The report “U.S Preparations for 2009-H1N1 Influenza” recently prepared by the President’s Council of Advisors on Science and Technology (PCAST) examined basic strategic issues and how to best minimize the impact of the likely resurgence of the 2009-H1N1 flu.
To further study the impact of the situation, PCAST assembled a Working Group to do an in-depth external review of the possible epidemic and then detail how the nation needs to respond to the problem. The Working Group was chaired by Dr. Harold Varmus, President, Memorial Sloan-Kettering Cancer Center and Dr. Eric Lander, President and Director, Broad Institute of Harvard and MIT. As a result of the group’s review, the “2009 H1N1 Working Group report” was completed.
The report’s chapter “Ensuring Adequate Data for Decision Making: Surveillance Systems” emphasizes the need to respond quickly to a flu epidemic. To do this, data is needed to detail how many people are becoming infected, experiencing illness, seeking medical care, being hospitalized, requiring intensive care, and how many are dying from H1N1. Also, the data needs to show how these numbers are changing over time, who is becoming infected and at the greatest risk for severe outcomes, how is the virus changing, and are medical and public health systems able to respond adequately.
According to the report, CDC works with local and state public health departments to support a large number of systems for surveillance of influenza activity. The output of this accumulated data is summarized publicly and published on www.cdc.gov/flu/weekly.
The systems have provided valuable data through the spring and summer and the Working Group is fully aware that CDC is developing plans to expand its surveillance efforts for fall 2009. However, the Working Group sees some shortcomings and thinks that while it is not possible to remedy all of these problems before the fall, there are several short-term steps that could be taken to significantly improve the available data such as:
• CDC needs to combine syndromic surveillance and emergency department data available from existing local and state surveillance systems. The data needs to be incorporated into a geographically representative national network
• Although nationally representative data would be valuable, it may be beneficial for these surveys to oversample in jurisdictions that have relatively robust surveillance plans in place for tracking influenza related primary care visits, hospitalizations, and deaths
• Hospital facilities may also become scarce, so an integrated system needs to be implemented to monitor the healthcare system with an emphasis on reporting the incidence and prevalence of cases occupying hospital beds, ICU beds, and mechanical ventilators
• Timely data on patients hospitalized for respiratory illnesses available to clinicians, public health officials, and the public needs to be make available. This data could be located in a network of participating sites specializing in influenza surveillance, healthcare systems with appropriate electronic record keeping systems, and interested states and localities.
• Adequate surveillance systems are needed for vaccine-associated adverse events with particular attention to adverse events that are likely to occur at high rates in high risk populations. Also, adverse event surveillance and analysis depends to a large degree on the ability to link vaccinations to possible adverse events via medical records
Go to www.whitehouse.gov/assets/documents/PCAST_H1N1_Report.pdf, to download information on the PCAST report “U.S Preparations for 2009 H1N1 Influenza”, and PCAST’s Working Group’s “2009-H1N1 Working Group Report”.
Sunday, August 30, 2009
Smartphones in Developing Countries
The University of Texas Health Science Center at Houston has developed new smartphone technology to help improve the quality of healthcare in developing nations where medical services can be scarce.
The technology includes an application with easy-to-follow medical guidelines that can be loaded onto smartphones based on Windows Mobile and used by community health workers in remote areas to diagnose and treat various medical conditions. The GuideView application and contents can be stored on a smartphone so that neither internet access nor the smartphone network is required.
Community health workers provide a large portion of healthcare in developing nations and many use smartphones or have access to them, according to M. Sriram Iyengar, PhD., GuideView inventor, and Assistant Professor at the University of Texas, School of Health Information Sciences at Houston.
In some areas, community health workers have limited medical training and are prone to errors so they can be greatly helped by the information available by using a smartphone. For example, a study done by CDC found that community healthcare workers in developing nations make errors in diagnosis and treatment as much as 62 percent of the time.
GuideView enables the user to get step-by-step instructions on diagnosing and treating medical conditions. Depending on the medical condition, there can be as many as 225 steps to use when treating a particular medical problem or condition. If at any time, the medical condition is deemed serious or life threatening, the application is programmed to dial the closest emergency service and records the steps taken so they can be reviewed at a later time.
