Bills Introduced on the Hill

Several pieces of legislation have been introduced to improve care for diabetic patients. Senators Jeanne Shakeen (D-NH) and Diabetes Caucus Co-Chair along with Susan Collins (R-ME) have introduced new legislation to establish a commission of healthcare experts to advance diabetes care and prevention.

The bill titled the “National Diabetes Clinical Care Commission Care Act” (S-539) would bring together public and private sector experts in diabetes research and treatment to offer insight in improving clinical care for diabetic patients. (more…)

FirstNet Discussed on the Hill

“The First Responder Network (FirstNet) model represents a significant step forward from the traditional model for public safety communications”, said Samuel Ginn, Chairman of FirstNet’s Authority Board appearing before the House Committee on Energy and Commerce’s Subcommittee on Communications and Technology. “Instead of having thousands of individual, dedicated, stand-alone public safety systems built for law enforcement, fire, and emergency medical services agencies, FirstNet will be an integrated nationwide public safety network.”

FirstNet is going to cover all of the states and territories and will need to serve more than 60,000 state, tribal, local, and federal public safety entities. To meet coverage requirements, the network will require tens of thousands of cell sites, a large core network, and secure satellite coverage for the hardest-to-serve areas.

FirstNet’s goal is to design and deploy a cutting-edge wireless broadband network to serve first responders and the public safety community with reliable, interoperable, wireless services, applications, and user devices at the lowest possible fees.

FirstNet will be the only network ever built entirely to meet public safety level specifications for security and reliability. The network will also be the only network to cover an entire nation geographically as opposed to coverage by population centers.

So far, some preliminary activities include:

  • Building an organization and management team
  • Executing an aggressive consultation and outreach strategy
  • Conducting  market research on terrestrial and satellite wireless carriers to identify optimal financial and operational deployment alternatives for the public safety network
  • Conducting business and financial modeling for the various network deployment scenarios
  • Evaluating network engineering technologies and potential network designs
  • Working with standards-setting bodies to ensure public safety critical communications elements are included in the standards
  • Performing network coverage planning and engineering activities
  • Establishing standard operating procedures in consultation with public safety entities
  • Working with network operators to ensure local control and incident response

 

FirstNet has structured their Public Safety Advisory Committee comprised of state, tribal and local organizations. The first face-to-face meeting is expected to take place in April. The Advisory Committee’s leadership will be presenters at conferences and act as advocates conducting direct outreach and soliciting feedback.

 

IT Moving Ahead in Virginia

The State of Virginia’s Information Technology Agency (VITA) is responsible for operating the IT infrastructure, handling information security programs, developing public safety and related technology, and procuring IT with 100 plus ready to use VITA contracts. VITA has been working with Northrop Grumman to modernize Virginia’s technology infrastructure.

The state used funding from ARRA to plan for a health information exchange. When the Federal administration ruled that states could utilize a 90 percent administrative match through Medicaid to fund infrastructure and eligibility systems, the Virginia General Assembly in 2011 provided state funding to build the Service Oriented Architecture infrastructure necessary for modernization and interoperability.

The eHHR program was established by the state’s Health and Human Resources Secretariat. The eHHR program oversees Virginia’s health IT and the Medicaid Information Technology Architecture (MITA). Ongoing efforts are to have the technology ready needed to modernize and transform how agencies collect, use, and share vital data. The initial focus is on interoperability but later phases are going to enable broader uses for technology.

Last year over 2.3 million applications for Medicaid and SNAP services were processed. The state had an error rate on Medicaid applications that needed to be addressed. A combination of factors meant that the state needed to begin to rethink the basic task of eligibility determination and enrollment. This resulted in an eligibility modernization contract being awarded and a program-related website set up at http://ehhr.virginia.gov.

The eHHR program is up and running with some projects in process. Phases 1 & 2 of the Customer Portal have already successfully been completed. Work is progressing to provide interoperability between the Virginia Department of Health and the state laboratories. eHHR is moving forward with procurement for the Independent Verification and Validation (IV&V) system, and care management systems are being initiated to address VDH Birth, Death, and Immunization.

The eHHR Program is designed to manage the state’s HIE called “ConnectVirginia”. So far, the DIRECT Messaging system is in place and “ConnectVirginia” is continuing to work on several issues that arose during the process to onboard and test the first node with Inova Health System.

VITA’s Shared Services monthly meeting is held so that meeting participants can stay informed and collaboratively work to onboard the state agency node to “ConnectVirginia”. Also, VITA’s Monitoring Subcommittee for the Virginia Rx Drug Abuse Reduction Workgroup is examining opportunities to enable interaction between Virginia’s Prescription Monitoring Program and ConnectVirginia.

As teams address various technology issues, the HIE’s Governing Board is focusing on future governance and sustainability. The sustainability committee continues to meet to identify funding and cost models to ensure HIE’s operations beyond the Federal funding period.

Telestroke Produces Expert Care

Researchers in studying the effectiveness of telemedicine programs in Oregon found that stroke coverage was pushed into previously uncovered less populated areas and expanded stroke coverage by approximately 40 percent. The results were found in a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania studying telemedicine programs

Senior study author Brendan Carr, MD, Assistant Professor of Emergency Medicine, Surgery & Epidemiology at the School of Medicine, said the study shows that by employing telemedical systems in concert with in-person care, nearly 80 percent of residents had access to expert stroke care within one hour.

