North Dakota’s healthcare varies in different parts of the state according to the new report “Environmental Scan of Health and Health Care in North Dakota” issued by the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences and commissioned by the Dakota Medical Foundation. The authors of the report were Boris Volkov, PhD, Brad Gibbens, MPA, Former Center Director Mary Wakefield, PhD, plus several other contributors.
According to the report, the state’s urban areas and small geographically rural and frontier populations are faced with a rapidly aging population with almost 22 percent of the population going to be 65 or older by 2020. Also the state has an expanding minority population that lives mostly on Indian reservations and has to deal with other problems such as unemployment, a shrinking youth population, and 12 percent of the population lives at the poverty level.
In addition, chronic diseases especially cardiovascular disease and cancer are the leading causes of death in North Dakota, but other chronic conditions are also affecting the quality of life such as arthritis, disabilities, asthma, and diabetes.
In general, North Dakota has high quality hospitals and nursing homes and provides efficient healthcare services. However, this specific report presents an in-depth assessment on health and the healthcare system in the state that is based on selected health issues where the authors saw the need for more improvement. To meet the needs of the state, health information technology is one of the important issues that needs improvement.
To help deal with the issue of health IT, in 2007, the North Dakota legislation created the HIT Steering Committee to help the adoption in the state. When an assessment was made of health IT in the state, it was found that significant HIT adoption existed across large provider organizations, with all six of the state’s urban hospitals having some form of electronic medical records.
However, according to the Environmental Scan report, only 14 of 37 rural hospitals have implemented some level of EMR due to the cost for implementation. The approximate cost of EMRs for small hospitals can run as high as $850,000 to $1.2 million and for a clinic setting, EMR costs may range between $15,000 and $25,000 per physician.
Since 2005, only three rural hospitals have adopted EMRs which was accomplished through grant funding but almost 80 percent of responding long term care facilities lack EMR systems. In addition, the development and use of HIT in the public health community is also slow. A survey of clinics conducted by the ND Health Care Quality Review Inc. found that only two independent rural clinics had EMRs.
The report emphasized that the need for telemedicine is underutilized in the state and is needed to provide outreach services such as teledermatology, telepsychiatry, teleradiology, and tele-ICU. Teleradiology has progressed due in part to grant funding by Blue Cross Blue Shield of North Dakota and from Rural Hospital Flexibility grants.
A survey done by the Center for Rural Health on health IT, found that North Dakota students in medicine, radiology technology, and clinical laboratory science have indicated that certain technologies are extremely or very important in their decision as to where to practice. It was also found in another study that new physicians coming from technology rich learning environments feel more comfortable practicing where HIT is used.
According to the report, a total of $9 million has been received by several healthcare facilities and networks in federal grants to plan and build health IT. The only source within the state that has funded health IT has been the BCBSND Rural Health IT grants. To date, BCBSND has invested $1,470,200 in technology for a total of $10,756,224 in federal and non-federal funds from 1999 to the present.
The report summarizes the challenges needed to improve the adoption of health technology in the state. The gulf developing between rural and urban providers with regard to the actual implementation of HIT and the resources available needs to be addressed. Secondly, adoption is occurring at different rates with hospitals adopting technology at a faster rate than clinics, long term care, and public health facilities. A third concern relates to workforce development as students want their work environment to have the needed technology.
There have been several success stories involving the use of technology in the state. For example, through the North Dakota Telepharmacy Project, a licensed pharmacist at a central pharmacy site is able to supervise a registered pharmacy technician at a remote telepharmacy site by using video conferencing technology to fill prescriptions. The project is a collaboration of the NDSU College of Pharmacy, Nursing, and Allied Sciences, the North Dakota Board of Pharmacy, and the North Dakota Pharmacists Association.
North Dakota as a forward thinking state was the first state to pass administrative rules allowing retail pharmacies to operate in certain remote areas without requiring a pharmacist to be present. Approximately 40,000 rural citizens have had their pharmacy services restored, retained, or established through the project.
