

In another ongoing project, the “Electronic Medical Records and Genomics” network or referred to as eMERGE, received $25 million over the next four years to demonstrate that patients genomic information linked to disease characteristics and symptoms in their EMRs could improve care. eMERGE operates as a consortium with more than 120 members with grants from NIH’s National Human Genome Research Institute (NHGRI) plus additional funding from the National Institute of General Medical Sciences.

The original eMERGE program started several years ago and in July wrapped up the first phase of the program. It was demonstrated that disease characteristics data contained in EMRs along with patient’s genetic information can be used in large genetic studies. So far, the eMERGE network has identified genetic variants associated with dementia, cataracts, high density lipoprotein cholesterol, peripheral arterial disease, white blood cell count, type 2 diabetes and cardiac conduction defects.

In the next phase, researchers will identify genetic variants associated with 40 more disease characteristics and symptoms, using genome-wide association studies across the entire eMERGE network. DNA from about 32,000 participants will be analyzed in each study.

eMERGE network members in this phase include Vanderbilt University Medical Center, Group Health Cooperative and University of Washington, Northwestern University, Geisinger Weis Center for Research, Essentia Institute of Rural Health, Mayo Clinic, and Mount Sinai School of Medicine.

The eMERGE Network Phase II Pediatric Study was announced last summer. The funding will support existing pediatric biorepositories with EMRs and genome-wide genotyping data to incorporate state-of-the-art methods generated in eMERGE Phase 1. The applications were due in September 2011.

In the spring of 2012, NHGRI plans to award up to $1.5 million to as many as three investigators for three-year pediatric eMERGE studies. Another NIH Institute the Eunice Kennedy Shriver National Institute of Child Health and Human Development plans to co-fund these grants with NHGRI.

Improving Maternal & Neonatal Health

2011-11-28T16:03:00.001-05:00

More than 98 percent of maternal and neonatal deaths occur in low-resource settings. Strategies to reduce maternal and neonatal deaths are needed to improve access and care especially in home and community settings where over half of the more than 60 million births occur each year.

Delivering innovative technologies across the continuum of care including technologies for frontline workers to use not only in homes and communities but also in first level clinics may significantly improve pregnancy outcomes. However, no quantitative process currently exists to evaluate and prioritize technology development options based on the potential to save lives in low resource settings.

To address the problem, the Bill and Melinda Gates Foundation issued a new grant program to address “Grand Challenges in Global Health”. The grant program in partnership with the “Global Alliance to Prevent Prematurity and Stillbirth” (GAPPS) is seeking letters of inquiry starting in November with final letters of inquiry due January 31, 2012. For more information on this new grant program, go to www.gatesfoundation.org/global-health/Pages/preventing-preterm-birth-rfp.aspx.

This initiative is hoping that the scientific knowledge on the causes and mechanisms important to preterm birth in developing countries would lead to low-cost novel technologies to address the problem

In another grant project to improve maternal and neonatal healthcare in low-resource countries, RTI International developed a web-based tool to objectively assess the impact of new medical technologies on maternal, fetal, and neonatal mortality. The assessment tool “Maternal and Neonatal Directed Assessment of Technology” or referred to as MANDATE is also being developed with funding from the Bill & Melinda Gates Foundation.

By calculating the potential number of maternal and neonatal lives saved, the tool allows users to identify and compare the potential impact of a technology. Users may adjust variables related to a technology’s availability, appropriate use, and efficacy to determine how a technology might be improved to have the greatest impact.

Once the variables are set by the user, MANDATE can determine the technology’s potential impact by patient category, medical condition and healthcare settings in sub-Saharan Africa and South Asia, the regions with the highest burden of mortality. The tool will soon be available to the public on the MANDATE website at http://mntech.org free of charge.

“Some very good technologies are simply not practical for use in low-resource settings,” said Doris Rouse, PhD, Project Director and Vice President of Global Health Technologies at RTI. “In some cases, innovative, low-tech solutions are more appropriate in these settings. MANDATE enables the user to assess the reduction in maternal and neonatal mortality that might results from a new or improved technology that is more appropriate or effective in specific settings.”

