Hays Medical Center (HaysMed) is the first major hospital in Kansas to submit data to the Kansas Health Information Network (KHIN). As of October, HaysMed began testing data capabilities to enable the exchange of secure clinical information between providers.
The Medical Center has successfully transmitted test data on patient demographics and problem lists, plus information on diagnoses, procedures, on allergies, immunizations, along with laboratory results. The center plans to test send medications data later this year.
Over the next several weeks in further testing, KHIN will transfer data back to the medical center. According to Laura McCrary, the network’s Executive Director, “They will look at how the data is populating the exchange to make sure it is populating correctly before going live and actually making the data available to other provider organizations.”
So far, more than 70 medical practices have signed on with KHIN which has also received agreements from more than a dozen hospitals and several more hospitals in various states of reviewing and approving the agreements.
Also in October, Via Christi Health, Wesley Medical Center, and the Kansas University Medical Center constituting the three largest hospitals in Kansas, signed up with the Wichita Health Information Exchange and KHIN. KHIN also works closely with the Missouri-based LACIE network.
McCrary anticipates KHIN to be an approved Health Information Organization (HIO) by the end of the year. This is important since providers who exchange information via an approved HIO are granted some immunity from lawsuits should they inadvertently breach patient privacy while exchanging electronic health records.
Providers in the state can now participate in KHINex, which is KHIN’s secure clinical messaging system that functions much like e-mail with attachments but works with a security level adequate for exchanging health records.
In August, an optometrist in Hiawatha became the first provider to share electronic health records with KHINex during a test of the new system. As McCrary explained, “Hutch Clinic located in a rural area is sharing information with the optometrist on diabetic patients who need eye exams. The patient’s medical information is sent electronically with a referral and their attached clinical information.”
KHIN is also building a bi-directional interface with the Kansas Immunizations Registry called “WeblZ” to enable KHIN participants to submit immunization information to the state electronically as well as to query the registry. The full functionality for immunizations is scheduled to be completed in 2012.
For more information, go to www.khinonline.org.
Wednesday, November 9, 2011
AHRQ's Simulation Research
In 2011, AHRQ funded eleven multi-year demonstration grants to evaluate the use and effectiveness of various simulation approaches and the role they play in improving the safety and quality of healthcare delivery.
For example, one project is aimed at helping medical teams deal with pediatric emergencies. Since critical consequences happen infrequently in community hospitals, medical teams in these hospitals have very few opportunities to perfect their skill in pediatric resuscitation skills.
To address pediatric resuscitations, researchers at Rhode Island Hospital in Providence are working to find effective ways to use situ medical simulation to assess how emergency departments are performing pediatric resuscitations.
In another project, researchers will assess the effectiveness of using simulator-based training in component tasks of cardiac surgery. They will examine the overall procedures based on three types of cardiac surgery plus the significant adverse events that can occur during cardiac surgery.
The researchers will use a computer-controlled, tissue-based cardiac surgery simulation that is able to duplicate an actual patient undergoing cardiac surgery. Eight institutions will participate and while the project focuses on cardiac surgery residents, the results could potentially apply across a broad spectrum of surgical practices.
At the University of North Carolina at Chapel Hill, researchers will demonstrate how training in cardiac surgery techniques can be improved by combining cardiac surgery simulation technology with a rigorous, simulation-based curriculum.
A demonstration to perfect a way to measure laparoscopic skills is taking place at Old Dominion University in Norfolk Virginia. Although clinicians can use simulators to practice their skills outside of the operating room, there is no standard method to determine whether a surgeon has achieved or maintained laparoscopic proficiency.
The goal for the researchers is to validate a new secondary task that targets the spatial skills needed to mentally translate 2-D display images into the 3-D operational space. The researchers will use laparoscopic simulators and fresh cadavers to demonstrate that the secondary task can be used to measure laparoscopic skills.
Other simulation demonstrations will:
• Develop simulation-based performance assessment tools
• Develop simulation to be used in emergency departments
• Use simulation to improve leadership and team performance
• Use simulation to improve the recognition of sepsis
• Use simulation to teach femoral arterial access
• Develop serious gaming so that physicians and nurses can improve communications
• Improve cancer care patient safety through pathology training simulation
• Improve patient safety related to medication infusion pump technology using systems engineering
• Create simulation-based performance assessment tools for practicing physicians
For more information, go to www.ahrq.gov/qual/simulproj11.htm.
For example, one project is aimed at helping medical teams deal with pediatric emergencies. Since critical consequences happen infrequently in community hospitals, medical teams in these hospitals have very few opportunities to perfect their skill in pediatric resuscitation skills.