In another recent technology initiative supported by the Center for Rural Health and the consulting firm Clarity Group, Inc., technology is now being used to address patient safety issues in 13 of North Dakota’s rural hospitals. The 13 hospitals are using a new web-based management system that enables the rural hospitals to obtain information efficiently and also to provide education and share resources. Participating hospitals collect information related to patient safety at their facilities and then use the data to help make the right improvements.
To download the “Environmental Scan of Health and Healthcare” brief and full report, go to
http://ruralhealth.und.edu/projects/escan/publications.php.
Tuesday, August 4, 2009
Technology Available for Licensing
Several research projects at the University of California have developed better ways to use microscopy in the field. Telemicroscopy can be used in fields requiring microscopy but the technology can be complex to use. For example, using advanced microscopy suitable for specialized applications requires a computer for data storage and an internet connection to transmit the data. Also, the microscopy device if coupled to a camera phone is not sufficient to use for any advanced microscopy.
Researchers at the University of California at Berkeley have overcome some of the problems and have coupled high numerical aperture optics to a camera phone or to other suitable telecommunications devices that are now able to capture and transmit high resolution images with a single device.
There are several ways that the technology could be used to diagnose illnesses. The immediate microscopy of microorganisms could be immediately available if it is not possible at a particular time to culture them in a laboratory. The technology is highly portable, can be used in remote locations, and be used with existing diagnosis devices such as microchip-based devices.
For more information on the technology called “High Numerical Aperature Mobile Telemicroscopy”, contact Curt Theisen at curt@berkeley.edu or call (510) 643-7214 referencing Tech ID #17789.
Researchers at the University of California, at Davis have developed a device that can attach to the aperture of a miniature camera of a mobile device such as a cell phone and a notebook computer to obtain and record microscopic images. The resolution is better than 2 micrometers and is useful for a wide range of applications including remote medical diagnosis, forensics, telemedicine, and education. The size of the device is small with a focal length of 0.1-10mm, has inexpensive lenses and can be fabricated from simple inexpensive parts.
For more information on the technology called “Microlens Assembly for Microscopy with Miniature Cameras”, contact Nancy E. Rashid at nerashid@ucdavis.edu or call (530) 754-8621 referencing Tech ID #19160. The UC case number is 2009-312.
Researchers at the University of California at Berkeley have overcome some of the problems and have coupled high numerical aperture optics to a camera phone or to other suitable telecommunications devices that are now able to capture and transmit high resolution images with a single device.
There are several ways that the technology could be used to diagnose illnesses. The immediate microscopy of microorganisms could be immediately available if it is not possible at a particular time to culture them in a laboratory. The technology is highly portable, can be used in remote locations, and be used with existing diagnosis devices such as microchip-based devices.
For more information on the technology called “High Numerical Aperature Mobile Telemicroscopy”, contact Curt Theisen at curt@berkeley.edu or call (510) 643-7214 referencing Tech ID #17789.
Researchers at the University of California, at Davis have developed a device that can attach to the aperture of a miniature camera of a mobile device such as a cell phone and a notebook computer to obtain and record microscopic images. The resolution is better than 2 micrometers and is useful for a wide range of applications including remote medical diagnosis, forensics, telemedicine, and education. The size of the device is small with a focal length of 0.1-10mm, has inexpensive lenses and can be fabricated from simple inexpensive parts.
For more information on the technology called “Microlens Assembly for Microscopy with Miniature Cameras”, contact Nancy E. Rashid at nerashid@ucdavis.edu or call (530) 754-8621 referencing Tech ID #19160. The UC case number is 2009-312.
