Tuesday, July 31, 2012

Fresh Start for NCI Informatics

This year the National Cancer Institute made a thorough reassessment of their Cancer Biomedical Informatics Grid (caBIG) program. The goal is to chart a new course for the informatics infrastructure needed to adequately support NCI’s research programs. While many of the principles of caBIG are valid, NCI wants to see their interoperable biomedical information systems built on community-driven data standards.

NCI’s new National Cancer Informatics Program (NCIP) will use the lessons learned from caBIG. A number of successful caBIG projects will be maintained and integrated into NCIP while other projects have been scaled back or eliminated as recommended by the Board of Scientific Advisors Working Group’s report. The newly formed Informatics Oversight Committee of the National Cancer Advisory Board is developing plans for NCIP.

NCI is undertaking two immediate tasks to initiate plans for NCIP. First, NCI is recruiting a new Director from their Center for Biomedical Informatics and Information Technology (CBIIT) and the director’s responsibilities will include overseeing NCIP. In the interim, George Komatsoulis is serving as the Acting Director of CBIIT.

Secondly, NCI has organized a meeting where leaders in the research community gathered to discuss the development of NCIP. The meeting attendees included basic and clinical scientists, informaticists, managers of core facilities, and representatives of the advocacy community.

Some of the recurrent themes at the meeting to launch NCIP were:

  • There is a driving need for data integration at every level of the biomedical enterprise
  • There is a need for the integration of analysis methods from informaticists, computational biologists, experimental biologists, and clinical researchers
  • There is a need for targeted training programs
  • NCIP should serve as a coordinating role at the beginning as this may work best with smaller rather than larger research groups tackling specific and sharply focused research challenges
  • Acknowledge the importance of clinical trial participants in the clinical information infrastructure
  • Develop lightweight informatics solutions in response to specific scientific needs that can be developed quickly within a matter of months and be user friendly
To view the new NCI Biomedical Informatics Blog, go to http://ncip.nci.nih.gov/blog/?p=511.

Delaware's Medicaid News

Since July 1st, the Delaware Medical Assistance Program has been providing telemedicine-delivered services to Medicaid clients for behavioral health and general healthcare services including medical subspecialties not widely available in the state.

Telemedicine services are being reimbursed for telemedicine-delivered services provided by an originating site that is paid a facility fee for the telemedicine space and equipment, with the consulting services reimbursed as if delivered face-to-face.

For services to be covered, both the distant provider and the originating site provider must be enrolled in the Delaware Medical Assistance Program or in one of the program’s managed care organizations.

Also in the state, Christiana Care Health System was awarded $10 million from the Center for Medicare and Medicaid Innovation (CMMI) to help create and test a system that will use a patient care hub and case mangers to improve care for post myocardial infarction and revascularization patients most of which are Medicare or Medicaid beneficiaries.

The system will enable Christiana Care to integrate the statewide health information exchange data with cardiac care registries from the American College of Cardiology and the Society of Thoracic Surgeons. This will enable more effective care and case management through near real- time visibility of patient care events, lab results, and testing.

In addition, Nemours Alfred I. DuPont Hospital for Children received $3,697,300 from CMMI for their “Optimizing Health Outcomes for Children with Asthma in Delaware” project. Nemours is partnering with Delaware Health and Social Services, Division of Medicaid and Medical Assistance and others to fund family-centered health homes to provide services for children with asthma.

The goal of this model is to reduce asthma-related emergency room use and asthma-related hospitalization among pediatric Medicaid patients in the state by 50 percent by 2015 with incremental declines in 2013 and 2014.

It was announced in July that the Delaware Division of Medicaid & Medical Assistance has signed a $50 million agreement for HP to continue to provide Medicaid fiscal-agent services for three years. Under this agreement, HP will continue to manage the state’s Medicaid Management Information System and will continue to provide a wide range of Medicaid services, including pharmacy and medical claims processing eligibility verification, call center support, and administer the state’s drug rebate program.

Safety Net Hospitals Funded

The Massachusetts “Delivery System Transformation Initiatives” (DSTI) has made $628 million available in joint state and federal funding to provide incentive payments for safety net hospitals over three years.

The hospital systems participating in the funding include Boston Medical Center, Cambridge Health Alliance, Holyoke Medical, Lawrence General Hospital, Mercy Medical Center, Signature Healthcare Brockton Hospital, and Steward Carney Hospital.

The seven hospital systems participating in DSTI were selected because they serve the highest percentages of Medicaid patients and lowest percentages of commercially-insured patients in Massachusetts.

The safety net hospitals will undertake projects to:

  • Develop a fully integrated delivery system to include converting primary care practices into Patient Centered Medical Homes, integrating physical and behavioral healthcare, and developing integrated networks linking providers via EHRs
  • Implement innovative care models to improve the quality of care and health outcomes to include building electronic chronic disease registries, new care management programs for patients with complex problems, and provide better coordination for patients when they leave the hospital
  • Develop and implement alternative payment models to include ACOs, plus pilot alternative payment models for low-income patents, and develop systems to monitor providers on how they are dealing with healthcare quality and costs
  • Develop population-focused health outcome improvements by developing projects aimed at collecting and reporting key measures that with enable the Commonwealth to track and assess the impact of the initiatives on patients and their healthcare

NYC Testing New Ideas

The New York City (NYC) Economic Development Corporation issued an RFP seeking a consultant to develop, launch, and operate the program referred to as “Pilot Health Tech NYC”. The program will partner entrepreneurial healthcare technology companies in the private sector with organizations or individuals providing healthcare services in New York City such as hospitals, physician clinics, payers, pharmaceuticals, nursing associations, and others.

Each project will focus on defined needs of the healthcare industry and test a technology prototype in a healthcare setting. The main goals are to:

  • Build relationships between NYC healthcare provider organizations and NYC healthcare technology companies that can turn into long-term client vendor relationships
  • Provide guidance to healthcare providers and companies on how to integrate and scale the most innovative healthcare technologies
  • Develop projects around EMR implementation
The consultant may be a company, non-profit organization, academic institution, industry group, or individual. NYCEDC will consider partnerships or joint ventures between multiple entities. Organizations hosting the pilot program need not be headquartered in New York City but should have a significant presence in New York.

NYCEDC is planning to award approximately ten pilot projects that will receive matching funds up to $100,000 each for a total of $1,000,000 of award money to be distributed by the consultant. Submission deadline is August 14, 2012. For more information on the subject matter of the RFP, email pilothealthtech@nycedc.com. For other questions call the hotline at (212) 312-3969. Go to www.nycedc.com/opportunity/pilot-health-tech-nyc-consultant-services-rfp to view the RFP.

