ONC Announces Funding

The HHS Office of the National Coordinator on December 20^th released the Funding Opportunity Announcement “Exemplar Health Information Exchange Governance Entities Program” to help public or private organizations with established HIEs. Funding will provide approximately $800,000 for selected organizations to collaborate with ONC.

ONC will enter into cooperative agreements with up to four awardees. The goal is to work with each awardee to help them further develop and adopt policies, interoperability requirements, business practices, discuss how to reduce implementation costs, and assure privacy and security when exchanging health information. Working through a cooperative agreement as opposed to a grant ensures that there will be substantial involvement between ONC and the awardees.

Eligible applicants must be a not-for-profit entity, state government, or a component of a state government. Applicants must focus on the governance of HIEs between unaffiliated healthcare organizations, health information organizations, and across multiple vendor products.

Applicants must submit a non-binding letter of intent by January 11, 2012 to apply for the funding.

Applications are due February 4, 2013 and the anticipated award date is March 25, 2013. For more information, go to www.grants.gov.

CT Issues RFP for SHOP

In December, HHS named Connecticut as one of six states approved to implement a state-based Health Insurance Exchange (HIX). The state previously received $116 million to design and build the Exchange. On December 17^th, the State of Connecticut issued “Connecticut Health Insurance Exchange RFP for the Small Business Health Options Program” or referred to as the SHOP Exchange to support Connecticut’s CT HIX.

The RFP seeks information from qualified vendors to assist with the design, development, and implementation of a SHOP Exchange solution. The SHOP Exchange is designed to help small employers access more affordable insurance and more health plan choices for their employees. The SHOP Exchange is to be operational by October 1, 2013 and provide coverage beginning January 1, 2014.

The Exchange is to develop information technology to:

• Engineer and build a flexible architecture for the Exchange and allow for national standards to provide security, privacy, interoperability, and information sharing
• Use Connecticut’s statewide technology architecture to streamline eligibility criteria and to ease future changes to rules
• Manage the exchange to allow for efficient and appropriate updates

 The ACA requires each SHOP Exchange to provide access to employers seeking support with consumer support programs, help with the application process, and assist with information on Qualified Health Plans. Once in operation, the SHOP Exchange will provide access to numerous choices in levels of coverage, plan designs, and costs.

The letter of intent was due December 21^st and the final proposal is due January 22, 2013 with the anticipated contract start date to be March, 1, 2013.

For more information, email Margo Lachowicz, Connecticut HIX Project Assistant at CTHIX.SHOPRFP@ct.gov.

UVA's Virtual Cancer Center

UVA is addressing the unique challenges faced by cancer patients in rural areas, communities, and organizations throughout Appalachia and Southwest Virginia. The University of Virginia (UVA) is working with rural communities to create a virtual hospital called the “Cancer Center Without Walls”. This effort is designed to help patients that need advanced cancer care and clinical trials close to their home.

Funding for the center comes from an 18 month $965,000 grant awarded by the Virginia Tobacco Indemnification Community Revitalization Commission with funding beginning in 2013.

According to Michael J. Weber, PhD, Director of the UVA Cancer Center, “The Center is designed to help create a seamless network for care so that everyone across the Commonwealth from the coalfields to the Atlantic will have access to the very finest resources.”

Many people in Virginia’s tobacco regions do not have access to clinical trials and specialists at NCI-designated cancer centers, like the Cancer Center that exists at UVA. To meet the needs of these residents, the virtual cancer center will take advantage of the broadband network in Southwest Virginia to expand telemedicine initiatives and increase access. 

The region has excellent cancer physicians and centers but the partnership with UVA will increase access to advanced care and clinical research. For example UVA will collaborate with local health systems to expand telemedicine opportunities for breast and cervical cancer screenings.

By expanding the use of mobile digital mammography and video-colopscopy, it is possible to bring screening and prevention options where cancer is prevalent and screening options are limited.

In another development at UVA, researchers have developed a new computer model showing how the heart reacts to stresses such as high blood pressure. This new model is shedding light on a common cause of heart failure and will make it possible to develop new drugs to treat and prevent heart failure.

The computer is able to map out the signaling network that controls how heart cells grow in response to biochemical and mechanical stresses. This is critically important to understand because the cells attempt to adapt to stresses when a heart attack occurs which can often lead to additional cardiac problems.

According to Jeff Saucerman, PhD, Assistant Professor of Biomedical Engineering at UVA, “Unlike previous research that focused on individual proteins and genes affecting heart growth, UVA’s model takes a broader approach.” As he explains, “Most studies have focused on individual trees, but we’re trying to see the bigger picture of the forest.”

