Connected Care Blog

Toumaz has BIG day, announcing FDA approval & joint venture with physician billionaire Patrick Soon-Shiong

2011-08-21T03:10:00.001-07:00

Cross posted from iMedicalApps.com.

Toumaz has BIG day, announcing FDA approval & joint venture with physician billionaire Patrick Soon-Shiong

by Brian Edwards Jul 15, 2011
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Toumaz Limited, developer of a new ultra-low power radio technology that competes with Bluetooth and Zigbee, announced this week that they have received FDA approval for its Sensium Digital Plaster technology.

Toumaz has also announced it will be entering into a new joint venture with California Capital Equity (CCE), the holding company of pharmaceutical billionaire Dr. Patrick Soon-Shiong, for the purpose of commercializing and distributing Sensium Digital Plaster. The new entity will be called Toumaz US and based in San Diego, CA.

This is a very big deal for the advancement of Body Area Network (BAN) technology, defined as a system of devices in close proximity to a person’s body that cooperate for the benefit of the user. Read after the break to find out why.

Sensium Digital Plaster is an ultra-small, ultra-low power wireless body-worn monitor that continuously and unobtrusively acquires high-quality vital signs data, including temperature, heart rate and respiration rate.

According to the company website, Toumaz will license its ultra-low power wireless sensor nodes to third party developers building “own brand” wireless monitoring systems. These systems can transmit data via the Sensium Base Station or a Smartphone app, though Toumaz shows no indications of a desire to become an app development company.

Dr. Soon-Shiong was quoted in the press release announcing the joint venture saying, “Without a doubt, wireless is the future of healthcare. Wireless technology is the key to bringing quality healthcare to everybody, wherever they may be, in real time. Toumaz’s ultra-low power technology is going to be a vital element in this, and our joint venture opens up exciting prospects.”

Under the terms of the new partnership, CCE will provide up to $25m of funding to the company over the next two years and will own 80% of the equity in Toumaz US. The remaining 20% will be held by Toumaz Limited and its CEO, Chris Toumazou, will join the board of Toumaz US as Vice Chairman while Dr. Soon-Shiong will serve as Chairman. Toumaz will also receive licensing and royalty revenues from the joint venture as it commercializes its Sensium Digital Plaster technology.

It was unclear in the press release if the joint venture is intended strictly for the commercialization of the Sensium Digital Plaster technology, but it seemed to indicate that Dr. Soon-Shiong also owns a small stake in Toumaz Limited. It seems reasonable to conclude that Toumaz US will be a one-product company, with Toumaz Limited maintaining ownership of its remaining intellectual property

Patrick Soon-Shiong is arguably the greatest physician entrepreneur to ever live. He has founded and exited two separate pharmaceutical companies, each time taking home a ten-figure paycheck, all in the last 10 years. He is now the wealthiest man and single largest landowner in Los Angeles, as well as 10% owner of the Lakers. However, Dr. Soon-Shiong is by no means ready to slow down, and he now has his sights squarely set on the mHealth sector.

Just last month his Institute for Advanced Health (IAH) announced it would be developing a $200m data center in Phoenix, AR, which is rumored to be the first of several data centers to come.

Below you can learn a bit more about Dr. Patrick Soon-Shiong, his contributions to medicine and his vision for the future of the connected health care system. He should be an inspiration to aspiring physician entrepreneurs everywhere!

Read more at www.imedicalapps.com

See this Amp at http://amplify.com/u/a1bms9

Three mHealth startups win Rock Health slots | FierceMobileHealthcare

2011-06-04T05:55:00.001-07:00

[1]Three mHealth startups have won coveted spots on business incubator Rock Health's new accelerator platform. Rock Health just announced 11 overall winners in its first class yesterday.

The program provides $20,000 in startup cash, plus five months of training sessions, mentoring, and workshops with business gurus from places like Harvard (the alma mater for all four of Rock Health's founders), and healthcare/eHealth experts with the Mayo Clinic, Epocrates and Doximity, Rock Health co-founder Halle Tecco tells FierceMobileHealthcare.

Right now the winners are all at different stages of development. Some are still polishing their initial idea, while others have prototypes they're beta-testing and a few are nearly ready for market, Tecco says. The program's goal, she explains, is to develop each participant's business plan, prototype and other key elements so that in five months, the companies are ready to pursue true six- or seven-figure venture capital to bring their products to market.

The three mHealth candidates include:

CellScope: This University of California-Berkley-developed company is working on smartphone attachments for at-home diagnostic testing. The first prototype, now in development, will diagnose children's ear infections, Tecco says. It works like this: A microscope-type device is attached to the smarthphone, and takes a high-resolution, microscopic picture of the inside of the ear. The image then can be transferred to a medical professional for diagnosis. The ultimate product, according to Tecco, will diagnose a "portfolio" of conditions, including other types of infection and possibly even cardiac conditions.

Pipette: Physicians will use this smartphone-based product to provide reminders and prompts to keep patients compliant with their treatment regimens, Tecco says. For example, if a patient has a new regimen of diet, drugs and therapy, the physician can craft a series of texts, messages or questions about pain, mobility, drug compliance, and other topics.
The messages are automatically delivered according to the parameters the physician sets up, she explains. For example, with a CHF patient, the physician might include daily reminders about measuring their weight, and automatic questions each week about the patient's diet. Patients respond to the prompts, and the physician uses the information to determine if the patient needs follow up.
One interesting note: The company's founders originally targeted the technology for service companies like hotels and restaurants, to interact with customers during travel. Ultimately, they saw a greater opportunity in healthcare, and switched focus to physician/patient use, Tecco says.

Skimble: This fitness app is the furthest along of all the mHealth candidates, and already has an offering in the iTunes app store. "It's doing quite well," Tecco says. The app is a relatively straightforward fitness product, providing personalized workouts and exercise guidance. One innovative item: It does offer some analytics that allow users to build on today's exercise or fitness data to craft future workouts, and ensure steady improvement. "We really wanted to make sure we had one fitness product in our portfolio," Tecco says.

To learn more:
- read the Rock Health press release [2]
- get more detail [3] at Xconomy
- check out coverage [4] at AllThingsD

Related Articles:
Rock Health gives mHealth startups platform [5]
Interactivity, time determine success of hospital apps [6]
Childrens Hospital of Boston launches app store competition [7]

via fiercemobilehealthcare.com

Rock Health has been one of the most exciting news stories of 2011 in the digital health space and just this week announced its first class of start-ups, including three mHealth companies. Rock Health was co-founded by Harvard MBA student Halle Tecco, who has emerged as a rising thought leader in the intellectual battle to bring innovative digital health technology to consumers though her incubator's focus on attracting successful entrepreneurs to take risks in the under-appreciated Connected Care sector. I expect big things from these companies as their products mature and they graduate as the inaugural Rock Health class.

Wireless applications makes monitoring health easy | CTIA-The Wireless Association® Blog

2011-06-04T04:49:00.001-07:00

via blog.ctia.org

Great feature on remote patient monitoring solutions. mHealth is absolutely (IMHO) the most under-appreciated emerging sector of information technology.