New York City is also actively involved in several projects involving REACH practices that use EHRs. By using a data tool nicknamed “The Hub”, the Primary Care Information Project (PCIP) operating in NYC and supporting the adoption and use of EHRs, is providing public health researchers with data on trends in population health.

The PCIP system pulls data from 600 NYC REACH practices with EHRs that includes 2.500 providers across NYC. This data represents about 2.5 million patients and over one million primary care visits in 2012.

Through PCIP’s use of “The Hub”, NYC Department of Health (DOH) is able to collect timely public health data on the city population. For example, DOH can identify where patients seek care whether they stay in their own neighborhood for primary care or go somewhere else.

This information tells the DOH whether public health issues in that neighborhood can be addressed by primary care physicians in that neighborhood of if the department needs to cast a wider net due to people leaving the neighborhood for care.

The DOH is also able to see which geographic populations are struggling with critical health issues such as diabetes, hypertension, obesity, and asthma. As a result, the DOH can assist community health leaders develop programs to support these areas of need.

Another function of the system is to use the tool for messaging. “The Hub” can send critical updates directly to providers through their EHR inboxes. Physicians can be notified of public health threats, and keep current on changes in healthcare law or policies such as in the case of changes in Medicare reimbursement.  

In another project, the NYC DOH, Office of Viral Hepatitis Coordination (OVHC) recently launched the “Check Hep C” project”. The project is designed to increase community-based organization and community health center capacity to provide hepatitis C (HCV) testing, patient navigation, and medical care in regions of NYC most affected by HCV.

As a public health initiative, MDLand, a NYC-based NYC REACH preferred EHR vendor has collaborated with the DOH to develop a software module “iClinic” to manage the “Check Hep C” testing and patient navigation care management in their EHR. The “iClinic” Check Hep C Module is currently being used at five Syringe Exchange Programs and three Community Health Centers as part of the Check Hep C Project.

Last spring, NY State approved the NY Medicaid Redesign Team Health Disparities Workgroup proposal “Promote Hepatitis C Care and Treatment through Service Integration”. This proposal will provide reimbursement for Hepatitis C wrap-around services to support medical care. In order for community health centers to provide and bill for these services effectively, incorporation of services into an EHR is critical.

For more information on the Check Hep C Project and OVHC testing and care management using EHRs, email Community Projects Specialist Nirah Johnson at njohnso2@health.nyc.gov.

Risks to Healthcare Workers

Healthcare is the fastest-growing sector of the U.S. economy employing over 18 million workers with women representing nearly 80 percent of the healthcare workforce. However, healthcare workers face a wide range of occupational hazards on the job. These hazards can include needlestick injuries, back injuries, latex allergies, exposure to infections, hazardous drugs, radiation, exposure to laser or electrosurgical smoke, violence, and stress.

CDC’s National Institute for Occupational Safety and Health (NIOSH) is working on research to understand the risks and conditions associated with occupational diseases and injuries, explore ways to reduce risks, minimize exposure to hazardous conditions, and translate research findings into prevention practices and products to effectively reduce work related illnesses and injuries.

In order to meet the research needs of the workforce to help remedy problems in occupational safety, NIOSH established their National Occupational Research Agenda (NORA) with plans to stimulate research and improve workplace practices. The goal is to support research that is relevant, of high quality, and demonstrates an impact on reducing occupations disease and injury.

In addition, NIOSH has initiated a “Research to Practice” (R2P) initiative to reduce or eliminate occupational illnesses and injuries. This will require the transfer and translation of knowledge, intervention, and technologies into highly effective prevention practices and products into the workplace. This means that the occupational safety and health community including researchers, communicators, decision-makers, and employer/employee groups will need to work collaboratively on research ideas.

To research and find ways to explore how to protect occupational health and reduce workforce injuries, NIOSH issued two Funding Opportunity Announcement (FOA) requests on July 27, 2012. Both grant opportunities seek research ideas to protect the workforce on the job.

NIOSH released their FOA “NIOSH Exploratory Developmental Grant Program (R21) plus their FOA “NIOSH Small Research Program” (R03).

The R03 mechanism supports small research projects that can be carried out in a short period of time with limited resources. Eligible applicants for both FOAs can include higher education institutions, nonprofits, for profits, governments, plus others.

The two FOAs have similar research goals to:

  • Identify and investigate the relationships between hazardous working conditions and associated occupational diseases and injures
  • Develop better ways to evaluate hazards at work sites
  • Develop methods for measuring early markers of adverse health effects and injuries
  • Develop new protective equipment and engineering control technology to reduce work-related illnesses and injuries
  • Develop work practices to reduce risks
  • Evaluate the technical feasibility or application of a new or improved occupational safety and health procedure, method, technique, or system
Go to http://grants.nih.gov/grants/pa-files/PAR-12-252.html for information on FOA (R21) and go to http://grants.nih.gov/grants/guide/pa-files/PAR-12-200.html for information on FOA (R03). The date for the earliest submission for both FOAs is September 16, 2012.

Sunday, July 29, 2012

Testing Behavioral Health Model

Colorado Beacon Community’s partner Rocky Mountain Health Plans (RMHP) is taking part in a project to better integrate the delivery of behavioral and physical healthcare. Benjamin F. Miller PsyD, the project’s principal investigator notes that research shows that treating behavioral health and physical health separately results in poorer outcomes, and higher costs.

With funding from the Colorado Health Foundation, their partner RMHP will participate in the pilot with the Collaborative Family Healthcare Association and the University of Colorado at Denver’s Department of Family Medicine.

Using RMHP’s payment system as a laboratory, the partners will select up to six primary care practices from Grand Junction and surrounding Western Colorado communities to test a global payment model to financially sustain integrated behavioral healthcare. Practice recruitment will begin this summer with the project scheduled to be underway by spring 2013.

The primary care setting is the place to begin since more people are seen in primary care offices than in any other healthcare setting and more mental health issues are dealt with in primary care than in any other context.

Traditionally, primary care providers have not been encouraged to consult or collaborate with mental health providers because of the way the current system is designed. The system ignores the behavioral needs of medical patients and provides disincentives for consultation, collaboration, and coordination among clinicians.

According to Miller, “It is our goal to disrupt old business models in healthcare by showing more effective models that offer realistic, practical, on-the-ground solutions that primary care providers find valuable and rewarding to their patients.”

As Patrick Gordon, Program Director for the Colorado Beacon Consortium explains, “Unlike many other projects, we’re not trying to tweak the status quo. Since it’s impossible to fix the problem on a per-procedure, fee-for-service basis, we are starting with a fundamental redesign of the payment system. We will implement value-based non-fee-for-service payments to support the integration of behavioral and primary care and fundamentally change the structure of how behavioral health is handled.”