To address pediatric resuscitations, researchers at Rhode Island Hospital in Providence are working to find effective ways to use situ medical simulation to assess how emergency departments are performing pediatric resuscitations.
In another project, researchers will assess the effectiveness of using simulator-based training in component tasks of cardiac surgery. They will examine the overall procedures based on three types of cardiac surgery plus the significant adverse events that can occur during cardiac surgery.
The researchers will use a computer-controlled, tissue-based cardiac surgery simulation that is able to duplicate an actual patient undergoing cardiac surgery. Eight institutions will participate and while the project focuses on cardiac surgery residents, the results could potentially apply across a broad spectrum of surgical practices.
At the University of North Carolina at Chapel Hill, researchers will demonstrate how training in cardiac surgery techniques can be improved by combining cardiac surgery simulation technology with a rigorous, simulation-based curriculum.
A demonstration to perfect a way to measure laparoscopic skills is taking place at Old Dominion University in Norfolk Virginia. Although clinicians can use simulators to practice their skills outside of the operating room, there is no standard method to determine whether a surgeon has achieved or maintained laparoscopic proficiency.
The goal for the researchers is to validate a new secondary task that targets the spatial skills needed to mentally translate 2-D display images into the 3-D operational space. The researchers will use laparoscopic simulators and fresh cadavers to demonstrate that the secondary task can be used to measure laparoscopic skills.
Other simulation demonstrations will:
• Develop simulation-based performance assessment tools
• Develop simulation to be used in emergency departments
• Use simulation to improve leadership and team performance
• Use simulation to improve the recognition of sepsis
• Use simulation to teach femoral arterial access
• Develop serious gaming so that physicians and nurses can improve communications
• Improve cancer care patient safety through pathology training simulation
• Improve patient safety related to medication infusion pump technology using systems engineering
• Create simulation-based performance assessment tools for practicing physicians
For more information, go to www.ahrq.gov/qual/simulproj11.htm.
Congress and the "Doc Fix"
On January 1, 2012, a 27.4 percent cut in Medicare payment rates to physicians will take place unless Congress does something to stop it according to Health Affairs and the Robert Wood Johnson Foundation’s latest “Health Policy Brief”. The brief examines the various proposals and their possible effects on federal spending and on healthcare providers.
As the deadline approaches, Congress, the Administration, and other government entities are deciding whether to pass another short-term “doc fix” or find a longer term solution while weighing the impact any plan will have on the federal deficit.
More than one million providers of vital health services including physicians, limited license practitioners such as podiatrists, nurse practitioners, and physical therapists are paid under the Medicare Physician Fee Schedule (MPFS).
Under current law, providers will face steep across the board reductions in payment rates, based on a formula referred to as the “Sustainable Growth Rate” (SGR) that was adopted in the Balanced Budget Act of 1997. The “Health Policy Brief” discusses the proposals on the table that would replace the formula.
In a statement released by Donald M. Berwick, M.D., CMS Administrator, “We need a permanent SGR fix to solve this problem once and for all. That’s why the President’s Budget and his Plan for Economic Growth and Deficit Reduction calls for permanent, fiscally responsible reform and why we are committed to working with Congress to achieve a permanent and sustainable fix.”
Congress is awaiting recommendations from the Joint Select Committee on Deficit Reduction or what is referred to as the “Super Committee”. Depending on what happens, it is possible that Congress will pass another short-term fix before the year’s end to prevent rate cuts from taking effect in 2012. Under current budget rules, putting off the cut yet again would not require any immediate offsetting savings elsewhere in the budget. However, the overall cost of postponing the repeal of the SGR formula becomes higher every year.
To view the full policy brief on the topic, go to www.healthaffairs.org.
As the deadline approaches, Congress, the Administration, and other government entities are deciding whether to pass another short-term “doc fix” or find a longer term solution while weighing the impact any plan will have on the federal deficit.
More than one million providers of vital health services including physicians, limited license practitioners such as podiatrists, nurse practitioners, and physical therapists are paid under the Medicare Physician Fee Schedule (MPFS).
Under current law, providers will face steep across the board reductions in payment rates, based on a formula referred to as the “Sustainable Growth Rate” (SGR) that was adopted in the Balanced Budget Act of 1997. The “Health Policy Brief” discusses the proposals on the table that would replace the formula.
