Using bar-code technology with an electronic medication administration record (eMAR) substantially reduces transcription and medication administration errors as well as potential drug-related adverse events. A new study funded by AHRQ was published in the May 6th issue of the “New England Journal of Medicine.”
Bar-code eMAR is a combination of technologies that ensures that the correct medication is administered in the correct dose at the correct time to the correct patient. When nurses use this combination of technologies, medication orders then appear electronically in a patient’s chart after the pharmacist approves.
Alerts are sent to nurses electronically if a patient’s medication is overdue. Before administering the medication, nurses are required to scan the bar codes on the patient’s wristband and then scan the medication. If the two don’t match the approved medication order, or it is not time for the patient’s next dose, a warning is issued.
Researchers on the project at Brigham and Women’s Hospital in Boston compared 6,723 medication administrations on hospital units before bar-code eMAR was introduced. The hospital then did 7,318 medication administrations after the bar-code eMAR was introduced.
The researchers were able to document a 41 percent reduction in non-timing administration errors and a 51 percent reduction in potential drug-related adverse events associated with this type of error. Errors in the timing of medication administration fell by 27 percent. No transcription errors or potential drug-related adverse events related to this type of error occurred.
The findings have important implications because bar-code eMAR technology is being considered as a 2013 criterion for “meaningful use” of health information technology under ARRA.
Sunday, May 9, 2010
Wednesday, May 5, 2010
New Competition Announced
A new $12 million innovation competition called “i6 Challenge” was just announced by the Department of Commerce’s Office of Innovation and Entrepreneurship and their Economic Development Administration (EDA) in partnership with NIH and the National Science Foundation (NSF). EDA will award up to $1 million to six individual teams in the U.S.
Teams will need to come up with innovative ideas that will drive technology commercialization and entrepreneurship. NIH and NSF will award up to $6 million in additional funding to NIH or NSF Small Business Innovation Research grantees associated with the winning teams.
“The i6 Challenge will help new biomedical technologies succeed and foster their entry into the marketplace,” said NIH Director Francis S. Collin, M.D., Ph.D. “NIH supports small business through both the Small Business Innovation Research and Small Business Technology Transfer programs.
“The i6 Challenge is exactly the type of interagency collaboration that can help advance President Obama’s innovation agenda by supporting and rewarding innovative approaches that will turn ideas into new products and businesses to help America compete in the global economy,” said Aneesh Chopra, U.S. Chief Technology Officer and Associate Director for Technology in the White House Office of Science and Technology Policy.
Entrepreneurs, investors, universities, foundations, and nonprofits are encouraged to participate in the i6Challenge. The deadline for applications is July 15, 2010. Letters of intent to participate are encouraged and should be sent to i6@doc.gov no later than June 15th. Go to www.eda.gov/i6 to learn more about the competition and for information on the conference call to take place at 2 pm EDT on May 17th. For other details, go to the May 4th issue of the Federal Register.
For further contacts, email Calvin Jackso at NIH at cj8e@nih.gov, Joshua Chamot at NSF at jchamot@nsf.gov, or email John Atwood at EDA at jatwood@eda.doc.gov.
Teams will need to come up with innovative ideas that will drive technology commercialization and entrepreneurship. NIH and NSF will award up to $6 million in additional funding to NIH or NSF Small Business Innovation Research grantees associated with the winning teams.
“The i6 Challenge will help new biomedical technologies succeed and foster their entry into the marketplace,” said NIH Director Francis S. Collin, M.D., Ph.D. “NIH supports small business through both the Small Business Innovation Research and Small Business Technology Transfer programs.
“The i6 Challenge is exactly the type of interagency collaboration that can help advance President Obama’s innovation agenda by supporting and rewarding innovative approaches that will turn ideas into new products and businesses to help America compete in the global economy,” said Aneesh Chopra, U.S. Chief Technology Officer and Associate Director for Technology in the White House Office of Science and Technology Policy.
Entrepreneurs, investors, universities, foundations, and nonprofits are encouraged to participate in the i6Challenge. The deadline for applications is July 15, 2010. Letters of intent to participate are encouraged and should be sent to i6@doc.gov no later than June 15th. Go to www.eda.gov/i6 to learn more about the competition and for information on the conference call to take place at 2 pm EDT on May 17th. For other details, go to the May 4th issue of the Federal Register.