AMA - Total Physicians by Race/Ethnicity (2006)

2010-04-21T00:00:00.001-07:00

Total Physicians by Race/Ethnicity - 2006
(total physicians = 921,904)
Race/Ethnicity Number Percentage
White 514,254 55.8
Black 32,452 3.5
Hispanic 46,214 5.0
Asian 113,585 12
American Native/Alaska Native 1,444 .02
Other 12,572 1.4
Unknown 201,383 22

Source: Physician Characteristics and Distribution in the US, 2008 Edition. American Medical Association.

via ama-assn.org

Interesting demographic breakdown of US physicians. I think the number to watch going forward will be the Hispanic share of the physician market, which could conceivably grow to a larger percentage than Asians (12%) within next 15 years.

Posted via web from Connected Care Solutions

The American National Broadband Plan on Health Care: Opportunity in Abundant Supply | Broadband for America

2010-03-26T02:43:00.001-07:00

This blog is a crosspost from http://theworldwellinherit.blogspot.com/2010/03/american-national-broadband-plan-on.html

The National Broadband Plan (NBP) was issued last week to a warm reception and many high profile endorsements of its overriding objectives. The NBP addresses the issues of telemedicine, mobile health and the health care information technology (HCIT) industry as a whole through a candid snapshot of the current marketplace in chapter 10 (download the chapter here). In short, there is a clear acknowledgment of the possibility for innovation and new economic activity. Above all else, it is a clear attempt to stimulate entrepreneurial activity in new and clearly under-served markets.

It gave particular emphasis to the expectations that mobile health will provide tremendous economic activity and innovation over the course of the coming decade and beyond (See 3G Doctor Blog for additional highlights). I can say there is already considerable headway made in pursuit of these mobile health initiatives, particularly in the realm of body sensor networks, which consist of 'very short-range networks consisting of multiple body-worn sensors and/or nodes and a nearby hub station. The sensors and/or nodes make it possible to wirelessly transmit data to body-worn or closely located hub devices.' Hub devices can be any variety of connectivity agent (e.g. wireless routers, smart phones, netbooks and wireless data cards) which enable to exchange of patient information via dedicated broadband network.

Wave Technology Group is a company my partners and I recently engaged through the University of Chicago Hospital's Pediatric Epilepsy Center. Wave was launched by Sam Cinquegrani, a local Chicago entrepreneur who cut his teeth is software developing object-oriented platforms for institutional clients such as the City of Chicago and the Chicago Board of Options Exchange (CBOE) and Fortune 100 corporations, namely JP Morgan and Mitsubishi.

Sam's financial platforms sit at the center of the global economy and the broadband superhighways, facilitating the millions of daily transactions that pass through the largest options exchange in the world within a millisecond of their execution by traders working via custom applications that reside on their standard issue smart phone (e.g. Blackberry, iPhone, Android or Windows Mobile) and laptops or netbooks. Yet, despite the robust growth and success of this venture, Sam began to see an even bigger opportunity to take his platform-centric vision to a similarly information-intensive industry – Health Care.

To begin realizing this vision and true to his innovation-oriented disposition, Sam soon began experimenting with variations of his mobile trading technology, which couples bluetooth and 3G data connectivity provided by telecoms. My partners and I see Sam's vision as a brilliant approach to spawning application development and innovation in specialized telemedicine applications for treatment of diseases with easily targetable patients, such as the pediatric epilepsy joint venture Sam broached with the University that led him to us.

Sam is not alone in his optimistic outlook for the HCIT marketplace - IBM Strategic Finance and GE Capital have both extended multi-billion dollar funds to provide zero-percent interest financing to physicians as an additional incentive to spur early adoption. These two multi-national corporations are primarily motivated by a desire to bolster their EHR, EMR and HIE products, but they also reap the long-term windfall of collecting the Federally mandated subsidies outline in the HITECH Act as part of last years stimulus package. In total, they subsidize are currently slated to be $19B and change during a four year time frame from October 2010 through 2014.

Broadband for America is a good resource on the current state of broadband deployment and adoption with specific information on the impacts in health care and medicine, BfA is on Facebook here: www.facebook.com/BroadbandforAmerica.

Other blog posts about: Health IT, Healthcare, National Broadband Plan, Telemedicine

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Brian T. Edwards @healthgrid's blog

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via broadbandforamerica.com

My guest contribution to BroadbandforAmerica.com following the National Broadband Plan, which was issued last week.

Posted via web from Connected Care Solutions

Federal Telemedicine News: $125 Billion Budget Request

2010-02-08T04:45:00.001-08:00

Monday, February 8, 2010

$125 Billion Budget Request

Eric K. Shinseki, Secretary of the Department of Veterans Affairs appeared before the House Committee on Veterans Affairs on February 4th to discuss the President’s VA budget request for FY 2011. The President’s budget provides $125 billion in 2011 which is almost $60.3 billion in discretionary resources and nearly $64.7 billion in mandatory funding.
The Secretary reported that in December 2009, the VA successfully exchanged electronic health record information in a pilot program between the VA Medical Center in San Diego and a local Kaiser Permanente hospital using the Nationwide Health Information Network. During the second quarter of 2010, DOD plans to join the pilot and there are plans to add additional Virtual Lifetime Electronic Record health community sites. The VA has $52 million available in IT funds in 2011 to continue the development and implementation of this priority.
The budget provides $51.5 million to use for medical care in 2011, which is an increase of $4 billion or 8.5 percent over the 2010 level. In 2011, the budget provides $2.6 billion to help meet the needs of veterans who have served in Iraq and Afghanistan.
The FY 2011 budget also includes funding to treat new patients resulting from the recent decision to add Parkinson’s disease, ischemic heart disease, and B-cell leukemia to the list of presumptive conditions for veterans with service in Vietnam.
The VA’s 2011 budget includes $250 million to strengthen access to healthcare for 3.2 million enrolled veterans living in rural and highly rural areas. Plans are to provide new rural health outreach and delivery initiatives and to expand the use of home-based primary care and mental health services.
The VA intends to expand the use of cutting edge telehealth technologies and would like to invest in $163 million in 2011 for home telehealth to take advantage of the latest technological advancement in healthcare delivery. The VA’s home telehealth program cares for 35,000 patients and a recent study found that patients enrolled in home telehealth programs experienced a 25 percent reduction in the average number of days hospitalized and a 19 percent reduction in hospitalizations.
According to the Secretary, the Department’s IT operations and maintenance program supports 334,000 users situated in 1,400 healthcare facilities, 57 regional offices, 158 national cemeteries around the country, plus the IT program maintains 8.5 million vital health and benefit records for veterans. The FY 2011 budget provides $3.3 billion for IT, which is the same level of funding provided in 2010.
The IT resources requested would fund IT to process education claims, to help the Financial and Logistics Integrated Technology Enterprise project replace outdated technology, further develop the paperless claims processing system, and continue to develop the VA’s EHR system for $342.2 million.

Posted by Carolyn Bloch at 7:24 AM

via telemedicinenews.blogspot.com

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Breakthrough and Telehealth's Tipping Point

2010-01-29T17:47:00.001-08:00

If you told me last year that web-base psychotherapy would gain traction I wouldn’t have believed you. That was before I met Mark Goldenson, CEO of Breakthrough, a silicon valley based web startup that matches patient and therapist through a secure online portal. Breakthrough clients can review a therapist’s qualifications and fees, view sample video, and initiate therapy by video or phone.
In a 2.0 world marked by clouds, hives and democratized healthcare, Breakthrough is cultivating one-on-one relationships through improved access to mental health services. Everyone should be talking about this.
Goldenson made the TechCrunch 50 this past fall and maintained his continence before the likes of Tim O’Reilly, Kevin Rose and other tech luminaries. You can check out the coverage in Wired and Forbes.