In a statement released by Donald M. Berwick, M.D., CMS Administrator, “We need a permanent SGR fix to solve this problem once and for all. That’s why the President’s Budget and his Plan for Economic Growth and Deficit Reduction calls for permanent, fiscally responsible reform and why we are committed to working with Congress to achieve a permanent and sustainable fix.”
Congress is awaiting recommendations from the Joint Select Committee on Deficit Reduction or what is referred to as the “Super Committee”. Depending on what happens, it is possible that Congress will pass another short-term fix before the year’s end to prevent rate cuts from taking effect in 2012. Under current budget rules, putting off the cut yet again would not require any immediate offsetting savings elsewhere in the budget. However, the overall cost of postponing the repeal of the SGR formula becomes higher every year.
To view the full policy brief on the topic, go to www.healthaffairs.org.
Washinton State Issues RFP
The Washington State Health Care Authority (HCA) issued RFP (K521) on October 28th for the state “Health Benefits (Insurance) Exchange” seeking Systems Integrator Services. The state is required to establish an operational exchange to offer qualified health insurance plans to individuals and small businesses by January 1, 2014, Once implemented, the state anticipates that the Exchange will serve 160,000 to 440,000 individual and group customers in 2014.
The state needs qualified vendors to provide development, implementation, and hosting services in order to implement the Washington Health Benefits (Insurance) Exchange by December 2013. The solution obtained through this RFP may consist of one or more commercial off-the-shelf (COTS) software products or a custom developed software offering or a combination of both.
The exchange solution must be a web-based solution hosted at a secure location and provide the following:
• A hosting solution meeting the requirements of the Exchange in terms of hardware, software, network, and infrastructure services
• An integrated exchange solution based on a single exchange portal to support individual Eligibility and Enrollment, Plan Management, Financial Management, and Small Business Health Options Program (SHOP)
• Operations and Maintenance of the exchange for one year with provisions for extensions
The new Exchange is to have a consumer focus and provide automated interaction with stakeholders. Since it is expected that consumers will access the exchange from their homes and other locations, the exchange web portal is expected to be available to users 24/7.
The State conducted a detailed Information Technology Gap Analysis for the exchange. The IT Infrastructure review and assessment developed a high level understanding of the requirements of the exchange and reviewed the State’s current Medicaid technology investments and architecture.
Proposals are due December 8, 2011. To view the RFP, go to www.hca.wa.gov/rfp/hbe.
The state needs qualified vendors to provide development, implementation, and hosting services in order to implement the Washington Health Benefits (Insurance) Exchange by December 2013. The solution obtained through this RFP may consist of one or more commercial off-the-shelf (COTS) software products or a custom developed software offering or a combination of both.
The exchange solution must be a web-based solution hosted at a secure location and provide the following:
• A hosting solution meeting the requirements of the Exchange in terms of hardware, software, network, and infrastructure services
• An integrated exchange solution based on a single exchange portal to support individual Eligibility and Enrollment, Plan Management, Financial Management, and Small Business Health Options Program (SHOP)
• Operations and Maintenance of the exchange for one year with provisions for extensions
The new Exchange is to have a consumer focus and provide automated interaction with stakeholders. Since it is expected that consumers will access the exchange from their homes and other locations, the exchange web portal is expected to be available to users 24/7.
The State conducted a detailed Information Technology Gap Analysis for the exchange. The IT Infrastructure review and assessment developed a high level understanding of the requirements of the exchange and reviewed the State’s current Medicaid technology investments and architecture.
Proposals are due December 8, 2011. To view the RFP, go to www.hca.wa.gov/rfp/hbe.
Saturday, November 5, 2011
DOD Issues Program Announcement
The Army Medical Research Acquisition Activity issued a program announcement seeking solutions on how to help care for critically injured burn patients and how to further advance the state of medical sciences for treating burn injuries. The Department of Army program announcement released October 28th is looking for innovative approaches to transition medical technologies into deployable products to provide new standards of care to prevent burn injuries, treat casualties, and provide rehabilitation.
One of the four priority areas for FY 2012 listed in the program announcement specifies pursing device and drug development for Inhalation Lung Injuries. The combination of inhalation injury and burns results in mortality rates that far exceed the rate for burns alone. Research is needed to develop a device to provide “Extracorporeal Lung Support (ECL) or other therapeutic devices to treat severe inhalation injuries. The total funding allotted to develop the ECL device and for drug biologics is $2 million
ECL has been shown to allow the lungs to recover while respiratory demand is partially or fully met. DOD is looking for research efforts to design and or better develop an ECL or other device that weighs less, is reduced in size, and has less oxygen requirements as compared to hospital-based units. Research is also needed to produce a device that could improve outcomes in times of severe organ failure.