With other grant funding, researchers at Ecole de Technologie Superieure in Canada with funding from the Gates Foundation Grand Challenges Exploration Grants are designing and testing a diagnostic tool using computer acoustical analysis of newborn cries to better detect medical conditions such as asphyxia, hypoglycemia, and infections.

With funding from another Gates Foundation Grand Challenges Exploration grant, researchers of Global Health Partnerships and the University of New Mexico are going to work with care providers in Nepal to evaluate the use and acceptance of inexpensive devices constructed from local materials that works to decrease blood flow to the pelvic organs for treating post-partum hemorrhage, a major cause of maternal morbidity and mortality in the developing world.

CMS Announces Challenge

2011-11-20T06:26:00.001-05:00

CMS through the Innovation Center on November 14, 2011, announced their “Health Care Innovation Challenge” (CMS-1C1-12-001) with awards up to one billion to be made through cooperative agreements. CMS is looking for the most compelling new service delivery and payment models to drive system transformation and deliver better outcomes for Medicare, Medicaid, and CHIP beneficiaries.

The aims of the initiatives are to:

• Produce better, care, better health, and reduced costs for high cost/high-risk groups. These groups include populations with multiple chronic diseases and/or mental health or substance abuse issues, poor health status due to socio-economic and environmental factors, multiple medical conditions, high-cost individuals, or the frail elderly.

• Identify new models of workforce development and related training and education to support new models either directly or through new infrastructure activities. Currently, reimbursement payment policies do not necessarily support all workforce needs but there are care coordination models that may be able to use less expensive but potentially highly effective individuals who are trained to interact with patients in a focused way

• Support innovators who can rapidly deploy care improvement models (within six months of the award) through new ventures or expand existing efforts to new populations of patients, in conjunction where possible with other public and private sector partners.

It is recognized that new types of infrastructure activity are needed to support more effective and efficient system-wide functions and to rapidly diffuse best practices. Infrastructure support might include the development of new registries, support the coordination of care in communities, develop preventive care models, telemedicine and remote monitoring models, medication reconciliation systems, shared-decision making systems, and innovation networks or community partnerships.

Eligible applicants and potential partners can include provider groups, health system payers and private sector organizations, faith-based, local government, public-private partnerships, and for- profit organizations.

Individual awards will range from approximately $1 million to $30 million for a three year period. A letter of intent is due December 19, 2011 with the application due January 27, 2012. To view the funding announcement, go to www.innovations.cms.gov or email InnovationChallenge@cms.hhs.gov for more information.

Studying Healthcare Financing

2011-11-20T06:24:00.001-05:00

The Health Care Cost Institute (HCCI) is going to provide researchers and policymakers access to a comprehensive collection of health plan and government payer data to gain new insights into healthcare costs and utilization. HCCI will provide access to data from plans operated by Aetna, Humana, Kaiser Permanente and UnitedHealthcare along with government data from Medicare Fee for Service and Medicare Advantage.

The data will include more than 5 million medical claim records representing more than $1 trillion of healthcare activity from over 5,000 hospitals and one million service providers from calendar year 2000 to the present. For the first time there will be comprehensive data on the privately insured that make up the majority of health consumers in the U.S according to Professor Martin Gaynor PhD of Carnegie Mellon University.

The de-identified data will be in accordance with HIPAA requirements and HCCI will establish a Data Integrity Committee whose primary focus will be on all matters related to data privacy, security, and integrity.

HCCI’s governing board will be controlled by independent national physician leaders and academic researchers to broaden the list of participating health plans and to add more data from government payers, including Medicaid. Beginning in 2012, HCCI plans to publish its own “Scorecards” that supports analysis on aggregate trends of healthcare cost and utilization.

In another project, the University of Pennsylvania Health System (UPHS) is partnering with the Leonard Davis Institute Center for Health Incentives and Behavioral Economics on a new initiative called the “UPHS Center for Innovations in Health Care Financing.”

It has been reported that the U.S. spends about $2.5 trillion per year on healthcare with costs growing at several percentage points faster than the growth of the economy. Wellness incentive programs are gaining popularity among employers and government. Medicare and insurance companies are moving to modify payment models while reducing health expenditures. However, proven models for doing so are rare and it is this gap that the new UPHS Center seeks to fill.

The new Center will combine the expertise of faculty members at the School of Medicine and the Wharton School. They will test how insights from behavioral economics and health economics can improve patient health and reduce the rate of growth in healthcare costs.