Recently GuideView was tested in the Human Patient Simulation Laboratory at the University of Antioquia Medical School in Medellin, Columbia. Fifty health workers used the application to treat medical conditions simulated by sophisticated, life-size mannequins. Ninety five percent said they would use this technology in their daily practice and perceived the technology as useful.
Iyengar came up with the idea for GuideView while helping NASA develop a medical instruction program that astronauts could use on extended missions. Initial funding was through NASA and the Army Telemedicine and Advanced Technology Research Center. Iyengar recently received a grant from Microsoft and the Office of Technology Management at the UT Health Science Center at Houston and also received a UT System Ignition Fund grant to develop the technology for commercialization. The researchers are currently working on versions of GuideView for iPhones, Blackberries, and other types of smartphone technologies.
The technology includes an application with easy-to-follow medical guidelines that can be loaded onto smartphones based on Windows Mobile and used by community health workers in remote areas to diagnose and treat various medical conditions. The GuideView application and contents can be stored on a smartphone so that neither internet access nor the smartphone network is required.
Community health workers provide a large portion of healthcare in developing nations and many use smartphones or have access to them, according to M. Sriram Iyengar, PhD., GuideView inventor, and Assistant Professor at the University of Texas, School of Health Information Sciences at Houston.
In some areas, community health workers have limited medical training and are prone to errors so they can be greatly helped by the information available by using a smartphone. For example, a study done by CDC found that community healthcare workers in developing nations make errors in diagnosis and treatment as much as 62 percent of the time.
GuideView enables the user to get step-by-step instructions on diagnosing and treating medical conditions. Depending on the medical condition, there can be as many as 225 steps to use when treating a particular medical problem or condition. If at any time, the medical condition is deemed serious or life threatening, the application is programmed to dial the closest emergency service and records the steps taken so they can be reviewed at a later time.
Recently GuideView was tested in the Human Patient Simulation Laboratory at the University of Antioquia Medical School in Medellin, Columbia. Fifty health workers used the application to treat medical conditions simulated by sophisticated, life-size mannequins. Ninety five percent said they would use this technology in their daily practice and perceived the technology as useful.
Iyengar came up with the idea for GuideView while helping NASA develop a medical instruction program that astronauts could use on extended missions. Initial funding was through NASA and the Army Telemedicine and Advanced Technology Research Center. Iyengar recently received a grant from Microsoft and the Office of Technology Management at the UT Health Science Center at Houston and also received a UT System Ignition Fund grant to develop the technology for commercialization. The researchers are currently working on versions of GuideView for iPhones, Blackberries, and other types of smartphone technologies.
NIH's CAP Offered to SBIR Awardees
NIH’s Commercialization Assistance Program (CAP) is now available to NIH SBIR Phase II awardees free of charge. The CAP program through a contract with the Larta Institute of Los Angeles is in place to help SBIR II awardees develop their commercial business and to transition their SBIR-developed products into the marketplace. All NIH SBIR awardees with Phase II awards that are active or were active in the past six years are eligible to participate. The 2009-2010 CAP will begin October 2009 and finish July 2010.
The program has the Commercialization Training Track (CTT) and the Accelerated Commercialization Track (ACT) to offer customized assistance. CTT with 60 slots available will help participants in the program enhance their skills and tools needed to create infrastructure, documentation, and business models.
ACT with 20 slots available targets the most critical issues needed to achieve a desired commercialization outcome. This track is for companies that have commercialized other products, have clearly-defined markets and partners, or have raised financing through institutional channels.
The deadline to submit an application is September 14, 2009. For more information, go to http://grants.nih.gov/grants/funding/cap/index.htm. For general inquiries, contact Kay Etzler at sbir@od.nih.gov, or call 301-435-2713. To contact the Larta Institute, contact Judy Hsieh at jhsieh@larta.org or call 213-538-1444 Extension 144.
