Accurate Data for AI/ANs

Testimony presented to the House appropriation Subcommittee on Interior, Environment, and Related Agencies on March 19th by Rex Lee Jim serving as the Navajo Area Representative to the National Indian Health Board (NHIB) and Vice President for the Navajo Nation, discussed critical healthcare needs that exist for American Indians and Alaska Natives (AI/AN).

Today, there are significant health disparities within AI/AN communities as compared to rates in the general U.S. population. The fact is that tuberculosis rates are 8.5 times higher, chronic liver disease and cirrhosis is 4.2 times higher, diabetes, 2.9 times higher, unintentional injuries 2.5 times higher, and homicide 2.0 higher. (more…)

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Helping Vulnerable Populations

The Veterans Administration’s research goal is to improve the quality and equity of health and healthcare for vulnerable populations. The primary focus is to research issues in vulnerable populations affecting racial and ethnic minorities, women, homeless, individuals with limited life expectancy, people with serious mental illnesses, TBI, and PTSD, stigmatizing or disabling medical conditions, victims of military sexual trauma, disadvantages existing in specific geographic areas, and gender minorities.

The secondary research focus is to improve the quality, safety, and value of clinical therapeutics which can include the appropriate use of medications, devices, and procedures to improve the patient’s quality of life and medical outcomes and do more to manage many chronic illnesses.  (more…)

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Foundation Awards Grants

The ABIM Foundation awarded grants supported by the Robert Wood Johnson Foundation (RWJF) to 21 state medical societies, specialty societies, and regional health collaboratives. The grant awards will help physicians and patients find ways to reduce unnecessary tests and procedures. The grants will run until March 31, 2015. State medical societies and specialty societies will receive $50,000 and regional collaborative will receive $70,000.

The grants will extend the ABIM Foundation’s “Choosing Wisely®” campaign in communities encouraging physicians and patients to think and talk about medical tests and procedures that may be unnecessary and in some instances could cause harm. Since April 2012, 25 medical specialty societies have created lists of tests and procedures they say are overused or inappropriate. (more…)

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Genomic Medicine Pilots

Although the potential for genomics to contribute to clinical care has long been anticipated, the pace of incorporating genomic findings into medical practice has been relatively slow since NIH has be able to support only a limited number of programs.

However, NIH has just announced funding for about $3,000,000 with 3 to 4 awards to support collaborative genomic medicine pilot demonstration projects. NIH’s Funding Opportunity Announcement (RFA-HG-13-004) will support projects that will adapt ongoing successful genomic projects or initiate new projects to expand the implementation of genomic medicine.

The demonstration projects will incorporate the patient’s genomic information into their EMR and provide clinical decision support for appropriate interventions or to give clinical advice.

Specific goals are to expand and link existing genomic medicine efforts, develop new collaborative projects and methods in diverse settings and populations, contribute to the evidence base regarding outcomes when incorporating genomic information into clinical care, and share the information with others.

NHGRI expects the project datasets and associated genotyping data from the participating projects to be widely shared with the scientific community for research. Information such as study protocols, descriptions, CDS, bioinformatic tools, and publications are expected to be made available through an open access sections of a database such as dbGaP, other public web sites, and/or published in the scientific literature.

Organizations eligible to apply for funding include higher education institutions, nonprofits, for-profits, and governments. The deadline for the application is July 17, 2013 with the earliest start date anticipated to be April 1, 2014.

Go to http://gratns.nih.gov/grants/guide/rfa-files/RFA-HG-13-004.html for more information.

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HRSA Supports Rural Vets

HRSA’s Office of Rural Health Policy (ORHP) is now accepting applications for FY 2013 “Flex Rural Veterans Health Access Program” (RVHAP). ORHP is providing funding for $960,000 to help coordinate activities so that rural veterans of Operation Iraqi Freedom and Operation Enduring Freedom will have access to services needed for mental healthcare via the use of networks, electronic communication, and telehealth networks.

RVHAP goals are to:

  • Utilize telehealth and health IT including EHRs to help improve care coordination for veterans who are seen by both the VA and private providers
  • Expand existing networks via partnerships and coalitions with other healthcare entities such as CAHs, FQHCs, rural health clinics, home health agencies, community mental health clinics, and other providers of mental health services such as pharmacists, local governments, and private practice physicians
  • Consult with state hospital associations, rural hospitals, providers of mental health services, and other stakeholders to provide services

 

Grant funds are to be used to strengthen coordination in rural healthcare networks with the VA and may also be used to help upgrade existing equipment and software in rural facilities.

