To Our Readers: New Web Site

We have a new website at www.federaltelemedicine.com. The new site was designed to make it easier to find information that interests you and to share it on Twitter, Facebook, and LinkedIn.

The present news coverage will continue with an emphasis on federal and state information including DOD and the Veterans Administration, news from Capitol Hill, university research activities, announcements from foundations, non-profits, plus information on selected RFPs and grants.

I will continue to attend and report on selected briefings, meetings, and conferences but there will also be more emphasis on news from industry as it relates to telemedicine, telehealth, and health technology. Richard Bloch an established technology writer located in Northern California will be the blog’s new HIT industry correspondent. His email is rjb@rbloch.com.  

You can go directly to the site at www.federaltelemedicine.news to see the most recent postings. For example, recent postings include news on NIH, Veterans Administration, bills in Utah and New York, and much more…

You can also click the RSS feed where the posts will immediately appear and if you subscribe to the RSS feed, then the information will come directly to your cell phone. If you already subscribe to Federal Telemedicine News through Constant Contact, you will receive a short capsule of information on the new postings as they become available.

Postings will appear at least twice a week or more if there is a need. To keep up with the latest news go to www.federaltelemedicine.com . If you have any questions or would like to send information or ideas, email cb@cbloch.com.

VA Committed to Innovation

The Department of Veterans Affairs launched the VA Center for Innovation (VACI) to build onto the VA Innovation Initiative (VAi2). VACI (www.innovation.va.gov) announced thirteen new awards from its industry innovation competition that focus on teleaudiology, prosthetic socket redesign, Blue Button, and the sterilization automating process for reusable medical instruments.

An awardee the University of Michigan (U-M) Kidney Epidemiology and Cost Center will use the $3.7 million to create a National Kidney Disease Registry to monitor kidney disease among veterans. The Registry is expected to help the VA to care for the more than 10,000 veterans on dialysis with an additional 3,200 veterans estimated to reach kidney failure each year. 

The University of Michigan nephrologist Rajiv Saran, MD, Associate Director of the U-M Kidney Center is the Principal Investigator. She will collaborate with biostatisticians, along with organ transplant and health policy specialists on the project.

Other awards were given to:

• RemotEAR by Otovation of King of Prussia, PA—to improve audiology services by providing a solution for assessing all audiology services through rehabilitation
• Technical Feasibility of Smartphone Based Teleaudiology by Phonak of Warrenville, Il—to enable remote programming of hearing aids through a smartphone
• Remote Audiometry in VA CBOCs, by Audiology, Inc., of Arden Hills MN—to develop an automated audiometer to support personnel in VA facilities
• Cochlear Implant Programming by Cochlear Americas of Centennial CO—to develop remote programming for cochlear implants
• Quasi-Passive Prosthetic Socket Technology by MIT—to improve socket fit by using a permanent socket that allows for adjustments to stiffness and reduces the socket movement by using continuous electronic sensors and laminate technology
• Pro-Active Dynamic Accommodating Prosthetic Socket by Infoscitex of Waltham MA—to create a prosthetic socket with sensors to conform to volume changes as well as changes caused by the gait cycle
• Socket Optimized for Comfort with Advanced Technology by Florida State University of Tallahassee, FL—to develop a prosthetic socket to better manage changes in volume and pressure and provide active cooling and temperature control
• Synergetic Improvements for Transfermoral Prosthetic Sockets, by the Ohio Willow Wood Company of Mt. Sterling OH—to create an improved transfermoral suspension and socket system made from polymer materials
• VA Mobile Blue Button by Agilex Technologies of Chantilly, VA—to allow patients to view and share their VA health data using their mobile devices
• Blue Button Authentication Field Test Proposal, by Northrop Grumman—to enable veterans to authenticate online to access their medical records
• Blue Button Extensions Medical Imaging by Ray Group International of Washington D.C.—to enable veterans to view and download their own medical images and  transmit the images to their non-VA physicians
• Automated Integrated Perioperative Process by GE Global Research of Niskayuna, N.Y—to help the VA develop a fully automated process for sterilizing reusable medical instruments

DOD Plans for Mobile Devices

The Department of Defense released their “Commercial Mobile Device Implementation Plan” that focuses on improving areas critical in using mobile devices, wireless infrastructure, and mobile applications. The Plan emphasizes the need for reliable, secure, and flexible devices to keep up with fast changing technology.

The Plan establishes a framework to equip the department’s 600,000 mobile users with solutions that leverage commercial off-the-shelf products, promotes the development and use of mobile applications to improve functionality, decreases costs, and enables increased personal productivity.

The Plan will provide for a series of operational pilots from across DOD components that will incorporate lessons learned, ensure interoperability, refine technical requirements, influence commercial standards, and create operational efficiencies for DOD mobile users.

