Tuesday, October 30, 2012

Several Worldwide NCD Initiatives

NIH’s Fogarty International Center awarded $14 million in grants to 15 research institutions to help counteract the rapid rise of chronic diseases in developing countries. Fogarty’s “Chronic, Non-Communicable Diseases and Disorders across the Lifespan (NCD-Lifespan) program funds training for research related to non-communicable health problems.

“Non-communicable diseases such as cancer, diabetes, cardiovascular disease, and chronic respiratory diseases continue to ravage developing regions of the world and the lack of trained clinicians and researchers compounds the epidemic”, said Fogarty Director Dr. Roger I. Glass.

Training will be part of a trauma and injury project in Uganda, a substance abuse effort in Ukraine, and on nutrition and chronic diseases in Ghana, Malawi and Bangladesh. Other projects will focus on improving the mental health infrastructure in Southeast Asia, and training in China related to gene-environment interaction. Cancer and tobacco control training will be provided in Kenya and a planning grant will support cardiovascular research training in India.

Another worldwide project to combat Non-Communicable Diseases (NCD) was launched by the International Telecommunication Union (ITU) and the World Health Organization (WHO). The program will develop a new partnership called the “mHealth Initiative” to help others use mobile technologies such as text messaging and apps to help combat NCDs.

The ITU-WHO mHealth Initiative will be a four year project and build on current projects, existing health systems, and platforms by involving partnerships between governments, NGOs, and the private sector. WHO is already using mobile devices to carry out surveillance of non-communicable diseases and their risk factors. For example, the Global Adult Tobacco Surveillance system has used mobile phones to capture data on tobacco use in 17 countries.

WHO and ITU Member States are also testing mobile solutions for NCDs ranging from helping people increase their activity level, teaching them to eat better, and helping patients with non-communicable diseases better manage their condition. In addition, partners will share knowledge and technical expertise to help develop the standard operating procedure for each mHealth intervention as well as build support for the Initiative.

“By joining forces, ITU and WHO will fight against debilitating non-communicable diseases that can be controlled through the intervention of mHealth solutions and services that are cost effective, scalable, and sustainable,” said ITU Secretary-General Harmadoun I Toure.

1st Round of Networks Selected

Illinois Governor Pat Quinn and the state’s Department of Healthcare and Family Services (HFS) selected six healthcare networks to launch the state’s transition to greatly expanded coordinated care. This will mean that by 2015, about 1.5 million Medicaid beneficiaries will be in coordinated care.

The HFS “Care Coordination Innovations Project” is working to redesign the Illinois healthcare delivery system to reduce costs to the Medicaid and All Kids program, improve health outcomes, and provide higher quality care to 2.7 million residents. The first phase of the Innovations Project is being directed at the 16 percent of Medicaid recipients currently accounting for 55 percent of Medicaid costs in Illinois.

Provider groups applied to be part of the Innovations Project led by HFS Director Julie Hamos. Six applicants were selected based on their demonstrated ability to offer a holistic approach to delivering coordinated care for special populations including seniors and adults with disabilities.

The Innovations Project is one of several initiatives the state is using to see that 50 percent of clients are enrolled into care coordination. Through this particular program, HFS is testing innovative models that offer risk-based care coordination through Care Coordination Entities (CCE) and Managed Care Community Networks (MCCN).

To jump start the care coordination movement, HFS released an RFP in January for the first phase looking for provider only proposals from CCEs and MCCNs. The goal was to form provider-based networks to provide care coordination to seniors and adults with disabilities who have the most complex health and behavioral health conditions.

The RFP required that these CCEs and MCCNs partners enlist participation from hospitals, primary care providers, and mental health and substance abuse providers. However, other RFPs are open to HMOs, providers, and Medicare Advantage (dual eligibles).

On October 16th, six proposals were selected from four applicants in northeastern Illinois and two in downstate Illinois. The agency realizes that these CCEs and MCCNs will need time to build their infrastructure, including the use of EHRs.

The five CCEs plus one MCCN selected include:

  • Be Well Partners in Health led by MADO Management LP, Bethany Homes and Methodist Hospital, Norwegian American Hospital, and Neumann Services
  • Healthcare Consortium of Illinois led by Healthcare Consortium of Illinois, a community-based, non-profit organization. The consortium includes a network of collaborators such as primary care physicians, behavioral health service providers, hospitals, and others
  • Macon County Care Coordination led by the Macon County Mental Health Board with a network of collaborators to include a Federally Qualified Healthcare Center for primary care, hospitals, behavioral health service providers, health departments, and others
  • Precedence Care Coordination group will be a collaboration of providers and community organizations to include hospitals, substance abuse entities, clinics, and three established community mental health centers
  • Togethr4Health led by Heartland Health Organization, Inc. includes 37 collaborators composed of hospitals, primary care providers at FQHCs, pharmacies, behavioral health providers, social services, and housing providers
  • The MCCN Community Care Alliance of Illinois led by Community Care Alliance of Illinois, is a wholly-owned subsidiary of Family Health Network that includes hospitals, and 6,000 practitioners

New Partnerships Formed

CellepathicRx based in Cleveland Ohio along with Duke University have formed a new company called Improved Patient Outcomes Inc. The partnership combines CellepathicRx’s mHealth mobile platform and Duke University’s research-backed patient behavioral content to focus on improving patient adherence and outcomes.

CellepathicRx’s mobile behavioral health platform is focused on initiating and sustaining patient communication. The platform targets patients to help them understand and adhere to medication regimens, clinical trial protocols, health coaching, and health and wellness programs.

CellepathicRX’s mHealth platform is joining up with Duke University’s behavioral management program content that currently covers 75 disease states. This academic and industry partnership is delivering proven behavioral coaching content to patients, right on their mobile phones, via SMS, via texts, mobile web, and email. The partnership also helps health plans and payers communicate with thousands of patients and identify those at risk for medication non-compliance. Patients with complicated needs can then be flagged for an over-the-phone nurse intervention.

A Virginia partnership established through the University of Virginia’s “Cancer Technology Partnership Initiative”, was awarded funding for three projects to bring university and industry researchers together to accelerate treatments for brain, breast, and pancreatic cancers.

The following public-private collaborations will each receive $90,000 to $100,000 to further research:

  • UVA researchers are working with a Charlottesville-based biotechnology firm ITI Health Inc. to develop  molecular-based imaging techniques to detect liver metastases in pancreatic cancer
  • UVA researchers are partnering with Reston-based nano-pharmaceutical company Parabon NanoLabs to produce and test a nano-pharmaceutical drug for simultaneous treatment and real-time monitoring of glioblastoma multiforme
  • UVA researchers are partnering with Jefferson Lab and Dilon Technologies Inc. to improve the speed and accuracy of cancer surgical procedures by developing advanced imaging tools.
In another venture in California, the University of California system has joined with representatives from five UC campuses to form the University of California Biomedical Research Acceleration, Integration, and Development (UC BRAID) program.

