Lockheed Martin has a new $2.8 billion seven-year Indefinite Delivery, Indefinite Quantity (IDIQ) contract to provide information technology to the Social Security Administration (SSA). The Information Technology Support Services Contract (ITSSC) encompasses a complete range of services related to SSA’s major systems modernization initiatives.
Lockheed Martin’s work under ITSSC includes integrating electronic medical records into SSA processes, leveraging the Nationwide Health Information Network, and developing new web-based self-service tools.
In August, Lockheed Martin received two contracts awarded by the Office of the National Coordinator for HIT at HHS totaling $9 million over two years to support the Nationwide Health Information Network.
Under the first contract, the company will create new reference implementation software to support the development, testing and adoption of future NHIN capabilities. The second contract calls for the development of real-world demonstrations and pilots for emergent NHIN capabilities.
Recently, Lockheed Martin assisted CMS on a project to demonstrate how the NHIN can support the secure exchange of standardized health assessments to help Medicare patients as they transition among healthcare providers and professionals.
Wednesday, October 6, 2010
Sunday, October 3, 2010
Telemedicine Needed Today
Donald M. Berwick M.D, the Administrator for CMS and Mark McClellan M.D. a past Administrator of CMS, Former Commissioner for FDA, and presently Director of the Engelberg Center for Health Care Reform at Brookings, were joint keynoters at the 2010 ATA Mid-Year Meeting luncheon. Both keynote speakers are increasingly enthusiastic about the adoption of telemedicine but also realize the important need for reimbursement for these services.
Both past administrators understand that to achieve these goals for telemedicine, the healthcare system along with CMS needs to improve medical services, reduce costs, and very importantly reach underserved populations both in rural and urban populations.
As Jonathan Linkous CEO, ATA told the meeting attendees in his introduction, “It is a pleasure to have two bipartisan leaders speaking today that are enthusiastic about the use of telemedicine to deliver care to the mainstream population.”
According to Dr. Berwick, he has a great deal of respect for telemedicine since he used telemedicine first hand in Alaska in 1997. As a pediatrician, he would fly to outlying villages to provide care and would sometimes see 40 to 50 kids when the community health worker felt that their health issues needed to be discussed and seen by a pediatrician.
In one case, a child was having hearing problems but after Dr. Berwick saw the child, he realized that the child was autistic. He was able to remotely connect the child to a child psychologist and then to the school for counseling. The psychologist and the school were able to remotely develop a plan of action, and as Dr. Berwick told the meeting attendees, the geographic barriers melted away.
Dr. Berwick recalls growing up in a small town in Connecticut where his father was the old time physician and did everything himself. He worked very hard and went out in the middle of the night. He didn’t realize it but he was actually practicing patient-centered care but that was the only way he knew to practice medicine.
As Dr. Berwick said, “Today, the system doesn’t provide the healthcare that we need but it is not out of our reach.” He is hopeful that the Accountable Care Act (ACA) passed to address healthcare reform will help to redesign, reshape, and help the system invest in different versions of integrated care such as Accountable Care Organizations (ACO) and medical homes.
According to the head of CMS, in order to redesign the system, goals have to be established to provide better care for individuals. CMS is going to begin to reward better care for five prevalent conditions, provide better healthcare for populations, and reduce per capita costs by eliminating waste and ineffectual ways that care is provided. One of the most important overall goals will be to provide better integrated care so the patient is not lost in the system.
McClellan’s remarks concentrated primarily on potential future cost savings. It is anticipated that there will be a savings resulting from the ACA with potential cost savings of $29 billion over the next ten years. As McClellan sees it, telemedicine will play an important part in this savings when telemedicine technologies used to deliver healthcare becomes the norm.
Like Dr. Berwick, McClellan looks at ACOs and sees telemedicine technologies used to create efficient delivery systems to support teams of physicians, hospitals, and other healthcare providers to collaboratively manage and coordinate care for Medicare beneficiaries. If these providers meet certain quality and efficiency benchmarks such as reducing duplicative services, improve productivity, or minimize paperwork, they may receive a share of any savings.