PCAST Releases Report on Spectrum

The report “Realizing the Full Potential of Government-Held Spectrum to Spur Economic Growth” was released July 20th, by the President’s Council of Advisors on Science and Technology (PCAST) an independent council of experts from industry and academia. PCAST concluded that the traditional practice of clearing and reallocating portions of the spectrum used by Federal agencies is not a sustainable model for spectrum policy.

PCAST finds that the best way to increase capacity is to leverage new technologies to enable larger blocks of spectrum to be shared. One advantage of sharing is that it does not require licensed businesses and government entities to fully clear certain wavelengths already in use.

The PCAST report notes that existing approaches to spectrum sharing can be augmented by a variety of means, including dynamic redirecting of devices to available frequencies along with better prevention of interference among signals in close proximity to one another. Several such approaches are in development and a number are ready for real-world testing.

Major recommendations in the report include:

·        The Federal government should share underutilized Federal spectrum to the maximum extent possible and identify 1,000 MHz of Federal spectrum as part of an effort to create the first shared-use spectrum superhighways

·        Authorize and implement in collaboration with industry partners, a Federal Spectrum Access System (SAS) to serve as an information and control clearinghouse for the band-by-band registrations and conditions of use that will apply to all users with access to each shared Federal band under its jurisdiction

·        Establish methodologies for spectrum management that consider both transmitter and receiver characteristics to enable flexible sharing of spectrum

·        Take stops to implement a mechanism that will give Federal agencies incentives to share spectrum

To view the entire report, go to www.whitehouse.gov/administration/eop/ostp/pcast.

3-D Tissue Chips for Drug Screening

NIH through the National Center for Advancing Translational Sciences (NCATS) has funded seventeen grants for up to $70 million over five years to create 3-D chips with living cells and tissues to accurately model the structure and function of human organs.

More than 30 percent of promising medications have failed in human clinical trials because they are determined to be toxic despite promising pre-clinical studies in animal models. Tissue chips, which are a newer human cell-based approach, may enable scientists to predict more accurately how effective a therapeutic candidate would be in clinical studies.

Tissue chips merge techniques from the computer industry with modern tissue engineering by combining miniature models of living organ tissues on a transparent microchip. Ranging in size from a quarter to the size of a house key, the chips are lined with living cells and contain features designed to replicate the complex biological functions of specific organs.

Once developed, these tissue chips will be tested with compounds known to be safe or toxic in humans to help identify the most reliable drug safety signals. This will ultimately advance research to help predict the safety of potential drugs in a faster and more cost-effective way.

Ten of the awards will support studies to develop 3-D cellular microsystems that represent a number of human organ systems. These bioengineered devices will be functionally relevant and accurately reflect the complexity of the tissue of origin, including genomic diversity, disease complexity, and pharmacological response.

The other seven awards will explore the potential of stem and progenitor cells to differentiate multiple cell types that represent the cellular architecture within organ systems. These could act as a source of cells to populate tissue chips.

The NIH tissue chip for drug screening initiative is the result of collaboration between NIH’s Common Fund and the National Institute of Neurological Disorders and Stroke, DARPA, and FDA. The NIH and DARPA programs will be coordinated closely.

For example, DARPA has entered into cooperative agreements with two of the NIH recipients, the Wyss Institute at Harvard and MIT to develop engineering platforms capable of integrating 10 or more organ systems. FDA will help explore how this new technology may be used to assess drug safety prior to approval for first-in-human studies.

OHA Approves Eight CCOs

The Oregon Health Authority (OHA) recently approved eight new Coordinated Care Organizations (CCOs) to provide care to more than 650,000 low income enrollees in the Oregon Health Plan/Medicaid. The eight certified CCOs are contracted to begin enrolling people August 1st with additional CCOs expected to be certified and to begin providing services later in 2012. 

Key to the services provided, the CCOs will coordinate mental and physical healthcare and focus on prevention. The CCOs will especially support patients with chronic conditions so that the patients are taking appropriate medications and are managing their appointments. One example of where an excellent opportunity exists for coordinated care is in the management of diabetes.

Under the new model, Oregon has agreed to reduce Medicaid inflation by two percentage points within two years by focusing on improving the health of clients to reduce unnecessary expenditures. The agreement calls for saving $11 billion over the next decade.

A third-party analysis found that by implementing CCOs, Oregon could save a significant portion of projected Medicaid costs in the short and long term. Savings would be more than $1 billion total fund dollars within three years and more than $3.1 billion total fund expenditures over the next five years.

Approximately 60 percent of Oregon Medicaid dollars are paid by the federal government through a $1.9 billion federal funding pact provided over five years. Governor Kitzhaber and state officials are working with CMS on federal waivers to allow CCOs the flexibility to manage care for the best health outcomes. The Governor is also discussing the possibility of financial investments through CCOs from the federal government in anticipation of future cost reductions.

The CCO AllCare Health Plan Inc. headquartered in Grants Pass, a town of 34,500 nestled in several mountain river valleys in Southern Oregon, represents 23,000 Oregon Health Plan members. The plan has contracts with 1,000 local healthcare providers which roughly includes 95 percent of the area’s physicians and also works with five different hospital systems. Although AllCare is located in a small town, they have implemented managed care concepts, EHRs, and the primary care patient-entered medical home.

AllCare in coordinating care will emphasize sharing treatment plans, exchanging information electronically, working in teams, incentivizing wellness and preventive medicine programs, reducing visits to the emergency rooms, and prioritizing primary care.

Other CCOs include, FamilyCare, Inc., Intercommunity Health Network CCO, PacificSource Community Solutions, Inc., Trillium Community Health Plan, Umpqua Health Alliance, Western Oregon Advanced Health, LLC and Willamette Valley Community Health, LLC.

Next steps in 2012 will allow OHA and the Department of Consumer and Business Services to share information so CCOs will not have to submit financial reports to both agencies. Also, plans are to continue current protections that prohibit discrimination of providers based solely on their license type in the CCO environment, and lastly require OHA to report quarterly on implementation of CCOs through 2017.

New Developments at RTI

RTI International received a contract from the Robert Wood Johnson Foundation (RWJF) to develop an online database and communication platform to help public health professionals share information about quality improvement initiatives.

The problem is that while sustained national efforts at quality improvement are critical to optimizing health across all populations; there is no nationally recognized online collaboration resource for quality improvement in public health.

The “Public Health Quality Improvement Exchange” (PHQIX) will serve as an online centralized communication hub to support quality improvement efforts in public health practices throughout the U.S.