The program has the Commercialization Training Track (CTT) and the Accelerated Commercialization Track (ACT) to offer customized assistance. CTT with 60 slots available will help participants in the program enhance their skills and tools needed to create infrastructure, documentation, and business models.
ACT with 20 slots available targets the most critical issues needed to achieve a desired commercialization outcome. This track is for companies that have commercialized other products, have clearly-defined markets and partners, or have raised financing through institutional channels.
The deadline to submit an application is September 14, 2009. For more information, go to http://grants.nih.gov/grants/funding/cap/index.htm. For general inquiries, contact Kay Etzler at sbir@od.nih.gov, or call 301-435-2713. To contact the Larta Institute, contact Judy Hsieh at jhsieh@larta.org or call 213-538-1444 Extension 144.
WVU's Research Activities
Combat related injuries have long plagued the military in part because of multidrug-resistant bacteria. Imagine being able to spray a compound fracture with microcapsules to deliver a drug that would bolster the immune system and stop infections before they start. This technology might be just around the corner according to Bingyun Li, PhD., at the West Virginia University Department of Orthopedics and Director of the WVU Biomaterials, Bioengineering and Nanotechnology Laboratory.
Research in these areas is important because of the wars in Iraq and Afghanistan. Li said “the treatment of battlefield casualties is expensive and the infection rate runs from 2 to 15 percent because in some cases the organisms develop resistance, and therefore the antibiotics don’t work.” Millions of people not in the battlefield could also be helped by the technology because infections can sometimes result when biomedical devices are implanted.
Li’s research team is working on several ways to deliver interleukin-12. One way would be to inject microcapsules or to potentially spray a fine mist on stents, pacemakers, pain pumps, artificial limbs, and to virtually any biomedical device before implantation.
According to Li “Interleukin-12 will maximize the body’s natural response to an extent where infections can be prevented without the risk of the bacteria developing resistance to the treatment. With nanocoating, the drug is right where it needs to be at the interface of the implant and the tissue. With the microcapsule, the drug can be injected or sprayed where desired and the nanocoating and microcapsule can prolong the half life of interleukin-12.”
Li’s team has been working for four years to develop the technology. The research has been funded in part by the WVU Research Corporation, the National Science Foundation, and the Osteosynthesis and Trauma Care Foundation.
The university’s Robert C. Byrd, Health Science Center, Department of Orthopedics has several ongoing research programs. The Telemedicine Research program is working with patients with orthopedic problems. Patients are able to go to a nearby medical center where local healthcare providers interact online with surgeons to decide on continuing care for patients with traumatic injuries such as total hip and knee replacements.
The Department also has developed an electronic outcomes data collections system. The system uses HIPAA compliant internet based software to collect and store patient information in a database. Patients are able to complete the condition specific validated surveys from any computer or any location before each outpatient clinic visit with the updated information available to physicians before the visit.
The database is also a valuable resource for researchers who want to answer specific clinical research questions. The database contains de-identified data on surgical spine, surgical shoulder, and total knee and hip replacement patients. The data can also be aggregated and analyzed with data from other institutions that are using the same electronic data collections system.
Research in these areas is important because of the wars in Iraq and Afghanistan. Li said “the treatment of battlefield casualties is expensive and the infection rate runs from 2 to 15 percent because in some cases the organisms develop resistance, and therefore the antibiotics don’t work.” Millions of people not in the battlefield could also be helped by the technology because infections can sometimes result when biomedical devices are implanted.
Li’s research team is working on several ways to deliver interleukin-12. One way would be to inject microcapsules or to potentially spray a fine mist on stents, pacemakers, pain pumps, artificial limbs, and to virtually any biomedical device before implantation.
According to Li “Interleukin-12 will maximize the body’s natural response to an extent where infections can be prevented without the risk of the bacteria developing resistance to the treatment. With nanocoating, the drug is right where it needs to be at the interface of the implant and the tissue. With the microcapsule, the drug can be injected or sprayed where desired and the nanocoating and microcapsule can prolong the half life of interleukin-12.”
Li’s team has been working for four years to develop the technology. The research has been funded in part by the WVU Research Corporation, the National Science Foundation, and the Osteosynthesis and Trauma Care Foundation.
