Telehealth Growing at the VA

The Veterans Administration is making good use of Clinical Video Telehealth (CVT) in new ways at VA’s Butler Healthcare System located in Pennsylvania. Several new programs are in effect. They include working with the Louis A. Johnson Medical Center in Clarksburg West Virginia to assist veterans with limb amputations with concerns related to fitting and other issues, assisting veterans receiving blood thinning products at the Mercer and Laurence Community-based outpatient clinics, and diagnosing treatments needed for speech language cognitive programs.

The Minnesota VA received over $200,000 in grants to improve emergency healthcare services for women and to offer more telehealth services. Several examples of specialized services include telepharmacy using video conferencing to provide pharmacotherapy, and support for the Maternity Care Coordination Telehealth pilot project located in Greater Los Angeles.

The VA Boston Healthcare System (VA-BHS) actively involved in telehealth is now adding more clinical options for patients to use. Right now VA-BHS offers telehealth to deliver services in radiology, mental health, spinal cord injury, nutrition, vascular surgery, allergy issues, orthopedic surgery, amputation care, dermatology and retinal imaging. In addition, many of the outpatient clinics are establishing a CVT based relationship to deliver and coordinate other clinical specialties to include home-based primary care and teleaudiology.

Since many veterans live in rural areas, the Veterans Rural Health Resource Center-Eastern Region is collaborating with the Lake City VAMC Spinal Cord Injury and Disorders Clinic to provide veterans with ALS a new care coordination program that involves telerehabilitation and telemedicine to help veterans in Northern Florida and in the Georgia Veterans Health System.

Cogmed Improves Memory

Cogmed Working Memory Training is a computer-based cognitive training program for children and adults who need to improve their working memory. The University of California at the Davis MIND Institute recently received a four year $1 million grant from the John Merck Fund’s Translational Research Program in developmental disabilities to study cognitive training in children with fragile X syndrome. (more…)

Assessing Replacement MMIS

North Carolina’s Department of Health and Human Services (DHHS requested that an independent assessment be done by Susan D. Young, a Charlotte-based IT consultant to gauge the readiness of the state’s Medicaid Management Information System (MMIS). The assessment was conducted between January 7, 2013 and February 1, 2013 and showed that the new MMIS system scheduled to live July 1, still has some critical challenges.

The new MMIS will replace a 35 year old computer system that processes 88 million state Medicaid claims each year on behalf of 1.5 million Medicaid recipients and issues checks to 70,000 providers totaling more than $11 billion.

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Bill Introduced in the House

Representative Diane Black (R-TN) introduced the “Electronic Health Record Improvement Act” (H.R. 131) to make some changes related to meaningful use requirements. The provisions of the bill would affect the requirements that would be needed to establish meaningful use.

The bill would:

  • Enable eligible professionals in a solo practice or near retirement age to be exempt for three years for  Medicare payment penalties for not demonstrating EHR meaningful use
  • Enable Medicaid meaningful users to be exempt from payment penalties
  • Shorten the EHR reporting period to apply Medicare EHR payment for eligible professionals
  • Provide for alternative meaningful use criteria for eligible professionals that utilize EHRs and specialty registry systems
  • Make it possible to use specialty registries to help specialists meet quality measures
  • Enable rural healthcare providers to be eligible for meaningful use
  • Improve EHR meaningful use under Medicare by eligible professionals who practice in ambulatory surgical centers
  • Provide for additional exceptions to applying for Medicare adjustment for certain Medicare and hospital-based eligible professionals not demonstrating EHR meaningful use
  • Develop an appeal process before penalties are applied

 

The bill would require that reports be submitted that describe the improvements made in streamlining requirements under Medicare, improvements that certified technology vendors have made in interoperability, the progress that has be made on the adoption of certified EHR technology, how effectively reporting systems are operating, and make recommendations on how to make regulations more interactive with EHR technology.

 

 

 

CCHP Scans State Telehealth Issues

Mario Gutierrez, Executive Director of the Center for Connected Health Policy (CCHP) put the spotlight on CCHP’s new information available at www.telehealthpolicy.us that scans and analyzes state telehealth laws and regulations for all 50 states and the District of Columbia. He spoke at a recent “Alliance for Health Reform” event “The Healthcare Workforce: Prescription for the Future” held March 22, 2013.

He noted that the CCHP report basically found that there are no uniform policies across states and states should explore telehealth policy with contiguous states. Secondly, telehealth is not being utilized to its fullest potential and states should promote policies that incentivize use of the technology. Thirdly, since federal policies influence states and their policies, federal agencies should expand policies and encourage states to do the same.

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HHSignite (beta) Launched

HHSignite (beta), an internal competitive seed-funding opportunity to test new and unconventional ideas at HHS was just launched to gain evidence for solutions to challenges. The program hopes to support up to 8 innovative concepts with budgets of $10,000 or less that can be completed within 6 months.

HHS is looking for early steps of concepts that are entirely new to the agency that support the Secretary’s priorities. Proposals can also go towards a process already underway but looking to take an unconventional next step.

In addition to the funds, HHSignite teams will be able to consult with HHS leaders, be introduced to HHSentreprenuers, a program that pairs innovative employees with experts outside of government to tackle difficult problems, and interact with top innovators at HHS. Awardees will also be exposed to flexible approaches in problem solving.

The program is looking for projects such as:

  • New or improved program/operations/scientific processes such as streamlining the grant application or contracting process, or new tools or methods to help HHS comply with operational standards and laws
  • New or significantly improved technologies to help HHS or stakeholders
  • New or enhanced collaborative partnerships to expand relationships with federal or non-federal partners
  • New or improved methods to disseminate information
  • New or improved methods for developing the workforce such as using distance learning and webcasts
  • New or improved ways to help HHS meet public health and sustainability goals

 

HHSignite (beta) is open to all HHS employees and the teams may include individuals from outside of HHS or government. However, project leads must be full time employees with HHS.

HHSignite (beta) was launched March 19, 2013 with May 15, 2013 the last day to submit a proposal. Go to www.hhs.gov/open/initiatives/ignite/index.html for more information.

Caring for Dementia Patients

In a partnership with the Veterans Administration’s medical centers and local Alzheimer’s Association chapters in Boston and Houston set up a five year trial so that two person care coordinator teams could provide telephone-based support to patients with dementia and their caregivers over a 12 month period. The VA serves more than 570,000 veterans with dementia.

The trial served veterans mostly male averaging 60 and older with a diagnosis of Alzheimer’s disease, or other dementia. The teams addressed medical and nonmedical needs through education, coaching, links to needed resources, and mobilization of an informal care network known as “Partners in Dementia Care”. (more…)

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