The UC Research Exchange (UC ReX), an unprecedented cross-campus searchable database of patient-level study data from all UC medical centers was one of the successful results. UC ReX enables physicians and scientist to identify and recruit patients from across the five health campuses based on diagnosis and demographics. The objective is to expand clinical trial networks, enhance outcomes research, and facilitate quality-of-care studies.

ASET Announces New Grants

The Arizona Strategic Enterprise Technology (ASET) Office  has just launched an “Unconnected Providers Grant Program” to support HIE planning and implementation. The ASET office is responsible for the programmatic implementation of ONC’s $9.3 million HIE cooperative agreement award for the state of Arizona. 

The grant program posted October 1, 2012 on www.hie.az.gov has funding of up to $1.1 million aimed at stimulating the adoption of HIE for healthcare providers who currently have not planned or implemented an information exchange solution.

Each organization is eligible to receive a maximum award up to $50,000 with a maximum of $25,000 that can be used for HIE implementation planning. When two or more organizations complete a single grant application, the grantee would be eligible to receive a maximum award of up to $100,000.

The grant program is open to any for-profit or non-profit healthcare organization that maintains a portion of its operations in Arizona targeting medically underserved and low income populations as well as the needs of special populations.

The following organizations are eligible to apply for grants such hospitals, long term care facilities, FQHCs, IHS facilities, behavioral healthcare organizations, primary care organizations, and large healthcare specialty organizations.

The grant performance is for six months with the award will run from January 1, 2012, to June 30, 2012. Grant applications are due November 16, 2012.

For more information contact Manisha Patel at (602) 748-0708 (cell) or email Manisha.Patel@azdoa.gov. 

St. Luke's to Implement Program

Philips Healthcare is going to improve local care provided by critical access hospitals affiliated with St. Luke’s Health System in Boise Idaho. The program will use Philips eICU technology to provide remote critical care support to critical access and other hospitals that do not have designated critical care staff available 24/7. St. Luke’s is planning to fund this effort through the $11.7 million “Innovation Award” received from CMS earlier this year.

“Studies show patients in ICUs managed by physicians trained in critical care have improved outcomes and decreased lengths of stay but many smaller hospitals are unable to have critical care physicians on site 24/7,” said Brian Goltry, M.D., Director of St Luke’s Boise eICU Program. “The eICU technology allows us to extend our critical care expertise virtually. We expect to see a reduction in mortality rates and patient lengths of stay as we roll out our program across the region.”

The eICU Program uses remote patient monitoring, two way videos, and clinical decision support at the bedside that link to an eICU center. This enables St Luke’s critical care physicians and other specialists from St. Luke’s Boise Medical Center to evaluate, treat, stabilize, and monitor patients in conjunction with providers and coordinators on-site.

“When physicians and other providers communicate by means of telemedicine, with full access to all patient information including imaging and laboratory studies, we are able to coordinate care,” said David C. Pate, M.D., St. Luke’s Health System President and CEO.

In another move, Kansas City's St Luke's system has announced a partnership with BJC HealthCare of St. Louis, CoxHealth of Springfield Missouri, and Memorial Health System in Springfield Illinois to partner to create the BJC Collaborative LLC.

While remaining independent, the Collaborative members will have a footprint of 4,821 hospital beds spanning Missouri, Illinois, and Kansas. The combined annual revenues of almost $7 billion will enable the members of the BJC Collaborative to focus on savings, deploying clinical programs and services, to improve access and the quality of healthcare, lower healthcare costs, and create additional efficiencies.

Several opportunities may also be explored in working with information systems and technology in terms of data center management, data warehousing, software applications, hardware configurations, emerging technologies, and data security. Plus other areas that may be explored include population management, training, capital asset management, and financial services.

Sunday, October 28, 2012

HRSA's Future Announcements

HRSA anticipates posting several grant announcements in the next few months. The first announcement is expected to be posted December 5, 2012 by the Maternal and Child Health Bureau for the “Emergency Medical Services for Children (EMSC) Target Issue Grant” program. Funding is estimated to be for $2,100,000 with the application due March 5, 2013.

The EMSC Program crosses many settings of care delivery. These settings can include pre-hospital environment, emergency department visits, tertiary care, rehabilitation, and care in outpatient settings. The goal of the EMSC program is to ensure optimal emergency care for ill and injured children within the continuum of the existing Emergency Medical Care System (EMSS).

The grant funding will help to improve pediatric emergency care by improving the science and evidence base, by providing national models for quality improvement or systems development, and providing national resources to improve care delivery.

Another HRSA Maternal and Child Health Bureau grant announcement scheduled to be posted November 5, 2012 will involve funding for “Community-Based Integrated Service Systems” involving state and local governments.

The Early Childhood Comprehensive Systems (ECCS) program improves quality by developing local infrastructures to coordinate services and the resources needed by the children and families to achieve favorable outcomes. The anticipated request for proposals will help to develop the next phase of the ECCS program. The funding will be for $7,800,000 and the due date for proposals is anticipated to be December 4, 2012.

The third HRSA Maternal and Child Health Bureau grant announcement due to be posted November 5, 2012 is titled “Developing Integrated Child Health Information Systems: Working with Immunization Information Systems to Establish a Child Health Profile in the Public Domain”. The estimated funding is $450,000 and the application due date is anticipated to be February 2, 2013.

This grant program is open to state, local governments, nonprofits, and for profit organizations, small businesses, Indian tribes, and faith-based and community-based organizations.

This grant program will involve several projects. Project 1 will be to develop the technological capacity for maternal and child healthcare coordination across public and private healthcare domains. Support will be provided to develop bidirectional health information exchange between state-level immunization information systems as well as other public health entities and state level HIEs. Project 2 will help states to implement a web-based electronic birth records system.

In addition to the three forecasted announcements, HRSA issued a pre-solicitation (13-250-SOL-00005) entitled “HRSA Evaluation Studies Indefinite Delivery Indefinite Quantity (IDIQ)” on October 17th. The overall purpose of the pre-solicitation is to assist HRSA with evaluation activities.

The types of activities are organized into three Domains with specific tasks.

  • Domain 1 may involve assessing the effectiveness and efficiency of HRSA supported programs, outcomes, performance, and polices
  • Domain 2 may involve describing how to strengthen the capacity for health and public health related evaluation both within HRSA and among programs and grantees. In addition, technical assistance and training may be needed to build evaluation capacity among HRSA programs and staff
 Domain 3 is a set aside for small businesses and may include:

  • Assessing and developing evaluation-related IT data systems both within HRSA and among HRSA’s programs and grantees
  • Developing professionally-validated data linking algorithms to support program evaluation
  • Developing IT capacity to support evaluation-related activities among small and medium sized public health organizations
 The anticipated date for release of the solicitation will be on or about November 19, 2012. Go to www.fedbizopps.gov or to www.hrsa.gov/grants/index.html for more information on the forecasted grant announcements and the pre-solicitation announcement.