The university’s Robert C. Byrd, Health Science Center, Department of Orthopedics has several ongoing research programs. The Telemedicine Research program is working with patients with orthopedic problems. Patients are able to go to a nearby medical center where local healthcare providers interact online with surgeons to decide on continuing care for patients with traumatic injuries such as total hip and knee replacements.
The Department also has developed an electronic outcomes data collections system. The system uses HIPAA compliant internet based software to collect and store patient information in a database. Patients are able to complete the condition specific validated surveys from any computer or any location before each outpatient clinic visit with the updated information available to physicians before the visit.
The database is also a valuable resource for researchers who want to answer specific clinical research questions. The database contains de-identified data on surgical spine, surgical shoulder, and total knee and hip replacement patients. The data can also be aggregated and analyzed with data from other institutions that are using the same electronic data collections system.
USDA Funding Rural Facilities
USDA is funding 102 rural community facility projects with $58 million immediately with Federal stimulus funding. Up to now, USDA has made $179.6 million in funding available for community facility projects, and in addition to that amount, USDA Rural Development has provided $58 million plus an additional $41.1 million came from other sources.
The USDA Rural Development Community Facilities Program helps to finance essential community facilities such as child care centers, hospitals, medical clinics, assisted-living facilities, fire and rescue stations, police stations, community centers public buildings and transportation. One recipient of the funding is the City of Mountain View located in Arkansas which used the funding of $50,000 to purchase first responder equipment.
In Whitehall, Montana, the Rural Development Community Facilities Program is providing a $450,000 loan and a $14,000 grant to Liberty Place, Inc., a non-profit corporation that conducts brain injury rehabilitation. The funding will be used to purchase a facility and expand the brain injury care program. Liberty creates structured programs to enable people severely disabled by a brain injury to live in a home-based setting.
The Rural Development program is providing a $9.4 million loan to Guadalupe County Hospital to replace an outdate facility in New Mexico with a new 10 bed acute care hospital and medical clinic. The new facility will serve Guadalupe County, a federally designated health professional shortage area as well as several small villages and surrounding communities. The Guadalupe County Hospital is the only emergency care facility on Interstate 40 between Albuquerque and Amarillo Texas.
The USDA Rural Development Community Facilities Program helps to finance essential community facilities such as child care centers, hospitals, medical clinics, assisted-living facilities, fire and rescue stations, police stations, community centers public buildings and transportation. One recipient of the funding is the City of Mountain View located in Arkansas which used the funding of $50,000 to purchase first responder equipment.
In Whitehall, Montana, the Rural Development Community Facilities Program is providing a $450,000 loan and a $14,000 grant to Liberty Place, Inc., a non-profit corporation that conducts brain injury rehabilitation. The funding will be used to purchase a facility and expand the brain injury care program. Liberty creates structured programs to enable people severely disabled by a brain injury to live in a home-based setting.
The Rural Development program is providing a $9.4 million loan to Guadalupe County Hospital to replace an outdate facility in New Mexico with a new 10 bed acute care hospital and medical clinic. The new facility will serve Guadalupe County, a federally designated health professional shortage area as well as several small villages and surrounding communities. The Guadalupe County Hospital is the only emergency care facility on Interstate 40 between Albuquerque and Amarillo Texas.
Wednesday, August 26, 2009
NIH/CDC SBIR Solicitation Issued
NIH and CDC issued SBIR Solicitation (PHS 2020-1) inviting small business concerns to submit research proposals. The objective of the SBIR program is to stimulate technology innovation in the private sector, strengthen the role of small businesses to meet Federal R&D needs, and to increase private sector innovation commercialization.