The road to viable online teletherapy is littered with skeletons of those who were either ahead of the parade or didn’t have the technical support of Breakthrough. But telehealth has reached a tipping point. And Breakthrough may be there to seize the moment and tap the 2/3 of America’s 58 million with mental illness too stigmatized to seek help in person.

I’d like to say I discovered Mark Goldenson but it was he who discovered me after I delivered a lunchtime keynote on social media at this year’s American Telemedicine Association meeting in Palm Springs. He’s a pretty sharp guy. And if the fervency of his questions is any measure of his capacity to lead, Breakthrough may be worth keeping and eye on.

via feedproxy.google.com

BreakThrough is continuing to move forward with its teletherapy model for matching psychiatric patients with specialists through streaming video connection. Most of the company's early successes have been the accolades lavished upon its CEO, Mark Goldenson, but little news has emerged about the Silicon Valley startup's experiences in the trenches. I would be particularly interested to hear about the company's experiences negotiating reimbursement with providers. More investigation seems to be in order, but its generally encouraging to see telehealth and telemedicine can play in Silicon Valley.

Posted via web from Connected Care Solutions

New Physician Adoption Statistics « Health IT Buzz

2010-01-28T14:06:00.001-08:00

New Physician Adoption Statistics
Tuesday, January 26th, 2010 | Posted by: Dr. David Blumenthal | Category: ONC

The CDC recently released its latest report on the adoption of electronic health records/electronic medical records (EHR/EMR) amongst office-based physicians from the National Ambulatory Medical Care Survey. As a physician who trained and initially practiced in a time where nearly every order, record, and prescription was paper-based, the results are striking to me.

The final results for 2008 show about 16.7 percent of physicians reported having systems that met the criteria of a basic EHR/EMR system, and about 4.4 percent reported that of a fully functional system. Preliminary results for 2009 show about 20.5 percent reported having systems that met the criteria of a basic system, and 6.3 percent reported that of a fully functional system.

Combined basic and fully functional statistics for the last 3 years are as follows:

2007 – 17%,

2008 – 21%,

Preliminary 2009 – 27%

The latest figures, especially the preliminary 2009 numbers, suggest that the pace of adoption of HIT is quickening. We expect that the federal government’s health IT strategy will accelerate the pace even further by systematically addressing the obstacles physicians experience in adopting health IT (see below).

HOW THE US FEDERAL GOVERNMENT IS SUPPORTING HEALTH INFORMATION TECHNOLOGY USE

The Obama administration believes health information technology (HIT) is a critical component of efforts to improve the quality, efficiency, and value of care delivered to patients. The Office of the National Coordinator for Health Information Technology (ONC) is leading the administration’s efforts to support the thoughtful application of HIT. Cognizant of the numerous barriers that exist to making health IT work in real-world settings, the ONC is administering programs to systematically address these barriers:

OBSTACLE INTERVENTION FUNDS

Financial Resources Medicare and Medicaid Incentive Program: incentive payments to “meaningful users” who use health information technology to improve value and efficiency of care delivered to patients

Technical Assistance Regional Extension Centers: Up to 70 regional extension centers (REC) will help providers through the process of selecting and implementing electronic health records $643 Million

The vision of a health care system that uses information technology to improve the value of services to patients is inching closer towards reality.

The ONC is committed to making the transition to electronic health records successful for every physician and hospital.

I hope you will share the experiences, challenges, and success stories that belie these encouraging statistics.

– David Blumenthal, M.D., M.P.P. – National Coordinator for Health Information Technology

via healthit.hhs.gov

National Coordinator for Health Information Technology, David Blumenthal, MD, blogs about physician adoption of electronic health records, a subject on which he has long been the go-to authority. With merely 27% of physicians deploying a fully functional EHR, its now up to Blumenthal to find real solutions and strategies for stimulating widespread adoption. So far his ideas and initiatives have been promising.

Posted via web from Connected Care Solutions

Video Conferencing saving lives in Irish Hospitals

2010-01-27T21:19:00.001-08:00

Claire O’Connell in the Irish Times has an interesting article on how a stroke patient at the Midland Regional Hospital in Mullingar received urgent and potentially life-saving treatment on Sunday after a consultant at another hospital used the RP-7 (the “Remote Presence Robot” pictured below) to assess her remotely and prescribe clot-busting medication.

“The patient, who had a stroke just after noon, was collected by ambulance and was at the Midland Regional Hospital in Mullingar by 1.30pm. She was assessed by Prof Des O’Neill at Tallaght Hospital using the RP-7, which also allowed him to talk with her, examine her scans and discuss treatment with members of the medical team in Mullingar. The patient was on clot-busting medication by 2.40pm and her condition improved in half an hour”

Prof O’Neill commented on this first with a reminder of the short time window there is for putting suitable patients on potentially life-saving thrombolytic drugs; “The key challenge is to get people to have their clot-busting drug within three hours of a stroke.”

Possibly related posts: (automatically generated)
eHealth 2008 Conference Review
NHS Trusts to allow mobile phones to be used in Hospitals
Health Minister bans use of premium rate charges for GP and Hospital calls
Stroke patients need quicker treatment

This entry was posted on Wednesday, January 20th, 2010 at 10:42 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

via 3gdoctor.wordpress.com

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Federal Telemedicine News: Grant Announcement Posted

2010-01-27T21:01:00.001-08:00

Grant Announcement Posted

HRSA recently posted their “Small Health Care Provider Quality Improvement Grant Program” announcement seeking rural providers ready to implement quality improvement strategies. The plan is to help improve patient care and chronic disease outcomes for diabetes mellitus, and cardiovascular disease. The grant’s goal is to help rural primary care providers achieve these goals by using the Chronic Care Model along with Electronic Patient Registries (EPR).
Both the EHR and EPR are electronic systems, but the EPR captures information that is population-based with data on specific conditions. This grant program does not support funding for an EHR, but healthcare providers who currently have an EHR are still eligible to participate in the program.
Some of the previous grantees have used their experience working with EPRs as a stepping stone to electronic medical records adoption. These grantees also have interests in the medical home model to help spread and sustain their quality improvement initiatives that go beyond chronic disease tracking to disease prevention. Grantees have also developed business case models to help sustain their quality improvement initiatives.
The program will provide funding during FY 2010-2012. Approximately $6,000,000 is expected to be available annually and to fund up to 60 grantees. Applicants can request up to $100,000 per year. Funding beyond the first year is dependent on the availability of funds in subsequent fiscal years.
Applicants must be a rural public or rural non-profit private entity and must not have previously received a grant for the Rural Quality Grant Program or a similar project. Examples of eligible entities include rural health clinics, critical access hospitals, small rural hospitals, and Federally Qualified Health Centers. For profit Rural Health Centers and Critical Access Hospitals may also apply.
Eligible applicants must also meet at least one of these three requirements:
• Applicants must be located in a rural area
• Applicants exist exclusively to provide services to migrant and seasonal farm workers in rural areas
• Applicant is a Tribal government where grant funded activities will be conducted within their Federally recognized Tribal area
The application is due March 15, 2010. For more information, go to http://www.grants.gov/ or contact Elizabeth Rezaizadeh, Program Coordinator by email at erezai@hrsa.gov or call (301) 443-410.

via telemedicinenews.blogspot.com

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Personal Health Systems: A View from Across the Pond | Chillmark Research

2010-01-27T20:07:00.001-08:00

The European Union (EU) is struggling with many of the same healthcare issues as the US, aging population, ever increasing costs of care and the need to move to new modalities of care. This is one of the key take-aways from a recent EU-sponsored report: Reconstructing the Whole: Present and Future of Personal Health Systems. This report looks at the present state of Personal Health Systems (PHS), assesses gaps (technology, process & culture) and lays out what is required to meet the “promise of PHS” by the year 2020.