NIH Launches "LiverTox" Database

A free source of evidence-based information for healthcare professionals and for researchers studying liver injury associated with prescription and over the counter drugs, herbals, and dietary supplements is now available . LiverTox at www.livertox.nih.gov  is a searchable database with information on about 700 medications available in the U.S. by prescription or over the counter. Over the next few years, another 300 drugs will be added. 

Drug-induced liver injury is the leading cause of acute liver failure in the U.S. accounting for at least half of the cases. It can occur at all ages, in men and women, and in all races and ethnic groups. Drug-induced liver disease is more likely to occur among older adults because they tend to take more medications than younger people.

Some drugs directly damage the liver, while others cause damage indirectly or by an allergic reaction. It is important in managing drug-induced liver injuries to identify the drug that is causing the problem and take appropriate steps to eliminate or reduce damage to the liver.
“Because drug-induced liver disease is not a single common disease, it is very difficult to diagnose with each drug causing a somewhat different pattern of liver damage,” said Jay H. Hoofnagle, M.D., the major creator of LiverTox and Director of the Liver Disease Research Branch at the National Institute of Diabetes and Digestive and Kidney Diseases.

The LiverTox database offers:

·        An overview of drug-induced liver injury, including diagnostic criteria, the role of liver biopsy, and descriptions of different clinical patterns and standard definitions
·        A detailed report on each drug, including background, case study, product package insert, chemical makeup and structure, dose recommendations, and references with links
·        An interactive section, allowing users to report cases of drug-induced liver injury to the LiverTox website. Reports will be automatically forwarded to FDA’s MedWatch program where FDA will use the information to monitor product safety

“LiverTox is the result of a significant scientific collaboration between the national and international clinical and research communities, the NIDDK and NLM”, said Steven Phillips, M.D, Co-Sponsor of LiverTox and Director of NLM’s Division of specialized Information Services. I hope the LiverTox model can be used to create a new suite of databases that can identify drug-induced injury to other organs such as the heart, kidney, and lung.”

Devices Providing Care

Georgia Tech and Emory University have developed and are testing a new pediatric medical device. Currently, pediatricians diagnose ear infections using the standard otoscope to examine the eardrum. With the Remotoscope device, parents will be able to take a picture or video of their child’s eardrum using their iPhone and send the images digitally to a physician for diagnostic review.

Wilbur Lan Assistant Professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University along with colleagues at the University of California at Berkeley developed the device with plans to commercialize it.

Remotoscope’s clip-on attachment uses the iPhone’s camera and flash as the light source. It also relies on a custom software app that provides automatic zoom and crop, image preview, and auto calibration. The iPhone’s data transmission capabilities seamlessly send images and video to a doctor’s inbox or to the patient’s EMR.

According to Dr. Lam, “The device can save money for families and healthcare systems”. Today, there are more than 15 million office visits for people with ear infections per year in the U.S that results in thousands of prescriptions for antibiotics being prescribed which are not always needed.

At the initial visit with a patient, physicians say it is difficult to differentiate between ear infections caused by viruses, which resolve on their own, and those infections caused by bacteria which require antibiotics.

“As pediatricians will likely only see the child once, they often err on the side of giving antibiotics for viral infections rather than risk not giving antibiotics for a bacterial infection, which can lead to complications,” Dr Lam said. “So, we are currently over-treating ear infections with antibiotics and consequently causing antibiotic resistance.”

Lam said, “Remotoscope may be able to change the physicians’ prescription patterns for antibiotics for ear infections. Receiving serial images of a child’s ear over several days via the Remotoscope would enable the physicians to wait and see if a child’s infection improves or whether antibiotics are warranted.

A clinical trial for the Remotoscope is underway at Children’s Healthcare of Atlanta to see if the device can obtain images of the same diagnostic quality as a physician sees with a traditional otoscope. The FDA through the Atlanta Pediatric Device consortium is partially funding the clinical trial.

Once a family agrees to be in the trial and the child has seen the emergency room doctor, a video is taken of the child’s ear with the Remotoscope and a traditional otoscope is linked to a computer. Next, physicians review the quality of the samples, make a diagnosis from the Remotoscope video, and see if it matches the original diagnosis by the ER doctor. The research team hopes to publish the trial’s results by the end of the year.

In another research project, the University of Washington, UW Medicine, and Seattle Children’s Hospital has a new tool that enables people to monitor their lung function at home or on the go simply by blowing into their smart phones.

“There’s a big need to make testing cheaper and more convenient to measure lung function,” said lead researcher Shwetak Patel, a UW Assistant Professor of Computer Science and Engineering. “Other people have been working on attachments for the mobile phone that you can blow into, but the researchers wanted to figure out how to do it with the microphone that is already there.”

Researchers have tested the system on 52 mostly healthy volunteers using an iPhone 4S smart phone and its built-in microphone. A grant from the Coulter Foundation will fund more clinical testing with patients of varying ages and lung health, and help the team seek FDA approval. The researchers are working with the UWs Center for Commercialization to bring the technology to market.

MobiSecure Validated by NIST

Diversinet’s MobiSecure® is the first mHealth platform to receive the Federal Information Processing Standards (FIPS) 140-2 validation by NIST after undergoing a rigorous testing program administered by NIST and the Communications Security Establishment Canada.

The FIPS 140-2 validation, a recognized North American standard for proper use of encryption, is required for use in U.S. and Canadian government communications systems to protect sensitive data.

This certification validates the security technology underpinning the company’s mobile health platform. This certification means that Diversinet’s mHealth solutions will not only exceed HIPAA requirements but also be future-proofed for years to come.

“FIPS 140-2 validation of our technology is a milestone not only for Diversinet but also for the mobile health industry,” said Dr. Hon Pak, Diversinet CEO. Pak added “The FIPS seal of approval demonstrates how Diversinet is leading the trend toward greater exchange and protection of personal health information fueled by increasing smartphone, tablet usage, and the popularity of bring-your-own-device or BYOD policies.

Today, government efforts are being made to protect personal health information as more and more mHealth solutions are adopted. In September, in a recent move toward higher security standards, the HIT Policy Committee advising HHS, called for requiring multi-factor authentication for applications involving remote access to patient information. If approved, this requirement will take effect in 2015 with Stage 3 of the HITECH Act’s meaningful use incentive program.

Also, Diversinet just announced that their MobiSecure mobile platform has 36 new features in its 4.5 version. New MobiSecure features include autonomous alerts, app wakeup, and remote data wipe. As Dr. Hon Pak explained, “We listened to the market and added significant features to help our customers innovate rapidly with mobile applications while overcoming concerns about protecting personal data.”