Some of the NIH topics listed for research and new technologies include:
• National Cancer Institute—Biopsy instruments and devices, POC analysis for circulating tumor cells, data harmonization and advanced computation of population health data, plus biosensors for early cancer detection
• National Institute on Drug Abuse—Technologies to integrate data from prescription monitoring programs to current clinical practices, innovative techniques and tools to use for clinical trial participants, handheld devices to support recovery, innovative technologies to support research in drug abuse, and web-based cognitive and neuropsychological testing for substance abuse
• National Heart, Lung and Blood Institute—Innovative tools, techniques and software needed for screening, recruitment, and follow-up of participants in pediatric research
Some of the CDC topics include:
• National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention—A novel technology to identify early infections, a database for storage and data mining, software to perform large scale analyses of infections caused by hepatitis viruses, and decision support tools to use with the Electronic Health Record
• National Center for Immunization and Respiratory Diseases—Technology needed for vaccination delivery and immunization programs
• Coordinating Office for Terrorism Preparedness and Emergency Response—Computer-based models to evaluate strategies and outcomes in pandemic preparedness along with technologies for rapid and efficient communication in emergency response
The due date for proposals is November 9, 2009. For more details, go to http://grants.nih.gov/grants/funding/sbir.htm, and for general questions, contact Jo Anne Goodnight at sbir@od.nih.gov.
Some of the NIH topics listed for research and new technologies include:
• National Cancer Institute—Biopsy instruments and devices, POC analysis for circulating tumor cells, data harmonization and advanced computation of population health data, plus biosensors for early cancer detection
• National Institute on Drug Abuse—Technologies to integrate data from prescription monitoring programs to current clinical practices, innovative techniques and tools to use for clinical trial participants, handheld devices to support recovery, innovative technologies to support research in drug abuse, and web-based cognitive and neuropsychological testing for substance abuse
• National Heart, Lung and Blood Institute—Innovative tools, techniques and software needed for screening, recruitment, and follow-up of participants in pediatric research
Some of the CDC topics include:
• National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention—A novel technology to identify early infections, a database for storage and data mining, software to perform large scale analyses of infections caused by hepatitis viruses, and decision support tools to use with the Electronic Health Record
• National Center for Immunization and Respiratory Diseases—Technology needed for vaccination delivery and immunization programs
• Coordinating Office for Terrorism Preparedness and Emergency Response—Computer-based models to evaluate strategies and outcomes in pandemic preparedness along with technologies for rapid and efficient communication in emergency response
The due date for proposals is November 9, 2009. For more details, go to http://grants.nih.gov/grants/funding/sbir.htm, and for general questions, contact Jo Anne Goodnight at sbir@od.nih.gov.
Iowa e-Health Project on Track
Iowa’s Health Information Technology Plan recently published defines the state’s vision for the Iowa e-Health project. The Electronic Health Information Executive Committee and Advisory Council and the Iowa Department of Public Health submitted the report with detailed information on the project.
Although Iowa is not yet currently engaged in a statewide HIE, so far, many health IT milestones have been accomplished. According to the report, Iowa has developed HealthNet connect (HNc) a 3,200 mile fiber optic network. Funds for $7.8 million were made available from the FCC in their Rural Health Care Pilot Program to provide for last mile connections so that nonprofit hospitals can link to HealthNet connect.
Today, the HNc backbone network runs throughout Iowa and spans four states, with direct fiber connections to major metropolitan cities stretching from Denver to Chicago. Additionally, the HNc backbone connects to Internet2 and National Lambda Rail networks.
The Iowa Hospital Association also received grant funding for three years from the FCC in 2008 to link 80 hospital facilities through the state-owned Iowa Communications Network. ICN has provided inter-hospital broadband networking for 23 years and will use the funds to provide the network capacity to extend services to rural hospitals and the communities they serve.
In 2008, seven North Iowa hospitals, integrated an electronic health record system, the first of its kind in a rural healthcare setting. The initiative was supported by two grants from AHRQ, and in addition, the Mercy Health Network-North Iowa, seven rural facilities, local public health agencies, Trinity Health, and the University of Iowa, College of Public Health worked to implement the EHR system.
Iowa has also participated in HISPC, to address privacy and security challenges. The project led by the Iowa foundation for Medical Care and a multi-stakeholder steering committee, studied privacy and security barriers, formed urban and rural consumer focus groups, developed a patient consent framework for treatment scenarios, participated in a continuity of care document exchange pilot, discussed legal and legislative issues, and developed a model for data sharing agreements.
