Sunday, January 31, 2010

CMS Implements New Demos

A community-wide health information exchange in Indiana and a consortium of community care physician networks in North Carolina are two new CMS demonstrations to encourage the delivery of improved care to an estimated 130,000 beneficiaries in those states.

The Indiana Health Information Exchange will be the first demonstration to examine and implement a regional, multi-payer, pay-for-performance, and quality reporting program based on a common set of quality measures. It is unique among recent Medicare projects because now Medicare data will be used by the IHIE along with clinical and administrative data from other sources to provide participating physicians with improved information on their patients.

The North Carolina Community Care Networks (NC-CCN) demonstration will extend the medical home concept to low income Medicare beneficiaries, and to those eligible for both Medicaid and Medicare. NC-CCN will include eight regional health care networks in several North Carolina counties that will combine community-based care coordination plus health information technology to support more effective care management.

Caring for Medicare and Medicaid dually eligible beneficiaries can be fragmented even when the care for Medicaid is coordinated well. Often the states that utilize effective care management programs in their Medicaid programs do not extend their care programs to those eligible for both Medicaid and Medicare but with this demonstration, care will be extended to Medicare beneficiaries.

The networks will include community physicians’ hospitals, health departments, and other community organizations to serve as the medical home or primary source of care for dual eligible beneficiaries. Each network will employ clinical care coordinators who will work with practices to plan and coordinate care for all of the patients in the medical home. The networks will also measure care performance through quality measurements and implement performance incentives for effective care.

For more information, go to

Growth Spurt for e-Prescribing

Reports show that e-prescribing has more than doubled from 68 to 190 million e-prescriptions in 2009 with the adoption of the technology by prescribers going from 74,000 in 2008 to 150,000 by the end of 2009. This data was reported by Surescripts CEO and President Harry Totonis speaking at the Annual eHealth Initiative Conference “Delivering on the Promise of eHealth” held January 25-26 in Washington D.C.

Totonis said there is still much more to be done and his company is actively planning for the future. For example, since the use of prescription history has grown more than four fold in 2009, Surescripts has plans in early 2010 to work on a contractual arrangement with Google and with others to make prescriptions histories available for Patient Health Records. In general this action will extend the availability of prescription histories overall and provide improved connectivity. Patients will be able to have access to their prescription information anytime/anywhere and will not have to go individually to each pharmacy for information.

Surescripts is also going to work with a few Health Information Exchanges (HIE) on a pilot basis to provide prescription history to the HIEs at a lower cost and is currently discussing “meaningful use” with the HIEs. In addition, Surecripts is forming an HIE Advisory Committee to discuss and tackle all of the issues involved in making this project a reality.

Totonis also announced that Surescripts as of January 1, 2010 has lowered the cost for e-prescribing services. The company anticipates reducing the costs for e-prescribing by 10 to 20 percent because of Surescripts has achieved operational efficiency and also as a result of the benefits from the company’s merger with RxHub. Totonis says his company is committed to continuing price reductions and as the cost for e-prescribing continues to go down, Surescripts will pass the savings on to others.

For more information on the eHealth Initiative Conference, go to

NIDA Seeks Technology

The National Institute on Drug Abuse (NIDA) issued a Funding Opportunity Announcement (FOA) to support research, development, and pilot testing to develop technological tools. These tools may include mobile enabling technologies, enhanced medication monitoring systems, computer software, portable digital devices, cell phones or digital assistant devices to help patients adhere to HIV treatment regimens found in substance abuse populations.

This funding will require multidisciplinary collaboration between social scientists, physicians, nurses, researchers, and technology experts to develop and refine mobile technological instrumentation, e-health technology, and software.

Possible research topics can include but are not at all limited to these topics such as forming focus groups and then examining reactions to using the interventions. Another topic is to develop pilot testing interventions that incorporate technological devices to determine feasibility, acceptability, and tolerance for a larger randomized trial.

The technological tools being studied may be used alone or in combination with other adherence-promoting behavioral or structural interventions to encourage consistent use of treatment regimens and associated HIV care.

The funding support is for both the R34 FOA (PAS-10-098) and the accompanying RO1 FOA (PAS-10-097) funding announcements. NIDA intends to commit up to $1.5 million in total costs in FY 2010 and $1.5 million for FY 11 for both FOAs. There are plans to award 6-9 new projects under these FOAs. Because the nature and scope of the proposed research will vary from application to application, the size and duration for each award will also vary.

Institutions of Higher Education, non-profits, for profits, small businesses, state and local governments, regional organizations, and others are eligible to apply. The opening date to submit applications is April 7, 2010 and the expiration date for applications is September 8, 2012.

Go to for more information.

Developing an Integrated System

The Minnesota Department of Human Services through their Children’s Mental Health Division at the State level is looking to develop an integrated system to deal with depression care management between primary healthcare and mental healthcare providers. The goal is to better identify depression in children and adolescents, provide access to evidence-based depression treatments, and this in turn should help more providers care for children and adolescents diagnosed with depression.

Approximately 9 percent of youth from 12 to 17 experiences at least one major depressive episode in a year with a lifetime prevalence rates for depression in adolescence estimated to be from 15 to 20 percent. Of those identified with depression only 17.2 to 42.9 percent received treatment for depression. Untreated depression associated with suicide, is the second leading cause of death for 15 to 19 year olds in Minnesota and the third leading cause of death for 10 to 14 year old Minnesotans.

The state of Minnesota is looking to enter into grant contracts with two primary care clinics enrolled in the Minnesota Health Care Programs to develop and integrate a depression care management system for children and adolescents that will function between primary care and mental health providers.

To address this issue, an RFP was released January 25th by the Minnesota Department of Human Services looking for responders to develop proposals in this needed treatment area.

The respondents to the RFP will be required to:

• Form a steering committee to inform and direct project goals
• Implement a tracking system and monitor the performance
• Develop universal screening for depression for all children ages 6 to 17 using the Child Depression Inventory
• Participate in educational activities on evidence-based treatment for depression
• Develop referral and treatment protocols for positive depression screening
• Develop communication and collaboration systems to go between primary care and mental health providers

The primary care clinic applicants need to obtain a Memorandum of Understanding from at least one mental healthcare clinic in their geographic region so as to partner with them on the projects.

Questions from responders regarding the RFP must be submitted by February 17, 2010 and proposals are due March 26, 2010.

Go to for more information, or email Cheryl Sybesma, PhD, Children’s Mental Health Division, Department of Human Services at , or call (651) 431-2328.

FCC to Hold Public Forum

The Federal Communications Commission’s Public Safety and Homeland Security Bureau plans to hold a public forum to discuss how and whether to create an emergency response interoperability center to deal with public safety broadband communications. The meeting will be held on February 10, 2010 at the FCC.

This meeting is being held in response to public comments that the FCC received as part of the National Broadband Plan proceedings. This forum will examine ways that an emergency response interoperability center could be set up to develop common standards and be able to provide interoperability and operating procedures. This will help public safety licensees that are authorized to construct, operate, and use the nationwide wireless broadband network.

The forum will address how an interoperability center could help resolve interoperability-related disputes between public safety entities, establish standards for commercial providers to expand public safety’s access to broadband services across the nation, and ensure that grant funds are used efficiently.

For more information, contact Susan McLean at (202 418-7868 or by email at

Wednesday, January 27, 2010

Grant Announcement Posted

HRSA recently posted their “Small Health Care Provider Quality Improvement Grant Program” announcement seeking rural providers ready to implement quality improvement strategies. The plan is to help improve patient care and chronic disease outcomes for diabetes mellitus, and cardiovascular disease. The grant’s goal is to help rural primary care providers achieve these goals by using the Chronic Care Model along with Electronic Patient Registries (EPR).

Both the EHR and EPR are electronic systems, but the EPR captures information that is population-based with data on specific conditions. This grant program does not support funding for an EHR, but healthcare providers who currently have an EHR are still eligible to participate in the program.

Some of the previous grantees have used their experience working with EPRs as a stepping stone to electronic medical records adoption. These grantees also have interests in the medical home model to help spread and sustain their quality improvement initiatives that go beyond chronic disease tracking to disease prevention. Grantees have also developed business case models to help sustain their quality improvement initiatives.

The program will provide funding during FY 2010-2012. Approximately $6,000,000 is expected to be available annually and to fund up to 60 grantees. Applicants can request up to $100,000 per year. Funding beyond the first year is dependent on the availability of funds in subsequent fiscal years.

Applicants must be a rural public or rural non-profit private entity and must not have previously received a grant for the Rural Quality Grant Program or a similar project. Examples of eligible entities include rural health clinics, critical access hospitals, small rural hospitals, and Federally Qualified Health Centers. For profit Rural Health Centers and Critical Access Hospitals may also apply.

Eligible applicants must also meet at least one of these three requirements:

• Applicants must be located in a rural area
• Applicants exist exclusively to provide services to migrant and seasonal farm workers in rural areas
• Applicant is a Tribal government where grant funded activities will be conducted within their Federally recognized Tribal area

The application is due March 15, 2010. For more information, go to or contact Elizabeth Rezaizadeh, Program Coordinator by email at or call (301) 443-410.