For further contacts, email Calvin Jackso at NIH at cj8e@nih.gov, Joshua Chamot at NSF at jchamot@nsf.gov, or email John Atwood at EDA at jatwood@eda.doc.gov.
Tracking Radiation Doses
In a report published by the National Council on Radiation Protection and Measurement, the U.S population’s total exposure to ionizing radiation has nearly doubled over the past two decades. These figures are expected to continue to grow. This rise is largely attributable to increased exposure from CT systems, nuclear medicine, and interventional fluoroscopy.
In 2010, FDA’s Center for Devices and Radiological Health published a white paper “Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging” with information on the steps needed to promote the safe use of medical imaging devices, support informed clinical decision making, and increase patient awareness concerning this issue so that imaging procedures are not ordered without sufficient justification.
There are a number of issues that need to be addressed to support informed clinical decision making, since many ordering physicians do not always have access to patients’ medical imaging or radiation dose history.
Problems that arise due to insufficient information:
• Physicians may unnecessarily order imaging procedures that have already been conducted
• Standardized dose structured reporting, while technically available in new CT systems and Fluoroscopes used in interventional procedures, is still in its infancy
• Dose reports are not always contained in either the image files or in the patient’s paper or electronic medical records
• Ordering physicians may lack or be unaware of recommended criteria to guide their decisions about whether or not a particular imaging procedure is medically efficacious
Go to www.fda.gov/Radiation-EmittingProducts/RadiationSafety/RadiationDoseReduction/UCM199904.htm to download the report.
In 2010, FDA’s Center for Devices and Radiological Health published a white paper “Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging” with information on the steps needed to promote the safe use of medical imaging devices, support informed clinical decision making, and increase patient awareness concerning this issue so that imaging procedures are not ordered without sufficient justification.
There are a number of issues that need to be addressed to support informed clinical decision making, since many ordering physicians do not always have access to patients’ medical imaging or radiation dose history.
Problems that arise due to insufficient information:
• Physicians may unnecessarily order imaging procedures that have already been conducted
• Standardized dose structured reporting, while technically available in new CT systems and Fluoroscopes used in interventional procedures, is still in its infancy
• Dose reports are not always contained in either the image files or in the patient’s paper or electronic medical records
• Ordering physicians may lack or be unaware of recommended criteria to guide their decisions about whether or not a particular imaging procedure is medically efficacious
Go to www.fda.gov/Radiation-EmittingProducts/RadiationSafety/RadiationDoseReduction/UCM199904.htm to download the report.
DOD Working with Academia
The Surgeon’s Office within the U.S. Joint Forces Command recently sponsored a working group meeting to bring military healthcare providers together with representatives from DOD’s partner academic institutions to discuss cutting-edge medical techniques. The working group in their study of restorative medicine is examining what DOD can learn from their partners to further develop medical technology to care for wounded warriors, according to Navy Rear Admiral (Dr.) Michael H. Mittelman, Command Surgeon for the Joint Forces Command.
The academic institutions are members of a consortium working with the Armed Forces Institute of Regenerative Medicine, a partnership set up in 2008 between the Defense Department and academic institutions to fund advanced research to rebuild human muscle and tissue.
Impetus for the working group came when Marine Corps General James N. Mattis, Commander of Joint Forces Command, visited the University of Pittsburgh’s McGowan Institute, one of the Armed Forces Institute of Regenerative Medicine partners. Admiral Mittelman said, “While Mattis was there, researchers demonstrated some important emerging care techniques.”
“There appears to be a lack of awareness in the DOD medical treatment facilities about new medical initiatives,” according to Admiral Mittelman. “We are attempting to establish relationships so that the services can educate the academic institutions on the ground rules and the academic institutions can then educate us on what they can provide to our wounded warriors and their families.”
The working group meeting enabled DOD representatives to meet with researchers from Rutgers University, University of Pittsburgh’s McGowan Institute, Wake Forest University, Mayo Clinic, Case Western Reserve University’s Cleveland Clinic, John Hopkins University, and Dartmouth College.