The prototype must be viable to use at level III/Combat Support Hospitals, during Enroute Care and can be used by a variety of personnel such as emergency physicians, ICU nurses, general surgeons, and intensivists that have little to no prior experience with such technologies.
In addition to an ECL device, there is still an urgent need for therapies that can be applied quickly post-injury to mitigate further damage and initiate healing. These therapies can be pharmacologic, biologic, or mechanical in nature.
The other priority areas in the program announcement are seeking to develop and assess the impact of checklists on standardizing burn care, perform multicenter studies of ICU-based rehabilitation outcomes based on evaluating physical and rehabilitation technologies and therapies, and develop appropriate therapies to manage scarring conditions.
The program announcement “Care for the Critically Injured Burn Patient” has a Pre-application submission deadline of December 2, 2011 and the application submission deadline is March 9, 2012. The total amount of funding available for the CCC/JPC 2012 initiative is $7.3 million with six awards anticipated.
Applications from investigators within the military services and other federal agencies are encouraged as are applications involving multidisciplinary collaborations among academia and industry.
TATRC is administering the application process for this funding opportunity and the U.S. Army Medical Research Acquisition Activity will be negotiating all resulting awards.
For more information, go to www.grants.gov announcement (W81XWH-12-CCCJPC-CCIBP). For questions email tatrc@aibs.org or call TATRC Help Desk at 1-703-674-2500 extension 207.
One of the four priority areas for FY 2012 listed in the program announcement specifies pursing device and drug development for Inhalation Lung Injuries. The combination of inhalation injury and burns results in mortality rates that far exceed the rate for burns alone. Research is needed to develop a device to provide “Extracorporeal Lung Support (ECL) or other therapeutic devices to treat severe inhalation injuries. The total funding allotted to develop the ECL device and for drug biologics is $2 million
ECL has been shown to allow the lungs to recover while respiratory demand is partially or fully met. DOD is looking for research efforts to design and or better develop an ECL or other device that weighs less, is reduced in size, and has less oxygen requirements as compared to hospital-based units. Research is also needed to produce a device that could improve outcomes in times of severe organ failure.
The prototype must be viable to use at level III/Combat Support Hospitals, during Enroute Care and can be used by a variety of personnel such as emergency physicians, ICU nurses, general surgeons, and intensivists that have little to no prior experience with such technologies.
In addition to an ECL device, there is still an urgent need for therapies that can be applied quickly post-injury to mitigate further damage and initiate healing. These therapies can be pharmacologic, biologic, or mechanical in nature.
The other priority areas in the program announcement are seeking to develop and assess the impact of checklists on standardizing burn care, perform multicenter studies of ICU-based rehabilitation outcomes based on evaluating physical and rehabilitation technologies and therapies, and develop appropriate therapies to manage scarring conditions.
The program announcement “Care for the Critically Injured Burn Patient” has a Pre-application submission deadline of December 2, 2011 and the application submission deadline is March 9, 2012. The total amount of funding available for the CCC/JPC 2012 initiative is $7.3 million with six awards anticipated.
Applications from investigators within the military services and other federal agencies are encouraged as are applications involving multidisciplinary collaborations among academia and industry.
TATRC is administering the application process for this funding opportunity and the U.S. Army Medical Research Acquisition Activity will be negotiating all resulting awards.
For more information, go to www.grants.gov announcement (W81XWH-12-CCCJPC-CCIBP). For questions email tatrc@aibs.org or call TATRC Help Desk at 1-703-674-2500 extension 207.
Harris Corp Receives Task Order
Harris Corporation has been awarded its first task order from the Department of Veterans Affairs to support the tracking of medication and treatment for veterans suffering from mental health disorders. The task order falls under the three-year “My Recovery Plan” blanket purchase agreement which has a ceiling of $4.5 million.
The “My Recovery Plan” is an interactive personal treatment planner for veterans to use in conjunction with their care providers. The “My Recovery Plan” application within the “My HealtheVet” Personal Health Record provides a web-based interface to allow veterans with behavioral or mental health concerns to track their progress towards recovery, track mental health symptoms, track changes in their level of functioning, identify how medications may affect them, and make guided changes in their treatment to compliment to the services delivered by VA clinicians.
Under the task order, Harris will provide support services for the “Medication Monitoring and Tracking Module” and the “My Goals Module” through requirements development, testing, and implementation support. “My recovery Plan” gives veterans an invaluable tool to monitor their own mental health regime, develop life goals, and stay in constant contact with their clinicians,” said Jim Traficant, President of Harris Healthcare.