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

Simulator Effective Teaching Tool

The METIman simulator connects wirelessly to a proprietary software program that allows the user to control the mannequin during instruction via a computer or touch-screen tablet. The $50,000 mannequin is equipped with blinking eyes, breathing abilities and provides vital signs, plus a host of other abilities. The simulator assists in teaching and training emergency responders and students good techniques and skills during simulated real-life patient scenarios.

As an example of how it can be effectively used, first responders were able to demonstrate their emergency response capabilities during a Desert Wind 13-01 exercise held at Edwards Air Force Base to test the response to a major aircraft incident. Medical personnel were able to train for the first time during a METIman exercise.

The training exercise enabled the mannequin to be operated through a simulator controlled wirelessly from a nearby laptop. The technology provides virtually a limitless variety of scenarios for medical personnel to use in training.

“The mannequin really suits our needs as it was designed for the pre-hospitable setting, and focuses a lot of its enhancements and computer programs found in that environment on the injuries we would normally see, said Ryan Billings 412 MDG Emergency Medical Technician Program Manager.

He continued, “During the exercise involving the aircraft incident, paramedics had to actually treat and practice on the mannequin. The injury sustained by the mannequin had a closed head injury, an open femur fracture, and a punctured chest and by having this simulator, our medics were able to practice advanced life support skills.”

The METIman simulator is also being used in several nursing programs. One scenario had nursing students at Louisiana Tech University, treating METIman simulator  for serious third degree burns and placed over 50 percent of the body. The goal was to help the students take care of the medical emergency without the help of an instructor.

Several other colleges have received some grant funding to purchase the METIman simulator to help nursing students.  Recently, Albany Technical College received a grant from USDA Rural Business Enterprise Grant to purchase the METIman mannequin for their simulation lab and Kent State’s East Liverpool’s Nursing Lab received funding to purchase METIman through Appalachian Regional Commission funding.

Research Projects Receive Grants

The NY Cap Research Alliance was established in 2012 by the Albany Medical Center, Rensselaer Polytechnic Institute and the University of Albany as part of New York Governor Cuomo’s Regional Council initiative. The Alliance just recently announced ten new awards totaling $745,000 to foster biomedical research in New York State.

The goal for the Alliance is to spur economic growth, formalize existing collaboration, and foster additional cooperation among numerous biomedical research entities located in New York’s Capital Region. The plan is to identify opportunities for the development of products as a result of the research, secure seed funding for their commercialization, and encourage the development of businesses producing biomedical devices.

Thirty three applications for funding were received that focused on pressing health challenges such as Alzheimer’s disease, cancer, other neurodegenerative diseases, and regenerative medicine.

Some of the ten projects being funded include:

·        $80,000 to develop a sensor for the early detection of Alzheimer’s Disease
·        $75,000 to develop smart bandages for healing wounds
·        $75,000 to develop a novel implantable sensor for use in orthopedics and for neurosurgery
·        $50,000 to develop sensors to differentiate forms of prostate cancer

“Biomedical research targets the cures for disease. Breakthroughs can have tremendous human and economic impact locally, nationally, and globally,” said Dr. Jackson, who serves as the Co-Chair of the Capital Region Economic Development Council. “By combining our strengths, focusing our resources, and leveraging our assets, the NY Cap Research Alliance will accelerate the potential for scientific discoveries and innovations in health care and expedite their pathway into the marketplace.”

For more information, go http://regionalcouncils.ny.gov/print/841.

Tuesday, October 23, 2012

Update on Quality Measures

The Veterans Administration was an early adopter of quality measurement, performance accountability, and the use of EHRs.  The VA is into their second decade of using EHRs along with quality measures to help care for veterans. Originally, most nationally recognized quality measures were implemented in a “one size fits all” manner.

Joseph Francis, MD., from the Office of Informatics and Analytics within the VA’s Central Office, provides commentary on quality measures on the VA’s Health Services Research & Development Service site. As he reports, most quality measures today focus on a single episode of care, and therefore, they may also fail to capture appropriate clinical decisions and changes in the patient’s health status and risk over a longitudinal timeframe.

His commentary points out that the EHR VistA-CPRS remains limited in its ability to capture clinical concepts using standardized data elements. As a result, the VA currently uses chart abstraction on a sample of veterans to estimate performance based on HEDIS a set of performance measures maintained by NCQA and Joint Commission measures.  

When structured clinical data is captured electronically, it often occurs through relatively inflexible clinical reminders, which can create challenges for clinicians due to the poor context-sensitivity of the reminders and their interference with workflow.

The situation today is that nearly $20 billion in incentive payments have been made available to hospitals and providers to accelerate EHR adoption as part of the HITECH Act. Providers and hospitals that adopt certified EHRs must demonstrate Meaningful Use by generating and reporting quality measures and public health information.

Also, Stage 2 and 3 of Meaningful Use will require information sent electronically to providers to use nationally recognized data standards so that health information will be shared seamlessly across multiple health systems and providers. In addition, rapid advances in computer science especially the use of natural language processing for complex analytics are allowing the use of much richer information to provide context-sensitive, patient-centric decision support.

As a result of these developments, new ways have to be considered on how to measure quality in the future with the need to:

  • Develop longitudinal quality measurements that incorporate clinical actions
  • Develop risk-tailored quality measurements
  • Develop patient-centered quality measurements
 These measures represent a major shift for quality measurement in the VA and the nation. Several of these actions are already being tested and deployed. For example, the VA is now implementing clinically appropriate action measures for diabetes and a predictive model for mortality and hospital admission within primary care. To expand research, it will require ongoing collaboration between health services researchers who can provide the objectivity to pilot, refine, and evaluate the measures.

HHC Improving Medical Care

The New York City Health and Hospitals Corporation (HHC) a $6.7 billion integrated healthcare delivery system with a 420,000 member health plan called MetroPlus is the largest municipal healthcare organization in the country. HHC provides medical, mental health and substance abuse services through its eleven acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community-based clinics, plus provides in-home services.

HHC has announced that all eleven city-run public hospitals have achieved full Meaningful Use status for their EMR system and will receive nearly $200 million through ARRA funds which will be reinvested back into patient care.

HHC IT is working to ensure that all patients in Patient-Centered Medical Home Practices are linked to primary care providers. To do this, HHC IT launched the Patient Panel Management System (PAMS) to train primary care front line and management staff to work with PAMS to manage patient assignment protocols. HHC PCMH practices have successfully assigned 82 percent of primary care patients to PCPs/care teams in FY 2012, an improvement of 11.4 percent since January 2012.

In 2011, the New York State Department of Health received approval for up to $250 million available over three years from CMS to conduct the Hospital-Medical Home (H-MH) Demonstration Program. HHC submitted applications for the H-MH Demonstration on behalf of their eleven hospitals in July 2012.

The demonstration funding will be available to New York State teaching hospitals to support transition of their outpatient training site to PCMHs. If successful, HHC is estimated to receive approximately $28 million of the $102 million to be disbursed in the first year of the demonstration based on a formula derived from Medicaid volume and number of primary care residents receiving training at the facilities.