The academic institutions are members of a consortium working with the Armed Forces Institute of Regenerative Medicine, a partnership set up in 2008 between the Defense Department and academic institutions to fund advanced research to rebuild human muscle and tissue.
Impetus for the working group came when Marine Corps General James N. Mattis, Commander of Joint Forces Command, visited the University of Pittsburgh’s McGowan Institute, one of the Armed Forces Institute of Regenerative Medicine partners. Admiral Mittelman said, “While Mattis was there, researchers demonstrated some important emerging care techniques.”
“There appears to be a lack of awareness in the DOD medical treatment facilities about new medical initiatives,” according to Admiral Mittelman. “We are attempting to establish relationships so that the services can educate the academic institutions on the ground rules and the academic institutions can then educate us on what they can provide to our wounded warriors and their families.”
The working group meeting enabled DOD representatives to meet with researchers from Rutgers University, University of Pittsburgh’s McGowan Institute, Wake Forest University, Mayo Clinic, Case Western Reserve University’s Cleveland Clinic, John Hopkins University, and Dartmouth College.
Commercialization Clinic Launched
The University of California Davis Health System received a two year $600,000 National Science Foundation “Partnerships for Innovation” grant to develop a Medical Technology Commercialization Clinic. The project will train students on how to translate innovative technologies developed in university laboratories into useful marketable products to advance patients health.
The grant will fund a multidisciplinary collaborative partnership of scientists, educators, and business leaders to stimulate economic development. The goal is to build a robust infrastructure to develop innovative medical technology as well as build up a diverse workforce.
The Clinic will use live and virtual forums to give graduate and postdoctoral students in biomedical sciences, engineering, and business, hands-on-training to convert high impact research into new treatments and products. This model will help to overcome the existing challenges to university technology transfer, which often focuses on discovering new knowledge and therapeutic applications rather than on business strategies. The students will gain entrepreneurship training and strategies to use to commercialize research projects.
A product now in development is a new endoscope that combines microscopic imaging and ultraviolet auto fluorescence for non-invasive real-time detection of cells progressing toward cancer in the esophagus.
The partnership will work with the UC Davis Center for Biophotonics Science and Technology plus other departments, centers and programs at UC Davis, and with Sacramento State University, a regional resource for medical technology entrepreneurs interested in researching, developing and testing new concepts and medical device prototypes.
Other partners include Fisk University, Los Rios Community College District, Pride Industries, T2 Venture Capital, Wavepoint Ventures, and the cities of Sacramento and West Sacramento.
The grant will fund a multidisciplinary collaborative partnership of scientists, educators, and business leaders to stimulate economic development. The goal is to build a robust infrastructure to develop innovative medical technology as well as build up a diverse workforce.
The Clinic will use live and virtual forums to give graduate and postdoctoral students in biomedical sciences, engineering, and business, hands-on-training to convert high impact research into new treatments and products. This model will help to overcome the existing challenges to university technology transfer, which often focuses on discovering new knowledge and therapeutic applications rather than on business strategies. The students will gain entrepreneurship training and strategies to use to commercialize research projects.
A product now in development is a new endoscope that combines microscopic imaging and ultraviolet auto fluorescence for non-invasive real-time detection of cells progressing toward cancer in the esophagus.
The partnership will work with the UC Davis Center for Biophotonics Science and Technology plus other departments, centers and programs at UC Davis, and with Sacramento State University, a regional resource for medical technology entrepreneurs interested in researching, developing and testing new concepts and medical device prototypes.
Other partners include Fisk University, Los Rios Community College District, Pride Industries, T2 Venture Capital, Wavepoint Ventures, and the cities of Sacramento and West Sacramento.
HHS Awards Task to NORC
The National Opinion Research Center (NORC) at the University of Chicago, a social science research organization was awarded a contract for $561,632 on April 26, 2010. NORC will collect, analyze, and then submit the data to HHS so that the agency will be able to draft a Report to Congress. The report is mandated by HITECH and must be submitted by June 2010.
The legislation requires the Secretary of HHS to submit a report on the findings and conclusions to determine if payments are available to healthcare providers who are not receiving incentives or only minimal incentives under HITECH. After the information is received from NORC, the Office of the Assistant Secretary for Planning and Evaluation will draft a report to be reviewed at HHS and then the report will be submitted to Congress.