Iowa Gearing Up to Save

Last December, the Governor of Iowa Chet Culver signed an Executive Order to enact cost saving recommendations that have the potential to save the state over $700 million over five years. Recently, the Iowa Efficiency Review Report was completed and made the 40 recommendations on how to achieve cost savings. The report was submitted to the Governor and Lieutenant Governor Patty Judge.

A portion of these measures will affect technology development, health, and medical fields. Some of the recommendations may require legislative action and some of the recommendations may also undergo further review.

According to the report, cost savings would be achieved if telemedicine services were to be reinstated between the Department of Corrections (DOC) and the University of Iowa. Most routine medical care for correctional facility inmates takes place in the prison and is provided by prison physicians with the University of Iowa physicians providing specialty care.

In past years, telemedicine links between the Department and the University provided experts in orthopedics, HIV, internal medicine, urology, cardiology, psychiatry, dermatology and other specialties. However, the University of Iowa provided its last telemedicine consultation in August 2009.

Before the telemedicine consultation program ended, the DOC transported an average of 113 prisoners each week to visit a University of Iowa physician for specialty consultations. The DOC estimates that transportation costs and pay for the overtime required for prison guards to transport inmates to the University medical facilities amounted to $393,000 a year. It was found that about 38 percent of these costs could be saved by using telemedicine. Plus if additional visits were avoided by using telemedicine, even more savings would accrue.

To save money, the state wants to increase the use of technologies and use more “Thin Client Technologies” or sometimes called server-based computing. Computers today have become very complicated and are not always a simple tool to use and as a result, when new hardware and software is released, determining compatibility can be a problem.

To simplify the problem, “Thin Client Technology” (TCT) is a computer or computer program that allows data storage memory and processing horsepower to be located on a computer server. This means that many clients will be able to share their computer work using the same server.

TCT saves money by allowing updates, maintenance, and security to be done at a central location during non-working hours thus reducing the amount of time that the staffs needs to travel to individual sites. TCT also eliminates connectivity problems to satellite offices and provides a secure way for employees to access the state system when they are out of their offices.

Michigan recently converted over 27,000 employees to its TCT system and saved between $3 million and $5 million within its first year of operation. It is thought that by replacing 33 percent of the PCs every five years with TCT, Iowa can save $4.3 million in five years.

The report also recommends that the state consolidate IT professional services contracts. In fiscal year 2010, Iowa is projected to spend $15 million on multiple professional services contracts with private vendors. It is thought that if the state consolidated its projected $15 million multiple contract spending, the state could negotiate lower prices because it would be buying many more services from the same vendor and could take full advantage of bulk purchasing prices for IT services.

Savings could also be achieved by expanding the use of electronic payments in the state Department of Human Services (DHS). Electronic payments are widely used in DHS, but are not used in the Children and Family Services Division. Additionally all Health Insurance Premium Payments and most payments to Medicaid providers are made by paper warrants. Only 25 percent of DHS payments are made electronically.

DHS could save about $156,000 in the first year of full implementation if 75 percents of these payments were made electronically. This takes into account the cost of $149,000 for the system changes that would be required. Total savings over five years would be $780,000.
Other measures that could effectively reduce costs would be to:

• Consolidate information technology planning and operations as feasible
• Consolidate wireless equipment purchasing and service contracts
• Ensure that the state is getting the best purchase prices for required Medicaid medical equipment
• Modify the Medicaid Durable Medical Equipment rental versus purchase policies
• Update Nursing Home Recoverable Cost Regulations to assure that the state’s financial interests are fully protected
• Claim federal reimbursement for eligible inmate hospital care
• Modify Medicaid prescription drug purchasing

Go to to download the report.

MHS IM/IT Plan Approved

The Military Health System Information Management/Information Technology Strategic Plan for 2010-2015 has been approved by the Senior Military Medical Advisory Committee. Leaders from the Army, Navy, Air Force, Health Affairs, TRICARE Management Activity, Joint Staff, Joint Task Force National Capital Region Medical, and the MHS Office of the Chief Information gathered last summer for a series of workshops to develop the plan.

While there have been strategic planning initiatives that have guided key priorities throughout the last ten years, this new effort by IM/IT leadership across the services, is the first formally approved plan since 1999.

The plan’s ten IM/IT goals that the Military Health Service (MHS) will focus on over the next five years are to:

• Provide rapid, affordable, secure delivery, and life cycle support for IT products and services
• Provide a comprehensive longitudinal EHR for all beneficiaries and care settings
• Implement a governance structure and process to enable effective and efficient use of resources
• Enhance enterprise intelligence through the use of enterprise tools, data, and services
• Advance the MHS personalized health agenda so that patients would have electronic access to their own records, have virtual visits, and be able to refill prescriptions online
• Advance IT interoperability using health, operational, and functional partners to create an accessible and complete virtual lifetime electronic record
• Show how the flow of funds from programming to execution can improve using better cost estimating methodologies
• Establish an innovation lifecycle management process to align IT innovation with MHS strategy
• Improve human capital management by having the right people with the right training and experience on the right job
• Develop processes, guidance, and standards to develop and integrate distributed services and applications so that time and money spent on products can be delivered rapidly and with a minimum amount of modification

In total, the planning team drafted 13 unique action plans and 14 performance measurements to define specific activities, deliverables, and milestones. In the months ahead, the IM/IIT strategic planning team will work with the action plan teams across the MHS and then draft updates, review the IM/IT measures, and determine if and how these measures should link to the broader MHS Value Measures dashboard.

For more information, go to

Medical Trade Center to Open

Tennessee Governor Phil Bredesen plans to locate the world’s first medical trade center on the site of the current Nashville Convention Center. “The Nashville Medical Trade Center is an innovative way to take cost, complexity, and time out of the procurement process for healthcare providers.

We believe physicians, healthcare administrators and caregivers of all kinds will come to Nashville to evaluate firsthand the latest technologies available”, said David Osborn, PhD, formerly of the Health Care Solutions Group now the company’s senior advisor for the project.

Having the medical trade center in Tennessee means that the state will be home to an important new concept in the marketing and procurement of medical equipment, technology, and services, said Bredesen. “The healthcare industry is a significant economic engine for our state and this project represents a major investment in our state’s healthcare economy.

The Market Center Management Company will oversee the work on the proposed trade center and will begin immediately to work on pre-leasing the proposed trade center’s permanent exhibition.

Development is contingent on pre-leasing a significant amount of exhibit space and securing financing. Developers estimate the cost of the project to be in the neighborhood of $250 million and estimate that the project will create approximately 2,700 new jobs.

Texting Helps Treat Children

Text messaging can be an invaluable tool according to Johns Hopkins Children’s Center pediatrician Delphine Robotham. Research has shown that up to half of the patients may fail to take their daily medication properly because they forget so in some cases, a text reminder may be all that a patient needs, adds Robotham.

Several recent studies have looked at the use of short message service (SMS) or text messaging in a medical context. According to Robotham, one study involving children with diabetes showed improved blood glucose testing rates and the children were more likely to share their blood glucose text readings with their doctor’s office.

In another study patients on immunosuppressive drugs after a liver transplant improved their medication adherence. The study detected measurable clinical benefits from text messaging with acute liver rejection episodes dropping dramatically as a result of better medication adherence.

Hopkins Children’s TB expert Sanjay Jain, M.D reports that texting is even a more popular way to communicate outside of the U.S. especially in developing countries. This is a great way to reach hard-to-reach patients, according to Jain.

Hopkins Children’ may soon formalize the use of this technology. Pediatric HIV expert Allison Agwu, M.D. is preparing to launch a formal study that has been using texts to remind her patients of follow-up appointments with good response so far.

The doctors agree that texting is not always a substitute for all communication, as it may be expensive and it doesn’t always ensure reaching a patient who may have changed their number or lost their phone.

Sunday, January 24, 2010

NTIA/RUS Broadband News

The Commerce Department’s National Telecommunications and Information Administration (NTIA) and USDA’s Rural Utilities Service recently released the second Notice of Funding Opportunity Availability (NFOA) for $4.8 billion to provide grants and loans to expand broadband access and adoption.

NTIA’s Broadband Technology Opportunities Program (BTOP) funding notice allocated $2.6 billion of which $2.35 billion will be made available for infrastructure projects. In this round, NTIA is adopting a comprehensive communities approach in awarding infrastructure grants and concentrating on middle mile broadband projects to connect key community anchor institutions.

In addition, NTIA plans to award at least $150 million of the funding for Public Computer Center projects to expand access to broadband service at libraries, colleges, and other institutions that serve the general public. NTIA also plans to award at least $100 million for Sustainable Broadband Adoption projects to provide broadband education, training, and equipment particularly to vulnerable population groups.

RUS has allocated $2.2 billion in this funding round for broadband infrastructure projects through their Broadband Initiatives Program (BIP). A second funding window will open later which will provide grants for satellite service for premises that remain unserved, make technical assistance grants to help develop plans to use broadband for regional economic development, and to provide grants to help bring broadband service to rural libraries.

This RUS round will focus on last mile projects which are anticipated to receive the vast majority of funding but RUS will also fund middle mile projects involving current RUS program participants. The first RUS NOFA had two funding options such as funding for grants up to 100 percent in remote rural areas, and 50/50 loan/grant combinations in non-remote rural areas. Now RUS has eliminated this distinction and adopted a base 75/25 grant/loan combination for all projects.