The study evaluated all the hospitals in Oregon, finding that 42 percent of the population could reach a stroke center in person within 60 minutes, 76 percent had telemedicial access, 40 percent had access to both, and 20 percent did not have access to stroke care within an hour.

Researchers noted that in-person stroke care was clustered in urban areas, and while telestroke care was also available in urban centers, it was able to reach less populated areas that had low rates of uninsured.

Penn Medicine is using telemedicine to extend stroke care to patients throughout the region through the Penn NeuroRescue program which uses telemedicine systems to bring expert consultations 24/7 to hospitals in distant locales and transfers those persons who need surgery and/or specialized neurointensive critical care to the Hospital of the University of Pennsylvania.

The Penn Medicine Neuroscience Center’s team of experts from neurology, radiology, neurosurgery, vascular surgery, emergency medicine, and nursing provides evidence-based care at the right level and at the right time, through the remote use of telemedicine plus onsite treatment is provided at affiliated primary stroke centers.

 

Funding for SORH Grants

The State Offices of Rural Health (SORH) Grant Program announcement posted March 15, 2013 is limited to the current 50 SORHs. The funding is expected to be $9,000,000 and will be used to assist States in strengthening rural healthcare delivery systems by maintaining a focal point for rural health within each State.

The SORHs maintain a clearinghouse for collecting and disseminating information on rural healthcare issues and research findings related to rural healthcare and innovative approaches needed to deliver healthcare in rural areas. In addition, SORHs identify Federal, State, and nongovernmental programs regarding rural health and provide technical assistance to public and nonprofit private entities that want to participate.

In nearly all the states, the Critical Access Hospital (CAH) Flex program is based in the SORH offices. The SORHs support quality improvement networks, loan repayment programs, annual rural health conferences, technical assistance for grant writing, and support rural health clinics and emergency services.

The FOA (HRSA-13-162) is due May 13, 2013 with the project period expected to be three years. For more information, go to www.grants.gov or email Keith Mulberry at kmidberry@hrsa.gov.

Mobile Devices Monitoring Hearts

A young female patient over 20 years ago with a severe heart condition underwent one of the first procedures at UCSF to restore normal heart rhythms called AV node ablation, which modifies the electrical pathway that connects the top chambers of the heart to its bottom chambers. At that time, a pacemaker was implanted into her chest.

For years, she had to fly several times a year from her New York home to California for checkups with the medical team at UCSF that performed the procedure to correct her heart rhythms when she was young.

Today, the patient is enrolled in an UCSF-developed online cardiovascular study “Health eHeart Study” that harnesses the power of mobile technology to monitor patients using their smartphones. This makes it possible for the information to go immediately to their doctors and then the patient can obtain instant feedback.  The study funded by the Salesforce.com Foundation aims to enroll one million people from around the world.

According to Jeffrey Olgin, MD Chief of the UCSF Division of Cardiology, hopefully more patients will be able to be diagnosed and treated more rapidly than is currently possible since we are working with a large patient population connected electronically through smartphones.

The apps and certain study-related devices are given free to participants. Olgin and his team plan to analyze the data to identify patterns. This will allow them to not only identify population-based predictors but to also identify deviations from baselines.

“We hope to collect copious amounts of data on a large segment of the population so that we can develop very robust and accurate models to predict the occurrence of heart disease in people who don’t yet have heart disease. We hope to slow the progression in people who don’t yet have heart disease, or to slow the progression in people who already have heart disease”, said Olgin.

Increasing Bandwidth to 100G

As telehealth becomes increasingly prominent, it is important to have a network that enables the transfer of high broadband applications such as multiple high-definition video streams and EHRs. This is necessary not only for discussion and diagnosis but importantly for education and treatment purposes.

Ciena Corporation, a network specialist recently announced that the Utah Education Network (UEN) selected Ciena to increase their network bandwidth from 10G to 100G and beyond.

UEN serves as the commercial internet and provider of connectivity between internet2, the state government, and the Utah Telehealth Network (UTN).

UEN has connected the University of Utah to its new downtown Salt Lake City data center and to UEN member organizations. This enables the university to meet the advanced connectivity requirements of both research and general data traffic of the university. In addition, extensions of the network to Provo and Logan are underway, enabling the network to serve Brigham Young University and Utah State University. 

UEN is an affiliate member of the U.S. Unified Community Anchor Network (U.S. UCAN) project connecting more than 65,000 member organizations to deliver  life-changing applications to communities via Ciena’s optical transport solutions.

The broadband connectivity was funded through the Broadband Technology Opportunity Program with an infrastructure grant made possible by ARRA. Other BTOP funded recipients using Ciena’s solutions to power future broadband activities in the U.S., includes CapeNet, Dakota Carrier Network, DC-CAN, Navajo Tribal Utility Authority, and MaineREN.

An example of future broadband activities, DC-CAN serving the District of Columbia is planning to deploy a high-speed middle mile broadband infrastructure to provide direct internet connections for community anchor institutions located primarily in economically distressed areas.

 For more information, go to www.ciena.com.

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