The report will include:
• The adoption rates for certified EHR technology by providers
• The clinical utility of the technology by healthcare providers
• Whether healthcare providers really benefit from the use of the technology
• Information on healthcare providers that might otherwise receive an incentive payment or other funding under HITECH, Medicare, Medicaid, or from other sources
• The potential costs and benefits for making payment incentives and any other funding available to healthcare providers
For more information, email Clint D. Druk at clint.druk@psc.gov.
The legislation requires the Secretary of HHS to submit a report on the findings and conclusions to determine if payments are available to healthcare providers who are not receiving incentives or only minimal incentives under HITECH. After the information is received from NORC, the Office of the Assistant Secretary for Planning and Evaluation will draft a report to be reviewed at HHS and then the report will be submitted to Congress.
The report will include:
• The adoption rates for certified EHR technology by providers
• The clinical utility of the technology by healthcare providers
• Whether healthcare providers really benefit from the use of the technology
• Information on healthcare providers that might otherwise receive an incentive payment or other funding under HITECH, Medicare, Medicaid, or from other sources
• The potential costs and benefits for making payment incentives and any other funding available to healthcare providers
For more information, email Clint D. Druk at clint.druk@psc.gov.
Sunday, May 2, 2010
States Taking Steps
Colorado Governor Bill Ritter issued an Executive Order that creates the position of Director of Health Reform Implementation and a new Interagency Health Reform Implementation Board. Lorez Meinhold was named Director of National Reform Implementation and Joan Henneberry, Executive Director of the Colorado Department of Health Care Policy and Financing, will Chair the Board.
Henneberry’s responsibility will be to coordinate activities between agencies needed to implement healthcare reform in Colorado. The board will have a number of other tasks that will include making information transparent by developing an updated web site with up-to-date information. Another task will be to pursue federal and state grants to help the state implement all aspects of health reform.
The Board has the authority to establish advisory groups, task forces, or other structures from within its membership or outside the membership as needed. These advisory groups may include representatives of non-governmental entities including doctors, nurses, economists, actuaries, healthcare professionals, patient advocates, public health, consumer advocates and representatives from health plans, insurers, and businesses
In addition, the Governor signed into law HB 1138 to help healthcare professionals in the state. The Bill will improve the existing public and private loan repayment programs for healthcare professionals practicing in rural and underserved communities to help the primary care workforce grow. The governor also signed Senate Bill 58 to improve the state’s existing nurse loan forgiveness program to extend current eligibility requirements.
The State of Illinois is in the process of developing a state roadmap to detail and analyze anticipated federal healthcare reform legislation and the subsequent federal regulation governing implementation. The Illinois Chamber’s Healthcare Council secured $20,000 secured through the Chamber’s Foundation to fund the roadmap that will highlight state specific options and challenges in dealing with health reform and provide a complete education resource for employers, consumers insurers, and providers.
The state of Illinois also passed HB 6441 establishing state authority to operate the Illinois Health Information Exchange. Illinois received $19 million in federal funds to develop the statewide health information exchange.
With part of the funding, the Governor created a new State Office of Health Information Technology. The Office will promote health IT, increase adoption, assure privacy and security of electronic health information, and direct the state’s planning for a statewide exchange.
The Governor of Ohio Ted Strickland announced that seven regional sites across the state will receive a total of $26.8 million in ARRA funding to help implement the state’s health information technology initiative.
The regional partner sites include the Akron Regional Hospital Association, Case Western Reserve University, Central Ohio Health Information Exchange, Greater Dayton Area Health Information Network, Hospital Council of Northwest Ohio, Northeast Ohio HealthForce, and Ohio University.
The funding resources being used are a portion of Ohio’s total $43 million in stimulus funding awarded to the Ohio Health Information Partnership (OHIP), the nonprofit entity designated by Strickland to lead the implementation of HIT in Ohio. OHIP and the seven regional partners will help more than 6,000 primary care providers install EHR systems and connect to a statewide health information exchange.
In addition, Cincinnati-based Healthbridge, an established health information exchange in the Greater Cincinnati area, received a federal grant to support eleven counties in the Cincinnati region. OHIP is working closely with Healthbridge, to support Ohio physicians and help them transition to EHRs.