NTIA has announced that the rules for applying for awards in this round have been modified to make the application process easier for applicants.

Some of the changes involve:

• Separating BTOP and BIP applications to increase efficiency

• Focusing on “Comprehensive Community” infrastructure projects

• Removing the requirement that infrastructure projects connecting community anchor institutions must be located in unserved or underserved areas although these areas will receive additional consideration

• Improving the online application system to streamline the intake of information and make the process more user-friendly

• Clarifying eligibility factors and for requesting waivers from several key statutory and programmatic obligations

The agencies are accepting applications from February 16, 2010 to March 15, 2010 for the second funding and awards will be announced in September.

Both NTIA and RUS will hold a series of public workshops to review the new application process and answer questions from prospective applicants. The workshops will be held starting on January 26th through February 12th in Portland, Oregon, Reno, Nevada, Denver, Colorado, San Antonio, Texas, Eureka, Missouri, Sioux Falls, South .Dakota, Detroit, Michigan, Blacksburg, Virginia, Fayetteville, North Carolina, and Atlanta, Georgia.

So far, NTIA has awarded grants to fund broadband mapping and planning activities in Connecticut, Hawaii, Kentucky, Maine, Mississippi, Nebraska, New Mexico, Oklahoma, Pennsylvania, and Texas under NTIA’s State Broadband Data and Development Grant Program. In addition, on January 20th, NTIA announced grants totaling $63 million to expand broadband access and adoption in Massachusetts, Michigan, and North Carolina.

For more information on the second round of funding go to and for information on the new online tool to facilitate partnerships go to

"Cloud Computing" Topic at Brookings

Brad Smith, Senior Vice President and General Counsel at Microsoft urges both Congress and the information technology industry to act now to ensure that the burgeoning era of cloud computing will be guided by an international commitment to privacy, security, and transparency for consumers, businesses, and government.

As the keynote speaker at the January 20th Brookings Institution event held on “Cloud Computing for Business and Society” he explained, we have entered a new era called cloud computing where software runs not only on the user’s own PC and IT systems but also the user is increasingly using applications and services increasingly obtained from the internet and from other remote data centers.

The potential benefits of cloud computing enable organizations to customize and rapidly scale their IT systems for their particular needs, enables expanded access to computational capabilities previously available only to the very largest global companies, and provides for better collaboration for users throughout the world.

At the Brookings event, Smith called for a national conversation on building confidence in the cloud and proposed that the “Cloud Computing Advancement Act” be put in place to promote innovation, protect consumers, and provide government with new tools to address the critical issues of data privacy and security. Smith also wants to have an international dialogue on data sovereignty to guarantee users that their data is subject to the same rules and regulations, regardless of where the data resides.

Microsoft is proposing legislation to:

• Improve privacy protection and data access rules by strengthening the Electronic Communications Privacy Act to clearly define and provide for stronger protections for consumers and businesses

• Modernize the Computer Fraud and Abuse Act so that law enforcement has the tools it needs to go after malicious hackers and to deter instances of online-based crimes

• Enhance security through greater transparency to help users benefit from Truth-in-Cloud-Computing principles. Consumers and businesses would then know whether and how their information is accessed and used by service providers and how the information is protected

• To pursue a new multilateral framework to address data access issues globally. Congress should ensure that the Executive Branch has the resources to engage in international negotiations to develop the framework needed to promote clarity and consistency in data protection

A panel discussion followed with Darrell West, Vice President and Director of Governance Studies at Brookings moderating. He said the internet is critical for the nation’s growth but added that the digital infrastructure needs to be supported and maintained just like the U.S. maintains roads and bridges.

Michael Nelson, PhD, Visiting Professor of Internet Studies in Georgetown University’s Communication, Culture, and Technology Program voiced his opinion that competition will help cloud computing and in two or three years cloud computing will be controlled by two or three companies. We cannot be locked into one company’s solution as we need to listen to customers, and provide customers choices along with transparency.

The panelists were in agreement that the Federal government needs to play a role in developing the Cloud, be there to clarify and update the rules, address privacy and security in the cloud especially in the case of mobile devices, and crack down on state centered lawlessness as in exhibited in countries like China.

SBIR Solicitation Released

NIH, CDC, FDA, and ACF released (PHS 2010-02) the Omnibus Solicitation for SBIR grant applications on January 15th. This Funding Opportunity Announcement (FOA) is an opportunity for Small Business Concerns (SBC) with research capabilities and technological expertise to submit SBIR grant applications in response to identified topics.

The SBIR program is structured in three phases. The first two phases are supported by SBIR funds. Phase I establishes the feasibility of doing the proposed research or R&D efforts and the objective of Phase II is to continue the work initiated in Phase I. Phase III is to help the small business community pursue with non ABIR funds commercialization objectives resulting from the results in Phase I and II.

The total award amount and number of awards will be dependent on available funding and on the number of meritorious applications received. Phase I is not to exceed $100,000 and Phase II is not to exceed $750,000.

The FOA just released includes a number of ideas and topics listed by the Institutes where there is interest in research and R&D. Some of the listed topics from the Institutes are:

• National Institute of Biomedical Imaging and Bioengineering—Develop new technologies to collect, store, retrieve, and integrate quantitative data, plus provide large scale data driven database methods to support data mining, statistical analysis, systems biology and modeling efforts, drug and gene delivery systems, and medical devices. NIBIB wants to develop software and hardware for telehealth studies

• National Institute on Aging—Develop practical applications using innovative technologies to do research on hand-held devices, telemedicine, robotics, social networking, and communications technologies

• National Institute of Neurological Disorders and Strokes---Develop instruments to monitor nervous system activity during surgical procedures, develop technologies to allow neurosurgeons to repair the brain, develop devices and methods to remove blood clots, develop rehabilitation devices, monitoring systems, pediatric brain imaging, and web-based entry and data management tools to use for clinical research

• National Institute of General Medical Sciences---Develop databases and data formats, develop tools to model complex biological systems, and design and develop related software and hardware

• National Institute of Mental Health---Develop informatics tools to enable brain scientists and clinicians to make better use of their data, develop technologies for clinical pediatric research, develop pediatric assessment tools, monitoring technologies, and deep brain stimulation

• National Cancer Institute---Develop new telemedicine technologies, remote medical imaging, and bioengineering technology that can be applied to cancer detection and diagnosis. Seeks methods for analyzing the data associated with molecular profiling and other comprehensive molecular analysis technologies, software to interpret and analyze clinical and pathology data to include methods that relate data from clinical databases to external data sources

• National Institute of Diabetes and Digestive and Kidney Diseases---Develop sensors and delivery devices for monitoring blood to prevent hypo and hyperglycemia in diabetic patients, design glucose sensor and insulin delivery systems to create an artificial pancreas, and research new devices to improve insulin delivery methods

• National Institute for Drug Abuse ---Develop new technologies to use for screening, assessing, and preventing problem drug use, to match HIV patients with appropriate treatment services, develop an electronic drug abuse treatment referral system for physicians, develop eHealth tools, plus develop new technologies to integrate data from prescription monitoring programs to current clinical practices

• National Heart, Lung, and Blood Institute ---Develop new medical devices for point-of-care monitoring to use to diagnose, develop personalized medicine, and develop new or improved software for clinical trials and studies. Research how computerized systems can be used to support evidence-based clinical practice in the prevention and treatment of hypercholesterolemia, coronary heart disease, heart failure, hypertension, and other cardiovascular risk factors and diseases. Also interested in the use of miniaturized devices for home monitoring, how to assess periodic breathing infant apneas associated with hypoxemia and also use to assess disorders in adults

For more information and for more complete details on topics from the other Institutes, Centers, CDC, FDA, and ACF, go to or to

LSDF Announces 2010 Grants

The Washington State Life Sciences Discovery Fund (LSDF) announced that the 2010 grant competitions will offer four different types of grant mechanisms—one of which is new for 2010. The awards will consist of a Project Competition for up to $4 million in total awards, a Program Competition of up to $13 million in total awards, and a Commercialization Competition of up to $750,000 in total awards. LSDF is also adding a new Opportunity Grant Mechanism for the first time in 2010.

The LSDF 2010 awards will support:

• Project Grants to support research to center on effective dissemination and implementation of best practices for advancing healthcare as well as outcomes research. Proposals are due July 28, 2010

• Program Grants funding to launch new collaborative research initiatives to address major problems within a field of study and position organizations for future competitiveness and leadership. Proposals are due July 14, 2010

• A single competition for Commercialization Grants to support small-scale, targeted studies to move promising technologies along the commercialization pathway. Proposals are due April 14, 2010

For the first time, the new 2010 Opportunity grant mechanism with $1.5 million allocated will allow LSDF to look at compelling time sensitive proposals from the state of Washington’s public and non-profit life sciences research community. The RFP for the new Opportunity Grants will be released in early May 2010 and be available for open submission after this date.

To be considered compelling, a proposal must be urgent and cannot be aligned with LSDF’s annual competition cycles, must indicate a high probability that the investment will attract future financial resources and lead to commercialization of research results, improve the quality and cost effectiveness of healthcare, and demonstrate a clear statewide benefit.