To specifically meet DOD’s need to deal with classified information, the agency is rolling out a program to enable users of a range of mobile devices working anywhere from remote battlefields to the Pentagon, to rapidly share classified and protected data across all components. Several thousand of mobile devices in use in DOD are capable of handling classified data.

According to Teri Takai, Chief Information Officer, “The challenge for the Defense Department is to design a unified system capable of fully leveraging the potential of devices that often differ in capabilities and sophistication in a way that will allow users to communicate in a secure, wireless environment.”

“The commercial mobile device market is moving so quickly, that we can’t wait to develop the full capability of these devices. If we don’t get something in place, we will end up with multiple solutions just because the demand to use these devices is so strong”, she added.

Officials are planning for a phased implementation involving vendor competition for developing a system to meet the needs that Takai suggests. Takai also thinks that DOD’s three million plus employees could prove to be a model for large companies that also need to protect the transmission of both open and confidential data.

HIE Operates Efficently

The State of Indiana provides healthcare for a population that has significantly higher rates than the national median for a variety of chronic diseases. Nearly 9.6 percent of the 455,000 residents in Indiana have diabetes which is more than the national average of 8.2 percent. Also, it is a fact that many people in the state aren’t getting the health screenings that they need for certain cancers.

The Central Indiana Beacon Community led by HHS enacted as a result of the HITECH Act, is trying to address these issues through better collection and use of data and by making improvements to the health system.

To rectify the need for better healthcare, the Indiana Health Information Exchange (IHIE) now supports a network of more than 25,000 physicians and 90 hospitals throughout the state. The collaboration between the Decatur County Memorial Hospital (DCMH) based in Greenburg Indiana and the Indiana Health Information Exchange (IHIE) is supported in part by the Central Indian Beacon Community.

To provide the information flow, the “DOCS4DOCS” Service is an electronic results delivery service provided by IHIE. The system offers a single sourced for clinical information such as lab results, radiology reports, transcriptions, pathology and hospital admissions reports, discharge and transfer reports from all participating Indiana hospitals, physician practices, labs and radiology centers. Results can be viewed through a web-based portal or delivered directly into the EMR system at no cost to the provider.

In a recent move, DCMH connected to the Indiana Health Information Exchange (IHIE) through the Indiana Network for Patient Care (INPC) which encompasses hospitals, long term care facilities, and other healthcare providers throughout the state to enable physicians to securely access necessary information.

INPC includes information from encounters covering over 90 percent of care provided at hospitals in the Indianapolis area. The network handles over a million secure health transactions daily that contain:

• 3 billion pieces of clinical data supporting care for an area with a population of about 6 million people
• 80 million radiology images
• 50 million text reports
• 750,000 EKG readings
•  Discharge summaries, operative notes, pathology reports, medication records, patient abstracts, and trend data

B2B Program Seeks Ideas

NIH is calling for proposals for their intramural “Bedside-to-Bench” (B2B) Award Program. The program funds research to translate clinical observations to the laboratory and then back to the patient. The program also promotes collaborations that can involve either intramural investigators from different laboratories or both intramural and extramural investigators. A B2B award provides up to $135,000 a year for two years.

Projects have represented research categories such as AIDS, rare diseases, behavioral and social sciences, minority health and health disparities, women’s health, diseases, drug development, pharmacogenomics, and other general research areas.

Through the end of the 2012 program cycle, about 700 principal and associate investigators have collaborated on 209 funded projects for approximately $48 million distributed in total bedside-to-bench funding resulting in partnerships at 74 institutions.

NIH funding is anticipated from the Office of Rare Diseases, National Center for Advancing Translations Research (NCATS), the Office of Behavioral and Social Sciences Research, Office of AIDS Research, Office of Research on Women’s Health, the Office of Intramural Research, and the Center for Regenerative Medicine.

Categories for awards to be funded include:

• AIDS—four awards related to AIDS
• Behavioral and Social Sciences—up to two projects with particular interest in interdisciplinary research, systems thinking, and modeling approaches that integrate multiple levels of analysis
• Rare Diseases—NCATS will co-fund two projects related to a rare disease
• Regenerative Medicine—one project to accelerate the clinical translation of stem cell-based technologies and to develop widely available resources to use as standards in stem cell research
• Women’s Health—one project will be funded to focus on improving the health of women through biomedical and behavioral research related to the roles of sex and gender in health and disease 

The B2B teams involve basic and clinical researchers often come from different NIH Institutes and Centers. However, in 2006, the B2B program started uniting the efforts of intramural and extramural NIH researchers. As a result, both intramural and extramural NIH investigators are able to apply for research projects.

Extramural principal investigators with an existing NIH grant may initiate proposals by seeking an intramural partner at NIH who would function as the project leader and serve as the point of contact. To identify a collaborator, interested parties can research the NIH database of current intramural research, the PI directory, or contact the B2B program office for assistance in identifying intramural partners.