Strategic Telehealth Event
A crucial three day industry forum highlighting the latest trends, best case studies, hands-on experiences, and innovative strategies presented by America’s top hospitals and other prestigious organizations will take place August 13-14, 2009 in Chicago. The presentations at the three day “A Strategic Event on Telehealth & Remote Patient Monitoring” industry forum will emphasize cost savings, reducing hospital stays, patient travel time, and greatly improving outcomes.
“The era of the electronic house is here, and family physicians must become leaders in the development, use, and promotion of the patientware systems of the future” stated by Ira Denton, M.D., as quoted from “Back to the Future: The Telemedicine House Call” Family Practice Management.
All clinical practitioners, technical support staff, leadership, financial and strategic planners involved in implementing and sustaining telehealth, telemedicine, remote monitoring operations should put this meeting on the top of the agenda to attend.
Directors of Telemedicine, Directors and Vice Presidents for Business Development, Nurse Practitioners, Registered and Licensed Practical Nurses, Physicians, Physician Assistants, Pharmacists, Healthcare Executives, Financial or Strategic Planners, Technical Support Staff, and others in the field need to take provide critical input and take an active part in this important forum.
Attendees will hear key strategies to make it possible to:
- Successfully apply telehealth & remote patient monitoring in the healthcare environment
- Identify key clinical administrative and technical design and support elements to implement a successful telehealth program at a lower cost
- Identify critical areas such as change management, organizational behavior, and buy-in from stakeholders
- Market and recruit to greatly impact the success or failure of telehealth programs
- Build a telehealth program to deliver more convenient, accessible, and efficient patient care at a lower cost
- Use telehealth programs to increase staff productivity, increase patient satisfaction, and to maintain quality of care
- Overcome the challenges to telehealth programs in terms of design, usability, evaluation, and reimbursement
- See the advantages of telehealth including reduced patient ER visits, travel and facility staffing needs
- Find out the latest in emerging technologies and applications in telehealth services and products
A partial list of speakers includes:
- Samuel Burgiss, PhD, Professor of Radiology, University of Tennessee Graduate School of Medicine, Knoxville TN
- Douglas J. McClure, MIM, Corporate Manager, Connected Health Operations, Center for Connected Health Partners Healthcare, MGH, Boston MA
- Terry Rabinowitz, MD. DDS, Medical Director, Division of Psychosomatic Medicine and Telemedicine, Fletcher Allen Healthcare
- Deborah A. Randall, Counsel Arent Fox LLP, Chevy Chase, MD
- Catherine L. Webb, MD, Director Telemedicine, Professor of Pediatrics, Northwestern University Feinberg School of Medicine
- Karen S. Rheuban M.D., Professor of Pediatrics, University of Virginia, Senior Associate Dean for CME and External Affairs Medical Director for the Office of Telemedicine, University of Virginia Health System, Charlottesville, VA
- Dale C. Alverson, MD., Medical Director, Center for Telehealth and Cybermedicine Research, University of New Mexico Health Sciences Center, Albuquerque, NM
- David Ellis, M.D., Director, Division of Telehealth and Healthcare Informatics, Erie County Medical Center, Buffalo, New York
- Steve Kropp, Director, Outreach Services and Telehealth, Saint Luke’s Health System
- Carol Quiring, RN, CEO/President, Home Care and Hospice, Saint Luke’s Health System
- Christine Martin, MBA, PMP, MT 9ASCP), Executive Director, California Telemedicine and eHealth Center
- Charles Nechtem, President, Charles Nechtem Associates
For more information and/or to register, please email conferences@acius.net or call (312) 780-0700 ext. 117 and use source code FEDTEL to receive your discounted rate. Active Communications International (ACI) is a leader in conference planning and production.
Thursday, July 23, 2009
Millions for Brain Research
NIH’s Health Blueprint for Neuroscience Research is launching a $30 million project to use cutting edge brain imaging technologies to map the circuitry of the healthy adult human brain. By systematically collecting brain imaging data from hundreds of subjects, the Human Connectome Project (HCP) will yield insight into how brain connections underlie brain function and will open up new lines of inquiry for human neuroscience.