Funding for the Project, Program, and Opportunity Grant competitions comes from the state’s allocation of payments under the Master Tobacco Settlement. Funding for the Commercialization Grant competition comes from a portion of the tobacco settlement payments and donor funds provided by Amgen, the Bill & Melinda Gates Foundation, Group Health Cooperative, Microsoft Corporation, the Paul G. Allen Family Foundation, Regence BlueShield, and Safeco Insurance Foundation.

For more information, go to

Surveillance Network Operating

The Army’s response to the antibiotic resistance crisis as reported in the current U.S. Army Institute of Surgical Research (USAISR) JTTS newsletter, was to establish the Multidrug-Resistant Organism Repository and Surveillance Network (MRSN).

The Army Medical Command in 2009 authorized the Walter Reed Army Institute of Research to establish the MRSN. The MRSN requires Army hospitals to submit all Multidrug Resistant Organisms (MDRO) encountered during healthcare delivery to the network repository along with associated clinical demographic information. The repository determines their genetic relatedness, performs extended phenotypic and phylogenetic analyses, and preserves them indefinitely.

The MRSN uses regular monitoring and feedback on infection control components along with site visits. Additionally, the MRSN plans to move beyond data-driven epidemiology and use diagnostic and research techniques to characterize and infer important phenotype and genotype changes.

By the end of 2009, the MRSN conducted four site assistance visits to stateside and overseas facilities and acquired over 800 MDRO from existing repositories. The network also assisted in two potential outbreak investigations.

Eventually, facility specific regional and global antibiograms along with other epidemiologic data will be made available on a secure web-enabled database with archived isolates available to investigators. The MRSN team will have system-wide active surveillance standardized characterization and centralized archiving available for organisms to enable teams to be able to detect outbreaks earlier.

For more information email Amy Summers at or Colonel Emil Lesho at

Monday, January 18, 2010

2010 Selling to HHS Report Available

Bloch Consulting Group has released the new 2010 edition of the report “How to Sell Healthcare Technologies to HHS”, a guide on navigating the marketplace for grant and contracting opportunities at this $500 billion agency.

The report is available as a free bonus for organizations that order the new “2010 Federal Agency Activities” report, which was also released this month.

“Additional Recovery Act stimulus funding has created a wealth of opportunities within HHS,” said Editor Carolyn Bloch. “So we revised this report to help executives learn techniques to use to develop key agency contacts and write successful proposals.”

The report has been revised to help organizations:

• Navigate the HHS marketplace and zero in on the most exceptional opportunities within various offices, divisions, and departments

• Find contacts within the agency structure to initiate introductions to key grantors, decision makers, and buyers

• Understand the intricate mechanisms under which HHS can negotiate contracts or solicit proposals

• Take advantage of the many opportunities reserved strictly for small businesses

• Write and structure proposals in a way that makes it easier for decision makers to evaluate specific technologies

“Doing business with HHS and other federal agencies has always been a challenge,” Bloch added, “But an understanding of the unique characteristics of this agency can help you capitalize on this huge marketplace.”

More information is available at the Bloch consulting Group web site at

Research on Consumer Health IT

Tailoring health information technology and eHealth solutions for consumers often referred to as Consumer Health Informatics (CHI), is a growing field but has not yet been rigorously reviewed. Johns Hopkins University’s Evidence-Based Practice Center saw the need to review the data available in this specialty field and prepared a detailed report “Impact of Consumer Health Informatics Applications”.

The report prepared by JHU for AHRQ, discusses issues and ideas on how to further CHI and its applications in the healthcare field. Investigators examined available information on breast cancer, diet, exercise, physical activity, alcohol abuse and smoking cessation, obesity, diabetes, mental health, asthma, and COPD.

They also studied the barriers that clinicians, developers, consumers, and their families or caregivers encounter that limit the utilization or implementation of CHI applications. The existing knowledge or the evidence supporting estimates on costs, benefits, and net value with regard to CHI applications was also studied.

Results show that while there may be a role for CHI applications to reach consumers at a low cost and can possibly eliminate the need for some activities currently performed by humans, it is likely that a more important role would be to enhance the efficacy of interventions currently delivered by humans.

Several studies compared the use of a CHI application with traditional therapy against traditional therapy alone. Many found that both groups exerted a significant effect on the outcome yet the CHI group had achieved even more benefits than traditional therapy alone.

Secondly, in the aggregate, the studies support the finding that at least three critical elements often found in CHI applications exert a significant impact on health outcomes such as individual tailoring, personalization, and behavioral feedback.

The reviewers also found that CHI applications may positively impact healthcare processes including medication adherence among asthmatics. CHI applications may also positively impact intermediate outcomes across a variety of clinical conditions and health behaviors, including cancer, diabetes mellitus, mental health disorders, smoking, diet, and physical activity. Strong evidence supports the positive impact of CHI on selected clinical outcomes but the data is insufficient to determine the impact of CHI on economic outcomes.

There are several barriers to using CHI applications including incompatibility with current care practices, professional staff perceptions of increased workload, poor social support and limited IT knowledge, literacy of consumers, cultural issues, and concerns about time, privacy, security, and control.

Although CHI tools and applications do not always require the involvement of a healthcare provider, it is likely that significant growth in the use of CHI tools will necessitate increasing provider and healthcare system competency with these emerging tools.

The report points out the need to develop uniform reporting and to improve the quality of work in this field. A national CHI applications design and registry along with a CHI applications trials registry with uniform reporting requirements needs to be developed.

The rapid growth and development of the internet combined with the rapid rise in the use of the internet to search for health related information suggests that individuals are drawn to using convenient and anonymous technologies for health purposes. If CHI applications and tools become available in a wider array of platforms, it may become easier to engage more people who are not actively managing their health.

For more information on this report, go to, or email M. Chris Gibbons, MD, MPH, Associate Director, Johns Hopkins Urban Health Institute, Director for the Center for Community Health, and Assistant Professor, Public Health and Medicine at

Online Tool to Find Partnerships

The National Telecommunications and Information Administration (NTIA) and USDA’s Rural Utilities Service (RUS) have just launched “BroadbandMatch” a new online tool to help develop partnerships among prospective applicants to the broadband grant and loan program.

BroadbandMatch at enables potential applicants to find partners so that applicants can combine expertise and create stronger proposals. For example, a broadband infrastructure provider might be able to partner with community institutions, such as universities, hospitals, libraries and work together on a proposal to bring high speed internet service to their facilities.

Any company, nonprofit, state, local government, or expert individuals interested in applying for funding under NTIA’s Broadband Technology Opportunities Program (BTOP) or RUS’s Broadband Initiatives Program (BIP) can post a profile with information on how they can contribute to make a broadband project successful and then at the same time use the site to search for other stakeholders whose skills and resources match their needs.

Both RUS and NTIA plan to announce the rules for the final funding round of the BTOP and BIP programs in the coming weeks.

Funds for Mental Health

HHS’s Substance Abuse & Mental Health Services Administration (SAMHSA) in their Center for Mental Health Service (CMHS) has made $21.8 million available to fund the program “2010 State Mental Health Data Infrastructure Grants for Quality Improvement.” On January 8th, the agency issued a Request for Applications (No.SM-10-009) due by March 4, 2010.

The goal is to develop the infrastructure to help collect and report on five Mental Health Block Grant National Outcome Measures over the next three years. The measures to be reported include employment/school attendance, stability in housing, criminal justice involvement, readmission, and access and capacity at hospitals, and demographic characteristics. This will enable state hospitals to better access and serve populations and communities with specific mental health needs.

Applicants for this funding must show the linkages, needs, the proposed infrastructure development strategy, and how the increased system capacity will sustain effective programs and services.

Experts predict that up to one third of returning veterans will need mental health and /or substance abuse treatment and related services. Therefore SAMHSA strongly encourages all applicants to consider the needs of returning veterans and their mental health needs.

There will be approximately 59 grants awarded for up to three years. The state mental health authorities including the District of Columbia that are selected for the grants are eligible for up to $132,941 each year for three years. Mental health authorities for the U.S. Territories that are selected are eligible for up to $60,000 each year for up to three years in funding.

For more information, go to or email Olinda Gonzalez, PhD, at

New Efforts in Public Health

The New York State Department of Health was awarded a two year $90,000 grant from the Robert Wood Johnson Foundation to lead a network to improve local public health services. The network will include the New York State Association of County Health Officials (NYSACHO), the University at Albany School of Public Health, the New York Academy of Medicine, the New York-New Jersey Public Health Training Center, and the Northeast Public Health Leadership Institute.

“On behalf of New York’s 58 local health departments, NYSACHO is pleased to participate in this research effort. As local health departments continue to be stretched to the limits in addressing community public health needs, the use of best practices is critical, along with having adequate resources and a strong public health workforce,” said Linda Wagner, NYSACHO Executive Director .

The NY Department of Health will work with the network organizations to conduct a small scale research project planned to lead to larger scale public health practice-based research projects in the future.

Mark Your Calendar for Med-e-Tel

Telemedicine, eHealth, and Health IT are all tools used by the medical and nursing profession, patients, healthcare institutions, and stakeholders to provide the best care possible. To discuss all of the important issues in this field, mark your calendar for Med-e-Tel 2010 to be held on April 14-16th in Luxembourg.