When the PHQIX launches in September 2012, the website will include a searchable online database and interactive discussion features to facilitate increased knowledge and understanding of quality improvement initiatives. Users will be able to submit their own quality improvement initiatives online and search for interventions and tools relevant to their specific health department and community needs.

The PHQIX currently being developed employs a user-centered design process. A user group consisting of public health practitioners will provide input as the exchange is created using an agile development process. While the technology infrastructure for PHQIX is being developed, initial submissions will be reviewed as the standardized submission format is established.

RTI International has also developed new search tools funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to improve access to kidney, diabetes, and liver clinical trial data to make it easier for scientists and others to access data. It is possible to use the tools to search the contents of the repository by disease, study type, treatment, or keyword. It is also possible to combine studies to increase the power of results obtained.

The set of five query tools were developed and recently added to the NIDDK Central Data Repository. The repository available at http://www.niddkrepository.org/ warehouses study information, biospecimens, and findings from clinical studies sponsored by NIDDK and makes electronic datasets from these clinical studies available to the research community.

Seeking Communications Manager

The Alliance for Health Reform in Washington D.C www.allhealth.org is looking for a Communications Manager to help the Alliance connect in new ways with reporters and users of the Alliance website.

The Alliance was found by John D (Jay) Rockefeller, Senator from West Virginia and the Alliance’s Vice President Ed Howard to help reporters and congressional staff to sort through the many options for changing the U.S healthcare system.

The Alliance has conducted more than 500 briefings on Capitol Hill and elsewhere with registrations surpassing 350 people plus the Alliance has helped reporters in Washington and beyond find experts and find new ideas for stories.

The Communication Manager will report to Ed Howard and Anastasia Dent, Director of Operations and Grant Management to identify priority audiences and find the most effective means to meet their information needs.

Specific tasks and responsibilities:

  • Communicate proactively with national, regional, trade, and internet reporters including blogs
  • Oversee editorial content for toolkits and a video series on the Affordable Care Act
  • Author, update, and revise content in a Robert Wood Johnson Foundation-funded sourcebook distributed to congressional offices and health reporters nationwide
  • Inform member of the media about Alliance Capitol Hill briefings and press events
  • Respond to media requests for follow-up information after briefings and refer reporters to experts as needed
  • Oversee the development and production of promotional materials and website updates to market the sourcebook “Find-an-Expert” service, toolkits, and other grant supported publications
  • Work with other Alliance staff, web designer and consultant on the integration of database and website capabilities, usability, appearance, and design
  • Edit publications and communications in conjunction with the Executive VP
  • Draft executive communications and grant related narratives
The knowledge, skills, and experience desired:

·        Substantive knowledge of and experience in social media, legacy media, and health policy
·        Knowledge of congressional functioning and the legislative process
·        Excellent interpersonal, writing, and organizational skills
·        Ability to work well in a team-oriented environment
·        Ability to work closely with web designers and other communication-related vendors
·        Demonstrated ability to meet deadlines

To respond, email cover letter, resume, and salary requirements to jobs@allhealth.org. No phone calls please. Applications received by August 1, 2012 will receive priority.

Tuesday, July 24, 2012

Cleveland Clinic CEO Speaks at NPC

Cleveland Clinic’s CEO Dr. Delos “Toby” Cosgrove speaking July 20th at a luncheon at the National Press Club, said “The key to reducing healthcare costs is employing physicians. All of the physicians at the Cleveland Clinic are employed and get a straight salary.” According to reports, today, 60 percent of the doctors in the U.S are employed and 75 percent of the medical graduates are now going to be employed instead of being self-employed.

The Dartmouth Atlas looked at top organizations in the U.S. and concluded that the two with the lowest Medicare costs were Mayo Clinic and the Cleveland Clinic where both employ physicians. Dr. Cosgrove pointed out that employed physicians at the Cleveland Clinic, are involved in decision-making as it relates to purchasing and utilization decisions resulting in purchasing costs being lowered by about $125 million.

Dr. Cosgrove also mentioned that one of the other important ways to lower costs is to integrate healthcare systems as this helps to reduce the duplication of services. At the Cleveland Clinic, pediatrics, trauma, rehabilitation, heart surgery, and obstetrics systems have been consolidated. enabling the medical center to become more efficient.

Many hospitals across the U.S are changing and coming together in terms of systems that are capable of talking to each other. Sixty percent of the hospitals in the U.S are now part of a system and as systems are brought together, the thinking is that more standardization of care, more efficiency, and more collaboration will result.

The Cleveland Clinic is working very hard to reduce the staggering toll of patients dying each year from infections contracted in hospitals and doctors’ offices. Dr Cosgrove is happy to report that actually the country has seen a 50 percent reduction in the incidents of central line infections across the country simply by bundling and using standard procedures.

The question Dr Cosgrove hears most often is how will the Affordable Care Act affect innovation? He is concerned that in developing a new drug or device it takes such a long time to get products through the system and into the marketplace.

For example, if a heart valve is developed, it can take about ten years of work in animals, and then a long time to get through the regulatory process and be approved by FDA. Plus the fact, if you need to establish if one heart valve is better than another heart valve, then that may take another ten years to come to a conclusion.

As a result, there aren’t too many venture capitalists willing to invest in a twenty year project so as a result, much of the innovation is being driven out of the U.S. As Dr. Cosgrove commented, “It’s important to emphasize the fact that healthcare products developed here are sold all over the world resulting in pharmaceuticals and devices being major exports from the U.S.”

Dr Cosgrove explained how the Cleveland Clinic ended up having a hospital in Abu Dhabi. After 9/11 happened, the Cleveland Clinic was operating on about 35 patients a month particularly on patients from the Middle East. Hospital officials then began to look in the Middle East to see if they could establish a hospital offshore. The Cleveland Clinic had offers from many countries to provide care but by far the most attractive offer was from Abu Dhabi.

He pointed out that the Cleveland Clinic in establishing their presence in the country is working with the government of Abu Dhabi. The government built the hospital facility and at the same time, the government is paying the Cleveland Clinic doctors their salaries plus management and consulting fees. As Dr. Cosgrove proudly pointed out, “The Cleveland Clinic is the first facility in the U.S that has gone overseas and helped design a healthcare delivery system for a country.”


AHRQ published their “Request for Information (RFI) “Quality Measurement Enabled by Health IT” in the July 20th Federal Register. AHRQ is looking for ideas on how to improve quality measurements through health IT from stakeholders, health IT developers, vendors, payers, quality measure developers, end users, clinicians, and healthcare consumers

AHRQ wants to develop further insight in order to achieve meaningful advancements in the next generation of quality measurement. Through this RFI, AHRQ seeks information on building blocks of health IT-enabled quality measurement in terms of practicalities and priorities. So far, developing quality measures has generally been based on developing the measures from paper chart information, from manual charts, abstracting information, and analyzing claims data. Health IT-enabled quality measurement is an emerging field.