Investigators are invited to submit proposals to carry out the HCP which will be funded for up to $6 million per year for five years. The HCP is the first of three Blueprint Grand Challenges projects to address issues in neuroscience research.
The HCP will optimize and combine state-of-the-art brain imaging technologies to probe axonal pathways and other brain connections and researchers will combine brain imaging technologies to map the brain’s connections. The HCP will develop new data models, informatics, and tools to help researchers make the most of the data. Funds will help build an on-line platform to disseminate HCP data and tools.
All institutions of higher learning, nonprofits, for profits, small businesses, and Federal, state, and local governments are eligible to apply. Letters of intent are due October 26, 2009 with applications due November 11, 2009. For more information go to www.nimh.nih.gov and click on Request for Applications or call Daniel Stimson, NINDS at (301) 496-5751.
In another effort to study the brain, the Department of the Army USAMRAA released information on July 10th on the Psychological Health and Traumatic Brain Injury Research Program with program funding of $24,000,000.
This grant award program supports research on promising new products, pharmacologic agents, behavioral interventions, devices, clinical guidance, and or emerging approaches and technologies. These awards are expected to yield potential products, approaches, or technologies to treat, prevent, detect, and diagnose psychological health and traumatic brain injuries relevant to the military.
Each principal investigator must be able to provide a transition plan including funding and resources to show how the product will progress to clinical trials and be able to deliver to the military market after the completion of the research.
The closing date for applications is October 28, 2009. There will be three grants awarded. For more information on the grant opportunity “Psychological Health and Traumatic Brain Injury Research Program” go to www.grants.gov.
Investigators are invited to submit proposals to carry out the HCP which will be funded for up to $6 million per year for five years. The HCP is the first of three Blueprint Grand Challenges projects to address issues in neuroscience research.
The HCP will optimize and combine state-of-the-art brain imaging technologies to probe axonal pathways and other brain connections and researchers will combine brain imaging technologies to map the brain’s connections. The HCP will develop new data models, informatics, and tools to help researchers make the most of the data. Funds will help build an on-line platform to disseminate HCP data and tools.
All institutions of higher learning, nonprofits, for profits, small businesses, and Federal, state, and local governments are eligible to apply. Letters of intent are due October 26, 2009 with applications due November 11, 2009. For more information go to www.nimh.nih.gov and click on Request for Applications or call Daniel Stimson, NINDS at (301) 496-5751.
In another effort to study the brain, the Department of the Army USAMRAA released information on July 10th on the Psychological Health and Traumatic Brain Injury Research Program with program funding of $24,000,000.
This grant award program supports research on promising new products, pharmacologic agents, behavioral interventions, devices, clinical guidance, and or emerging approaches and technologies. These awards are expected to yield potential products, approaches, or technologies to treat, prevent, detect, and diagnose psychological health and traumatic brain injuries relevant to the military.
Each principal investigator must be able to provide a transition plan including funding and resources to show how the product will progress to clinical trials and be able to deliver to the military market after the completion of the research.
The closing date for applications is October 28, 2009. There will be three grants awarded. For more information on the grant opportunity “Psychological Health and Traumatic Brain Injury Research Program” go to www.grants.gov.
Massachusetts Broadband Efforts
Last summer, the state established the Massachusetts Broadband Institute (MBI) with a $40 million state capital bond authorization to expand broadband throughout the state. This legislation was passed months before the Federal government made $7.2 billion available through ARRA for broadband deployment.
MBI’s action plan is to:
• Assess broadband conditions in communities with or no broadband
• Promote access for essential state and local governmental services, homes, and businesses
• Inventory state and local government services to see if they can contribute resources
• Work to secure federal broadband stimulus funding
MBI is looking for letters of support from fiber network build and design contractors, fiber network operators, and last mile providers. Providers will need to address requirements such as how they plan to provide service in underserved areas, types of customers to be targeted, types of technologies that network service providers will need to deploy for last mile services, pricing levels to offer, examine whether service provider partners are applying for ARRA funds in the regions, and look into any past experiences that service providers have had with similar projects.