Plan on attending this vital conference to hear presentations and meet with a global audience with diverse professional backgrounds to discuss today’s outstanding HIT market possibilities and new applications. The meeting will present outstanding opportunities to hear over 150 presentations, workshops, panel discussions, and satellite conferences.

Topics will include bioinformatics, broadband and wireless networks, business models, cost benefit studies, current ehealth realizations and projects, developing countries and their ehealth projects, distance education programs, ehealth integration into routine medical practices, home monitoring and homecare applications, legal and ethical aspects, reimbursement issues, satellites and ehealth, standardization and interconnectivity, and telemedicine applications and projects.

Establish networking opportunities by meeting with key networking leaders in the field. They will include association executives, consultants, distributors and agents, educators and researchers, funding agencies, government representatives, health insurance providers, homecare service organizations, hospital management and department heads, international authorities, medical specialists and general practitioner, nurses, venture capitalists, and investors.

The expo area is an opportunity to see the many services and applications that will be displayed such as diagnostic/monitoring systems and devices, home and personal monitoring equipment, hospital information systems, imaging devices, mobile/wireless devices and applications, satellite communications, surgical systems telecommunication services and devices, telecare/telehealth/telemedicine equipment, assistive technologies, videoconferencing, and vital signs monitoring.

The expo area will present many opportunities for Conference attendees to participate in demonstrations and attendees will also be able to use the dedicated meeting rooms for one-on-one meetings with industry leaders.

What will make this conference stand out this year is the workshop dedicated specifically to Free/Libre Open Source Software in Health Care (FLOSS-HC) which is not only a licensing model but also a software development process. The workshop will serve as a meeting place for old and new FLOSS-HC enthusiasts and a place for exchanging ideas, knowledge, and experiences.

For more details on speakers, exhibitors, and special events go to

Wednesday, January 13, 2010

Funds for Rural Healthcare

Colorado’s Governor Bill Ritter announced that$1 million in grant funding is now available through the Colorado Rural Health Care Grant Council to support Colorado’s rural healthcare infrastructure. This is the third cycle of grants to be awarded through the Colorado Rural Health Care Grant Program that by 2012 is expected to deliver a total of $7.5 million.

The Rural Health Care Grant Council created by an Executive Order is responsible for the grant program funded by the UnitedHealth Group. Organizations located outside of the state’s urbanized areas to provide outpatient primary care services in the medical, oral, and mental health fields.

The deadline for Letters of Intent for the third grant cycle is January 22, 1010 and the grant application deadline is March 11, 2010. The maximum award amount is $50,000 per applicant. For more information contact Kent O’ Connor (303) 832-7493 or email

In addition to the grant program, UnitedHealthcare and Centura Health last fall announced their initial pilot locations for the Connected Care Telehealth program. The program will provide patients in rural areas expanded access to physicians and specialists using advanced telehealth technology

The sites include the Rio Grande Hospital in Del Norte, Buena Vista Family Practice in Buena Vista, High Plains Community Health Center in Lamar, and St Vincent General Hospital in Leadville. These sites are to be established at federally qualified community health centers, critical access hospitals, rural health clinics, or Centura Health entities, and in the future, may be implemented in retail, workplace locations, and homes.

The Connected Care sites will be installed starting during the first quarter of 2010 and the sites are expected to make 4,800 specialist visits available per year in those communities. The program will initially target medical specialties that are either not currently available at a local level or only have services available on a part time basis. Initially, these services will include cardiology, dermatology, pulmonology, diabetes management, ENT, plus additional services will be added.

Funds to Jumpstart Commercialization

On January 5, 2010, NIH’s National Cancer Institute issued Funding Opportunity Announcement (FOA) RFA-CA-10-009 to help support the next stage for projects previously funded by SBIR Phase II Bridge Awards. The plan is to use the additional funding to help small business concerns transition their SBIR Phase II projects to the commercialization stage.

Areas of R&D supported by NCI often require substantial levels of additional financing beyond the SBIR Phase I and Phase II stages. Also, a number of emerging products in these areas are becoming increasingly complex due to the technological advance in multidisciplinary fields. For example, new products may involve measurement of both physical and molecular signatures, combine devices and molecular probes, or perform dual functions of diagnosis and therapy.

These products are referred to as combined technologies by FDA and examples in oncology include those related to genomics, proteomics, certain approaches to imaging, image-guided diagnosis and therapy, and other therapeutics. In addition, the developers of these technologies often face additional challenges during the regulatory approval process requiring even more time and effort to commercialize these technologies.

The development of medical biotechnology products is often impeded by a significant funding gap, known as the “Valley of Death” that occurs between the end of the SBIR Phase II award and the commercialization stage.

Large pharmaceutical and biotechnology companies as well as venture capital firms have traditionally provided the resources to fully develop and commercialize biomedical products and technologies initiated with NIH SBIR funding.

Recently, many investors in life science technologies have shown a bias toward financing the continued development of relatively mature technologies at established companies, rather than the higher-risk emerging technologies under development at many small businesses.

Therefore, the intent of this FOA is to help commercialize SBIR II Projects applicable to specific areas such as cancer therapeutics, cancer imaging technologies, interventional devices and in vivo diagnostics or in vitro and ex vivo cancer diagnostics and prognostics. Projects may address preclinical and/or clinical stages of technology development and clinical trials may be proposed but are not required.

The estimated amount of funds is $10,000,000 for fiscal year 2010 and will be available for up to ten projects with future amounts dependent on appropriations.

It is hoped that this FOA will promote partnerships between NIH awardees and third-party investors and/or strategic partners to accelerate the capital intensive steps that are required to commercialize new products and technologies. Applicants will need to provide a commercialization plan that includes information on any independent third-party investor funding that has already been secured or is anticipated.

The opening date to submit an application to is February 1, 2010 with applications due on March 1, 2010.

For more information, go to http://grants.nih.gove/grants/guide/rfa-files/RFA-CA.10-009.html.

Mobile Phones Help Globally

Global health workers in developing countries frequently find insufficient communications infrastructure available but Johns Hopkins University’s Electronic Mobile Open Source Comprehensive Health Application or eMOCHA is working to bridge these gaps. eMOCHA is designed to assist health programs in developing countries improve provider communication and education as well as provide better patient care by coordinating wireless devices with local server-based clinical training and patient care support services.

Dr. Robert Bollinger, a Fogarty Informatics grantee and his team have been trying to create tools for distance learning programs in low resource settings in India and sub-Saharan Africa. Though many of the platforms developed so far have been based on older technologies, eMOCHA relies on the use of mobile phones to transmit and receive instructional data.

Uganda has good communication access with powerful 3G capacity in 80 percent of the country. This coverage is particularly well suited for mobile health training projects so that large files such as databases and videos can be sent. The eMOCHA platform is being used by PEPFAR and connects 17 partners throughout Uganda.

The program’s nerve center at Mulago hospital in Kampala has a group of local experts, a server base, and a decent fiber network. If the programs aren’t having an impact, according to Dr. Bollinger, the Mulago team responds by pushing out new training data to the phones and then the cycle starts again. The team is building a toolbox of different tools for distance learning including eMOCHA, but the ultimate goal is to hand off that toolbox to the people in India, Uganda, and other places.

However, questions have been raised concerning the sustainability and scalability of mobile platforms that must be addressed along with concerns about the compatibility needed among various operating systems. One of the most important compatibility issues is the tendency of cell phone and PDA manufacturers to require specialized chargers for each of their devices.

Another concern is that while some pilot programs are technically innovative, they may not be well suited for large scale implementation because of costs, logistical concerns, or copyright issues. Some projects involve the use of both open source and copyrighted software and this makes them less attractive options for some countries.

Security, privacy, and other ethics related issues are also emerging as mobile health platforms become more commonplace. Market forces and the secure management of data often is a problem for cell phones users. Since cell phones are recycled annually with many villages sharing phones, this means that underserved populations are especially at risk for the theft or misuse of medical data. However, most experts agree that patients in low and middle income countries would probably choose the benefits of mobile health over secure data.

Remote Monitoring Grants Announced

California’s Center for Technology and Aging on January 11th released information on their “Remote Patient Monitoring Diffusion Grants” program. The Center is now soliciting letters of intent from organizations that are interested in expanding the use of remote patient monitoring technologies to help improve the health and safety of older adults. Total funding available for this grant program is $500,000 with up to six grants to be awarded.

The three areas concerning remote patient monitoring that need to be addressed are chronic disease monitoring, post acute care monitoring, and safety monitoring. The goal is to reduce the use of emergency departments, enable older adults to remain independent, improve costs and quality of care, reduce the need for older adults to move to higher cost care settings, reduce the burden on caregivers, and develop better methods to monitor patient safety.

The strongest consideration will be given to applicants that not only demonstrate the ability to provide for clear and robust diffusion and adoption of the technologies but also can discuss how the project aligns with current and emerging reimbursement policies. It is important to demonstrate how the project will have strong potential to influence public policies that can in the long run improve long term and post acute care. In addition, a clear plan for sustainability must be included.

The program is designed to benefit older adults residing in California. The majority of the five or six projects including consortia and other collaborations must primarily provide direct benefits to older Californians. No less than four or as many as five of these grants must directly benefit older adults in California but one or two may benefit older adults in other regions of the U.S.