Demonstration awardees will be required to submit a work-plan describing selected resident training, continuity of care enhancements, care integration initiatives with a focus on primary care and behavioral health integration, and inpatient safety projects. Continued funding will be dependent upon meeting certain performance milestones, including achieving Level 2 or 3 NCQA PCMH re-certification by December 2013.

Also, the HHC ACO has filed an application to operate as a Medicare ACO, and seeks to participate in the Medicare Shared Savings Program, a payment model that aligns payment reward with performance based on quality, process and cost reduction targets. The HHC ACO application to the Medicare Shared Savings Program is expected to be reviewed by CMS in the next few months. If approved, HHC ACO will begin operating in January 2013.

For HHC to operate over the next 20 years with upcoming changes in the healthcare industry around home care and HHS’s ACO status, the EHR system must be updated. To meet these future needs, a Request for Proposal was issued, demonstrations were held, additional product reviews were done, and site visits took place. HHC’s Board of Directors selected Epic Systems Corporation as the vendor. The EHR is being extended into behavioral health, operating rooms, emergency department, long term care, and will be integrated with the Soarian financial system.

The contract with Epic is for an initial term of ten years with an additional five year renewal option with the total amount not to exceed $302,807,986. The total 15 year cost to migrate from the current trajectory to Epic is $1.4 billion which includes both new costs and the cost to maintain existing systems during the transition.

In 2011, Governor Cuomo created a Medicaid Redesign Team to find ways to increase quality and efficiency in the Medicaid program and to reduce costs. One of the recommendations enacted into law was the creation of Behavioral Health Organizations (BHO). However, as it turned out, BHOs resulted in an increased administrative burden to hospitals without producing useful results.

Effective October 1, 2012 the two state agencies who oversee BHO performance, the NYS Office of Mental Health, and the Office of Alcoholism and Substance Abuse Services, are going to reduce the burden by changing the reporting requirements to focus on the more complex, difficult-to-discharge and frequently readmitted patients. The hope is that this change will result in more useful data for the move into the second phase of managed behavioral healthcare. It is further expected that the State will delay implementation of Phase 2 until 2014.

Addressing Accessible Technology

The Department of Labor’s Office of Disability Employment Policy awarded a grant for $950,000 to the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) to establish the Accessible Technology Action Center (ATAC). The Center will promote the use of accessible technology in the hiring, employment, retention, and career advancement of individuals with disabilities and will expand access to information along with communication technologies in the workplace.

Jennifer Simpson, a well-known accessible technology strategist has joined RESNA as Project Director to launch ATAC. “This is a critical time in the disability community,” said Simpson. “Not only is there high unemployment and underemployment, but more and more information and communication technologies are being used in the workplace. Our Center will bring together first-class partners and expert resources to advance employment for people with disabilities by focusing on accessible technology solutions and adoption.”

Simpson previously worked at the American Association of People with Disabilities (AAPD), a national disability membership organization, as Senior Director for Government Affairs. While at AAPD, she led national efforts to increase technology accessibility widely in telecommunications, health information technology, broadband deployment, and emergency awareness.

In another action related to the disabled, Section 510 of the Rehabilitation Act requires the Architectural and Transportation Barriers Compliance Board or referred to as the Access Board to issue accessibility standards for medical diagnostic equipment in consultation with FDA, Department of Justice, and the VA.

In February 2012, the Access Board published a Notice of Proposed Rulemaking proposing the accessibility standards. The proposed standards contain minimum technical criteria to ensure that medical diagnostic equipment, including examination tables, chairs, weight scales, mammography equipment, and other imaging equipment used by healthcare providers are accessible to and usable by individuals with disabilities. As a result, the Access Board has established the Medical Diagnostic Equipment Accessibility Standards Advisory Committee that is going to meet October 29-30, 2012 in Washington D.C.

For more information on the meeting, go to www.access-board.gov/medical-equipment.htm or email Rex Pace at pace@access-board.gov or call (202) 272-0023.

Job Growth in NE Ohio

 In 2012, Great Lakes Neuro Technologies has seen their workforce grow by 50 percent, bringing sustainable high-tech jobs to Northeast Ohio. Since 2006, the company has focused on developing innovative medical devices specifically in the area of movement disorders.

The company’s Kinesia technology provides a telemedicine platform for assessing movement disorders such as Parkinson’s disease.  Today, this technology is being developed beyond patient care, to include cutting-edge therapies such as deep brain stimulation and today clinical trials are testing new pharmaceutical interventions to treat and slow disease progression.

Since the beginning of 2012, the company has increased the number of employees from 14 to 21 full time employees. The jobs have included software engineering, biomedical engineering, firmware engineering, quality management, accounting, and human resources.

This growth has created a highly skilled workforce in the region attracting new talent to the area. In 2012, the company added over $580k in new payroll to the Northeast Ohio biotech market with additional openings at the company still being filled.

According to Lisa Halasy, Human Resources Coordinator, “We anticipate our growth and required resources to continue through 2013. As new and emerging markets for the Kinesia technology continue to expand commercial opportunities, the company anticipates continued employee growth.”

“We are proud to be a part of economic growth in the Cleveland area that can be driven by biomedical engineering and medical device development,” said President Joseph Giuffrida, PhD. “Not only are we positively affecting the lives of people living with movement disorders, we are growing an exciting company and creating opportunities for talented individuals looking to make a difference.”

For more information, go to www.glneurotech.com and for information on the company’s Kinesia technology, go to www.glneurotech.com/Kinesia.

Eye-Free Mobile Device Developed

Qualcomm Incorporated through its Wireless Reach™ initiative and Project RAY Ltd. announced that they have developed the RAY mobile device. The RAY is an always-on, easy-to-use, multi-function smartphone synchronized with Israel’s Central Library for the Blind, Visually Impaired and Handicapped audio books content.

According to the World Health Organization, 285 million people are visually impaired worldwide, 39 million are blind, and 246 million have low vision. About 65 percent of all people who are visually impaired are 50 and older. With an increasing elderly population in many countries, more people will be at risk of age-related visual impairment.

Today the majority of blind and visually impaired people use simple 2G mobile phones for voice telephony only. In addition, they depend on an array of specialty devices, such as audio book readers, special bar-code scanners, and large-buttoned voice-enabled MP3 players which are prohibitively expensive.

Based on the off-the-shelf Android OS smartphone powered by Qualcomm Snapdragon™ processor, the RAY device integrates the capabilities of smartphone technology and the capabilities of multiple specialty devices into a single, cost-effective handset with 24/7 mobile broadband connectivity and a UI designed for eye-free interaction.

The UI supports phone calls, text messaging with vocal read-out, navigation, object recognition, social network services, remote assistance, audio-book reading, and other leisure and entertainment offerings. A trial project is currently underway that is testing the new system with 100 participants throughout Israel.