However, challenges hindering the process can involve:

  • Underdeveloped or unavailable infrastructure
  • Incompleteness of the measure set and to prevent developing measures that matter to consumers
  • Knowing how to capture unstructured data in the EHR
Comments are to be submitted by August 20, 2012. AHRQ will host a national web conference July 31 at 1:30 pm to provide additional information on the project and the report “Environmental Snapshot—Quality Measurement Enabled by Health IT: Overview, Possibilities, and Challenges”.

Go to http://healthit.ahrq.gov/HealthITEnabledQuality%20Measurement/Snapshot.pdf to view the report published under contract by Booz Allen Hamilton (July 20, 2012).

For more information, email Angela Nunley at Armela.Nunley@AHRQ,hhs,giv or call (301) 427-1505.

VA Expanding Telemedicine

According to the VA’s Office of Rural Health (ORH), the Veterans Rural Health Resource Center-Eastern Region (VRHRC-ER) is partnering with the Multiple Sclerosis (MS) Society to help increase awareness of the VA’s telemedicine program that is helping rural veterans with MS.

VA neurologists are providing follow up exams in the homes of rural veterans with MS via telemedicine, but in addition, the Eastern Region has launched a wellness program to provide personalized exercise education and instruction through televideos.

The rural VA Medical Center in Lake City Florida is partnering with the VRHRC-ER to help coordinate services and care for veterans with MS and ALS. The Lake City VAMC is home to the Multiple Sclerosis Comprehensive Care Clinic Clinical Demonstration project supported by ORH and led by Dr. Paul M Hoffman, Neurologist and VRHRC-ER Director. The project uses secure televideo to coordinate primary and specialty care provider visits to rural Community- Based Outpatient Clinics and/or to the veteran’s home.

The VA’s VISN 4 is increasing the use of e-consults and today more than 15 of their specialty clinics use e-consults. For example, patient care teams within the VISN meet twice a month using teleconferencing to discuss ways to improve care.

The VISN 4’s teledermatology program, a store and forward program used at Butler Healthcare was recently recognized as one of the top three best practice programs. The estimated savings to Butler was $90,000 in FY 2011.

To help veterans on the legislative front, Representatives Glenn “GI” Thompson (R-PA) and Charles B. Rangel (D-NY) recently introduced the “Veterans E-Health & Telemedicine Support” (VETS) Act of 2012” (H.R.6107) to increase veteran healthcare access. The bill has the support of twelve bi-partisan members of Congress and numerous other groups including ATA.
The bill expands the current VA state licensure exemption to allow credentialed healthcare professionals to work across state borders performing telemedicine without having to obtain a new state license. The bill will enable the VA to expand key treatment services including behavioral health.

Previously, Congressman Thompson introduced the “Service Members Telemedicine & E-Health Portability Act” now Public Law 112-81 where Section 713 removed the state licensure requirement for qualified and credentialed DOD healthcare professionals when DOD is working to expand access to service members through various existing programs.

"Meducation" to Improve Treatment

Asthma affects almost ten percent of children and is the most common health condition reported by North Carolina public schools. Latino children have higher rates of uncontrolled asthma and make more asthma-related emergency department visits than other children. Is it because they aren’t using their medication device correctly? So far, no studies have been done to evaluate Latino children to see if they are using their asthma device correctly.

Now a new feasibility pilot study is being sponsored by the University of North Carolina, Chapel Hill to determine whether the “Expanding Networks for Latinos through Community Engagement” (ENLaCE) study now recruiting Latino children into a randomized controlled trial will find the answers. ENLaCE is comprised of over 15 organizations in the Greensboro North Carolina area.

To help solve the problem, “Meducation”, a NIH-funded project developed by Polyglot Systems, Inc. has developed asthma device technique videos in both Spanish and English and believes that the videos would help the Greensboro Latino community.

An estimated one hundred boys and girls between eight years to sixteen years will be recruited from two pediatric ENLaCE clinics in the area to be in the study. One group will be randomly assigned to watch device technique videos in Spanish or English after a regularly scheduled medical visit. Their device technique will be assessed before and after the visit. The other control group will watch a two minute nutrition video.

The study (NCT01641211) is due to start July 2012 but has not yet opened participant recruitment. For more information email Delesha Carpenter PhD at dmcarpenter@unc.edu.

In another development to help patients, the Western New York Beacon Community has partnered with “Meducation” to develop a Health 2.0 standalone web-based tool capable of generating patient centered medical instructions that are easier to read, understand, and available in the patient’s preferred language.

For example, Medicor Associates in Western New York one of the pilot sites is working with the Beacon Community through a Cooperative Agreement Program to fully utilize Meducation’s technology. Other partners involved include HEALTHeLINK and the Western New York County of Chautauqua.

Developing CSF Monitoring Device

A monitoring device for Cerebrospinal Fluid (CSF) shunts is being developed by a team of chemical and biomedical engineers, physicists, pathologists, and neurosurgeons. The researchers are working to find therapeutic options for hydrocephalus as part of the Clinical Translational Science Center’s Biodesign Initiative at the University of Mexico HSC.

Very little has advanced in this field since CSF shunts became standard practice more than 50 years ago. Malfunctions occur when the shunt breaks, moves, gets infected, or most commonly becomes blocked. Currently there are no methods for non-invasively monitoring flow in a cerebral shunt to tell whether blockage is occurring. Standard practice involves puncturing the valve system through the skin and using perhaps unnecessary CT scans, which often can provide limited information.

The UNM Clinical Translational Science Center pilot funding the biodesign project has a device under development to enable physicians or clinical technicians to immediately obtain a two-dimensional map of the CSF flow in real-time during an office visit. The device would greatly increase diagnostic capabilities for earlier intervention and provide a way for clinicians to create an individual profile of flow rate for each patient.

The device works with a Silastic tube carrying water across a temperature controlled fluid pack from a glass (the brain) to another beaker (the peritoneal cavity of the stomach) where a valve system regulates the flow of the liquid through the tube. Insulated by a cloth of pigskin and sitting on a stack of Styrofoam, the liquid in the tube is being monitored by a state-of-the-art infrared camera and software program that plots temperature change and flow rate.

Most patients with CSF shunts are children and children tend to experience more problems with shunt devices than adults since their bodies are still growing and their immune systems are not fully developed. Hydrocephalus is particularly prevalent and associated with premature birth.