Projects are required to provide at least 25 percent in matching funds and/or in kind support equivalent to at least 25 percent of the requested award amount. This must be new funding specifically identified for the project and cannot come from existing operating funds. Technology and equipment costs cannot be counted toward the match.

A “Remote Patient Monitoring Tool Kit” will be developed to consist of successful strategies, case studies, and outcome measures. In addition, the Center will conduct an external evaluation on projects. Grantees must be willing to contribute to the development of a program tool kit and participate in the external project evaluation.

Primary applicants may be non-profit organizations, local, state, and federal government agencies, universities and colleges, consortia, and public/private partnerships.

Applicant conference calls will be held February 2 and March 2. The application and letter of intent must be received by March 12th. By March 26th, the Center will invite those organizations with top projects of interest to submit a Full Grant Proposal. Those full proposals will be due by April 30th. The final award decision will be made by June 18 and July 1 is the expected start date.

For general information, go to For specific questions, email Valerie Steinmetz at or call (510) 285-5687.

Contract Awarded to Harvard Pilgrim

FDA awarded a contract to Harvard Pilgrim Health Care Inc. to develop a pilot for FDA’s Sentinel System that will use automated healthcare data to evaluate medical product safety. The Sentinel System will help FDA monitor product safety by analyzing information collected during the course of routine healthcare such as the data obtained from EHR systems, administrative and insurance claims databases, and from medical registries.

The one year contract with Harvard Pilgrim includes four renewable years for a total of $72 million. Harvard Pilgrim will establish a coordinating center to operate as a scaled down version of the Sentinel System. This “Mini Sentinel” center will identify appropriate databases, develop a scientific framework for obtaining real-time data, and work to ensure data quality. To protect personal information only summary results will be sent to the coordinating center.

The Harvard Pilgrim contract is just one of the activities contributing to building the Sentinel System. FDA has also awarded ten small contracts addressing scientific operations, data and infrastructure, privacy, and stakeholder engagement.

The reports resulting from these contracts are contain information on safety signal identification, how to engage patients, consumers and healthcare professionals, finding potential data sources for a National Network of Orthopedic Device implant registries, how to evaluate possible database models, develop a governance and operations structure, evaluate the timeliness of medical updates, and how to evaluate potential network data sources for blood and tissue product safety surveillance and studies.

On January 11th, Brookings Institution’s Engelberg Center held the 2nd Annual “Sentinel Initiative Public Workshop” to explore many issues and also to discuss the issues included in the completed FDA contracts. Discussion is also taking place on developing not only a multi-purpose distributed system to conduct safety surveillance work, but also how to use the system to collect comparative effectiveness research data and perform product quality assessments.

Go to for more information.

mHealth Conference Coming Soon

Mobile phones and new communication patterns are changing our society. Attend mHealth Initiative’s “mHealth Networking and Web Conference” February 3-4, 2010 at the Marriott Washington Wardman Park Hotel in Washington D.C. to understand how this new trend is impacting healthcare. This is a golden opportunity to meet and network with users, developers, and vendors in the field.

Learn about the myriad of mobile devices and apps for clinicians and patients, new disease management, new participatory health approaches, management of mobile phones in provider settings, and much more.

C. Peter Waegemann, Vice President, mHealth Institute has said “the mHealth is a tsunami-like wave that will hit all healthcare stakeholders. One can delay mHealth, but nobody can halt this spontaneous movement.” His presentation at the “mHealth Revolution” will address:

• Current status of 5,000+smart phone apps and apps developments in the near future
• Exciting developments in new communication patterns and what this means for future provider competitiveness
• The future of communication-based disease management
• Discussion on the impact of this disruptive change. Is it a revolution?

Claudia Tessier, President, mHealth Institute and author of the first comprehensive book on mHealth “Management and Security of Health Information on Mobile Devices” to be published by the American Health Information Management Association (AHIMA) in early 2010, will discuss how:

• mHealth will change the way patients deal with providers and payers
• Clinicians will use mobile communication devices to communicate, access patient information, and use to retrieve guidelines and protocols
• New “digital tools” are helping healthcare professions
• HIM professionals need to prepare for mHealth

Some of the other top speakers in the field include:

• Derrell West, Vice President and Director, Government Studies, Brookings Institute will speak on mHealth and Public Policy; Strategies for Moving Forward
• Christopher Wasden, Manager, Strategy and Innovation, PricewaterhouseCoopers LLC, will speak on the Future of Home Monitoring
• Joseph Kvedar, M.D., Director, Center for Connected HealthCare will speaking on Mobile Phone Technology: Addressing Unmet Needs of Parents of Children with Diabetes

Plus many other additional speakers will be on hand to provide invaluable information and take part in the networking process at the meeting.
Topics for thought provoking breakout sessions will highlight:

• The future of home monitoring
• Voice-based cellular medication reminders
• Remote patient care and telemedicine
• Effect of telemonitoring on adherence and behavior
• Innovative systems for communicating with patients in the home

Participation in the mHealth Conference can be through personal attendance or by virtual mode. However, if you attend the conference, you will have the advantage of networking with both colleagues and vendors.

For more information on the Conference, go to For questions or problems in registering, please contact

Sunday, January 10, 2010

2010 Report on Federal Activities Available

Bloch Consulting Group has just published the 2010 edition of its comprehensive 250 page report on federal government activities in telemedicine, telehealth, and health IT.

The new edition includes information on grants, funding, and contracting opportunities at 23 cabinet-level and independent agencies throughout the government—including significantly updated information on Recovery Act stimulus funding at many of these agencies.

The report includes URLs for government web sites to help organizations search for even more information on federal activities.

According to Editor Carolyn Bloch, this year’s report is exceptionally timely. “The passage of the Recovery Act has made more money available, but it’s still a challenge to identify how agencies are spending this money.”

“Because activities in telemedicine, telehealth, and health IT are spread across dozens of agencies and departments, it can be difficult for many organizations to identify opportunities,” she added. “This in-depth report makes it easier for executives, professionals, consultants, and anyone researching telemedicine and health IT to quickly zero in on specific areas of interest.”

This new report also includes a free copy of the 2010 Edition of Bloch’s “How to Sell Healthcare Technologies to HHS” report, a 40 page guide on techniques for developing key HHS contacts and securing grants and contracting opportunities within HHS.

These reports are available either as a digital download in PDF format or can be shipped as printed versions.

More information is available at the Bloch Consulting Group web site at

Moving into HIE Implementation

The state of Maryland is in a good position to begin to implement their statewide HIE. The State’s health technology picture shows that there are 47 acute care hospitals with EHR adoption reported in around 80 percent of these hospitals. Nearly 60 percent have computerized physician order entry with 17 percent actively implementing technology to enable some electronic data sharing with appropriate users outside the hospital.

The state has roughly 1,795 physicians in active practices treating patients in 7,907 practices. Physician EHR adoption parallels the nation at 20 percent but many of these EHRs do not have clinical decision support, CPOE, or e-prescribing. The number of service area health information exchanges or community data exchanges where a hospital acts as the technology hub is increasing in numbers throughout the state.

In 2008, to move the process forward, the Maryland Health Care Commission (MHCC) funded two independent multi-stakeholder groups to develop two competing approaches for governance, architecture, privacy and security, access and authentication, financing, and to establish a sustainable business model. The information was consolidated and presented to the MHCC, and as a result, a Request for Application was released in April 2009.

The Maryland Health Services Cost Review Commission approved the funding August 2009, and the Chesapeake Regional Information System for our Patients (CRISP) was selected to receive $10 million in startup funding from Maryland’s all payer system to implement the statewide HIE.

After evaluating the funding models employed by other HIEs, CRISP decided to go with the state funding and rely on participant subscription fees to achieve financial sustainability. CRISP also has relied on philanthropic funding from the Erickson Foundation to support the medication history service and other HIE planning efforts. However, CRISP is not planning for philanthropic funding to continue and will seek additional funding from government and other philanthropic sources beyond the initial $10 million.

The HIE budget is comprised of infrastructure costs that include hardware and software costs to support the statewide HIE as a whole. Software licenses are calculated at $1,500,000 in the first year, $1,000,000 for licenses in the second year, and $600,000 for the third year with an anticipated increase of 3.5 percent in each successive year. The budget will be adjusted if open source software is provided by ONC’s Federal Health Architecture group.

The budget for equipment includes all of the hardware necessary to implement the HIE and the equipment budget is estimated at $1,017,704 over four years. Approximately, $500,000 has been budgeted in the first year for the contract to provide all hardware and supporting software for the exchange. The hardware and supporting software projected for the second year is $166,700 with increases anticipated.

If the statewide HIE must acquire computer hardware and incur installation and maintenance costs, a Maryland organization will be contracted for these services with the hardware to be leased through an agreement with the service provider.

The HIE will use a number of systems thinking design tools to conduct ongoing evaluations of the HIE. The key assessment tools will include causal loop diagrams, behavior over time graphs, systems archetypes, and flow diagrams. The systems thinking design tools will enable the HIE to to provide a realistic measurement of performance and to identify changes that may be needed.

The governance is comprised of the MHCC Policy Board, Board of Directors, and the Advisory Board. The Policy Board has 25 members with consumer backgrounds to provide oversight to the development of the HIE and to develop policies related to privacy and security.