The Massachusetts House and Senate passed a bill last week that will make changes in the way state agencies interact. The bill makes changes in defining the state’s ownership of fiber it leases and for any wireless spectrum it might lease for expanding broadband access. The legislation gives MBI access to conduits that are already being laid along I-91 by the Massachusetts Highway Department for its own communications needs.
According to Sharon Gillett, Director of MBI, the bill makes it easier for the MBI to take advantage of existing infrastructure and build-outs already under construction. “It allows us to work collaboratively with other agencies, and to use what already exists so we can work more rapidly. We have to be able to show that our plans can be substantially completed in two years and totally completed in three. In order to do that there has to be streamlining of the construction.”
For more information, go to http://www.massbroadband.org/.
MBI’s action plan is to:
• Assess broadband conditions in communities with or no broadband
• Promote access for essential state and local governmental services, homes, and businesses
• Inventory state and local government services to see if they can contribute resources
• Work to secure federal broadband stimulus funding
MBI is looking for letters of support from fiber network build and design contractors, fiber network operators, and last mile providers. Providers will need to address requirements such as how they plan to provide service in underserved areas, types of customers to be targeted, types of technologies that network service providers will need to deploy for last mile services, pricing levels to offer, examine whether service provider partners are applying for ARRA funds in the regions, and look into any past experiences that service providers have had with similar projects.
The Massachusetts House and Senate passed a bill last week that will make changes in the way state agencies interact. The bill makes changes in defining the state’s ownership of fiber it leases and for any wireless spectrum it might lease for expanding broadband access. The legislation gives MBI access to conduits that are already being laid along I-91 by the Massachusetts Highway Department for its own communications needs.
According to Sharon Gillett, Director of MBI, the bill makes it easier for the MBI to take advantage of existing infrastructure and build-outs already under construction. “It allows us to work collaboratively with other agencies, and to use what already exists so we can work more rapidly. We have to be able to show that our plans can be substantially completed in two years and totally completed in three. In order to do that there has to be streamlining of the construction.”
For more information, go to http://www.massbroadband.org/.
VA Halts 45 IT Projects
The Department of Veterans Affairs announced that 45 Information Technology projects which are either behind schedule or over budget will be halted. The agency is going to review the 45 projects and determine whether these projects should be continued. Secretary Shinseki has ordered a review of the all the department’s 300 IT projects.
A new project plan will now need to meet the requirements of the Program Management Accountability System (PMAS) to be created by the project manager and approved by the VA’s Assistant Secretary for Information and Technology.
The PMAS requires projects to establish milestones to deliver new functionality to its customers. Failure to meet deadlines indicates a problem within the project. Under PMAS, a third missed customer delivery milestones is cause for the project to be halted and re-planned.
A partial list of the IT projects temporarily halted:
• Pharmacy R-Engineering Pre.5 and Pre 1.0
• Health Data Repository (HDR) II and Health Data Repository (HDR) Data Warehouse
• Home Telehealth Development and Home Telehealth Infrastructure Enhancements
• Barcode Expansion
• Clinical Data Service, Clinical Flow Sheet, and Clinical/Health Data Repositories Phase II
• BCMA Inpatient Medication Request for SFG IRA
• Radiology HL7 Interface Update
• Ward Drug Dispensing Equipment Interface
• Lab Data Sharing & Interoperability
• National Teleradiology Program
PMAS in conjunction with the analytical tools available through the IT Dashboard is going to assure the early identification and the correction of problematic IT projects. The IT Dashboard at www.usaspending.gov is a one-stop clearinghouse of information to track federal information technology initiatives.