Determining malfunction can involve invasive procedures and CT scans which for children can be a problem since children are more radiosensitive than adults, and often determining what is malfunctioning can necessitate lengthy visits to the hospital emergency room.

This is a particular burden for families living in remote areas in the West. As it happens, the University of New Mexico Hospital is one of the only facilities in the Mountain West region that can perform pediatric neurosurgery.

According to the main investigator on the project, Erich Marchand MD a specialist in pediatric neurosurgery, the device has the potential to speed diagnosis and lower the threshold of visiting a doctor to check shunt functioning. He reports that in some instances, a shunt can be malfunctioning or move in the body but the malfunctioning causes no symptoms because the device is no longer needed by the patient. However, it is impossible to know if this has occurred without an invasive procedure.

Dr. Marchand is very encouraged by the idea of having a tool to use to monitor shunt function that could be incorporated into regular exam visits and longitudinally track cerebral fluid flow, when there is a healthy situation and can also reveal patterns that a child with a shunt develops over a period of time.

The research team has submitted an SBIR grant to NIH to move the project into the next phase of development. Since the procedure is non-invasive, involving only the discomfort of an ice cube on the skin, it is expected that the project will be able to move rapidly from simulation to testing on humans without the need to develop an animal model. The CTSC is going to assist with the regulatory and commercialization process.

Source: UNM HSC “CTSC June 2012 Update” newsletter available at http://hsc.unm.edu/research/ctsc/index.shtml. The newsletter features a new column on translational research projects at UNM HSC. For more information on sharing research, email Kara McKinney at KMcKinney@salud.unm.edu.  

ATA's Fall Forum Almost Here

The ATA Fall Forum to be held September 10-11, 2012 at the Roosevelt Hotel in New Orleans will keep you up to date on what is around the corner for telemedicine and healthcare. The Fall Forum will enable you to prepare for the future of telemedicine and remote healthcare technology. The speakers will explain business and clinical trends in the industry and highlight opportunities for new market segments and services.

Some of the issues to be addressed include:

·        The changing face of telemedicine and how to outsource clinical services and make telehealth an integral part of your business strategy
·        Using telemedicine in the fight against re-hospitalization
·        Using telemedicine as a tool for international development and disaster relief
·        Creating the best mHealth apps and services by bringing together the 6 “Players” in the mHealth ecosystem
·        Discussions on the Opportunities created by the ACA and by other Federal and State legislation
·        Discussions on legal issues of a start-up telehealth company
·        Ways to integrate social media into clinical healthcare services to improve outcomes

To see the full program schedule and register, go to http://www.atafallforum.org/.

Sunday, July 22, 2012

VA Proposing RVCP Grants

As published in the July 18th Federal Register, the Department of Veterans Affairs proposes to establish a pilot program known as the “Rural Veterans Coordination Pilot” (RVCP). The program would provide grants to eligible community-based organizations, local, and state government entities to assist veterans and their families as they transition from military service to civilian life in rural or underserved communities.

The proposed pilot program is a result of the “Caregivers and Veterans Omnibus Health Services Act of 2010”. The legislation calls for:

  • Coordination of community, local, state, and Federal providers of healthcare and benefits for veterans transitioning from military service to civilian life
  • Availability of high quality medical and mental health services as veterans transition
  • Assistance to veterans and families to inform them about the availability of benefits and connect them with appropriate care and benefit programs
The grants would go to rural areas, areas with populations that have a high proportion of minority group representation, areas that have individuals who have limited access to healthcare, and areas that are not close to an active duty military installation.

The VA proposes to award five RVCP grants for a maximum period of two years. Grantees would not be required to provide matching funds to receive a grant. When the VA is ready to announce the availability of the grants, the VA will publish a Notice of Funds Availability (NOFA) where detailed information will be provided at www.grants.gov.

For more information, contact Karen Malebranche, VHA, Office of Interagency Health Affairs at (202) 461-6001.

BTOP Report Released

The Broadband Technology Opportunities Program (BTOP) 13th Quarterly Program Status Report detailing activities from January to March 2012 was sent to Congress and released June 2012. NTIA has invested $4 billion in 233 BTOP projects and supported 123 infrastructure projects totaling $$3.5 billion in Federal grants to construct broadband networks.

From January to March 2012, BTOP grant recipients continued to demonstrate strong performance across the program’s FY 12 goals. Significant progress has been made in areas such as new fiber-optic infrastructure construction since more than 12,000 network miles have been deployed during the past quarter. NTIA expects the pace of network construction to remain strong through the summer as most recipients are engaged in the implementation phase of their projects.

BTOP is working on infrastructure projects that focus on connecting anchor institutions, such as schools, libraries, hospitals, and public safety facilities. Last quarter, BTOP improved service to nearly 2,000 anchor institutions within their project areas bringing the total number of institutions to 8,300 across 40 states. The total number of anchors connected with BTOP funds increased by more than 30 percent from the previous quarter. This quarter, NTIA was able to reach 83 percent of the FY 12 goal to connect 10,000 institutions.

Additionally through the State Broadband Initiative (SBI), NTIA granted $293 million in BTOP funds to 56 recipients that included one grant for each of the 50 states, five territories, and the District of Columbia.

SBI consists of the State Broadband Data and Development Program and the National Broadband Map. NTIA works with SBI grant recipients to help expand their data collection efforts and improve data accuracy and validation. SBI recipients will continue to collect new data every six months from 1,800 broadband providers nationwide.

Last February, funding was provided through legislation to provide for a nationwide public safety broadband network. The legislation calls for establishing the First Responder Network Authority or “FirstNet” as an independent authority within NTIA and charges FirstNet with the building, deployment, and operation of the network.

23 Telemedicine Grants Awarded

The Public Service Commission of Wisconsin on June 28th approved 23 grant applications as part of the Commission’s Medical Telecommunications Equipment Program. These grants are being funded by the state’s Universal Service Fund and total nearly $1 million. The grants range from $3,000 to $116,269 and include one tribal health agency, two county health agencies, and twenty non-profit medical organizations.

The purpose for the grant program is to promote technologically advanced medical services, to improve access to medical care in rural or underserved areas of the state and to enhance access to medical care by underserved populations or persons with disabilities. The grants target projects that demonstrate the use of advanced telecommunications services.

Several of the grants awarded:

  • Home Health United of Dane County and St. Vincent & St. Mary’s Hospital in Green Bay received grants to purchase improved in-home health monitoring equipment to permit better day-to-day care for patients recovering at home

  • Aspirus, Inc. of Wausau, Lakes Community Health Center of Iron River, and Gundersen Lutheran Medical Foundation of La Crosse will receive funds to purchase telemedicine carts
Other grants provide funds to purchase digital x-ray equipment and teleconferencing equipment to permit medical imagery to be evaluated by radiologists and other specialists located in other cities, equipment to promote consumer awareness of the dangers of strokes, and funds to purchase an improved telecommunications system for a non-profit organization operating three clinics in Sawyer County.