In January 2009 the first meeting of the Electronic Health Information Executive Committee and Advisory Council met. At that time, several workgroups were established to promote the adoption and use of health IT in Iowa. These groups looked at HIEs, privacy and security, provider adoption of EHRs, workforce and education issues, patient identify concerns, and the types of clinical data to be exchanged using the HIE governance.
The Committee discussed the significant start-up and ongoing funding needs. Some of the largest expenses include hardware, software, technical support, legal expertise to safeguard privacy and security, technical project management support for pilot projects, and resources for the overall management and coordination of activities.
Some of the states will receive financial support from their state government for startup costs and ARRA is expected to provide federal financial support. However, this still means that the states will be required to match $1 for each $10 of federal funds in 2011, $1 for each $7 in 2012 and $1 of state match for each $3 for federal funds in 2013 and beyond.
So far, the workgroups and stakeholder organizations have worked together and in the coming year, IDPH and the Electronic Health Information Executive Committee and Advisory Council plan to support additional workgroup meetings to further define and execute project activities, determine cost requirements, and then pursue federal and state grant programs to secure the funding needed for the projects.
To see the full report, go to www.iowamedical.org/news_detail.cfm?newsID=204.
Although Iowa is not yet currently engaged in a statewide HIE, so far, many health IT milestones have been accomplished. According to the report, Iowa has developed HealthNet connect (HNc) a 3,200 mile fiber optic network. Funds for $7.8 million were made available from the FCC in their Rural Health Care Pilot Program to provide for last mile connections so that nonprofit hospitals can link to HealthNet connect.
Today, the HNc backbone network runs throughout Iowa and spans four states, with direct fiber connections to major metropolitan cities stretching from Denver to Chicago. Additionally, the HNc backbone connects to Internet2 and National Lambda Rail networks.
The Iowa Hospital Association also received grant funding for three years from the FCC in 2008 to link 80 hospital facilities through the state-owned Iowa Communications Network. ICN has provided inter-hospital broadband networking for 23 years and will use the funds to provide the network capacity to extend services to rural hospitals and the communities they serve.
In 2008, seven North Iowa hospitals, integrated an electronic health record system, the first of its kind in a rural healthcare setting. The initiative was supported by two grants from AHRQ, and in addition, the Mercy Health Network-North Iowa, seven rural facilities, local public health agencies, Trinity Health, and the University of Iowa, College of Public Health worked to implement the EHR system.
Iowa has also participated in HISPC, to address privacy and security challenges. The project led by the Iowa foundation for Medical Care and a multi-stakeholder steering committee, studied privacy and security barriers, formed urban and rural consumer focus groups, developed a patient consent framework for treatment scenarios, participated in a continuity of care document exchange pilot, discussed legal and legislative issues, and developed a model for data sharing agreements.
In January 2009 the first meeting of the Electronic Health Information Executive Committee and Advisory Council met. At that time, several workgroups were established to promote the adoption and use of health IT in Iowa. These groups looked at HIEs, privacy and security, provider adoption of EHRs, workforce and education issues, patient identify concerns, and the types of clinical data to be exchanged using the HIE governance.
The Committee discussed the significant start-up and ongoing funding needs. Some of the largest expenses include hardware, software, technical support, legal expertise to safeguard privacy and security, technical project management support for pilot projects, and resources for the overall management and coordination of activities.
Some of the states will receive financial support from their state government for startup costs and ARRA is expected to provide federal financial support. However, this still means that the states will be required to match $1 for each $10 of federal funds in 2011, $1 for each $7 in 2012 and $1 of state match for each $3 for federal funds in 2013 and beyond.
So far, the workgroups and stakeholder organizations have worked together and in the coming year, IDPH and the Electronic Health Information Executive Committee and Advisory Council plan to support additional workgroup meetings to further define and execute project activities, determine cost requirements, and then pursue federal and state grant programs to secure the funding needed for the projects.
To see the full report, go to www.iowamedical.org/news_detail.cfm?newsID=204.
Subscribe to:
Posts (Atom)