As McClellan reports, CMS is working to make the ACO program operational by January 1, 2012. Unlike other provisions on payment reform, ACOs will be a real part of Medicare and will not operate as a pilot, a demo, but be part of the Medicare program Proposed rules will be issued later this year plus CMS and partner organizations will continue to held public forums.
Other key cost saving provisions as a result of the ACA is the creation of the Center for Medicare and Medicaid Innovation to support the ongoing development for new models of payment and delivery. Ten million has been invested in the Center for the next 10 years to test payment and delivery innovations.
In addition, The ACA will establish the Independent Payment Advisory Board (IPAB) to monitor the fiscal health of the Medicare program and to recommend payment policy revision to contain Medicare cost growth. The IPAB begins its work in 2012 and will need to submit recommendations on an annual basis to Congress.
Both past administrators understand that to achieve these goals for telemedicine, the healthcare system along with CMS needs to improve medical services, reduce costs, and very importantly reach underserved populations both in rural and urban populations.
As Jonathan Linkous CEO, ATA told the meeting attendees in his introduction, “It is a pleasure to have two bipartisan leaders speaking today that are enthusiastic about the use of telemedicine to deliver care to the mainstream population.”
According to Dr. Berwick, he has a great deal of respect for telemedicine since he used telemedicine first hand in Alaska in 1997. As a pediatrician, he would fly to outlying villages to provide care and would sometimes see 40 to 50 kids when the community health worker felt that their health issues needed to be discussed and seen by a pediatrician.
In one case, a child was having hearing problems but after Dr. Berwick saw the child, he realized that the child was autistic. He was able to remotely connect the child to a child psychologist and then to the school for counseling. The psychologist and the school were able to remotely develop a plan of action, and as Dr. Berwick told the meeting attendees, the geographic barriers melted away.
Dr. Berwick recalls growing up in a small town in Connecticut where his father was the old time physician and did everything himself. He worked very hard and went out in the middle of the night. He didn’t realize it but he was actually practicing patient-centered care but that was the only way he knew to practice medicine.
As Dr. Berwick said, “Today, the system doesn’t provide the healthcare that we need but it is not out of our reach.” He is hopeful that the Accountable Care Act (ACA) passed to address healthcare reform will help to redesign, reshape, and help the system invest in different versions of integrated care such as Accountable Care Organizations (ACO) and medical homes.
According to the head of CMS, in order to redesign the system, goals have to be established to provide better care for individuals. CMS is going to begin to reward better care for five prevalent conditions, provide better healthcare for populations, and reduce per capita costs by eliminating waste and ineffectual ways that care is provided. One of the most important overall goals will be to provide better integrated care so the patient is not lost in the system.
McClellan’s remarks concentrated primarily on potential future cost savings. It is anticipated that there will be a savings resulting from the ACA with potential cost savings of $29 billion over the next ten years. As McClellan sees it, telemedicine will play an important part in this savings when telemedicine technologies used to deliver healthcare becomes the norm.
Like Dr. Berwick, McClellan looks at ACOs and sees telemedicine technologies used to create efficient delivery systems to support teams of physicians, hospitals, and other healthcare providers to collaboratively manage and coordinate care for Medicare beneficiaries. If these providers meet certain quality and efficiency benchmarks such as reducing duplicative services, improve productivity, or minimize paperwork, they may receive a share of any savings.
As McClellan reports, CMS is working to make the ACO program operational by January 1, 2012. Unlike other provisions on payment reform, ACOs will be a real part of Medicare and will not operate as a pilot, a demo, but be part of the Medicare program Proposed rules will be issued later this year plus CMS and partner organizations will continue to held public forums.
Other key cost saving provisions as a result of the ACA is the creation of the Center for Medicare and Medicaid Innovation to support the ongoing development for new models of payment and delivery. Ten million has been invested in the Center for the next 10 years to test payment and delivery innovations.
In addition, The ACA will establish the Independent Payment Advisory Board (IPAB) to monitor the fiscal health of the Medicare program and to recommend payment policy revision to contain Medicare cost growth. The IPAB begins its work in 2012 and will need to submit recommendations on an annual basis to Congress.