For more information, go to http://psc.wi.gov/ and then click on news.

Maine Addressing Payment Reform

The Maine Health Access Foundation (MeHAF) on July 2, 2012 released an RFP seeking to help organizations develop robust payment reform projects that would promote a patient-centered approach to care delivery and would integrate behavioral and physical healthcare. This is the third round for MeHAF grants focused on payment reform. The Foundation funds up to four grants between $75,000 and $100,000 per year.

The intent of the RFP is to provide grants to Maine non-profit organizations to advance substantive payment reform efforts that would control costs without sacrificing access and quality of care. Successful projects will address improving the health of populations and reducing per capita costs of healthcare.

Projects funded under this RFP must help position Maine’s health system to be eligible and competitive for ACA opportunities or for pilot or demonstration projects fielded by the Center for Medicare and Medicaid Innovations.

The proposals are due August 10, 2012. Webinars were held July 16th and July 17th. For more information, go to www.mehaf.org/advancing-payment-reform-maine-2012. Answers to frequently asked questions will be summarized and posted on the MeHAF website on July 24, 2012.  Email Cathy Luce, MeHAF Grants Manager at cluce@mehaf.org for further details.

The statewide health information exchange referred to as HealthInfoNet is making news, as the HIN has launched a first in the nation’s pilot program to archive X-rays, mammograms, and other digital records in the Cloud. This new digital archive will save personnel and patient time, diagnostic costs and administrative, transfer, and storage costs.  Anticipated savings are projected to be $6 million over seven years.

 HIN’s healthcare provider participants collectively generate 1.4 million of the total 1.8 million electronic images produced in the state each year. Pilot participants include MaineGeneral Medical Center in Augusta and Waterville, Eastern Maine Medical Center in Bangor, and Cary Medical Center in Caribou.

NLM Releases RFP

The National Library of Medicine (NLM) released a Request for Proposal (RFP) to fund small projects that would improve access to disaster medicine and public health information. The funding will go to healthcare professionals, first responders, and others that play a role in health-related disaster preparedness, response, and recovery. Contract awards will be for a minimum of $15,000 to a maximum of $30,000 each for a one year project.

NLM is soliciting proposals from partnerships that include at least one library and at least one non-library organization with disaster-related responsibilities. The groups can include health departments, public safety departments, emergency management departments, pre-hospital and emergency medical services, fire/rescue, local, regional, or state agencies with disaster health responsibilities, hospitals, faith-based organizations, plus voluntary organizations.

Projects should:

  • Increase awareness of health information resources
  • Demonstrate how libraries and librarians can assist planners and responders with disaster-related information needs
  • Show ways in which disaster workers can educate librarians about disaster management
  • Provide for collaboration among partners in developing information resources to support planning and response to public health emergencies

For example, funding in 2011 supported Inova Fairfax Hospital’s “Northern Virginia Disaster Health Information Initiative”. The outreach project is helping to develop a medical librarian-led disaster information specialist role to work with members of the Northern Virginia Hospital Alliance (NVHA) to provide disaster related health information.

In another example, the Kanawha-Charleston Health Department, Division of Emergency Preparedness in West Virginia is collaborating with the West Virginia School of Osteopathic Medicine Library, and Concord University in Athens, to create both a vortal (a web-based portal specific to the needs of a particular community), and related mobile applications derived from the vortal to be used during a health-related disaster by health professionals.

This RFP for 2012 has been split into two solicitations. One solicitation is a “Partial Small Business Set-Aside” (RFP No: NIHLM2012411) and the other solicitation is a “Full and Open” RFP (RFP No. NIHLM2012412. For more information go to http://www.fbo.gov/ or go to http://nnlm.gov/psr/newsbits. For more details, email Keturah Busey at buseyk@mail.nlm.nih.gov or call (301) 451-6557.

Oral Health Epidemic Persists

Former Surgeon General David Satcher and Former HHS Secretary Dr. Louis Sullivan, President of the Sullivan Alliance were speakers at a recent conference held to address the oral health epidemic in this country. The Morehouse School of Medicine and the Sullivan Alliance sponsored the one day conference “Unmet Oral Health Needs, Underserved Populations, and New Workforce Models: an Urgent Dialogue”.

Former Surgeon General David Satcher reported, “Profound oral health problems exist for large portions of the population. Oral health care in America continues to be a crisis as tooth decay is the most common chronic disease among children and is almost five times more prevalent than asthma.”

Another fact is that children, minorities, and the poor are disproportionately affected by the oral health crisis:

  • Thirty seven percent of African American children and forty one percent of Hispanic children have untreated tooth decay, compared with twenty five percent of white children
  • American Indians and Alaska Natives have the highest rate of tooth decay of any population: five times the national average for children ages 2 to 4
  • Seventy two percent of American Indian and Alaska Native children ages 6 to 8 have untreated cavities more than twice the rate of the general population
  • More than a third of all poor youngsters ages 2 to 9 have untreated cavities, compared with seventeen percent of children who are not poor

The Satcher issued a renewed call for action to expand access to oral health care since more than five million additional children are expected to gain dental benefits through the ACA in 2014. However, the fact is that there are not enough providers to meet the need. Currently, just 20 percent of all practicing dentists accept Medicaid patients. As a result, HRSA estimates a current shortage of approximately 10,000 dentists in the future.

Satcher advocates launching workforce pilot programs to determine how best to expand access to dental care. He said, “We need more dentists and we need more professionals who are not dentists but who can contribute to oral healthcare services. The real key is whether or not systems are going to ensure that everyone is allowed to practice to the level of their potential.”

According to Satcher, states must purse all avenues to expand access to dental care, including looking for ways to create new dental providers and how to build a cadre of ethnically-diverse, culturally competent dental practitioners as well as how to expand the reach of the dental team with other healthcare professionals.

More than a dozen states are exploring creating new midlevel dental providers, also known as dental therapists, to expand access to preventive and routine dental care. Dental therapists currently practice in Alaska and Minnesota. In Alaska, dental therapists have been able to provide care to 35,000 Alaska Natives who couldn’t access dental care before. Connecticut and Oregon are planning pilot projects and numerous other states have put forward legislation to allow dental therapists.

CMS Announces New Initiative

HHS Secretary Kathleen Sebelius announced the new ”State Innovation Models Initiative”, a competitive funding opportunity so that States can develop and test multi-payer payment and delivery models to deliver high quality healthcare and improve health system performance.