The report takes a very broad brush to what is PHS including IT, sensors, diagnostics, and drug development (personalized). This is a big report at some 240pgs and unfortunately is one of those reports that is all too big and all too academic to be useful to the average healthcare wonk. But tucked within this future, sitting-on-the-bookshelf and collecting dust report are a couple of tidbits worth mentioning.

On pages 79-86 are a series of gap analysis tables (20 in all) addressing a wide range of areas associated with PHS. Below is the Table addressing Patient Decision Aid Tools.

While the above gap analysis tables are instructive, they are not terribly “deep” and at times come across as superficial – thus would make good fodder for a “high-level” presentation to a less informed audience.

Arguably the best Table is found towards the end of the report titled: Six Domains of Implementation Gaps.

The table clearly lays out what are the future challenges to broader adoption and use of PHS. The key take-away here is the surprising similarity between the US and its EU counterparts in the deployment and use of PHS, despite what are very different healthcare system models. Which raises the question: Will such uber-players in the Personal Health Platforms (PHP) market, e.g., Dossia, Google Health and HealthVault create the systems and platforms required to support PHS data requirements? HealthVault’s move into international markets, (Canada and Thailand) signal yes, but will providers, payers and ultimately consumers join in?

Still more questions then answers at this early juncture in the development of consumer-focused systems and platforms. But there is a ray of hope in the global commonality of challenges faced that will lead to increasing attention and subsequently resources dedicated to bridging the gaps, addressing these challenges to create more effective and efficient care delivery models.

Possibly related posts: (automatically generated)
Good, Bad & the Ugly at the Aspen Health Forum
Time to Kill the PHR Term: Part 2
Wanted: Quickstart Guide for Personal Health Platform
One View from Across the Pond

via chilmarkresearch.com

Chillmark Research does some very nice digging for useful learnings to be gleaned from an EU-sponsored report on the present and future of personal health systems. The second chart in particular does a great job of outlining the barriers to the establishment of a wholly unified personal health system.

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Federal Telemedicine News: MHS IM/IT Plan Approved

2010-01-27T19:52:00.001-08:00

MHS IM/IT Plan Approved

The Military Health System Information Management/Information Technology Strategic Plan for 2010-2015 has been approved by the Senior Military Medical Advisory Committee. Leaders from the Army, Navy, Air Force, Health Affairs, TRICARE Management Activity, Joint Staff, Joint Task Force National Capital Region Medical, and the MHS Office of the Chief Information gathered last summer for a series of workshops to develop the plan.
While there have been strategic planning initiatives that have guided key priorities throughout the last ten years, this new effort by IM/IT leadership across the services, is the first formally approved plan since 1999.
The plan’s ten IM/IT goals that the Military Health Service (MHS) will focus on over the next five years are to:
• Provide rapid, affordable, secure delivery, and life cycle support for IT products and services
• Provide a comprehensive longitudinal EHR for all beneficiaries and care settings
• Implement a governance structure and process to enable effective and efficient use of resources
• Enhance enterprise intelligence through the use of enterprise tools, data, and services
• Advance the MHS personalized health agenda so that patients would have electronic access to their own records, have virtual visits, and be able to refill prescriptions online
• Advance IT interoperability using health, operational, and functional partners to create an accessible and complete virtual lifetime electronic record
• Show how the flow of funds from programming to execution can improve using better cost estimating methodologies
• Establish an innovation lifecycle management process to align IT innovation with MHS strategy
• Improve human capital management by having the right people with the right training and experience on the right job
• Develop processes, guidance, and standards to develop and integrate distributed services and applications so that time and money spent on products can be delivered rapidly and with a minimum amount of modification
In total, the planning team drafted 13 unique action plans and 14 performance measurements to define specific activities, deliverables, and milestones. In the months ahead, the IM/IIT strategic planning team will work with the action plan teams across the MHS and then draft updates, review the IM/IT measures, and determine if and how these measures should link to the broader MHS Value Measures dashboard.
For more information, go to www.health.mil/mhscio/governance.htm.

via telemedicinenews.blogspot.com

This would be a great action plan for innovating/improving any health system, from the military to local and regional providers. Hopefully this crosses the president's desk and he adopts some of the major action items to his own health reform agenda. These are the major things that need to be addressed which will have the greatest impact on the health care industry.

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Privacy & Security of Personal Health Information | Chillmark Research

2010-01-23T01:09:00.001-08:00

On Saturday, Jan. 10th, I’ll be moderating a panel at the Consumer Electronics Show’s (CES) Digital Health Summit. The distinguished panel that includes executives from Dossia, Kaiser-Permenante, Microsoft and Walgreens will address the topic: Who Will you Trust with Your Health Data?

In preparation, I have been doing some research on the subject and following are a few data points for consideration:

Since April 2003, HHS’s Enforcement Office has handled over 9,666 cases that required some form of enforcement/corrective action regarding HIPAA privacy and security violations of Personal Health Information (PHI). That works out to over 1,200 cases a year.

In 2009, PrivacyRights.org reports that there were 46 breaches of PHI representing nearly 80M records. Note that 76M of those records were from the VA that inadvertently sent one of its RAID drives out for repair without cleansing it of those 76M records of veterans. If you can’t trust the government to keep your PHI safe, who can you trust?

Subtract the VA outlier and you get about 4M individuals who had their PHI breached in 2009 across 45 documented incidents or about 89,000/breach. That’s a lot of compromised records!

Also in May of 2009 we saw the Virginia Health Data, Dept of Health Professionals get hacked in which 531,000 individuals PHI were compromised and held ransom by the hackers for a cool $10M.

And let us not forget CVS who was fined $2.25M for sloppy disposal of prescription records. No one has any idea as to how many individuals may have been compromised in this blunder by a major pharmacy chain.

The scary thing about the above is that these numbers represent documented/reported cases of data breaches and it would be easy to argue that the actual number of breaches that occur in a given year is quite a bit higher (let’s remove the 76M records in the VA breach as that really is out there).

This all raises the question:

If organizations like the VA, the Virginia Health Data, Dept. of Health Professionals and some of the most prestigious hospitals in the country can’t keep PHI safe, who can?

Which logically leads to the next question…

Is there any true, fool-proof way to insure absolute privacy and security of PHI that is held by a covered entity, business associate or even an organization like Microsoft or Dossia acting on behalf of the consumer?

Yes, there are strong passwords, yes, data can be encrypted on a server but for just about every barrier thrown up, hackers have found a way to break in. Also, beyond just hackers, what is surprising is that a number of the PHI breaches in 2009 were done by employees who were then selling such data to others, such as ambulance chasing lawyers and tabloid magazines.