The Board of Directors consists of nine individuals with overall management and governance responsibilities. The Advisory Board has 30 members who are divided into three committees that include the Exchange Technology Committee, the Clinical Excellence and Exchange Services Committee, and the Finance Committee.

The MHCC’s Center for Health Information Technology Center, Director David Sharp will serve as the Maryland Government HIT Coordinator. The Director is currently working with Medicaid to explore data sharing opportunities under the MITA transformation project and is actively involved with CMS as part of their EHR demonstration.

Nonprofits Boosting VA Research

The November-December issue of “VA Research Currents,” reports that nonprofits are helping researchers at the Veterans Administration. In 2008 alone, the nonprofits took in and paid out close to $250 million to support more than 4,000 studies at the VA.

The Veterans Medical Research Foundation (VMRF) a nonprofit based in San Diego supports research at the VA’s San Diego Health Care System by administering grants, hiring the staff needed to renovate laboratories, and also supports equipment purchases. The San Diego nonprofit is the second largest of 82 organizations of this type nationwide.

According to Kerstin Lynam, CEO of VMRF, the Foundation’s nonprofit partnership with the VA is able to provide individualized and flexible grant management because we are much smaller than most other research foundations and other organizations conducting research. She oversees a staff of 250 with a budget of $30 million.

She reports that VMRF will case manage a project through the compliance process from start to finish when necessary and often works hard to meet proposal submission deadlines. Lynam added that “because we are a VA Foundation, we know and understand VA processes well and we work particularly well with the VA Research Service and their staff.”

Research funding is also available from federal agencies other than the VA, such as NIH and the Department of Defense. For example, NIH awarded a $1.8 million grant to be administered by the San Diego nonprofit to research HIV-AIDS and to help VA Researcher Doug Richman, M.D., and the team at the University of California, San Diego study enzymes that will enable the virus to stay latent and evade treatment.

Additional funding comes from private-sector companies and organizations. About half the money is used to pay nurses, technicians, and other study personnel, and pay for travel expenses to help foot the bill so VA researchers can attend conferences. Sometimes bridge funding is provided to tide over investigators if there is a gap in their funding, plus seed funding can be provided for an investigator who has a new idea and wants to collect some preliminary data.

Up until now, the VA nonprofits haven’t done much to raise funds to augment their revenue. At least three Foundations are actively seeking donations including the VMRF, along with two other groups in California. Lynam reports that the VMRF is retooling its website to entice potential donors.

Barbara West Executive Director of the National Association of Veterans Research and Education Foundations (NAVREF) is quick to point out that her group still advocates for adequate annual funding from Congress to support VA research since that funding is still the mainstay of VA research. According to West, even with the sharp growth of the nonprofits contribution in the past two decades, the funds they administer can never replace the federal VA research appropriation.

Army Issues RFI

In December, the Army Medical Research Acquisition Activity while supporting the Telemedicine & Advanced Technology Research Center (TATRC) issued a Request for Information (RFI) on simulation-based training technologies and systems. The response to the RFI will be accepted through February 5, 2010.

The Army is seeking information on how to apply medical education, training, and/or use for treatments. The information received from organizations and consortia may be used to assist with the possible development of a future Request for Proposal.

For example, the military is interested in systems:

• To use for medical training systems that will reduce or replace live tissue training and conduct research to compare simulation training systems to live tissue training

• To standardize medical modeling and simulation training curricula to be used by physicians, nurses, allied health professionals, and combat medics

• To further advance the development of simulation-based systems in the ophthalmology and anesthesiology disciplines. Seeks information on virtual reality-based systems, using mannequins and hybrids, using both mannequins and virtual reality, web based simulator systems, and serious game technology

Responses to the RFI due February 5th are to be sent electronically to and must be identified with W81XWH-MEDSIM.

For more information, go to Then click on the December 22nd press release on the RFI. Or go to and search for the December 18th RFI notices. The point of contact is Pamela E. Nevels (301) 610-8802.

Foundation Seeks Applications

The Peter and Elizabeth C. Tower Foundation is looking for applications for community-based projects to be considered for funding via the Robert Wood Johnson Foundation’s Local Funding Partnerships (LFP) program. Through the LFP program, the RWJF offers matching grants for projects to deliver health related services to vulnerable populations using new and innovative methods.

The vulnerable population identified by the RWJF Foundation includes children and adolescents with severe mental illness, children and adolescents with substance abuse issues, and children and adolescents with developmental disabilities. The Tower Foundation is particularly interested in projects that provide direct services to populations not served by traditional mental health or social services.

The Tower Foundation will provide a dollar-for-dollar match up to $500,000 over three or four years for projects that are successful in obtaining funding through the RWJF’s LFP program. Grants awards will be made for three or four years.

Eligible organizations must be located within or serve the residents primarily in Erie or Niagara counties in New York State or Barnstable, Dukes, Essex, or Nantucket Counties in Massachusetts.

This RFP has a two step application process. The first step is to complete a pre-screening telephone call with the Tower Foundation staff to determine whether a project is a fit with both the Tower Foundation and the RWJF’s LFP program.

At this point, a concept paper and preliminary project budget must be submitted if requested. Arrangements for this pre-screening telephone call must be made by February 5, 2010 with screening calls to be completed by February 12, 2010. Concept papers are due on March 19, 2010 and decisions by the board will be made by June 4, 2010.

The second step is to submit a full proposal with a complete description of the project, objectives, evaluation plan, discussion of the anticipated impact, and plans for long term sustainability. The full proposal is due in November 2010.

For more information, email Don Matteson at or call (716) 689-0370 extension 207.

Wednesday, January 6, 2010

Center Moving to Bethesda MD

In 2011, the Defense Vision Center of Excellence (VCE) is scheduled to move into the new Walter Reed National Military Medical Center in Bethesda. Co-located with other optometry and ophthalmology offices, the VCE will be a part of an eye center at the new Walter Reed. VCE was established in 2008 to improve care for service members with visual disorders or visual disturbances, including traumatic brain injuries.

Currently, there are not many statistics surrounding blast injuries and vision loss. According to VCE Director Col. (Dr) Donald Galiano, “VCE plans to gather information from joint DOD/VA records and use the information to learn about the relationship between blasts, traumatic brain injury, and vision interruption or loss. The data can then be used to develop preventive techniques and treatment options for service members and veterans.”

Plans are to develop the Defense and Veterans Eye Injury Registry (DVEIR) to track the occurrence, treatment, and outcomes for all eye injuries or visual dysfunction experienced by service members who have served since 9/11.

“Our goal is to bring researchers together everywhere on specific issues and to communicate with one another to enhance our own work and the work of others,” said Dr. Claude L. Cowan Deputy Director of VCE and Senior VA staff member.

Tech Development at Harvard

Many tumors occur in parts of the body that are difficult to locate and image such as with the colon, stomach, or lung tumors because a patient’s breathing can cause the entire area to move several millimeters each second.

Current technologies focus only on a single bright spot namely the tumor, which is smeared out during the slow imaging required to achieve high resolution. Targeting the radiation treatment relies on guessing where the tumor will be assuming that the patient breathes at a constant rate. When this does not happen, the beam will miss the tumor and may damage surrounding healthy tissue.

Harvard’s “PLuTARCTM technology”, when integrated with a fast 3D imaging system such as in the case of MRIs or CT scanning, can precisely locate in real-time the exact position of the tumor as it moves, which can then be targeted dynamically by existing radiation treatment methods. Harvard’s technology is able to fully reconstruct the geometry of the tumor and its surroundings in real time to target lock tumors with far higher speed and precision.

Information on the technology invented by Peter J. Lu and David A. Weitz, is available from Harvard University’s Office of Technology Development under the category of medical devices. A patent application has been filed and is pending. For more information on Harvard Case #2874, contact Daniel Behr, Director of Business Development at (617)-495-3067.

In a worldwide exclusive license, Barrett Technology, Inc. has signed a licensing agreement with Harvard and has the exclusive rights to a novel polymer-bases robotic hand technology known as the “SDM Hand”. The first production units are to be available in 2011.

The robotic hand has fingers with flexible joints, which allows it to easily conform to objects and grip them solidly without exerting excessive force. These special joints enable the hand to grasp objects that vary widely in size, share, and mass, plus the hand is able to overcome positioning errors if the object is not placed correctly.

Kentucky Helps High Tech Firms

Capital is needed to help high tech firms grow since product development can be expensive and it may be difficult to raise private investment funds. The state of Kentucky provides assistance to help high tech companies find funds and opportunities.

Governor Beshear recently announced that five Kentucky high tech companies will share over $1.3 million in state funds as part of a Kentucky initiative to attract and support technology-based small businesses located in the state. The state of Kentucky helps companies by matching up to $100,000 for SBIR awards for either a Phase I award or up to $500,000 per year for up to two years for a Phase II award. If a single company receives both a Phase I and Phase II award, that company can receive up to $1.1 million.

“To date, the SBIR-STTR program has made a total of 71 awards to 44 Kentucky companies for a combined $15.5 million which has helped to bring eight new high-tech businesses to the Commonwealth,” said Governor Beshear.