The Governor of Maine John E. Baldacci has put into action the process needed in the state to implement the healthcare reform law. The Governor’s Office of Health Policy and Finance, state health officials, the Advisory Council on Health Systems Development, and other offices along with a steering committee are beginning to discuss how to meet all of the requirements under the federal law.
The Governor’s Office and its Health Reform Implementation Steering Committee will be working with the Joint Select Committee on Implementation created by the Maine legislature, stakeholders, and local, federal, and tribal governments.
In Kentucky, Governor Steve Beshear announced that the Kentucky Health Information Exchange has been launched with six pilot hospitals and one clinic participating in the exchange. The cabinet will also work to bring other hospitals and providers on board in the months and years ahead. The project was funded by CMS through its $4.9 million Medicaid Transformation Grant program in 2007.
Henneberry’s responsibility will be to coordinate activities between agencies needed to implement healthcare reform in Colorado. The board will have a number of other tasks that will include making information transparent by developing an updated web site with up-to-date information. Another task will be to pursue federal and state grants to help the state implement all aspects of health reform.
The Board has the authority to establish advisory groups, task forces, or other structures from within its membership or outside the membership as needed. These advisory groups may include representatives of non-governmental entities including doctors, nurses, economists, actuaries, healthcare professionals, patient advocates, public health, consumer advocates and representatives from health plans, insurers, and businesses
In addition, the Governor signed into law HB 1138 to help healthcare professionals in the state. The Bill will improve the existing public and private loan repayment programs for healthcare professionals practicing in rural and underserved communities to help the primary care workforce grow. The governor also signed Senate Bill 58 to improve the state’s existing nurse loan forgiveness program to extend current eligibility requirements.
The State of Illinois is in the process of developing a state roadmap to detail and analyze anticipated federal healthcare reform legislation and the subsequent federal regulation governing implementation. The Illinois Chamber’s Healthcare Council secured $20,000 secured through the Chamber’s Foundation to fund the roadmap that will highlight state specific options and challenges in dealing with health reform and provide a complete education resource for employers, consumers insurers, and providers.
The state of Illinois also passed HB 6441 establishing state authority to operate the Illinois Health Information Exchange. Illinois received $19 million in federal funds to develop the statewide health information exchange.
With part of the funding, the Governor created a new State Office of Health Information Technology. The Office will promote health IT, increase adoption, assure privacy and security of electronic health information, and direct the state’s planning for a statewide exchange.
The Governor of Ohio Ted Strickland announced that seven regional sites across the state will receive a total of $26.8 million in ARRA funding to help implement the state’s health information technology initiative.
The regional partner sites include the Akron Regional Hospital Association, Case Western Reserve University, Central Ohio Health Information Exchange, Greater Dayton Area Health Information Network, Hospital Council of Northwest Ohio, Northeast Ohio HealthForce, and Ohio University.
The funding resources being used are a portion of Ohio’s total $43 million in stimulus funding awarded to the Ohio Health Information Partnership (OHIP), the nonprofit entity designated by Strickland to lead the implementation of HIT in Ohio. OHIP and the seven regional partners will help more than 6,000 primary care providers install EHR systems and connect to a statewide health information exchange.
In addition, Cincinnati-based Healthbridge, an established health information exchange in the Greater Cincinnati area, received a federal grant to support eleven counties in the Cincinnati region. OHIP is working closely with Healthbridge, to support Ohio physicians and help them transition to EHRs.
The Governor of Maine John E. Baldacci has put into action the process needed in the state to implement the healthcare reform law. The Governor’s Office of Health Policy and Finance, state health officials, the Advisory Council on Health Systems Development, and other offices along with a steering committee are beginning to discuss how to meet all of the requirements under the federal law.
The Governor’s Office and its Health Reform Implementation Steering Committee will be working with the Joint Select Committee on Implementation created by the Maine legislature, stakeholders, and local, federal, and tribal governments.
In Kentucky, Governor Steve Beshear announced that the Kentucky Health Information Exchange has been launched with six pilot hospitals and one clinic participating in the exchange. The cabinet will also work to bring other hospitals and providers on board in the months and years ahead. The project was funded by CMS through its $4.9 million Medicaid Transformation Grant program in 2007.
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