ONC Announces Challenge Competition

ONC announced a new Challenge Competition to create a mobile device-optimized tool to engage and empower women to help prevent and treat breast, cervical, uterine, and ovarian cancer in underserved and minority communities.

Disparities in prevention, early treatment, and final outcomes exist across the spectrum of cancer types affecting women’s health. With over 300,000 new cases combined and 68,000 deaths annually strike many more minority and women living in underserved areas in the U.S. 

The mobile device tool must:

·        Provide information on preventive and screening services

·        Interface with patient health records or provider-sponsored patient portals to provide specific reminders and trigger HER-based clinical decision support for the timing of preventive services

·        Support the storage, viewing, and exchange of complex patient care plans

·        Strengthen communication among provider care teams possibly spread out across large geographic location to enable optimal remote follow-up

·        Enable patient information to EHRs via “Direct”

·        Help patient and or their caregivers keep track of complex care plans, such as connections to community health workers

The first prize is $85,000, second prize is $10,000 and third prize is $5,000. In general, applicants must provide for continuous access to the app, a detailed description of the app, instructions on how to install and operate the app and system requirements required to run the app.

Go to www.challenge.gov or to www.health2con.com/devechallenge/challenges/onc-i2-challenges for more details on how to apply.

CHCF Issues RFP

The California HealthCare Foundation (CHCF) with $150,000 available has issued an RFP to develop a “Pilot for the Electronic Prescribing of Controlled Substances”. Electronic prescribing has the ability to improve the quality and efficiency of healthcare delivery but despite this potential; California is consistently near the bottom in Surescripts’ annual SafeRx rankings that measure how states adopt and use e-prescribing.

One of the barriers to widespread adoption of eRx has been the prohibition until recently of the Electronic Prescribing of Controlled Substances (EPCS) which accounts for about 11 percent of the prescriptions written annually.

In June 2010, DEA issued an Interim Final Rule permitting EPCS but subject to stringent security and audit requirements which means that pharmacies, pharmacy communication networks such as Surescripts, and health IT vendors must comply.

The purpose of this project is to pilot EPCS in up to three ambulatory provider organizations (medical groups, community clinics, etc.) to better understand the issues and challenges dealing with implementing federal regulations affecting physicians, community pharmacies and health information networks to send prescription-related information. The goal is to identify the implementation challenges and share the lessons learned broadly in California and nationally to facilitate the widespread adoption of EPCS.

To be eligible, the applicant must be an ambulatory provider organization in California, using e-prescribing for non-controlled substances for at least six months, met the Stage 1 MU requirements for e-prescribing, and use eRX/EHR software certified for EPCS or software that will be certified by the fourth quarter of 2012.

To see the proposal online, go to www.chcf.org/rfps/2012/epcs-pilot. It is anticipated that the individual grants will be for $50,000.

A webinar will be held September 6, 2012 to discuss the RFP. Questions are due September 12, 2012, with proposals due on September 28, 2012.

Questions about this RFP should be directed to Ronald Wacker, EPCS Project Manager at ronwacker@yahoo.com with the subject line “Questions re:EPCS RFP”. Questions received after the September 6^th webinar will be answered and posted online, along with the complete RFP at www.chcf.org/epcs.

App Brings Human Anatomy to Life

The hip bone is connected to the knee bone, but now you can see them both up close and personal on your iPad. Healthline Networks just announced that Healthline Body Maps for the iPad, a 3D interactive visual learning tool has been released to help medical students, doctors, and consumers understand the human body like never before.

Many Patients find it difficult to ask their doctors questions during office visits due to time constraints and also nerves can contribute to forgetfulness. With BodyMaps, patients from small children to elderly patients can literally tell their doctor where it hurts.

An estimated 44 million people serve as caregivers to individuals with medical conditions like Alzheimer’s heart disease, and vision loss. Bringing BodyMaps with an iPad to a doctor’s visit can help caregivers as well as patients. 

So for example, if you have a question for the doctor, bring your iPad to the office instead of that stack of printouts from the web. If you want to know what happens to a knee affected by osteoarthritis, or how appendicitis affects the abdomen, BodyMaps will help. Users on their iPads can drill down into anatomical structures from the skin through the layers of muscles down to the organs and bones and view illustrated videos in Retina Display detail.