ONC Funding HIT Study
The Institute of Medicine will do a one year study to examine how HIT can achieve its full potential to improve patient safety. The study will be done under a $989,000 contract just announced by the Office of the National Coordinator.
The study will examine a comprehensive range of patient safety-related issues on how to prevent HIT-related errors and provide for the rapid reporting of any HIT related patient safety issues. The study will also make recommendations concerning the potential effects of government policies and private sector actions in maximizing patient safety.
Highlights of the study will:
• Identify approaches to promote safety enhancing features of HIT
• Identify approaches for preventing HIT-related patient safety problems before they occur
• Identify approaches for surveillance and reporting activities to bring about rapid detection and correction of patient safety problems
• Address the potential roles for private sector entities such as accrediting and certification bodies, patient safety organizations, and professional and trade associations
• Discuss the potential role for key federal agencies such as FDA, AHRQ, and CMS
“Since 1999, when IOM published the study “To Err is Human”, the Institute has been a leader in the movement to improve patient safety,” said David Blumenthal, M.D., National Coordinator for Health Information Technology. “This study will draw on IOM’s depth of knowledge in this area to help ensure that HIT reaches the goals we are seeking for patient safety improvement.”
The study will examine a comprehensive range of patient safety-related issues on how to prevent HIT-related errors and provide for the rapid reporting of any HIT related patient safety issues. The study will also make recommendations concerning the potential effects of government policies and private sector actions in maximizing patient safety.
Highlights of the study will:
• Identify approaches to promote safety enhancing features of HIT
• Identify approaches for preventing HIT-related patient safety problems before they occur
• Identify approaches for surveillance and reporting activities to bring about rapid detection and correction of patient safety problems
• Address the potential roles for private sector entities such as accrediting and certification bodies, patient safety organizations, and professional and trade associations
• Discuss the potential role for key federal agencies such as FDA, AHRQ, and CMS
“Since 1999, when IOM published the study “To Err is Human”, the Institute has been a leader in the movement to improve patient safety,” said David Blumenthal, M.D., National Coordinator for Health Information Technology. “This study will draw on IOM’s depth of knowledge in this area to help ensure that HIT reaches the goals we are seeking for patient safety improvement.”
VA's Purchasing Changes
Frederick Downs Jr., Chief Procurement and Logistics Officer for the VA’s Veterans Health Administration, appeared before the House Committee on Veterans Affairs, Health Subcommittee to discuss the VHA’s contracting and procurement practices.
All acquisition personnel previously reporting to the VISNs or to medical center directors now report to the Procurement and Logistics Office (PL&O). The PL&O develops the annual VHA acquisition plan that forms the basis for VHA’s acquisition strategy and serves as the liaison for the logistics staff in each of the 21 VISNs. VHA has approximately $5 billion worth of medical equipment in service at more than 1,400 sites with over 750,000 devices in hundreds of different categories.
The VHA has centralized their medical equipment within Biomedical Engineering (BME) and is working directly with clinicians, logisticians, and acquisitions staff to purchase equipment. BME identifies equipment that needs to be replaced, does market research, defines functional requirements with clinicians, writes specifications and statements of work, evaluates proposals, and operates as the contracting officer’s technical representative on contracts.
Acquisitions are accomplished by using VA’s Federal Supply Schedules but a significant portion is acquired through sources obtained via their publication of solicitations in www.fbo.gov, by commercial advertising, or by the VHA hearing about responsible bidders and vendors with products and services to offer.
All acquisition personnel previously reporting to the VISNs or to medical center directors now report to the Procurement and Logistics Office (PL&O). The PL&O develops the annual VHA acquisition plan that forms the basis for VHA’s acquisition strategy and serves as the liaison for the logistics staff in each of the 21 VISNs. VHA has approximately $5 billion worth of medical equipment in service at more than 1,400 sites with over 750,000 devices in hundreds of different categories.
The VHA has centralized their medical equipment within Biomedical Engineering (BME) and is working directly with clinicians, logisticians, and acquisitions staff to purchase equipment. BME identifies equipment that needs to be replaced, does market research, defines functional requirements with clinicians, writes specifications and statements of work, evaluates proposals, and operates as the contracting officer’s technical representative on contracts.