For more information, go to www.harris.com.
The “My Recovery Plan” is an interactive personal treatment planner for veterans to use in conjunction with their care providers. The “My Recovery Plan” application within the “My HealtheVet” Personal Health Record provides a web-based interface to allow veterans with behavioral or mental health concerns to track their progress towards recovery, track mental health symptoms, track changes in their level of functioning, identify how medications may affect them, and make guided changes in their treatment to compliment to the services delivered by VA clinicians.
Under the task order, Harris will provide support services for the “Medication Monitoring and Tracking Module” and the “My Goals Module” through requirements development, testing, and implementation support. “My recovery Plan” gives veterans an invaluable tool to monitor their own mental health regime, develop life goals, and stay in constant contact with their clinicians,” said Jim Traficant, President of Harris Healthcare.
For more information, go to www.harris.com.
Developing New Cardiac System
A researcher from Cornell University along with Blue Highway Inc. a new technology incubator in New York state are working together on a non-contact cardiac imaging system called “Magnetocardiography” (MCG). The system uses extremely sensitive novel sensors to measure magnetic fields produced by the heart’s electrical activity and is a new way of accurately analyzing cardiac function without using nuclear imaging, functional MRI, or ultrasound.
An MCG device will output data reflecting cardiac functionality by mapping the heart’s magnetic field and identify functional abnormalities. Magnetic field detection is enabled by an array of chip-based sensors and digital signal processing modules integrated on a planar substrate.
When the sensor array is moved over a patient’s chest, magnetic data is collected and proprietary algorithms generate a map of the patient’s cardiac function which can be represented as an image or wave form.
Present ECG available technology cannot locate conductive pathways in the heart. Because conduction pathways are often the source of arrhythmias, clinicians lack complete cardiac function information. To date, detecting arrhythmias has been a time consuming process for clinicians but with the advent of a low-cost non-contact assessment tool could revolutionize cardiac screening across the continuum of global healthcare settings. The MCG device is able to identify abnormalities or weaknesses not detected by ECGs.
In addition, the device does not transfer energy into the body, measurement is unaffected by the patient’s clothing and body size, the device has superior electrical sensing sensitivity, operable in electrically noisy environments, and doesn’t require electromagnetically shielded exam rooms.
It is expected that the total available market for MCG is $242 million and the targeted market segments include cardiology clinics, emergency departments, large primary care practices, hospitals, and out-patient clinics.
Blue Highway envisions a first generation embodiment of the MCG device to include a full array system of sensors connected to a processing and computing system capable of imaging the magnetic field generated by depolarization and repolarization currents in the chest cavity during a cardiac cycle. The device will enable clinicians to map the heart in both time and space. Second generation development may include a portable device.
For more details, email David Eilers, Vice President for Business Development at deilers@blue-highway.com or call (315) 443-6212.
An MCG device will output data reflecting cardiac functionality by mapping the heart’s magnetic field and identify functional abnormalities. Magnetic field detection is enabled by an array of chip-based sensors and digital signal processing modules integrated on a planar substrate.
When the sensor array is moved over a patient’s chest, magnetic data is collected and proprietary algorithms generate a map of the patient’s cardiac function which can be represented as an image or wave form.
Present ECG available technology cannot locate conductive pathways in the heart. Because conduction pathways are often the source of arrhythmias, clinicians lack complete cardiac function information. To date, detecting arrhythmias has been a time consuming process for clinicians but with the advent of a low-cost non-contact assessment tool could revolutionize cardiac screening across the continuum of global healthcare settings. The MCG device is able to identify abnormalities or weaknesses not detected by ECGs.
In addition, the device does not transfer energy into the body, measurement is unaffected by the patient’s clothing and body size, the device has superior electrical sensing sensitivity, operable in electrically noisy environments, and doesn’t require electromagnetically shielded exam rooms.
It is expected that the total available market for MCG is $242 million and the targeted market segments include cardiology clinics, emergency departments, large primary care practices, hospitals, and out-patient clinics.
Blue Highway envisions a first generation embodiment of the MCG device to include a full array system of sensors connected to a processing and computing system capable of imaging the magnetic field generated by depolarization and repolarization currents in the chest cavity during a cardiac cycle. The device will enable clinicians to map the heart in both time and space. Second generation development may include a portable device.
For more details, email David Eilers, Vice President for Business Development at deilers@blue-highway.com or call (315) 443-6212.
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