Which leads me to conclude…

Maybe the belief in absolute privacy and security of PHI is a fallacy.

As we move to digitize PHI through the adoption and use of EHRs by physicians and hospitals it is inevitable that we will see more breaches. Hopefully, the benefits that we, as a nation and citizens, accrue from the adoption and use of such digital records to better manage our health and coordinate health among our healthcare team will far outweigh the risks we will be taking in the potential compromise of our PHI.

Possibly related posts: (automatically generated)
23 April 2007 – Not All Agree with Privacy Week’s Focus

via chilmarkresearch.com

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Healthcare IT Consultant Blog: Up to $43.2M to GE Healthcare for US Military Patient Monitoring Systems

2010-01-18T05:52:00.001-08:00

Sunday, January 17, 2010

Up to $43.2M to GE Healthcare for US Military Patient Monitoring Systems

GE Healthcare in Wauwatosa, WI won a maximum $43.2 million fixed price with economic price adjustment contract to supply patient monitoring systems to the US military as well as federal civilian agencies.

GE Healthcare received its 1st contracts to supply patient monitoring systems to the US military in March 2009, after 2 years of negotiations between the company and the US Defense Supply Center Philadelphia. GE received two 10-year contracts (1 year base with 9 one-year options), worth a maximum of $63 million annually, to supply patient monitoring systems as well as supporting communications equipment and IT systems…

Under the March 2009 contracts, GE Healthcare is also supplying diagnostic cardiology devices and cardiology information archival systems; catheterization laboratory monitoring; Datex-Ohmeda anesthesia delivery, infant incubators and warmers; and fetal monitoring, perinatal information systems, and blood pressure cuffs to the US military and US federal agencies.

For the $43.2 million contract, the date of performance completion is Jan 13/11. There were originally 17 proposals solicited with 9 responses received by the Defense Supply Center Philadelphia, PA (SPM2D1-09-D-8300).

Source

via hitconsultant.blogspot.com

GE Healthcare locks up remote patient monitoring contract with the DoD for $43.2mm, but this is merely the tip of the iceberg in Federal Health IT-related opportunities.

Posted via web from Connected Care Solutions

Billionaire Doctor Puts His Money Where His Mind Is...

2010-01-01T18:49:00.001-08:00

via cnbc.com

Patrick Soon-Shiong elaborates in this CNBC feature on his ambitious vision and $1Billion philanthropic commitment to build a true naitonal Public HealthGrid.

Boldly, and brilliantly IMHO, Soon-Shiong asserts that we need to stop obsessing over advances in genomic, biotech and nanotech R&D and recognize that health systems, technology parks and even most academic research labs are ill-equipt to discover anything "meaningful" from this deluge of random data. It will be "mathematicians, physicists and computer scientists" that Dr Soon-Shiong believes hold the key to unlocking the greatest potential value for patients, physicians, regional providers, public health agencies and society at large.

The politician inside me hears Dr Soon-Shiong's vision to be a blueprint for sowing the seeds of a hyper-modern renaissance movement in America. By using "team science" to engage the greatest minds from every scientific discipline in one unified pursuit of a wickedly complex problem, Patrick may have unwittingly stumbled onto the secret formula for reshaping the very fabric of society!!

Posted via web from Connected Care Solutions

Public Health Informatics Institute | phConnect.org

2010-01-01T11:03:00.001-08:00

phConnect is a web-based, interactive, collaboration platform created for public health professionals and those interested in public health to meet, share expertise, and work together on advancing public health. phConnect has been created to foster collaboration and communication across PHIN CoPs, the larger public health community, the health informatics community, and with other partners.

via phii.org

Posted via web from Connected Care Solutions

Public Health Information Network (PHIN) | Communities of Practice - CDC.gov

2010-01-01T11:00:00.001-08:00

Welcome to the PHIN Community!
Communities of Practice (CoPs) are working to strengthen the Public Health Information Network (PHIN) as members collaborate, share, and focus on issues prioritized by the PHIN Community. The PHIN Community provides a participatory environment for members to learn, share expertise, and develop informatics solutions to improve public health’s capacity to use and exchange information electronically. PHIN CoPs are now collaborating on phConnect.org.
Communities of Practice are open to everyone, easy to join, and your level of commitment is up to you. Based on the feedback received from public health and information technology partners, a collaborative approach toward implementing PHIN is needed. CoPs provide that collaborative framework, enabling PHIN members to work together to identify and leverage best practices and standards for public health, information technology, and informatics as they relate to PHIN. Your involvement in a PHIN CoP will not only help set PHIN priorities, but also assist in strengthening and shaping the future of PHIN.
Your feedback will help expand and improve the PHIN CoPs. Please provide comments or feedback by completing the form on the Contact Us page, or by sending an email to phin@cdc.gov. To learn more about existing PHIN Communities of Practice, visit here. To Join a CoP, please complete the online form here.

via cdc.gov

Posted via web from The World We'll Inherit

Distributed Systems Laboratory at UChicago | Main Page - CSWiki

2010-01-01T10:58:00.001-08:00

Distributed Systems Laboratory (DSL) at University of Chicago

The DSL group at University of Chicago's Computer Science Department and lead by Dr. Ian Foster conducts research in various areas of distributed systems with an emphasis on designing, implementing, and evaluating systems, protocols, and applications. Our mission is to prepare the next-generation of researchers and developers in these areas by investigating challenging, high-impact research projects. These projects span many areas, including Grid middleware, Grid applications, and data-intensive scientific computing.

News
Projects
People
Publications
Theses & Dissertations
DSL Seminar
DSL Workshop
Reading & Research
Courses
Links

via dsl-wiki.cs.uchicago.edu

Posted via web from Connected Care Solutions

Grid, Distributed and Cloud Computing Resources

2010-01-01T08:40:00.001-08:00

Grid, Distributed and Cloud Computing Resources (GridResources.info) is a Subject Tracer™ Information Blog developed and created by the Virtual Private Library™. It is designed to bring together the latest resources and sources on an ongoing basis from the Internet for grid, distributed and cloud computing resources which are listed below. We always welcome suggestions of additional sites and resources to be added to this comprehensive listing and please submit by clicking here. This site has been developed and maintained by Marcus P. Zillman, M.S., A.M.H.A.; Internet expert, author, keynote speaker, and consultant. His latest white papers include Searching the Internet, Academic and Scholar Search Engines and Sources, and Knowledge Discovery Resources 2010. All of his Subject Tracer™ Information Blogs and his white papers are available from WhitePapers.us.
His latest monthly column is available by clicking here. Subscribe to his free monthly Awareness Watch™ Newsletter. Learn more by clicking here.