BodyMaps was created by Healthline and GE Healthymagination in partnership with Visible Productions, the company that provides video plus animations for the Dr. Oz show. The result is the most vividly detailed, interactive model of the human body to date with app features including anatomical structures for common specialties such as orthopedics, cardiology, and neurology.

“BodyMaps can be used as a teaching tool for nurses, healthcare, and body workers, and even for high school and elementary students’ first learning anatomy. It’s a great patient education tool for ancillary staff in the physician’s office,” said Gloria Horns, RN, JD, longtime nurse educator and well-known patient advocate from UCSF. “Visuals make Body Maps the perfect tool for short teachable moments and the markup along with the email function can be ideal for subsequent patient reference at home. Medical professionals can also use the tool with patients in a hospital setting.”

“BodyMaps for iPads brings human anatomy to life for everyone,” said West Shell III, Chairman and CEO of Healthline Networks. “The exceptionally high quality imagery combined with our industry-leading health search technology, simple navigation, and compelling content makes it a powerful learning tool—one that grows with users as they increase their knowledge levels over time.”

This app is available in the iTunes app store and features Retina Display anatomy models of both sexes. For more information and details, go to www.healthline.com.

Foster Care Medical Homes

Wisconsin’s Department of Health Services (DHS) is creating a foster care Medical Home program to be located in the southeastern region of the state slated to begin this fall. The program is a joint initiative of the DHS and the Department of Children and Families DCF).

The general provisions to be implemented in the Foster Care Medical Home program include:

• Integrated health service delivery services
• Access to a full range of developmentally appropriate services
• Continuity and coordination of care
• Transitional planning and follow-up services
• Providing for the foster children’s well-being outcomes

Wisconsin’s program will create a virtual “Medical Home” for children in foster care and out-of-home care enabling the children to receive individualized treatment plans addressing their specific trauma-related needs. As a result, these children are expected to have improved physical and mental health, improved resiliency, shorter stays in out-of-home care, plus the Medical Homes will result in long-term savings in Medicaid costs.

“Many children who enter foster care have experienced traumatic events in their young lives and often have intensive physical, behavioral, and mental health needs,” said Eloise Anderson, Secretary of DCF. By immediately assessing their needs with a trauma-informed approach, we have another tool to help break the cycle of harm caused by these adverse experiences.”

Under the program, some 2,500 children in the six counties will continue to have access to all covered Medicaid services but these services will be coordinated to ensure that the services are appropriate to each child. Each child will have a primary care provider and team that will create a medical care plan focused on the specific needs of the child, including physical, mental health, and dental care. A Care Coordinator will communicate with the person in charge of the child’s protection, the child’s parents or guardian, and other providers to ensure they receive needed services promptly.

DHS will certify one or more integrated health systems to participate in the new program. To be certified, qualified healthcare providers must practice with an integrated health system capable of demonstrating capacity in trauma-informed care and evidence-based treatment. They must also be able to work with qualified physicians, nurse practitioners, other support staff, along with a network of qualified providers for medical, dental, and behavioral health services. In addition, they must also contract with providers outside their network.

Alabama's Medicaid News

The Alabama Medicaid Agency intends to release a Request for Proposal (RFP) in the near future seeking healthcare consulting services. In the meantime, the State Medicaid Agency on August 15, 2012, released a Request for Information (RFI) seeking ideas on what needs to be included in the future RFP. The response to this RFI needs to describe specific suggestions to be included in the scope of work in the future RFP such as:

·        The economic impact of the possible Medicaid expansion options under the amended provisions of ACA

·        The way to handle the influx of several hundreds of thousands of newly eligible individuals

·        The internal organizational structure for operating Alabama’s Medicaid Agency

·        The current revenue streams and financing mode of the Medicaid agency and recommend alternative models.

Go to www.medicaid.alabama.gov/content/2.0_newsroom/2.4_Procurement.aspx to view the RFI due September 14, 2012. For more information, email Kathy Hall at Kathy.hall@medicaid.alabama.gov.

Alabama’s HIE called One Health Record® when fully implemented will offer interoperable sharing of data for providers who have federally-certified EHR systems. However, providers are able to take advantage of a messaging tool within One Health Record called “Direct”.