Telehealth Summit Just Days Away

Insightful discussions on virtual care models across a variety of specialties including diabetes management, tele-ICUs, ocular, pediatrics, and telemental health will take place at the World Congress Telehealth Executive Summit January 28-29, 2013 at the Hilton San Diego Resort and Spa.

Attendees will have the perfect learning environment while examining all of the issues involved in actively pressing forward to effectively use telehealth in today’s healthcare system.

Clinicians, administrators, and case managers will benefit from relevant case studies examining patient outcomes in active telemedicine initiatives as well as expert-led panel discussions on Credentialing, Grants and Funding, Technology and Vendor Selection, and Virtual Care Communication and Management Models.

Attendees will be able to listen to in-depth discussions on:

·        Aligning incentives and reimbursement models to support telehealth programs

·        The impact that the Affordable Care Act and SCOTUS decision will have on the future of telemedicine

·        How to overcome legal and regulatory barriers such as state licensing and credentialing

·        Ways to expand specialty telehealth initiatives to create an enterprise wide strategy

·        Determining ROI and how to improve outcomes from evidence-based case studies

·        Ways to reduce re-admissions and keep patients in their homes using remote monitoring technologies

·        Integrating disparate data sources to achieve interoperability

·        Ways to engage physicians and adapt clinical and workflow efficiently

Keynoter Jay H Sanders, MD, President and CEO, for the Global Telemedicine Group and Professor of Medicine at Johns Hopkins University School of Medicine will present his vision on how to transform healthcare delivery through telemedicine to effectively meet the needs of the 21^st century.

Some of the other speakers include:

·        Dale C. Alverson MD, Professor Emeritus of Pediatrics and Regents, Medical Director of the Center for Telehealth and Cybermedicine Research, University of New Mexico

·        Eric Brown President and CEO of the California Telehealth Network

·        Jeffrey P. Kessler, PsyD, Chief Operations Officer at the Georgia Partnership for TeleHealth

·        Nina M Antoniotti R.N, PhD, Telehealth Director for the Marshfield Clinic

·        Ronald S Weinstein MD, Founding Director for the Arizona Telemedicine Program

·        Mario Gutierrez, Executive Director for the Center for Connected Health Policy

·        Nancy Vorhees, Chief Operating Officer for the Inland Northwest Health Services

·        Yael Harris, Director, Office of Health IT and Quality, Office of Special Affairs at HRSA

·        Lisa Robin, Chief Advocacy Officer, for the Federation of State Medical Boards

Plus many more speakers from hospitals, colleges, industry, state organizations will provide their knowledge and insight on the vital and critical issues involving the use of telehealth.

For more information or to register, go to www.telehealthsummit.com/events/HL13014. Federal Telemedicine News readers and friends can save an additional $300 off the current registration fee by using Promo Code FTN912 when registering.

For more information on other World Congress Conferences, go to www.congress.com.

AHRQ Reports on HIT

AHRQ’s “Transforming Healthcare Quality Through IT” (THQIT) program, with 118 grantees in 38 states has planned, implemented, and studied health IT implementations from 2004 to 2009 across a wide range of care settings, communities, and health IT systems. The majority of grantees report that health IT upgrades and investments in the health IT infrastructure are warranted.

The report “Sustainability, Partnerships, and Teamwork in Health IT Implementation” published December 2012, presents THQIT grantees and their experiences working on the grants along with follow-up interviews with selected grantees. The report was prepared by Mathematica Policy Research and Geisinger Health System under Contract HHSA 290200900019.

One year planning grants of up to $200,000 were awarded and two sets of 3 year implementation cooperative agreements of up to $1.5 million from AHRQ were made available with a requirement for equal matching funds.

The first 40 grants were available to a broad group of applicants. The second 16 grants were awarded to grantees that completed THQIT planning grants. In addition, three year grants for up to $1.5 million were awarded to 24 grantees.

Eighty six percent of funded projects included at least one hospital as a partner, more than half included private physician practices, and over a quarter included safety net providers. The most common technologies of interest were HIEs, EHRs, CPOE, and telehealth. Eighty six percent of the grantees pursued more than one type of technology.

In general grantees reported that most health IT implemented and upgraded during the study is still used. However, in order for health IT projects to be successful, clinician buy-in and support must be established early in the planning and be sustained during implementation and maintenance phases.

Effective planning includes completing a workflow analysis, developing an implementation plan, and developing a process redesign assessment prior to implementation. Strategic partnerships were indicators for success and helped grantees to overcome challenges in health IT implementation.