Acquisitions are accomplished by using VA’s Federal Supply Schedules but a significant portion is acquired through sources obtained via their publication of solicitations in www.fbo.gov, by commercial advertising, or by the VHA hearing about responsible bidders and vendors with products and services to offer.
Seeking Robotics Technology
A joint agency SBIR Funding Opportunity Announcement (FOA) Phase 1 was released on September 14th to encourage small business firms to participate in the development of robotics technologies. The agencies participating in the announcement include NIH, DOD, NSF, USDA and DHS.
The market for robotics is growing rapidly and now spans many diverse industries including military, medicine, healthcare, manufacturing, logistics, and consumer products. Robotics technology is reaching a “tipping point” and is poised for explosive growth because of improvements in core technologies such as microprocessors, sensors, and algorithms. Also robotics technology has the potential to make a tremendous contribution to help the elderly and disabled.
NIH supports developing robotic applications to help in surgery, health interventions, prostheses, rehabilitation, behavioral therapy, and for personalized care and wellness health promotions. The most significant challenges will be to address safety issues, especially for applications to be used in home and surgical settings. For home care, NIH is interested in helping caregivers manage chronic heart, lung, or blood diseases.
A few of the areas where NIH is emphasizing their need for robotic assistive devices are with neurological disorders or with muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, spinal cord or traumatic brain injuries, and with strokes.
NIH is also looking for surgical tools and techniques. Examples of relevant technologies are robotic assist devices that enable surgeons to transcend the physical limitations of the human hand and eye, minimally invasive robotic surgery, miniaturized surgical devices for robotic surgery, robotically assisted surgical systems, the integration of imaging and interventional modalities in robotic surgical procedures, and ocular surgery. NIH is seeking implantable wireless technology to use in medical devices to monitor and diagnose via telehealth and mHealth.
The FOA title is “Robotics Technology Development and Deployment” (RTD2 (R43). For more information, go to http://grants.nih.gov/grants/guide/pa-files/PAR-10-279.html. The earliest submission date is November 20, 2010 and all applications are due by December 20, 2010.
The market for robotics is growing rapidly and now spans many diverse industries including military, medicine, healthcare, manufacturing, logistics, and consumer products. Robotics technology is reaching a “tipping point” and is poised for explosive growth because of improvements in core technologies such as microprocessors, sensors, and algorithms. Also robotics technology has the potential to make a tremendous contribution to help the elderly and disabled.
NIH supports developing robotic applications to help in surgery, health interventions, prostheses, rehabilitation, behavioral therapy, and for personalized care and wellness health promotions. The most significant challenges will be to address safety issues, especially for applications to be used in home and surgical settings. For home care, NIH is interested in helping caregivers manage chronic heart, lung, or blood diseases.
A few of the areas where NIH is emphasizing their need for robotic assistive devices are with neurological disorders or with muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, spinal cord or traumatic brain injuries, and with strokes.
NIH is also looking for surgical tools and techniques. Examples of relevant technologies are robotic assist devices that enable surgeons to transcend the physical limitations of the human hand and eye, minimally invasive robotic surgery, miniaturized surgical devices for robotic surgery, robotically assisted surgical systems, the integration of imaging and interventional modalities in robotic surgical procedures, and ocular surgery. NIH is seeking implantable wireless technology to use in medical devices to monitor and diagnose via telehealth and mHealth.
The FOA title is “Robotics Technology Development and Deployment” (RTD2 (R43). For more information, go to http://grants.nih.gov/grants/guide/pa-files/PAR-10-279.html. The earliest submission date is November 20, 2010 and all applications are due by December 20, 2010.
Combating Prescription Abuse
The House approved (H.R. 5710) introduced by Representative Ed Whitfield from Kentucky to reauthorize a program critical to combating the abuse of prescription drugs across the nation. The “National All Schedules Prescription Electronic Reporting (NASPER) Reauthorization Act of 2010” amends the NASPER Act of 2005 to establish state administered controlled substance monitoring systems.