GRID, DISTRIBUTED AND CLOUD COMPUTING RESOURCES
3TERA - Cloud Computing Platform
http://www.3tera.com/
Access Grid Project
http://www.AccessGrid.org/
Advanced Collaboration with the Access Grid
http://www.ariadne.ac.uk/issue42/daw/
Amazon Elastic Computer Cloud (Amazon EC2)
http://aws.amazon.com/ec2/
Aneka: A Software Platform for .NET-based Cloud Computing
http://www.gridbus.org/reports/AnekaCloudPlatform2009.pdf
Apache Hadoop Core - Easily Write and Run Applications That Process Vast Amounts of Data
http://hadoop.apache.org/core/
Appistry-Cloud Computing Middleware
http://www.appistry.com/
AppNexus
http://www.appnexus.com/
Artificial Intelligence Systems Distributed Computing Project
http://www.intelligencerealm.com/aisystem/system.php
BioGRID
http://www.thebiogrid.org/
BOINC - Open-Source Software for Volunteer Computing and Grid Computing
http://boinc.berkeley.edu/
Boomi AtomSphere(SM)
http://www.boomi.com/
Building the Info Grid
http://www.ariadne.ac.uk/issue45/buildinginfogrid-rpt/
caBIG™ - cancer Biomedical Informatics Grid
https://cabig.nci.nih.gov/workspaces/Architecture/caGrid/
CenterGate Research Group LLC
http://www.centergate.com/
CISS - Canadian Internetworked Scientific Supercomputer
http://www.cs.ualberta.ca/~ciss/
Clean Energy Distributed Project
http://cleanenergy.harvard.edu/go/
Climate Prediction
http://climateprediction.net/
CloudBerry Online Backup
http://www.cloudberrylab.com/default.aspx?page=cloudberry-backup
CloudBuddy - Your Virtual Desktop
http://www.mycloudbuddy.com/
Cloud Computing and Emerging IT Platforms: Vision, Hype, and Reality for Delivering Computing as the 5th Utility
http://www.gridbus.org/reports/CloudITPlatforms2008.pdf
Cloud Computing and High-Performance Computing
http://search.techrepublic.com.com/search/cloud+computing+and+high-performance+computing.html
Cloud Computing Expo
http://cloudcomputingexpo.com/
Cloud Computing Journal
http://cloudcomputing.sys-con.com/
Cloud Computing Resource Center
http://www.deitel.com/ResourceCenters/Programming/CloudComputing/tabid/3057/Default.aspx
Cloud Computing Resource, News and Support
http://www.dabcc.com/section.aspx?sectionid=12
Cloud Computing - Wikipedia
http://en.wikipedia.org/wiki/Cloud_computing
Cloudo - The Computer Evolved
http://www.cloudo.com/
CloudSim: A Novel Framework for Modeling and Simulation of Cloud Computing
Infrastructures and Services by Rodrigo N. Calheiros1, Rajiv Ranjan1, César A. F. De Rose, and Rajkumar Buyya
http://www.gridbus.org/reports/CloudSim-ICPP2009.pdf
Cluster Computing: The Journal of Networks, Software Tools and Applications
http://www.springerlink.com/link.asp?id=101766
Cluster Resources
http://www.clusterresources.com/
Community Grids Lab
http://www.communitygrids.iu.edu/
Condor Project - High Throughput Computing
http://www.cs.wisc.edu/condor/
Cosmogrid - Grid-enabled Computational Physics of Natural Phenomena
http://www.cosmogrid.ie/
D2OL - Drug Design and Optimization Lab - Discover Drug Candidates
http://www.d2ol.com/
DataMiningGrid Consortium
http://www.datamininggrid.org/
Deep Web Research
http://www.DeepWebResearch.info/
dhtmlxGrid - Ajax-enabled DHTML Grid with Rich Javascript API
http://www.dhtmlx.com/docs/products/dhtmlxGrid/
Digipede Technologies - Distributed Computing Solutions on Microsoft.NET Platform
http://www.digipede.net/
Distributed.net - Node Zero
http://www.distributed.net/
Distributed Computing Resources
http://www.jamesthornton.com/hotlist/distcomp.html
Distributed Generic Information Retrieval (DiGIR)
http://digir.sourceforge.net/
Distributed Search Engines
http://www.openp2p.com/pub/t/74
Distributed Systems - Google Code University
http://code.google.com/edu/parallel/index.html
Distributed Systems Laboratory at University of Chicago
http://dsl.cs.uchicago.edu/
Economy Grid (EcoGrid) Project
http://www.gridbus.org/~raj/ecogrid/
EGEE: Enabling Grids for E-science in Europe
http://egee-intranet.web.cern.ch/egee-intranet/gateway.html
Einstein@Home Distributed Computing Research Project
http://einstein.phys.uwm.edu/
EuroGRID
http://www.eurogrid.org/
ExcelGrid
http://www.gridbus.org/excelgrid/
eyeOS - Cloud Computing Operating System - Web Desktop - Web OS - Web Office
http://www.eyeos.org/
FightAIDS@Home Distributed Computing Research Project
http://fightaidsathome.scripps.edu/
Flexiscale
http://www.flexiscale.com/
Folding@Home Distributed Computing
http://folding.stanford.edu/
Force.com - Cloud Computing for the Enterprise
http://www.Force.com/
Ganglia - Scalable Distributed Monitoring System for Clusters, Grids and Clouds
http://ganglia.info/
Genome@home
http://www.stanford.edu/group/pandegroup/genome/
GGF Document Process - Final Documents (Global Grid Forum)
http://www.ggf.org/documents/final.htm
GIS Working Group - Global Grid Forum Information Services Area Group Charter
http://www-unix.mcs.anl.gov/gridforum/gis/
Gladinet Cloud - Delivering Cloud Services to Your Desktop and Operating System
http://www.gladinet.com/
GoGrid
http://www.gogrid.com/
Google™ App Engine - Run Your Web Apps On Google's Infrastructure
http://code.google.com/appengine/
Google™ Apps - Software-As-a-Service for Business Email, Information Sharing and Security
http://www.google.com/apps/intl/en/business/index.html
Google™ Directory - Cloud Computing
http://snipurl.com/ddrdr
Google™ Directory - Distributed Computing
http://snipurl.com/8jv3
Google™ Directory - Parallel Computing
http://snipurl.com/8jv6
GRACE - GRid seArch and Categorization Engine
http://www.ub.uni-stuttgart.de/grace/
GRID.ORG ™ - Grid Computing Projects
http://www.grid.org/
Grid Application and Deployment Projects
http://www-fp.mcs.anl.gov/~foster/grid-projects/
Grid Application Development Sofware Project (GrADS)
http://hipersoft.cs.rice.edu/grads/
GridBlocks
http://gridblocks.hip.fi/
GridCafe - The Place for Everybody To Learn About Grid Computing
http://www.gridcafe.org/
Grid Computing - IEEE Distributed Systems Online
http://dsonline.computer.org/gc/
Grid Computing Info Centre (GRID Infoware)
http://www.gridcomputing.com/
Grid Computing Planet
http://gridcomputingplanet.com/
Grid Forum
http://www.gridforum.org/
GridIron™ XLR8™
http://www.gridironsoftware.com/
GridLab: A Grid Application Toolkit and Testbed
http://www.gridlab.org/
Grid Market Directory (GMD)
http://www.gridbus.org/gmd/
Grid Markets Project
http://www.lesc.ic.ac.uk/markets/
GridMiner - Intelligent Grid Solutions
http://www.gridminer.org/
Grid Performance and Information Services (GGF)
http://www-didc.lbl.gov/GridPerf/
GridRepublic - Volunteer Computing
http://www.gridrepublic.org/
GridServer - Grid Computing for Business Critical Applications
http://www.datasynapse.com/
GridSim: A Grid Simulation Toolkit for Resource Modelling and Application Scheduling for Parallel and Distributed Computing
http://www.gridbus.org/gridsim/
GridSim Toolkit -- Resource Modeling and Scheduling Simultation
http://www.buyya.com/gridsim/
GRID'XY: IEEE/ACM Grid Computing International Workshop
http://www.gridcomputing.org/
GriPhyN - Grid Physics Network
http://www.griphyn.org/
Grub's Distributed Web Crawling Project
http://www.grub.org/
IBM Cloud Computing
http://www.ibm.com/ibm/cloud/
IEEE Distributed Systems Online
http://dsonline.computer.org/
IEEE Task Force on Cluster Computing
http://www.ieeetfcc.org/
iland Workforce Cloud
http://www.iland.com/solutions/workforce-cloud
Institute of Parallel and Distributed Systems (IPVS)
http://www.ipvs.uni-stuttgart.de/start/en
Internet-based Distributed Computing Projects
http://distributedcomputing.info
IRIS: Infrastructure for Resilient Internet Systems
http://iris.lcs.mit.edu/
JCGrid Web (Java Grid Computing)
http://jcgrid.sourceforge.net/
Journal of Grid Computing
http://www.springerlink.com/link.asp?id=111140
JXTA Project
http://www.jxta.org/
Lawrence Berkeley National Laboratory - Above the Clouds: A Berkeley View of Cloud Computing
http://www.lbl.gov/CS/
LHC@home Distributed Computing Research Project
http://lhcathome.cern.ch/
Manchester HEP Grid Working Group
http://www.hep.grid.ac.uk/grid/
Manjrasoft - Innovative Cloud and Grid Computing Technologies
http://www.manjrasoft.com/
Mersenne Prime Search
http://www.mersenne.org/