“Secure messaging via the One Health Record web portal will help providers who want to enjoy some of the benefits of HIE but are not yet in a position to adopt and use a certified EHR system,” according to Gary Parker Project Director for the HIE.

The Direct messaging system was first available last February and has more than 400 enrolled providers. Parker is now coordinating an effort to link four community hospitals and the University of Alabama at Birmingham though Direct.

“Direct messaging offers a significant advantage for the mental health community, even though mental health professionals are not eligible for the federal incentive program”, said Parker. “Most mental health centers cannot afford to upgrade their computer systems. With direct messaging, case managers can log in, pull up the patient’s information, see what prescriptions have been filled, and determine if the person has been to the doctor or the emergency room”.

Alabama Medicaid’s “Patient Care Network” program has been in place for one year, performing well, and has saved money for the state. The Care Networks are set up to function as medical neighborhoods where doctors, pharmacists, and others work together to coordinate care. The networks have been particularly effective in controlling emergency room use resulting in a 15 percent decrease from July 2011 to January 2012.  

Kim Eason, Executive Director of the Care Network of East Alabama attributes the program’s first year successes to strong relationships built between primary care providers and case managers.

The East Alabama program is one of three pilot sites started during the past year that has successfully reduced costs to the state while improving the quality of care. The three network areas serve 80,000 Medicaid recipients through the Patient 1^st program.

Care Network of East Alabama now plans to expand during their second year by strengthening their relationship between primary health providers, local mental health agencies, and substance abuse providers. A full time pharmacist has also been hired to assist physicians and community pharmacists with medication issues for patients. 

In addition, MedNet of Tuscaloosa was selected to pilot test a six county network in West Alabama and another pilot program was established in North Alabama. Plus a fourth pilot program, the Gulf Coast Patient Care Network covering Mobile and Washington Counties was launched in July.

Improving Veterans Use of eHealth

The VA’s “eHealth Quality Enhancement Research Initiative” referred to as eHealth-QUERI is working with VA program offices to implement and evaluate eHealth as a model of care. The eHealth-QUERI’s database focuses on all clinical issues that are applicable so researchers are able to use the data to evaluate My HealtheVet (MHV).

The VA created MHV to provide veterans with an online personal health record so that veterans could refill VA prescriptions, receive wellness reminders, view appointments, view lab results and participate in secure messaging with their healthcare team 24/7.

In connection with eHealth-QUERI, the VA Medical Center’s Center for Health Quality Outcomes and Economic Research located in Bedford Massachusetts is conducting a study is using the eHealth QUERI Database’s clinical data to study how the data relates to MHV use.

The staff at Bedford will obtain information from the database to track how the MHV is used across disease categories and patient demographics. Initially, the focus will center on the most prevalent or high-priority diagnoses and conditions among veterans. Researchers will conduct in-depth analyses to characterize how veterans with specific health conditions are using MHV.

By identifying groups of patients who are actively using MHV and then looking at how many other groups are falling behind in using MHV, the VA will be able to help identify areas where further improvements are needed and should be made. This information will be of value to MHV coordinators and patient-aligned care teams.

For more information on the VA Study “Optimizing Veterans’ Use of eHealth Technologies”, email Stephanie Shimada at Stephanie.shimada@va.gov or call (781) 687-2872

Oregon's CareAccord Expanding

“CareAccord” currently providing statewide health information exchange services in Oregon is continuing to expand according to the state’s Health Information Technology Oversight Council’s August newsletter. This is the result of having larger medical groups adopt Direct Secure Messaging a free method to send patient information electronically available to all their member physicians.

There were 56 account registrations by the end of July with August tallies anticipated to jump as medical groups and Coordinated Care Organizations register large number of providers. Participants are starting to use Direct Secure Messaging, though at this early stage, the messages are largely internal. This is expected to change as more participants sign on and start securely transmitting patient information to other participants.

CareAccord’s strategy will have representatives traveling around the state introducing the benefits of Direct Secure Messaging to more potential users, beginning with a trip to Eastern Oregon in this fall. In addition, there will be new educational materials about CareAccord’s services and the HIE made available. The materials include videos that explain how to register and use the service.

Go to http://cms.oregon.gov/OHA/OHPR/HITOC/pages/index.aspx to view the newsletter. CareAccord is sponsored by the Oregon Health Authority and operated by Harris Corp.