RFI Addresses Medicaid Fraud

2011-11-20T06:22:00.001-05:00

The Texas Health and Human Services Commission (HHSC) released RFI (No. 529-12-0056) “Pre-Payment Review of Claims and Other Strategies to Reduce Medicaid Fraud”. Feedback is needed by December 10, 2011 from capable sources to provide leading cutting-edge technology capabilities for predictive modeling/management software as well provide claim review services and workflow management tools.

HHSC is trying to determine what products exist in the marketplace that will help eliminate pre-payment fraud. HHSC also wants to know about products that are not ready and when the product release is planned. HHSC may use the information contained in the RFIs received to develop a future procurement.

HHSC wants more information on systems that can:

• Handle high volume of transactions
• Be integrated into the existing Medicaid claims flow with minimal effort, time, and cost
• Provide a rapid, real-time, or near real-time solution with large data storage available to provide for data mining and pooling capabilities
• Analyze Medicaid managed care encounter data as HHSC transitions from FFS to a MCO delivery system
• Permit modifications to the software in a rapid and timely manner
• Provide a change control process to enable quick changes to be made to changing patterns of behavior
• Mark each flagged claim with a Medicaid-defined reason code to help the human reviewer understand the reason the claim is potentially improper and recommend an action
• Allow HHSC visibility into data analysis so that patterns of excessive usage, unusual patterns, are identified, scored, and implemented rapidly
• Provide views for all provider and patient activities across all federal health program payers
• Provide workflow management and workstation tools that can systematically present scores, reason codes, and treatment actions

Go to www.hhsc.state.tx.us/contract/529120056/529120056-RFI.pdf to view the RFI. For more information, email Steve R. Bailey at steve.bailey@hhsc.state.tx.us or call (512) 206-4653.

Oral Health Initiative Launched

2011-11-20T06:20:00.001-05:00

Delta Dental of Wisconsin awarded $1.1 million to Marshfield Clinic Research Foundation the largest private medical research institute in Wisconsin. The funding to be used for dental research will provide $500,000 towards dental-informatics research, $500,000 will help the oral-and-systemic-health research project, and $100,000 will go towards clinician-initiated dental and craniofacial research through the Delta Dental Oral and Systemic Health Research Initiative.

The dental-informatics research brings computer-based research, biological science, and medical-dental integration down to an individual level. The research will create a dental-health information exchange to incorporate historical medical and dental information and electronic dental-health records.

The oral-and-systemic-health research center focuses on the connection between a healthy mouth and body and on expanding the links between oral health and diabetes, heart disease, and preterm births. The dental and craniofacial research uses the latest molecular and genetic tools to explore health and disease.

The research builds on an earlier Delta Dental-funded project that integrated medical and dental records in a single electronic health record so that a detailed picture of an individual’s whole-body health is now provided.

New Mobile-Ready Guide Available

2011-11-20T06:18:00.001-05:00

A new interactive guide to aid deployed medics, nurses, and commanders in recording medical information is now available on iPhone, iPod Touch, iPad, and android devices, according to the Army’s Combined Arms Center for Training. The initial Guide was only available in a PDF format on computers via Army Knowledge Online.

The new guide enables the mobile medical force to use the ATN2GO app on their mobile device to access best practices, guidelines, and procedures for using MC4 in the field. Users can create direct links to procedures specific to their specialties and link to updated checklists, presentations, and step-by-step procedures.

Deployable medical staff use MC4 to document and track patient care, digitally manage medical supplies, and conduct health surveillance in the combat zone. The new guide ensures a continuous, systematic approach to supporting the creation and transmission of EMRs and automated maintenance of class VIII medical supplies.

“Mobile devices are driving the Army’s training delivery model,” said Lt. Col. William Geesey MC4 product manager. “By empowering deployable medical forces with the ability to get answers to questions on the fly, we are in effect improving their ability to make informed decision on the healthcare delivered to soldiers in theater.”

In addition to offering mobile access, the 2.0 MC4 guide focuses more on specific guidance and need-to-know information and as a result, has reduced the volume by 60 percent and is making data retrieval fast and easy.

For more information on STN2Go, visit https://atn.army.mil.