Microsoft Cloud Computing Tools
http://msdn.microsoft.com/en-us/vstudio/cc972640.aspx
Microsoft Live Mesh
https://www.mesh.com/Welcome/default.aspx
Milkyway@Home - Help Discover the Structures in the Milky Way Galaxy
http://milkyway.cs.rpi.edu/milkyway/
Mithral - Client-Server Software Development Kit (CSSDK)
http://www.mithral.com/products/cs-sdk/
MoneyBee
http://uk.moneybee.net/
MusicGrid - A Case Study in Broadband Video Collaboration by Hassan Masum, Martin Brooks, and John Spence
http://firstmonday.org/htbin/cgiwrap/bin/ojs/index.php/fm/issue/view/184
myGrid
http://www.mygrid.org.uk/
MyGrid - Open Source Grid and Grid Middleware
http://mygrid.sourceforge.net/
MysterNetworks - The Evolution of Peer-to-Peer
http://www.mysternetworks.com/
National Centre for eSocial Science (NCeSS)
http://www.ncess.ac.uk/
NetSolve GridSolve
http://icl.cs.utk.edu/netsolve/
Network World Fusion
http://www.nwfusion.com/
NeuroGrid - P2P Search
http://www.neurogrid.net/
NextGRID: Architecture for Next Generation Grids
http://www.nextgrid.org/
NIST Cloud Computing Definition
http://csrc.nist.gov/groups/SNS/cloud-computing/index.html
NMI-EDIT Consortium
http://www.nmi-edit.org/
NSF Middleware Initiative
http://www.nsf-middleware.org/
NVIDIA Tesla Personal Supercomputer
http://www.nvidia.com/object/personal_supercomputing.html
OGCE - Open Grid Computing Environments Collaboratory
http://www.ogce.org/
OneHub - Flexible Cloud to Share Files, Manage Projects and Online Collaboration
http://onehub.com/
Open Cluster Group
http://www.openclustergroup.org/
Open Data Grid
http://grid.okfn.org/
Open Grid Forum - Applied Distributed Computing
http://www.ggf.org/
OpenP2P.com
http://www.openp2p.com/
OpenSim - Open Grid Services
http://www.opensimulator.org/
Open Science Grid
http://www.opensciencegrid.org/
OSCAR : Open Source Cluster Application Ressources
http://www.csm.ornl.gov/oscar/
Parabon Computation - Internet Computing is Computing Outside the Box
http://www.parabon.com/
Parasitic Computing
http://www.nd.edu/~parasite/
Paremus - Redefining Enterprise Grid
http://www.paremus.com/
PCs Do Thousands of Years of Work By Jo Twist
http://news.bbc.co.uk/1/hi/sci/tech/4270241.stm
Peer to Peer Working Group - P2P WG - Internet2
http://p2p.internet2.edu/
PlanetLab
http://www.planet-lab.org/
Platform GRID Computing
http://www.platform.com/
Proteins@home Distributed Computing Research Project
http://biology.polytechnique.fr/proteinsathome/
Public Data Sets on AWS
http://aws.amazon.com/publicdatasets/
PVM: Parallel Virtual Machine
http://www.csm.ornl.gov/pvm/
QADPZ - Quite Advanced Distributed Parallel Zystem
http://qadpz.sourceforge.net/
Quadrics
http://www.quadrics.com/
RackSpace Cloud - Cloud Computing, Cloud Hosting and Online Storage
http://www.rackspacecloud.com/
Reservoir - Infrastructure for Cloud Computing
http://www.reservoir-fp7.eu/
rPath - A Pragmatic, Incremental Approach to Cloud Computing
http://www.rpath.com/corp/cloud-adoption-model?pi_ad_id=2947665472&gclid=CLzfgpmhk5kCFQITswodsmUaZw
RSS Cloud
http://www.RSSCloud.org/
SETI@home: Search for Extraterrestrial Intelligence
http://setiathome.berkeley.edu/
SmartFrog - Smart Framework for Object Groups
http://www.hpl.hp.com/research/smartfrog/
Spinhenge@home Distributed Computing Research Project
http://spin.fh-bielefeld.de/
Stratos Learning - Cloud Computing Education
http://stratoslearning.com/
Sun Grid Engine -- Data Sheet
http://wwws.sun.com/software/gridware/datasheet.html
Swarm - A Transparently Scalable Distributed Programming Language
http://code.google.com/p/swarm-dpl/
SZTAKI Desktop Grid
http://desktopgrid.hu/
TeraGrid
http://www.teragrid.org/
Terremark Enterprise Cloud
http://www.theenterprisecloud.com/
The Beowulf Cluster Site
http://www.beowulf.org/
The ChessBrain Network
http://www.chessbrain.net/
The Cloud, Cloud Computing, Cloud Hosting, and Cloud Services
http://www.mosso.com/
The DataGrid Project
http://eu-datagrid.web.cern.ch/
The Globus Alliance
http://www.globus.org/
The GRIDS Lab and the Gridbus Project
http://www.gridbus.org/
The Open GRiD Project
http://www.ecsl.cs.sunysb.edu/~maxim/OpenGRiD/
The Semantic Grid
http://www.semanticgrid.org/
ThinkCycle - Open Distributed Collaborative Design
http://www.thinkcycle.org/
TOP500 Supercomputer Sites
http://www.top500.org/
UNICORE Distributed Computing and Data Resources
http://www.unicore.eu/
UPnP™ Forum
http://www.upnp.org/
University of Florida - OCEAN Project
http://www.cise.ufl.edu/research/ocean/
VMLogix LabManager - Cloud Edition
http://www.vmlogix.com/VMLogix-LabManager-Cloud-Edition-Solution/
WaveMaker - Open Source Development Platform
http://www.WaveMaker.com/
Web Services Grid Application Framework (WS-GAF)
http://www.neresc.ac.uk/ws-gaf/
World Community Grid for Health Research
http://www.worldcommunitygrid.org
Worldwide Virtual Computer - Legion
http://www.cs.virginia.edu/~legion/
WS GRAM - Grid Resource Allocation and Management (GRAM)
http://www-unix.globus.org/toolkit/docs/3.2/gram/ws/
XtremWeb - Opensource Platform for Desktop Grids
http://www.XtremWeb.net
Yahoo! Directory Computer Science > Distributed Computing
http://dir.yahoo.com/Science/Computer_Science/Distributed_Computing/
ZDNet - Grid Resources
http://updates.zdnet.com/tags/grid.html
Current Subject Tracer™ Information Blogs:
Accessibility Resources
http://www.AccessibilityResources.info/
Agriculture Resources
http://www.AgricultureResources.info/
Artificial Intelligence Resources
http://www.AIResources.info/
Astronomy Resources
http://www.AstronomyResources.info/
Auction Resources
http://www.AuctionResources.info/
Biological Informatics
http://www.biologicalinformatics.info/
Biotechnology Resources
http://www.BiotechnologyResources.info/
Bot Research
http://www.botresearch.info/
Business Intelligence Resources
http://www.biresources.info/
ChatterBots
http://www.ChatterBots.info/
Data Mining Resources
http://www.DataMiningResources.info/
Deep Web Research
http://www.deepwebresearch.info/
Directory Resources
http://www.DirectoryResources.info/
eCommerce Resources
http://www.eCommerceResources.info/
Elder Resources
http://www.ElderResources.info/
Employment Resources
http://www.EmploymentResources.info/
Entrepreneurial Resources
http://www.EntrepreneurialResources.info/
Financial Sources
http://www.FinancialSources.info/
Finding People
http://www.FindingPeople.info/
Games Resources
http://www.GamesResources.info/
Genealogy Resources
http://www.GenealogyResources.info/
Grant Resources
http://www.GrantResources.info/
Green Files
http://www.GreenFiles.info/
Grid, Distributed and Cloud Computing Resources
http:/www.GridResources.info/
Healthcare Resources
http://www.healthcareresources.info/
Information Futures Markets
http://www.InformationFuturesMarkets.com/
Information Quality Resources
http://www.InformationQualityResources.info/
International Trade Resources
http://www.InternationalTradeResources.info/
Internet Alerts
http://www.InternetAlerts.info/
Internet Demographics
http://www.internetdemographics.info/
Internet Experts
http://www.internetexperts.info/
Internet Hoaxes
http://www.internethoaxes.info/
Intrapreneurial Resources
http://www.IntrapreneurialResources.info/
Journalism Resources
http://www.JournalismResources.info/
Knowledge Discovery
http://www.knowledgediscovery.info/
Military Resources
http://www.MilitaryResources.info/
New Economy Analytics, Resources and Alerts
http://www.NewEconomyAnalytics.com/
Outsourcing/Offshoring Information and Resources
http://www.OutsourcingOffshore.us/
Privacy Resources
http://www.PrivacyResources.info/
Reference Resources
http://www.ReferenceResources.info/
Research Resources
http://www.researchresources.info/
RestStress™
http://www.RestStress.com/
Script Resources
http://www.ScriptResources.info/
ShoppingBots
http://www.ShoppingBots.info/
Social Informatics
http://www.SocialInformatics.net/
Statistics Resources
http://www.statisticsresources.info/
Student Research
http://www.studentresearch.info/
Theology Resources
http://www.TheologyResources.info/
Tutorial Resources
http://www.TutorialResources.info/
World Wide Web Reference
http://www.WWWReference.info/
© 2010 Marcus P. Zillman, M.S., A.M.H.A.