“Subscribers can use RAY devices to easily access and download audio assets from the library over an advanced mobile broadband network rather than waiting to receive CD copies,” said Amos Beer, Chief Executive Officer of the Central Library for the Blind, Visually Impaired, and Handicapped.

For more information, go to www.project-ray.com.

CEO to Keynote at mHealth Summit

Aetna CEO Mark T. Bertolini to deliver keynote address at the 2012 mHealth Summit to be held December 3-5 at the Gaylord National Resort and Convention Center located in the Washington D.C. area. In his keynote, he will share his personal passion for creating a connected convenient healthcare system empowering patients to take control of their health. In addition, Bertolini will demonstrate how Aetna is using innovative technology to bring this connected convenient system to life.

Bertolini is a spinal cord injury survivor and partially disabled as the result of a severe skiing accident in 2004 and in 2007, he donated a kidney to his son. These experiences are foundational to his dedication to improve the patient experience and address the longstanding challenges facing the U.S. healthcare system.

“We are pleased this year’s summit will kick-off with a keynote from Mark Bertolini as it signals a broadening of the mHealth Summit to include greater representation of thought-leaders from across the payer and health delivery community,” commented Richard Scarfo, Director for the mHealth Summit and Vice President of Vendor Events at HIMSS Media. “

The 2012 mHealth Summit will bring together 4,500 leaders from over 50 countries to encourage dialogue and advance collaboration for the use of wireless technology to improve health outcomes. This year’s expanded program offers analysis of the critical issues surrounding mobile health in the areas of health, innovation, technology, research, policy, and business, and finance.

The mHealth Summit will connect leaders in government, private sector/industry, academia, foundation, and not-for-profit organizations to advance discussion and decision-making related to the intersection of mobile technology, health research, and policy in the U.S. and abroad.

The mHealth Summit is presented by the HIMSS Media in partnership with NIH, the mHealth Alliance, and the Foundation for NIH. For more conference details or to register, go to www.mhealthsummit.org.

Sunday, October 21, 2012

NwHIN Transitions to eHealth Exchange

The Nationwide Health Information Network (NwHIN) exchange is transitioning from an ONC federal program initiative to a public-private endeavor, called eHealth Exchange. The eHealth Exchange includes federal agencies and private partners that have implemented nationwide health information network standards and services and initiated the Data Use and Reciprocal Support Agreement (DURSA).

On October 1, 2012, the eHealth Exchange Coordinating Committee officially designated Healtheway, a nonprofit organization as ready to assume the operations and support of the eHealth Exchange. The operation and support includes:

  • Testing and onboarding
  • Maintaining DURSA and operating policies and procedures
  • Supporting the eHealth Exchange infrastructure including service registry and digital certificates
  • Supporting the eHealth Exchange Coordinating Committee
 ONC will also continue to work closely with organizations like Direct Trust and Healtheway to ensure the development of secure, effective, and cost efficient health information exchange standards, services and policies, and provide guidance for their implementation.

Healtheway recently announced the selection of the Certification Commission for Health Information Technology CCHIT as the testing body for the eHealth Exchange. This selection was made in partnership with the EHR/HIE Interoperability Workgroup, a New York eHealth Collaborative NYeC- led consortium of states and vendors.

The Federal Health Architecture (FHA), an E-Government Line of Business initiative managed by the ONC for HIT and was formed to coordinate health IT activities among more than 20 federal agencies that provide health and healthcare services.

The FHA is supporting the transition of eHealth Exchange from ONC to Healtheway and is working with the eHealth Exchange to communicate this transition to the broader health IT industry.

 In another move, RHEx funded by the FHA program uses a World Wide Web-based approach to HIE. The program established in 2012 has formed a successful partnership with FHA and other federal partners, HealthInfoNet, the Maine HIE, and TATRC. As a result of this partnership, two pilots were completed September 2012 that will help to provide a path for public and private entities interested in using the web for health information exchange. Details are available at http://wiki.siframework.org/RHEx.

Telehealth Available to Employees

American Well, Blue Cross Blue Shield of North Carolina (BCBSNC), and Walgreens have collaborated to make telehealth services available to thousands of BCBSNC employees located throughout North Carolina. Walgreens Take Care Health System will manage the on-site BCBSNC centers.

The service called OnLineCareNC enables BCBSNC employees from their home and at virtual clinics located at corporate headquarters in Durham and Winston-Salem, N.C., to receive a healthcare consultation from credentialed Take Care nurse practitioners, health coaches, or nutritionists though two-way video, secure text chat, or phone.

During each online visit, Take Care healthcare providers will be able to review the employee’s available clinical information, discuss symptoms, and recommend follow-up care as appropriate to established patients. The telehealth system will automatically create a complete electronic record for each online visit to help support continuity of care and collaboration among the providers caring for employees.

Telehealth service offerings are undergoing rapid adoption by insurers and employers across the U.S. to meet employer and consumer demand for convenient and cost effective care. OnlineCareNC provides a convenient and cost effective option for BCBSNC employees who are more actively looking for ways to manage their own medical costs.

“Healthplan and employer sponsored telehealth solutions are gaining momentum nationally and globally as they prove to increase access to care and to start to rein in costs,” said Ido Schoenbery, M.D Chairman and CEO of American Well Inc. “Online Care is increasingly being embraced as it delivers on the promise to lower costs while increasing patient access to immediate, real-time healthcare when and where it is needed.”

Tracking Patients in Emergencies

Two new technologies being tested by the National Library of Medicine (NLM) may help transform the way that hospitals keep track of patients during emergencies according to an article in the October issue of “NLM in Focus”. The article discusses several research projects such as the “People Locator ™” and the “Patient Tracking and Locating System”.

The People Locator is an online lost and found website of people that includes name, gender, age, health condition and photo when available that family members, emergency officials, and others can search during disasters.

The People Locator as part of the Lost Person Finder project includes several supporting applications such as ReUnite™, an app for smart phones, other mobile devices, and shares data with third party applications. These third party applications can include the Google Person Finder that is able to simultaneously search emergency sites by the International Federation of Red Cross, Red Crescent Societies, and others.

ReUnite first came into play during the January 2010 earthquake that devastated Haiti, and was NLM’s first downloadable iPhone app. Most recently, the NLM quickly set up the People Locator during the 2012 Philippine Floods to help track survivors of the torrential rains in the Philippines that inundated Manila and surrounding areas.

The Patient Tracking and Locating System produced by NLM’s Office of Computer and Communications Systems (OCCS) has a commercial digital pen that captures patient information via a tiny camera. The Real-Time Locating System is able to broadcast patient location and condition to care providers at a central location. With a software application devised by OCCS, patient records are transferred electronically from hospital to hospital.

Students of the Faculty of Medicine at Makerere University, in Kampala, Uganda used a scaled-down version of the OCCS to study the impact of bed nets in protecting 300 families from malarial mosquitoes in a distant rural city of Mifumi. They collected house-to-house data with the digital pen and special digital paper, then uploaded summary information and detailed records for the same day review back at the university.