For more information, contact Katie Roberts at Katie.roberts@va.gov or call (202) 461-4982.
A new project plan will now need to meet the requirements of the Program Management Accountability System (PMAS) to be created by the project manager and approved by the VA’s Assistant Secretary for Information and Technology.
The PMAS requires projects to establish milestones to deliver new functionality to its customers. Failure to meet deadlines indicates a problem within the project. Under PMAS, a third missed customer delivery milestones is cause for the project to be halted and re-planned.
A partial list of the IT projects temporarily halted:
• Pharmacy R-Engineering Pre.5 and Pre 1.0
• Health Data Repository (HDR) II and Health Data Repository (HDR) Data Warehouse
• Home Telehealth Development and Home Telehealth Infrastructure Enhancements
• Barcode Expansion
• Clinical Data Service, Clinical Flow Sheet, and Clinical/Health Data Repositories Phase II
• BCMA Inpatient Medication Request for SFG IRA
• Radiology HL7 Interface Update
• Ward Drug Dispensing Equipment Interface
• Lab Data Sharing & Interoperability
• National Teleradiology Program
PMAS in conjunction with the analytical tools available through the IT Dashboard is going to assure the early identification and the correction of problematic IT projects. The IT Dashboard at www.usaspending.gov is a one-stop clearinghouse of information to track federal information technology initiatives.
For more information, contact Katie Roberts at Katie.roberts@va.gov or call (202) 461-4982.
HRSA Posts Grant Notice
The notice for the “Rural Health Network Development Planning Grant Program” (HRSA-10-020) was posted on July 20th. The purpose for the Network Planning Grant program is to bring together key parts of the rural healthcare delivery system to work together.
The funding goal is to establish or improve the local coordination of care. The grant program funds one year of planning activities to help rural communities provide for an integrated healthcare network if the participants in the network are not already collaborating.
There is considerable evidence that rural healthcare providers benefit greatly from developing networks. The realities of rural healthcare delivery create an environment where rural providers need to be able to build a more sustainable infrastructure by joining together in formal arrangements. However, identifying and exploring these kinds of partnerships can be a challenge.
The lead applicant organization must be a rural, non-profit, or public entity that represents a consortium/network of three or more health related entities that need assistance to plan, organize, and develop a healthcare network. For profit organizations are not eligible to be the lead applicant but can participate in the network. Faith-based and community-based organizations as well as tribal organizations are also eligible to apply for the funds.
The grant will be funded with FY 2010 appropriations depending on the funds available. The amount of the funding is anticipated to be $1,700,000 with 20 awards. The estimated average size of the awards is $85,000. The application deadline is September 14th
For more information, go to www.grants.gov or contact Eileen Holloran, Program Coordinator, Office of Rural Health Policy at eholloran@hrsa.gov or (301) 443-7529.
The funding goal is to establish or improve the local coordination of care. The grant program funds one year of planning activities to help rural communities provide for an integrated healthcare network if the participants in the network are not already collaborating.
There is considerable evidence that rural healthcare providers benefit greatly from developing networks. The realities of rural healthcare delivery create an environment where rural providers need to be able to build a more sustainable infrastructure by joining together in formal arrangements. However, identifying and exploring these kinds of partnerships can be a challenge.
The lead applicant organization must be a rural, non-profit, or public entity that represents a consortium/network of three or more health related entities that need assistance to plan, organize, and develop a healthcare network. For profit organizations are not eligible to be the lead applicant but can participate in the network. Faith-based and community-based organizations as well as tribal organizations are also eligible to apply for the funds.
The grant will be funded with FY 2010 appropriations depending on the funds available. The amount of the funding is anticipated to be $1,700,000 with 20 awards. The estimated average size of the awards is $85,000. The application deadline is September 14th
For more information, go to www.grants.gov or contact Eileen Holloran, Program Coordinator, Office of Rural Health Policy at eholloran@hrsa.gov or (301) 443-7529.
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