This needs to be done to ensure that there is appropriate law enforcement, regulations, and to make certain that state professional licensing authorities have access to prescription histories to control the dispensing practices of errant prescribers or pharmacists.
The legislation allows:
• Grants to be used to maintain and operate existing state controlled substance monitoring programs
• Requires the Secretary of HHS to redistribute any funds that are returned among the remaining grantees
• Requires states that are not in compliance to submit a plan to bring the state into compliance
• Requires a progress report to be submitted to Congress
The Senate has a similar bill (S.3575) sponsored by Senator Richard Durbin from Illinois and has been referred to the Senate Committee on Health, Education, Labor, and Pensions.
This needs to be done to ensure that there is appropriate law enforcement, regulations, and to make certain that state professional licensing authorities have access to prescription histories to control the dispensing practices of errant prescribers or pharmacists.
The legislation allows:
• Grants to be used to maintain and operate existing state controlled substance monitoring programs
• Requires the Secretary of HHS to redistribute any funds that are returned among the remaining grantees
• Requires states that are not in compliance to submit a plan to bring the state into compliance
• Requires a progress report to be submitted to Congress
The Senate has a similar bill (S.3575) sponsored by Senator Richard Durbin from Illinois and has been referred to the Senate Committee on Health, Education, Labor, and Pensions.
Call for Proposals Issued
The recently enacted Affordable Care Act includes a variety of provisions aimed at stimulating payment and delivery system reforms along with new federal payment experiments expected to unfold in a few years. These payment efforts will focus primarily on Medicare and to a certain extent Medicaid. The Robert Wood Johnson Foundation (RWJF) is trying to stimulate payment experimentation with this solicitation.
RWJF seeks to fund innovative proposals for payment reform that are designed to promote high-value healthcare outcomes that use existing market knowledge, partnerships and resources. These funds will not support extensions of existing pay-for-performance efforts or implementation of generic medical home demonstrations.
However, consideration will be given to fund Pay for Performance (P4P) efforts or medical home demonstrations that are linked with outcome-based performance payments. For example, a payment incentive based on reducing hospital readmission rates for chronic disease patients might be an appropriate place to start for a given group or community and could be built around a P4P or medical home effort.
Applicants may propose a multi-stakeholder payment strategy or a payment reform experiment that pertains to a limited care dyad or triad for instance health plans, employers, and healthcare providers.
Proposals for the project titled “Payment Reform for High-Value Care” are due February 2, 2011 with the deadline for brief proposals due on October 20, 2010. Applicants will be notified if invited to submit a full proposal.
A maximum of three grants between $50,000 and $300,000 each will be awarded for up to 36 months each. Applicants must be based in the U.S. and may either be a public entity or non-profit organization.
Go to www.rwjf.org/applications/solicited/cfp.jsp?ID=21281 for more information or for inquiries go to payment-reform@rwjf.org.
RWJF seeks to fund innovative proposals for payment reform that are designed to promote high-value healthcare outcomes that use existing market knowledge, partnerships and resources. These funds will not support extensions of existing pay-for-performance efforts or implementation of generic medical home demonstrations.
However, consideration will be given to fund Pay for Performance (P4P) efforts or medical home demonstrations that are linked with outcome-based performance payments. For example, a payment incentive based on reducing hospital readmission rates for chronic disease patients might be an appropriate place to start for a given group or community and could be built around a P4P or medical home effort.
Applicants may propose a multi-stakeholder payment strategy or a payment reform experiment that pertains to a limited care dyad or triad for instance health plans, employers, and healthcare providers.
Proposals for the project titled “Payment Reform for High-Value Care” are due February 2, 2011 with the deadline for brief proposals due on October 20, 2010. Applicants will be notified if invited to submit a full proposal.
A maximum of three grants between $50,000 and $300,000 each will be awarded for up to 36 months each. Applicants must be based in the U.S. and may either be a public entity or non-profit organization.
Go to www.rwjf.org/applications/solicited/cfp.jsp?ID=21281 for more information or for inquiries go to payment-reform@rwjf.org.
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