The People Locator is finding success beyond its original disaster assignment. Recently St. Francis Hospital in Indianapolis Indiana closed its old hospital and with help from the Managed Emergency Surge for Healthcare, Inc., an emergency preparedness healthcare coalition supporting area hospitals in Indianapolis, created a private People Locator Website to monitor the transfer of patients to the new hospital.

The People Locator and the Patient Tracking and Location System are projects developed as part of the Bethesda Hospitals Emergency Preparedness Partnership (BHEPP). BHEPP partners include NLM and three nearby hospitals, NIH Clinical Center, Walter Reed National Military Medical Center, and Bethesda’s Suburban Hospital associated with Johns Hopkins Medicine. They are working together to develop a coordinated disaster response model for hospitals across the country.

Some of the BHEPP sponsored projects underway:

  • Roof top lasers and a dedicated optical fiber network are being installed at each partner hospital to transmit data between hospitals as a back-up dedicated disaster communications system
  • Technology is being evaluated that links voice communications systems used in disaster response such as hand-held devices, land-line phones, mobile phones, and radios
  • Digital pen recording for triage data is being evaluated to record disaster patient triage data and then uplink the data to a computer database
  • Tracking patients with RFID but so far this research projects has not yet begun due to funding issues
  • Devising a core set of patient data elements so that hospital partners can communicate common patient data in a disaster
  • Evaluating prescription data to access patient medication data available from commercial databases
  • Developing a reliable, interoperable, and redundant communication system to communicate with systems throughout the National Capital Region
 To manage the data, the NLM’s Disaster Information Management Research Center (DIMRC) coordinates NLM’s disaster research. Current projects include the Military Affiliate Radio System (MARS) a back-up communications system for hospital emergency operations centers, and the Hospital Incident Command Center, a responder training research project using virtual world technologies.

Reducing Radiation Exposure

 Researchers at Rensselaer Polytechnic Institute (RPI) seek to solve one of the world’s most pressing healthcare technology challenges and find ways to reduce radiation exposure from X-rays and CT imaging scans. RPI received a $2.6 million grant from the National Institute of Biomedical Imaging and Bioengineering (NIBIB) to fund a team of researchers to develop new techniques for quickly calculating the radiation dose a patient will receive from a CT scan.

The research team will use video cards and leading-edge parallel processing techniques to help reduce radiation dose calculations from 10 hours to less than 60 seconds. “There is a high level of interest at the national level to quantify and reduce the amount of ionizing radiation involved in medical imaging.

With this new study, we hope to bring massively parallel computing power that is currently only available to national laboratories and major research universities, to busy and resource-limited hospitals,” said X. George Xu, Professor in the Department of Mechanical, Aerospace, and Nuclear Engineering and the Department of Biomedical Engineering at Rensselaer, plus he heads the university’s Nuclear Engineering Program.

A 2009 report by the National Council on Radiation Protection and Measurements details how the U.S. population is now exposed to seven times more radiation every year from medical imaging exams that they were in 1980. While CT scans only account for 10 percent of diagnostic radiological exams, the procedure contributes disproportionately about 67 percent to the national collective medical radiation exposure.

The radiology community is calling for new measures to avoid unjustified CT scans and to greatly reduce the radiation exposure for pediatric and pregnant patients. However, current software packages for determining and for tracking CT doses are insufficient for such a critical task, Xu said.

In the new $2.6 million study funded by NIBIB, the research team will design and test new simulation software to be run on the graphic processing units found in computer graphics cards, instead of running solely on the central processing units of a desktop computer.

The team will have to build the software from scratch, as no existing radiation dose software is compatible with extremely fast processors. Connecting a small number of video cards presents an inexpensive option for users in hospitals to tackle this “Big Data” challenge and perform massively parallel computation.

After developing and validating the software, the research team will integrate it with GE LightSpeed CT scanner models. Finally, to demonstrate and evaluate the technology’s clinical benefits, the research team will perform a series of calculations for typical diagnostic CT scanning protocols of the head, chest, and abdomen at Massachusetts General Hospital.

CAP Assists Awardees

The NIH Commercialization Assistance Program (CAP) is a specialized technical assistance program for SBIR/STTR Phase II awardees. CAP is designed to help promising small life science and healthcare companies develop their commercial businesses and transition their SBIR/STTR developed technologies into the marketplace.

Assisting small businesses is a top priority for NIH to ensure the success of the SBIR/STTR program and to maximize the agency’s investment. The program is managed through a contract with Humanitas, Inc. at www.humanitas.com of Silver Spring MD that has teamed up with Larta Inc at www.lartainc.com located in Los Angeles.

The plan is for CAP to provide selected participants with individualized assistance toward accomplishing their commercialization goals. This is to be achieved through individual mentoring and consulting sessions, training workshops, access to domain experts, and discussions on how to focus on outcomes that will enhance the commercialization profile and readiness of participating grantees.

Two parallel tracks are offered to provide assistance:

  • The Commercialization Training Track (CTT) assists participants evaluate their commercialization options based on their specific technologies and to develop a solid market-entry plan covering an 18 month period. Help is also provided to develop market appropriate tools to accomplish these objectives
  • The Accelerated Commercialization Track (ACT) applies to a select group of NIH SBIR/STTR Phase II companies who have successfully commercialized or sold products and/or services, generated revenue, established partnerships, and/or otherwise achieved a level of market development that is sustainable over a definitive period.
 The application deadline for CAP is November 7, 2012 and Awardees will be selected November 21, 2012.  

For inquiries at NIH, email sbir@od.nih.gov, for inquires at Humanitas Inc. email Lura Myers at lmyers@humanitas.com, and for technical assistance, email Judy Hsieh at jhsieh@larta.org. For general information and news, go to http://grants.nih.gov/grants/funding/sbir.htm.

Wednesday, October 17, 2012

HRSA Issues Replacement Award

The Health Resources and Services Administration (HRSA) announced October 12th in the Federal Register that a non-competitive replacement award was issued for $179,748 under the Rural Health Network Development Program to the Siloam Springs Regional Health Cooperative (SSRHC) Inc. The support for the award is from October 1, 2012 to April 30, 2014.

In general, the purpose of the Network Planning Program is to promote the development of integrated healthcare networks to provide access, improve the quality of essential healthcare services, and to strengthen the rural healthcare system as a whole.

The grant program supports one year of planning to develop and assist healthcare networks to become operational. These networks can include a wide range of community partners. For example a Community Access Hospital and a Community Health Center, and a social service organization can work together to ensure that local patients have access to a full continuum of care.

In this specific case, HRSA issued the replacement award to continue activities to improve the treatment and prevention of chronic disease, increase provider knowledge on using health IT, and continue network development activities to serve the people in rural Northwest Arkansas and Northeast Oklahoma.

