Tuesday, December 20, 2011

Time Out

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

Improving Neonatal Care

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

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

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

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

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

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

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

NIST's Call for Proposals

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

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

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

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

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

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

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

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

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

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

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

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

EU/U.S eHealth Collaboration

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

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

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

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

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

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

Digital Divide Still Exists

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

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

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

Overall the report found:

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

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

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

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

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

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

Studying Medication Use & Safety

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

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

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

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

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

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

Saturday, December 17, 2011

Hemophilia Funding & Research

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

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

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

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

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

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

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

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

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

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

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

Patient-Centered Care Discussed

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

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

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

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

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

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

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

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

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

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

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

Interim CEO Appointed

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

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

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

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

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

Screening to Protect Human Health

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

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

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

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

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

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

DOD's Private Sector Opportunity

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

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

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

Improving Hospital Care

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

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

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

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

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

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

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

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

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

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

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

Wednesday, December 14, 2011

DLT Grants for Rural Healthcare

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

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

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

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

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

D.C to Be 1st 100 Gigabit City

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

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

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

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

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

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

Improving DOD Program Coordination

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

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

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

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

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

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

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

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

Wireless Technology to Help Seniors

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

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

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

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

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

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

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

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

RFP Seeks Proposals in D.C Area

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

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

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

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

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

Free App to Improve Patient Care

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

The app has several features:

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

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

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

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

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

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

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

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

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

Save the Date March 15-16

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

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

Featured keynote speakers are:

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

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

Sunday, December 11, 2011

FCC's Future Health Strategies

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

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

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

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

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

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

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

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

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

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

CHCF to Help Labs Exchange Orders

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

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

CHCF’s goals for this initiative are to:

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

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

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

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

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

Aventyn Announces Clinical Study

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

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

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

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

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

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

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

Attaining Security Milestone

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

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

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

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

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

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

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

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

AMIA Holds Health Policy Meeting

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

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

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

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

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

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

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

Connecticut Calling for Pilots

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

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

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

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

Wednesday, December 7, 2011

HHS Secretary Touts Innovation

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

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

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

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

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

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

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

HRSA Announces Demo

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

The funding announcement seeks to:

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

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

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

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

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

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

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

HL7 & Regenstrief Working Together

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

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

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

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

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

Qualcomm Announces Spin-Off

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

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

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

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

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

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

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

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

• Software health IT applications

• Health related informatics/analytics

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

Disabled Need Wireless

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

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

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

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

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

HP Streamlining State Process

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

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

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

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

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

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

• Improved insight into claims data through the NC-MMIS

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

Sunday, December 4, 2011

AHRQ Collaborating With NSF

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

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

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

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


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

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

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

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

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

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

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

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

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

FCC Initiating CAF

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

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

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

Company Receives FDA Clearance

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

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

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

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

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

NIH's Device to Treat Eyes

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

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

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

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

Research to Help Children

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

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

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

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

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

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

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

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

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

Europeans Support Telemedicine

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

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

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

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

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

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

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

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

Monday, November 28, 2011

HRSA Seeks Applications

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

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

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

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

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

NIH Streamling Tech Transfer

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

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

The new system will streamline the licensing process by:

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

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

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

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

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

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

California HIT Forging Ahead

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

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

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

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

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

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

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

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

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

Enabling Better Rural Healthcare

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

Some of the grants are going to:

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

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

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

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

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

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

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

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

OPM Issues HIT Report

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

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

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

This year’s findings include:

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

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