Addressing Health Concerns

2011-11-16T06:33:00.002-05:00

Mesa Tech, a spinoff of Los Alamos National Laboratory (LANL) in New Mexico received a $400,000 Phase I SBIR grant from NIH’s National Institute of Allergy and Infectious Disease. The funding will develop an inexpensive instrument-free nucleic-acid testing device to diagnose various respiratory diseases in record time. Mesa Tech is currently developing a prototype plan to target the global diseases surveillance market.

They also envision developing applications to use in point-of-care diagnostics, particularly in poor areas of the world reports former LANL scientist Hong Cai, who co-founded Mesa Tech and principal investigator for the effort. For the point-of-care applications, Mesa Tech plans to develop an inexpensive handheld device about the size of a cell phone with a disposable cartridge. Cai said, “In the case of a pandemic, such as SARS or avian influenza, the device could also be made disposable.”

In another project, LANL completed a Cooperative Research and Development Agreement (CRADA) with Biomagnetics Diagnostics, Inc. and licensed the LANL-developed prototype waveguide-based optical biosensor to Biomagnetics.

Under the CRADA, Biomagnetics will continue to work to develop a commercial product to detect a specific biomarker in urine that could aid in the diagnosis of tuberculosis infection. So far, a commercially available product has not yet been built or clinically tested to aid in diagnosing tuberculosis infections. With further research, scientists at LANL believe that a portable biosensor can become a reality and could greatly improve field-based detection of active tuberculosis infection.

“Excellent progress has been made to detect tuberculosis-specific biomarkers and to explore biomarker choices” according to David Hadley in the LANL Technology Transfer Division. “To convert this R&D into a commercial product, the antibodies need to be licensed and the surface chemistry needs to be better understood. At this point, a field site in Southeast Asia or South Africa should be identified where the population with HIV co-infection could be evaluated.

State Developing Data System

2011-11-16T06:30:00.001-05:00

The State of New Hampshire Department of Health and Human Services (DHHS) is implementing the federal “Maternal Infant & Early Childhood Home Visiting” (MIECHV) Program. The state intends to contract with Home Visiting New Hampshire –Health Families America (HVNH-HFA) to implement the program.

HVNH-HFA an initiative of the Division of Public Health Services (DPHS) received funding to implement MIECHV to help the diverse needs of children and families in communities. The plan is to improve health and development outcomes for at-risk children through evidence-based home visiting programs.

HVNH-HFA uses specialty trained visitors and nurses to regularly visiting pregnant women and their families in the home. They provide health and parenting education, information and referrals, and other support for the participants.

On November 7, 2011, RFP (2012-009) seeking a “Home Visiting Data System” was issued by the New Hampshire DHHS, Division of Public Health Services. The RFP is looking to procure secure, web-based, Commercial-Off-The-Shelf (COTS) software or Software as a Service (SaaS) model to collect and manage the data and reporting requirements for this program. Proposals are due December 21, 2011.

The requirement is to develop a Home Visiting Data System to measure progress and report on:

• Participants and their outcomes

• DPHS performance measurements

• Measurements for MIECHV benchmark data constructs

• The data collected that is required for HFA home visiting model accreditation,

• The tools needed to provide for continuous quality improvement

• Future activities to streamline data collection across multiple home visiting and family service programs in the state

In future years, the goal for the state’s Home Visiting Data System is to meet the needs for multiple programs in the state to reduce the administrative burden for agencies. The data system in the future will need to have the capacity be able to track multiple programs that a family might need, including multiple individualized Family Service Plans.

The amount available for this contract is $100,000 for the first year of the contract (SFY 12) and $60,000 for each subsequent year. However, the state will accept and consider proposals that exceed available funding.

Go to http://admin.state.nh.us/purchasing/specRFP.asp?rfpID=7082%20 to view the RFP. For more information, email Shannon.wood@dhhs.state.nh.us or call (603) 271-4566.

Software Identifies Cancer Cells

2011-11-16T06:28:00.001-05:00

The Office of Naval Research’s (ONR) funded software to find and recognize undersea mines is now being applied to help doctors identify and classify cancer-related cells. “The results are spectacular,” said Dr. Larry Carin, Professor at Duke University and developer of the technology. “This could be a game-changer for medical research.”