States can apply for either Model Testing awards to assist in implementing their already developed models, or Model Design awards that will provide funding and technical assistance as they determine what type of system improvements would work best for them.

Up to five states will be chosen for the initial round of Model Testing awards and up to 25 states will be chosen for Model Design awards. Up to $275 million is available in funding, including $50 million for Model Design and $225 million for Model Testing.

CMS expects to offer a second opportunity for all states to apply for a Model Testing award next year. State Innovation Models initiative applications will be evaluated and reviewed by an independent review panel, CMS and its independent Office of the Actuary.

To learn more about this new initiative, CMS Innovation Center staff will be hosting a webinar Thursday July 26, 2012 at 3:00PM (ET). To register, call 1-877-306-0462. Conference ID: 8055039.

For more information, go to www.innovation.com.govinitiatives/State-innovations or go to www.grants.gov (July 19, 2012).

Tuesday, July 17, 2012

Improving Pediatric EHRs

The National Institute of Standards and Technology (NIST) released a guide to help improve the design of EHRs for pediatric patients so that the focus is on users, doctors, nurses, and other clinicians who treat children.

While hospitals and medical practices are accelerating their adoption of EHRs, these systems are not always ideal to help support children’s healthcare needs. Young patients’ physiology is different from adults and varies widely over the course of their growing years. Tasks that are routine in larger bodies can be complex in smaller ones, and also, pediatric patients typically cannot communicate as fully as adults.

These challenges can create additional physical and mental demands on the professionals who treat children and affect the way they interact with an EHR. This makes the selection and arrangement of information displays, definition of “normal” ranges and thresholds for alerts in pediatric EHRs more challenging to design and implement than those created for adults.

The new NIST guide was developed with help from experts in pediatrics, human factors engineering, usability, and informatics. The guide was peer-reviewed by human factor experts and clinicians as well as other professionals in leading pediatric healthcare organizations in the U.S. and Canada.

“A Human Factors Guide to Enhance EHR Usability of Critical User Interactions when Supporting Pediatric Patient Care” (NISTIR 7865) is now available at www.nist.gov/manuscript-publication-search.cfm?pub_id=911520.

Measuring Quality of Care

The Affordable Care Act (ACA) will extend coverage for millions of the uninsured population and focuses on improving access, affordability, and the overall quality of care. As a result, states will need to develop their capacity for standardized collection and reporting of data on the quality of healthcare provided to adults covered by Medicaid.

On July 13th an initial Funding Opportunity Announcement (FOA) “Adult Medicaid Quality Grants to Measure and Improve the Quality of Care in Medicaid” was published in www.grants.gov. The ACA in section 2701 makes $300 million available for Adult Health Quality Measures of which $112 million will be used for this funding opportunity.

Specifically, up to $56 million will be awarded each fiscal year over a two year period of performance. A total of 56 grant awards will be made available for up to $1 million for each 12 month budget period with the estimated total to be up to $2 million per grantee over the two year project period.

The FOA is open to all 56 State Medicaid agencies to support testing, collecting, and reporting the Initial Core Set Measures to CMS. Additionally, the funding will also support the states’ efforts to use the data to improve the quality of care for adults covered by Medicaid.

The Letter of Intent is due July 31, 2012 with the application due August 31, 2012.

Sandia Seeks Commercial Partners

Researchers at Sandia National Laboratories have developed a lab-on-a-disk platform that they believe will be faster, less expensive, and more versatile than similar medical diagnostic tools. Lab officials are now seeking industry partners to license and commercialize the SpinDx technology.

The technology can determine a patient’s white blood count, analyze important protein markers, and process up to 64 assays from a single sample, all in a matter of minutes. The use of SpinDx can have implications for patient care since heart attacks, strokes, infections, certain cancers, and other afflictions could be detected days or weeks sooner than they are today.

The SpinDx platform has several advantages such as:

  • Small sample size—Patients have only to provide a pin-prick sample of blood
  • Ease of use—Device uses a spinning disk, much like a CD player to manipulate a sample. The disks contain commercially available reagents and antibodies specific to each protein marker
  • Custom applications—A plug and play approach will enable physicians to be able to choose among a cardiac disk, immune disk, and similar options
  • Inexpensive technology—Disks cost pennies to manufacture
  • Quick response time—Results can be delivered to the physician’s computer in 15 minutes

“We envision medical personnel using SpinDX routinely,” said Greg Sommer, the Sandia researcher who spearheaded development of the project. “Instead of standard blood panels and costly lab tests, a SpinDx disk could be processed right in the office while the medical office staff is collecting routine data.

According to Sommer, the team is developing a deployable prototype to run the assays, with the goal of a fully integrated automated device to be used for field testing. “We’ve done most of the testing in a benchtop setting, where we spin the sample on the disk and then read it out on a microscope,” Sommer explained, “The next step is to automate those processes and get the system into users hands.

For more information, email Jill Micheau at jmmiche@sandia.gov or call (925) 294-3672.

Focusing on Neurology

SUNY Downstate Medical Center received an award as part of the Patient-Centered Outcomes Research Institute’s Pilot Projects Program to improve patient care in the field of neurology. Steven R. Levine, MD, Professor of Neurology and Emergency Medicine and Vice Chair of Neurology is the scientific principal investigator on the $500,000 award to develop mobile phone applications for stroke patients and their caregivers.

Researchers from SUNY Downstate’s College of Medicine and the School of Public Health are participating in the study. The study is being developed in conjunction with the National Stroke Association and the Arthur Ashe Institute for Urban Health. The grant team will survey stroke survivors and their caregivers to investigate the interest in and preference for smart phone apps to improve identifying and managing risk factors. For more information, go to http://www.pcori.org/.

Dr. Levine is also the principal investigator on SUNY’s Downstate’s NIH-funded clinical trial network referred to as the Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT) involving four SUNY medical center campuses.

The Network was created to conduct studies for treatments for neurological diseases through partnerships with academia, private foundations, and industry. The network is designed to expand the National Institute of Neurological Disorders and Stroke’s (NINDS) capability to test promising new therapies. The plan is to increase the efficiency of clinical trials before embarking on larger studies in order to respond quickly as new opportunities arise. The network includes multiple clinical sites, a Clinical Coordinating Center and one Data Coordinating Center. For more information, go to http://www.neuronext.org/.

On June 4, 2012, NINDS released a notice for a webinar to be held August 2, 2012 at 1:00 PM to introduce new academic investigators and existing Neurological Disease Study Groups to the NeuroNEXT network. An overview of the network will be given including the scope, purpose, and available resources. To sign up, go to https://www1.gotomeeting.com/register/306886344.