The grantees reported that what influenced sustainability the most was:

• The ability to demonstrate benefits from health IT to their organizations
• Having adequate clinician support available to sustain or increase their use of health IT. Four grantees reported that lack of clinician or physician enthusiasm was a reason they never implemented or they discontinued the use of health IT
• Related to cost-related issues and was one of the main reasons why some of the THQIT funded health IT stopped being used at least two years after the end of their project

 There were several successful stories. For example the Erie Family Health Center’s EHR-focused project initially implemented a single centrally operated EHR in four FQHCs. Today, 32 safety net clinic sites spread across eleven states use this EHR system.

In another case, International Severity Information Systems implemented health IT in 15 nursing homes through the “On Time Quality Prevention Program for Long-Term Care” program. It was found that the use of health IT helped to reduce pressure ulcers. Twenty-one additional nursing homes implemented health IT the next year and now at least 46 others have implemented the system encouraged by Medicaid incentives to use health IT.

The report drew information from four sources which included final reports available form AHRQ, a web-based survey of all the grantees in 2011, and interviews with 16 grantees in 2011, plus quality improvement stories completed with nine grantees.

Go to http://healthit.ahrq.gov/THQIT to view the report.

Preventice Launches Trials

As announced at the December mHealth Summit, Preventice’s BodyGuardian RMS will be commercially available to hospitals, clinics, and testing facilities in the U.S. and Europe in 2013. Preventice received 510(k) clearance from FDA in August enabling the company to market and sell the remote monitoring systems to hospitals and clinics to wirelessly transmit physiological data on non-lethal, cardiac arrhythmias in ambulatory patients. The data is transmitted to the mhealth platform where it can be stored for 30 days at a time.

Meanwhile, clinical trials are underway to study the impact of the monitoring system on clinical care delivery. Specifically, trials are being conducted with Mayo Clinic in Rochester, Minnesota, Sanpietro Clinic in Milan Italy, and Bordeaux Hospital University Center in Bordeaux France. The trials are being conducted to analyze and quantify the clinical impact of advanced monitoring involving the remote transmission of ECG signals, on-demand event transmission, and the ability to analyze significant amounts of data.

Specifically, the clinical trials are studying:

• Post-surgical cardiac patients to evaluate how monitoring cardiac rhythms remotely influences all phases of hospital recovery
• Patients with congestive heart failure to determine early warning of decompensated heart failure and the ability to deliver more timely interventions to prevent more serious and expensive complication
• How to do 24/7 continuous monitoring of non-surgical, infrequently symptomatic patients as they go about their daily lives with the objective of detecting potential arrhythmias by tracking ECG, respiratory rate, and activity

 Jon Otterstatter, Co-Founder, President and CEO of Preventice notes that a new clinical trial to study the use of remote monitoring to manage default hospital admissions for cardiac patients is planned for 2013 at Mayo Clinic.

Also, according to Michael Emerson, Senior Vice President of Marketing, “In addition to their collaboration with the Mayo Clinic which developed the algorithms on which the technology is based, Preventice is also working with STMicroelectronics and Samsung Electronics to bring the BodyGuardian to market.”

Preventice is located in Minneapolis with offices in Rochester, Minnesota and Fargo North Dakota. For more information, go to www.preventice.com.

Congressman Calls for More EMRs

Congressman Brian Higgins representing the 27^th Congressional District in Western New York spoke on the floor of the House of Representatives in December to highlight the need to increase the use of EMRs. Higgins cited the benefits for using EMRs during natural disasters like Hurricane Sandy that will not only improve the quality of patient care but also save the U.S more than $81 billion annually.

As the Congressman remarked, “While many hospitals and medical centers were devastated by the storm, hospitals that used EMRs were able to ensure that vital health information was maintained and not lost. Also EMRs enabled care to be continued while patients were transferred between hospitals.”

The HITECH Act which created the Beacon Grant program made it possible for Western New York to receive $16.1 million enabling the HEALTHeLINK system to integrate EMRs. Several examples of how health IT is improving healthcare and economic growth in Western N.Y include:

• Western New York one of eleven communities selected by the VA to participate in the VLER Health Communities Program, is now connecting physicians from the VA to private practices and hospitals through HEALHeLINK system
• The new $300 million Global Vascular Institute at the Buffalo Niagara Medical Campus to  be able to integrate health IT into all practice settings
• Buffalo-based Computer Task Group has be awarded twelve national contracts for EMR work including work for a comprehensive statewide system in Texas
• Dell Computer announced that a $15 million partnership with the University of Buffalo  will improve the supercomputer facility at the Medical Campus and improve the research capabilities for university researchers and entrepreneurs with the goal to create over 100 jobs
• UBMD, a practice plan with 450 physicians who are also professors at the UB School of Medicine and Biomedical Science, received a $20 million grant from the state to establish a Health IT network for physicians to work with patients with chronic diseases
• Two million in federal funding was awarded to the P2 Collaborative to provide outreach and support services to at least 5,100 primary care providers to expand health IT within two years