A Letter of Intent is due April 3, 2013 with full proposals to be submitted by May 2013. For more information, email bedisdetobench@mail.nih.gov or go to www.cc.nih.gov/ccc/btb/awards.shtml.

GLNT Secures NIH Funding

Great Lakes Neuro Technologies (GLNT) funded by NIH for $1,743,051 with a Phase II SBIR grant, is launching commercialization and clinical studies to validate a system to continuously monitor dyskinesias associated with Parkinson’s disease (PD).

The technology will be developed and commercialized at GLNT with clinical validation studies to be completed at the University of Rochester, Johns Hopkins University, and Albany Medical College.

Patients with PD often have side effects using common therapies to treat motor symptoms known as dyskinesias which are involuntary and irregular rapid movements. Severe dyskinesias can cause patient exhaustion, fatigue, social isolation, and depression, as well as increase healthcare costs.

Specifically, the NIH-funded program will develop a patient worn system of motion sensors that can continuously assess the presence and severity of dyskinesias as a patient goes about their daily activities. The technology integrates wireless patient sensing with a home-based tablet that transfers patient reports over a broadband link to a cloud server. The technology will help clinicians to optimize existing treatments or help pharmaceutical companies during clinical trials to evaluate new treatments.

The two year program will focus on two specific development stages. Year 1 will focus on technology development to include sensor development, patient ergonomics, and technology integration. Year 2 will then utilize the technology in a multi-site clinical trial to validate and compare with traditional dyskinesia measurement tools and to demonstrate improved patient care when integrating continuous dyskinesia monitoring in patient homes.

As new therapies emerge to better control or delay the onset of dyskinesias, it is important that innovative monitoring and assessment technologies are able to gage treatment efficacy,” said Thomas Mera, Product Development Manager at GLNT and Principal Investigator on the program.

He continued to explain, “Traditional strategies for assessing dyskinesia include subjective clinical rating scales and using patient diaries. While clinical rating scales have proved useful, clinicians cannot be continuously present, or at the patient’s home.”

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

DOJ Seeks Funding Applications

The Department of Justice’s Office of Justice Programs within the Bureau of Justice Assistance (BJA) is funding the Harold Rogers Prescription Drug Monitoring Program (PDMP) to help prevent and detect the abuse of pharmaceutical controlled substances in this country.

Forty three states now have operational PDMPs and six states and Guam have enacted legislation to establish a PDMP but these PDMPs are not yet fully operational. Since the grant program started with the FY 2002 appropriations, grants have been awarded to 49 states and 1 U.S. territory to support efforts to plan, implement, or enhance a PDMP.

The Harold Rogers PDMP enables states to use their discretion to plan, implement, or enhance a PDMP. In FY 2013, the program is expanding further to provide funding to states and localities to pilot innovative ways to use PDMPs and to come up with other ideas on prevention, treatment, and enforcement.

State governments and country governments located in states with existing and operational prescription drug monitoring programs plus recognized tribal governments can also apply for grant funding within three categories.

Category 1—(Implementation and Enhancement Grants) includes up to $400,000 to use to implement and/or enhance PDMP systems. Funds may be used to establish and build a data collection and analysis system, develop an infrastructure to support programs, facilitate the exchange of information, establish collaborations, develop education/training programs, facilitate electronic information sharing among states, and provide unsolicited reports of controlled substance prescribing to authorized individuals.

Category 2—(Tribal PDMP Data Sharing Grants ) includes up to $150,000 for tribal governments seeking to report and request data from individual states PDMPs for the purpose of equipping providers with prescription drug monitoring history. Funds may be used to help tribal governments develop and implement the necessary legal, policy, and technical infrastructure needed to support the reporting of patient-level controlled substance prescription dispensing data transmission from tribal and urban healthcare facilities.

Category 3—(Data-Driven Multi-Disciplinary Approaches to Reducing Rx Abuse Grants) includes up to $400,000 to pilot an innovative approach to combat and reduce prescription drug abuse. Funds may be used to form multi-disciplinary action groups consisting of county, state, and federal criminal justice professionals in addition to state and local health authorities as well as treatment providers.

The action groups will collect data from various sources such as medical examiners, emergency rooms, crime data and other sources to examine PDMP data as well as provide additional information to help pinpoint specific locations within the county that are at-risk for prescription drug abuse and drug overdose deaths.

Grant activities should focus on data sharing arrangements, data collection, and analysis. Grantees will determine best practices for sharing data, intelligence gathering, targeted regulatory and enforcement activities, and prioritizing of treatment and prevention efforts for at-risk individuals and communities.

Go to www.bja.gov/Funding/13PDMPsol.pdf or www.grants.gov for more information.