The current grantee ARcare was originally awarded the Rural Health Network Development Grant on May 1, 2011. However since May 2011, SSRHC an organization composed of the participating network members primarily responsible for administering the program activities for the Network project has obtained 501(c)3 status. SSRHC has successfully managed and achieved project goals and has the organizational structure to fiscally manage the grant.

ARcare has notified HRSA that while they will remain involved in the project they would like to relinquish their responsibilities as grantee to SSRHC. This is being done with the goal to strengthen the Network’s future viability and growth.

MAeHC Launches State HIE

The Massachusetts eHealth Collaborative (MAeHC) participated in the official launch on October 16th of the statewide healthcare information exchange, known as the Massachusetts Health Information Highway (HIway). Governor Deval Patrick executed the exchange’s first transaction, transmitting his own health record between two hospitals on opposite ends of the Commonwealth.

Also, as part of the event dubbed the “Golden Spike”, MAeHC successfully received a health record from the Beth Israel Deaconess Medical Center (BIDMC) into its Quality Data Center (QDC), a hosted clinical quality measurement and reporting solution. “We are thrilled that the QDC was able to demonstrate the Massachusetts HIway’s ability to securely send a standardized patient medical record”, said Micky Tripathi, CEO for MAeHC.

Upon receiving the BIDMC patient record, MAeHC’s QDC extracted the clinical data elements of the transmitted medical record and prepared it for future analysis and reporting. The medical record belongs to Kathy Halamka, co-owner at Unity Farm, and wife of BIDMC CIO John D. Halamka M.D. The record is stored in a high-performance cloud-based patient records data warehouse which is vendor-agnostic, federally certified, and able to securely support the growing number of quality reporting requirements providers face today.

“The BIDMC-MAeHC transaction during the Golden Spike event was a great demonstration of the Commonwealth’s new HIE infrastructure as well as the QDC’s capabilities,” said Halamka. “Now with streamlined access to the QDC, BIDMC’s reporting will be even faster and more accurate than ever before. MAeHC’s QDC has historically been one of the most trusted resources for BIDMC and reliable and safe enough for my wife’s EHR to be the first transmitted through the HIway.”

For more information, go to www.maehc.org/services/quality-data-services.   

Tool Helps Cancer Patients

Database enhancements developed at the Cancer Institute of New Jersey (CINJ) are helping physicians use technology to ensure the safe delivery of chemotherapy. Known as the Cancer Treatment Regimen Library, this new tool includes more than 400 standard care regimens for more than 100 different cancer categories.

This enables clinicians to ensure appropriate treatment doses for patients based on the recommended standard of care and cross-checked against a patient’s medical record. CINJ is a Center of Excellence at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School.

The collection of standard care regimens for cancer care is not a new process. What is different about this Regimen Library developed by Adam Lisi, PharmD, a pharmacy informatics specialist at CINJ, is the incorporation of a rule and notification functionality where safety elements are built in.

When chemotherapy is ordered, the database system reviews a patient’s EMR. Each treatment regimen has specific rules associated with it. If an abnormal test result is detected within a patient’s record, the system will review the treatment rules and recommend a modification for therapy. The regimens and rules are constantly reviewed and updated by a multidisciplinary team at CINJ, including tumor-specific oncologists, pharmacists, and nurses.

“The Cancer Treatment Regimen Library will further enhance clinical decision support mechanisms,” noted CINJ Deputy Director Susan Goodin, PharmD, who also collaborated with Lisi in developing the system. “While this system assures doctors and nurses that their patients are receiving patient appropriate doses of chemotherapy, the system will also assist with inventory management of very expensive and short supply chemotherapy drugs,” said Dir Goodin, who is also Professor Medicine at UMDNJ-Robert Wood Johnson Medical School.

For more information, go to www.cinj.org or follow CINJ on Facebook at www.facebook.com/TheCINJ.   

SDRHIE to Advance HIT

The San Diego Beacon Community program leader Dr. Ted Chan announced the creation of the San Diego Regional Healthcare Information Exchange (SDRHIE), an independent community organization. The new organization will assume leadership and oversight of the San Diego Beacon Community’s health IT portfolio, a federally-funded three year initiative to build, strengthen, and demonstrate the benefits of health IT in the region.

The new community SDRHIE Board of Directors will operate with Robin Brown, Jr., Chief Executive for Scripps Green Hospital and Scripps Health and President of the Board. Other members of the inaugural SDRHIE Board includes leaders from across the San Diego healthcare community including hospital systems, community clinics, medical groups and health plans, and local government.

The Board will also be responsible for transitioning the San Diego Beacon Community from its initial federal funding to a self-sustaining entity supported by the community. As part of that effort, SDRHIE is in the process of applying for non-profit status with the state and federal government.  

Rady Children’s Hospital, San Diego, UC San Diego Health System, and the VA San Diego Healthcare System are currently active on the exchange with other healthcare organizations planning to join later this year.

Services offered include real-time transmission of electrocardiograms and patient information from ambulances to hospital emergency departments and electronic reporting of immunizations and infectious diseases to County public health officials. In the near future, SDRHIE will launch a secure messaging service to notify healthcare providers about their patients being seen in emergency departments or hospitals.

Missouri EHR News

The Missouri Health Connection (MHC) has announced a partnership with five healthcare organizations to participate in the State’s electronic medical information network. The organizations BJC HealthCare, Mercy, and SSM Health Care provide almost 40 percent of inpatient care in Missouri along with Burrell Behavioral Health, and Nevada Medical Clinic, a rural multi-specialty clinic support thousands of physicians and caregivers in providing healthcare to Missourians.

The Missouri health information network powered by InterSystems HealthShare™ involved globally, across communities, and regions, provides health information software for connected care.

The Delta Regional Authority (DRA) and the American Health Information Management Association (AHIMA) have teamed up to address the health of the Delta region through a new initiative “Health IT Workforce Revolving Loan Fund Program”. DRA covers specific counties within Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee.

The goal is to assist healthcare providers enhance healthcare delivery in these underserved communities by helping providers who are eligible for meaningful use incentives purchase an EHR system.

To help small Healthcare Providers Offices (HPO), DRA will provide interest free loans throughout the Delta region that can be used to install and adopt an EHR system. AHIMA will assist in the recruitment and approval of the HPOs.

Each participating HPO must meet the following eligibility requirements such as:

·        Have an internet connection and use an electronic billing system
·        Be a small practice group of one to five healthcare providers, community health center, or a federally qualified health center
·        Can show that there is a reasonable prospect that the applicant meets the definition of small and emerging private business enterprises defined as any private business that employs fifty or fewer employees and has less than $1 million in projected gross revenues

Providers practicing in Medically Underserved Areas (MUA) or Health Provider Shortage Areas (HPSA designated by HRSA within the DRA region are encouraged to apply.

For more information, email Bonnie Aguda at bonnie.aguda@ahimafoundation.org.