One company Louisville Bioscience received SBIR funding to develop a blood test to profile a patient’s blood plasma proteins. This will help to detect autoimmune and infectious diseases, as well as cancer in the early stages, since many deadly diseases including cancer are inaccurately or inadequately diagnosed.

Another awardee SureGene of Louisville is developing and commercializing its AssureGene ™ test, the first in a planned series of proprietary tests designed to help physicians provide more precise and individualized diagnoses for patients with bipolar disorders and schizophrenia.

SBIR funds went to EndoProtech to develop and commercialize unique therapies for organ transplantation and cardiovascular surgery, including a product that will protect cells, tissues, and organs that can be damaged when blood flow is restored following the procedures.

In addition, the Kentucky Enterprise Fund provides seed-stage capital to Kentucky based companies that are commercializing a technology-based product or process. The Fund awards grants for $30,000 with investments up to $750,000 to go to small and medium-sized Kentucky based companies for business development activities.

To further help Kentucky attract high tech companies, the Cabinet for Economic Development administers high tech investment pools to help build and promote technology-driven industries with loans and grants. Also, the Kentucky Innovations and Commercialization Center Program a statewide network of regional innovation and commercialization centers is helping businesses obtain funding.

Maine Announces 4th Grant Round

Maine’s ConnectME Authority on December 21st announced their fourth grant round as part of their broadband infrastructure funding program. The goal is to find creative solutions to provide affordable broadband service to the unserved areas of Maine. This round is requesting smaller, focused proposals with a suggested grant limit for each project of $100,000 and will fund no more than 50 percent of the total project but there is some flexibility for exceptional proposals.

Applicants will need to submit brief, pre-application letters describing a project or projects by January 29, 2010. The pre-application letters will be shared with existing or incumbent broadband service providers for review. This will be done to ensure that the area proposed to be served is an unserved area with no broadband expansion projects planned by other providers in the near term. Secondly, this will also help to encourage collaboration between providers or other grant applications to avoid overlap.

Applicants themselves are also required to communicate with nearby incumbent or existing broadband service providers for current and future plans for expansion in the proposed project area. This is required so that ConnectMe Authority funds will not be used in areas where private investment is or will be used to deliver broadband services.

Pre-application letters also need to include not only the type of service to be provided but detailed information on the technology to be used. Information on the estimated upstream and downstream speeds of the service to be provided and an estimate on the time needed to complete the proposed project needs to be included. In addition, the letter needs to address the percentage of households in the unserved area that will have access to the new service and the estimated number of customers who will benefit.

ConnectME Authority also recommends that applicants find partners among the various providers of broadband services or community-based organizations. The grants may also be used as seed money to get further operational infrastructure installed.

Full application packages may be available by February 15, 2010 with completed applications due March 15, 2010. For more information, go to www.Maine.Gov/ConnectME or call Philip Lindley, Executive Director (207) 624-9970 or email

States Receive EHR Funds

CMS has announced that both Tennessee and Pennsylvania’s Medicaid programs will receive federal matching funds to use for state planning activities necessary to implement their electronic health record incentives programs. The funding will provide Tennessee with $2.7 million and Pennsylvania will receive $1.42 million.

The Recovery Act provides a 90 percent federal match for state planning activities to use to administer incentive payments to Medicaid providers, to ensure proper payments through audits, and to enable states to participate in efforts to promote interoperability and the meaningful use of EHR technology statewide.

Both states will use their federal matching funds for planning activities that will be used to conduct a comprehensive analysis to determine the current status of HIT activities in their state. Also, both states will use the funding to gather information on existing barriers to using EHRs, to determine provider eligibility for EHR incentive payments, and for the creation of their individual state Medicaid HIT plan to define their state’s vision for the long term use of HIT.

Sunday, January 3, 2010

Two New Reports Available

Next week Bloch Consulting Group will release two new reports on federal government activities in telemedicine, telehealth, and health IT.

“With the passage of the Recovery Act and legislative changes for healthcare on the horizon, we’ve made major updates to both our Federal Activities and How to Sell to HHS reports,” said Editor Carolyn Bloch.

“Both reports have been updated with information on how to find and take full advantage of stimulus finding opportunities,” she added.

The 250 page edition of the Federal Activities report for 2010 covers grants and contracting opportunities in telemedicine, telehealth, and health IT at more than 20 cabinet level and independent federal agencies.

The 40 page Selling to HHS report has also been updated to add timely advice on the techniques needed to navigate the federal marketplace and is included free with all orders of the Federal Activities report.

According to Bloch, “A growing number of organizations use these reports to help get past the red tape so common at many agencies. Securing grants and contracts isn’t easy, but knowing where money is being spent can help you zero in on valuable funding opportunities.”

These reports will be available either as a digital download in PDF format or can be shipped as printed versions.

More information is available at the Bloch Consulting Group web site at

CMS & ONC Issue Regulations

On December 30th, CMS and the Office of the National Coordinator for HIT issued regulations defining “Meaningful Use” and the rules for setting standards for Electronic Health Record incentives. The regulations are needed to help implement the EHR incentive programs enacted under the Recovery Act. Public comments are encouraged to help finalize the regulations that are due in 2010.

As required by the HITECH Act, HHS issued an initial set of standards, implementation specifications, and certification criteria needed to enhance the interoperability, functionality, utility, and security of HIT. According to Dr. David Blumenthal, National Coordinator for HIT, the adoption and meaningful use of IT in healthcare is central to a necessary and overdue modernization of the U.S. health system.

The criteria outlined in the Interim Final Rule (IFR) on Standards & Certification Criteria details the requirements for certified electronic health record systems and the technical specifications needed to support the interoperable nationwide electronic exchange and the meaningful use of health information. The IFR interim final rule will become effective 30 days after the information is published with comments requested for the next 60 days.

In a related announcement, CMS issued a notice of proposed rulemaking that outlines provisions governing the Medicare and Medicaid EHR incentive programs including a proposed definition for the concept of the meaningful use of EHR technology.

“These regulations are closely linked”, said Charlene Frizzera, CMS Acting Administrator. “The CMS proposed regulation defines the meaningful use of EHR technology as required as a prerequisite for receiving the Medicare incentive payments.

The Recovery Act established programs to provide incentive payments to help eligible professionals and hospitals participating in Medicare and Medicaid adopt and make meaningful use of certified EHR technology. Incentive payments may begin as soon as October 2010 to go to hospitals and incentive payments to go to eligible providers beginning in January 2011.

For more information and details on the regulations, go to then click on Public Inspection for the draft regulations that are due to be published on January 13th. To view the CMS proposed rule and fact sheets go to or go to to view ONCs interim final rule.

Broadband Telehealth Network Launched

The Oregon Health Network (OHN) a non-profit membership organization is proud of their new Network Operations Center (NOC) operated by Easystreet Online Services®. OHN along with healthcare, technology and telecommunications experts have worked hard to create the first broadband telehealth network in Oregon. This means that now the NOC is able to troubleshoot and monitor the quality of service requirements for Oregon’s first broadband telehealth network.

Current network members include Wallowa Memorial, Blue Mountain Community College, and the Oregon Coast Community College System. The new connection through OHN at Wallowa Memorial will run seven times as fast as before and will only cost the hospital $150 per month. The true cost of the OHN broadband service will be approximately $2,000 per month for Wallowa Memorial with OHN establishing the fiber optic and Ethernet Infrastructure free with the FCC absorbing 85 percent of the ongoing cost for the next five years.

As part of the long range plan, OHN is looking into ways to cover some of the costs beyond the initial five years, along with other long term plans to extend the service to nursing homes, businesses, and other for profit organizations.

Today, if a hospital in Wallowa is having a video consultation with a doctor at the Oregon Health Science University in Portland and is faced with connection problems, all it takes is one easy call to take care of the problem. The OHN NOC will work with service providers on both ends of the connection to get the problems resolved. The system is operated in conjunction with a 24/7 call center to assist the IT staff of OHN members and their service providers with troubleshooting and incident management.

This broadband telehealth network was made possible in large part by the FCC’s Rural Health Care Pilot Program. OHN received the fifth largest award under this program for a $20.2 million RHCPP subsidy and now the Oregon broadband infrastructure investment will be able to connect non-profit healthcare and healthcare education facilities across the state.

However, the cardiac monitoring equipment on the Wallowa County end will be paid for by a separate funding source. Fortunately hospital administrators were awarded nearly $400,000 USDA distance learning grant to purchase equipment.

So far about 70 percent of Oregon non-federal clinicians work in practices where EHRs are present. The remaining 30 percent of Oregon’s providers have made little or no progress toward implementing an EHR system. In addition, some of the state’s clinicians that have adopted EHRs still face significant steps needed to achieve the federal definition of meaningful use.

The high EHR adoption numbers in the state mask the low adoption of EHRs by healthcare providers in rural and in small practice settings. These practices worry about funding issues, workflow changes, the inability to identify qualified information systems personnel, and the fear that productivity will be reduced.

The State if funded will work with stakeholders to develop a Health IT Regional Extension Center with two lead partners. OCHIN, the lead applicant and the Oregon Health & Science University will work with several independent provider associations, rural research networks, academic institutions, and technical partners. The goal is to assist more than 3,000 providers to comply with the federal definition of “meaningful use” of health IT.