Eligible applicants can only be current Medicare Rural Hospital Flexibility Program grantees in states with certified CAHs. The estimated award amount will be up to $329,000 per year. The response to HRSA’s funding announcement released April 3, 2013 is due May 17, 2013.

For more information on (HRSA-13-246), go to www.grants.gov or contact Larry Bryant, at LBryant@hrsa.gov or call (301)443-1330.

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NINR to Contract with Inova

The National Institute of Nursing Research (NINR) within NIH intends to contract with Inova Fairfax Hospital in Fairfax, Virginia. The funding will used to study the biological mechanisms underlying the risks that can produce the onset of PTSD as well as long lasting neurological impairments.

Data will be obtained from clinical procedures and medical records as part of standard of care to determine the patient’s eligibility. Recruitment will be for 120 patients to be enrolled over year with an average of 10 patients enrolled per month. NINR will then categorize patients into two groups. One group will include trauma patients who do not develop PTSD and the other group will include trauma patients who do develop PTSD.

Specifically, this study will identify differences in the DNA methylation of stress-related genes and concentrations of inflammatory proteins that collect in blood and sweat that may contribute to a higher risk for PTSD onset. Blood for research will be taken when phlebotomy is done for clinical evaluation and/or treatment or in conjunction with clinical care.

This notice appearing April 2, 2013 at www.fbo.gov is not a request for proposals but a capability statement, proposal, or quotation may be submitted by other sources by April 17, 2013. Primary point of contact is Louis A. Kuta, Sr. at kutal@od.nih.gov.

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Remote Monitoring Trials

Since hospital readmission penalties in the U.S. will take effect in 2013 and mHealth technologies are expected to become more pervasive in the care delivery system, interest in remote patient monitoring is expected to remain strong especially with older adults in the coming years.

Mayo Clinic and Preventice have developed a non-invasive minimally obtrusive, interactive remote monitoring platform designed for physician-directed patient self-management and can be very useful in monitoring CHF patients.

Mayo is sponsoring a new clinical trial along with NIH as a collaborator to study the use of remote monitoring to manage cardiac patients. The clinical trial “Assessment of the BodyGuardian RMP in Elderly Healthy Subjects” (NCT01808053) is going to assess how the BodyGuardian remote health monitoring system could be improved by incorporating ECG, heart rate activity, and breathing data.  Weight, blood pressure, and symptom data will also be integrated.

The study will center on individuals in an independent living center and will transmit data wireless to a central data analysis hub. The BodyGuardian sensor adheres to the patient’s skin and is smaller than a cell phone, giving patients complete mobility and freedom to go about their normal lives without restriction.

The study’s start date of March 2013 is currently recruiting 20 participants of both genders 50 years or older that are healthy with their life anticipated survival to be more than one year and living in an independent living facility.

Go to http://clinicaltrials.gov/ct2/show/NCTO1808053 for more information. The Principal Investigator is Charles J. Bruce at the Mayo Clinic. For more details, contact Nancy Lexvold at (507) 255-7013 or email lexvold.nancy@mayo.edu

Another clinical trial “Patient Perspective on Remote Monitoring of Cardiovascular Implantable Electronic Devices” (NCT01691586) sponsored by UMC Ultrecht in the Netherlands is studying Remote Patient Monitoring (RPM) when the patient has a cardiovascular electronic device implanted. The study will look at how effectively RPM systems can interrogate the device automatically and then send the data from the patient’s home directly to the physician.

The purpose of the study is to evaluate the effect of RPM along with in-clinic follow-up versus in-clinic follow-up only. The second objective is to identify patients who prefer RPM over in-clinic visits and all of the cost factors involved.

The study not yet open for recruitment will include 900 individuals from 18 years old to 85 that are heart failure patients implanted with a first time ICD/CRT-D device. This study excludes patients on the waiting list for heart transplantation.

Go to http://clinicaltrials.gov/ct2/show/NCT01691586 for more information. The Principal Investigator is Mathias Maine, MD, PhD at +31 (0)88 466 6184 or email mmeine@umcultrecht.nl. The estimated completion date is expected to be May 2016.

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