The problem that physicians encounter in analyzing images of human cells is surprisingly similar to the Navy’s challenge of finding undersea mines. When examining tissue samples, doctors must sift through hundreds of microscopic images containing millions of cells.

To pinpoint specific cells of interest, they are using an automated image analysis software toolkit called “FARSIGHT” funded by NIH and DARPA. FARSIGHT identifies cells based upon a subset of examples initially labeled by a physician. Up to now, the problem has been that the resulting classifications can be erroneous because the computer applies tags based on the small sampling. Also, it can take days even weeks for a pathologist to manually pick out all the endothelial cells in 100 images. The enhanced FARSIGHT toolkit can accomplish the same feat in a few hours with human accuracy.

By adding ONR’s active learning software algorithms, the identification of cells is accurate and FARSIGHT’s performance more consistent, according to the researchers. The enhanced toolkit also requires physicians to label fewer cell samples because the algorithm automatically selects the best set of examples to teach the software.

A medical team at the University of Pennsylvania is applying the ONR algorithms embedded in FARSIGHT to examine tumors from kidney cancer patients. Focusing on endothelial cells that form the blood vessels that supply the tumors with oxygen and nutrients, this research could one day improve drug treatments for different types of kidney cancer.

NSF to Award Grants

2011-11-16T06:26:00.001-05:00

The National Science Foundation (NSF) though their “Smart Health and Wellbeing (SHB) program issued their cross-cutting grant solicitation (12-512) on November 10, 2011. The purpose for the funding opportunity available across three NSF directorates is to draw expertise from multiple domains of science and engineering including social, behavioral, and economic sciences. The estimated program funding if funding is available is $15,000,000 for 18 awards.

The work to be funded by the solicitation must relate to a key health problem and make a fundamental contribution to engineering, computer and information sciences, or social behavioral and economic sciences. Traditional disease-centric medical, clinical, pharmacological, biological, or physiological studies and evaluations are outside the scope of the solicitation.

Addressing the challenges will require research and the development of new tools and methods for:

• Researchers to develop effective ways to enable the effective sharing and use of EHR data and networked applications, be able to access the data, and be able to exchange current and future health and wellness data originating from a number of diverse sources available in multiple formats

• Developing PHRs while aggregating clinical, biomedical, and environmental data about each patient to include in their EHRs and PHRs in order to take the knowledge obtained to make vital decisions

• Individuals to be empowered by investigate the underlying socio-economic and behavioral principles underlying patient participation in healthcare and wellness

• Researchers to develop medical prosthetic and embedded devices and devices to be used for storage and the transmission of physiological state and environmental data

Proposers may submit proposals in two project classes to include Type I (Exploratory Projects) for $200,000 to $600,000 total budget to last from two to three years, and Type II (Integrative Projects) for $600,000 to $2,000,000 total budget to last from four to five years.

Proposals may be submitted by universities and colleges, nonprofits, non-academic organizations, independent museums, observatories, research laboratories, professional societies and other organization associated with educational or research activities.

The closing date for application is February 6, 2012. For more information, go to www.grants.gov.

ONC's App Challenge

2011-11-16T06:24:00.001-05:00

ONC is looking for projects where multidisciplinary teams can come together to build technology solutions to address specific issues. Any government agency, community organization, foundation, healthcare and technology company, software developer, UI designer, and subject matter expert is eligible to apply.

The ONC “Reporting Device Adverse Events Challenge” seeks multidisciplinary teams to develop an application to facilitate the reporting of adverse events related to medical devices, whether implanted or used in the hospital, clinic, or home.

The objective is to make it easy for patients to report adverse events that occur with any medical device to their providers who would then use the EMR or PHR embedded software to auto-populate relevant report fields, as well as add additional EMR/PHR-based text and information. The information would then be reported to the “Manufacturer and User Facility Device Experience (MAUDE) database.”

The first prize is $25,000 plus the awardee would be asked to set up a demonstration at the CMS Quality Net Conference plus two free passes and paid travel expenses to the Health 2.0 Spring Conference. The second prize is $10,000 with a third prize of $5,000.

The submission period began in September with the submission period ending December 2, 2011. Go to www.health2challenge.org/reporting-device-adverse-events-challenge for more information.