via gridresources.blogspot.com

Great list of Grid computing projects and information sources.

Posted via web from The World We'll Inherit

California hospital's implementation of open-source EHR bears watching | EHR Watch

2009-12-10T00:45:00.001-08:00

By the end of the year, Kern Medical Center, a county-owned 222-bed acute-care teaching hospital in Bakersfield, Calif., will have implemented Medsphere Systems’ OpenVista electronic health record (EHR). This deployment bears watching because it may become a trend in terms of providers adopting an open-source EHR.

For one, 2011 is the first year that providers can qualify for bonuses, or increased Medicare reimbursements, under ARRA. That’s shy of a year away from now. I think it’s virtually impossible to implement an EHR and derive meaningful use from it all within a year if you go the traditional, multi-million dollar, multi-year route. But KMC pointed out that the reason it chose OpenVista, which is the commercial version of the Dept. of Veterans Affairs’ VistA EHR, is for its ability to go live rapidly and its lower cost of implementation and maintenance.

In these tough economic times healthcare systems need to do more with less. KMC provides care for more than 16,000 inpatients annually, while its clinics provide care and services for more than 100,000 patients. Its emergency department handles some 43,000 visits per year. The data may be old (fiscal year 2001-2002), but they’re still relevant, especially for healthcare systems like KMC. Over the past three fiscal years prior to 2001-2002, the average daily patient census has increased. With nearly 75 percent of its patients either indigent or on Medi-Cal, KMC has to find ways to become more cost efficient in its delivery of care. On top of that, as a healthcare provider to county inmates and juvenile detainees the hospital system must also meet legal requirements for inmate and juvenile medical care. The KMC folks are banking on an open-source EHR to improve clinical outcomes in a cost-efficient manner.

What you’ll likely see in 2010 are resource-strapped healthcare systems that nonetheless believe in the clinical and financial benefits of health IT. The ARRA bonuses serve as an incentive to implement EHRs. The short timeline for qualification, however, is what will drive healthcare systems to choose EHRs that have a quick, inexpensive implementation.

The next step is achieving meaningful use. Stay tuned.

via ehrwatch.com

Open source systems are gaining acceptance in early phases of EHR adoption. Medicare reimbursement rates and whether choice of open source positively or negatively affects reimbursement policy will be the determinant of open source EHRs ultimate success/failure when 'meaningful use' guidelines are finally released in the coming months. Stay tuned...

Posted via web from Connected Care Solutions

Hilton Head Island Fire & Rescue STEMI Program - Understanding the Prehospital 12-lead ECG

2009-12-04T12:30:00.001-08:00

Check out this SlideShare Presentation: South Carolina Regional Prehospital STEMI Network outlined from the perspective of the emergency responder. 12-lead ECG procedures and criteria for analysis in the prehospital setting is outlined in detail. Includes very informative breakdown of actual ECG strips; indentifies characteristics of a STEMI Alert and outlines clinical reasoning behind the interpretation of the ECG taken by paramedics. Great resource for developing understanding of data captured by 12-lead ECG and the implications of this data on the acute nature of the patient's condition.

HHIFR STEMI Program - September 2009 Case Study

View more presentations from Tom B..

HHIFR STEMI Program - October 2009 Case Study

View more presentations from Tom B..

GE Healthymagination Fund - Investment Platform

2009-11-09T20:24:00.001-08:00

Investment Platform

The Healthymagination Fund draws on capabilities from across GE Healthcare, GE Capital and GE Global Research and has a global footprint. The investment committee is comprised of senior leaders of these groups.

via healthymaginationfund.com

Exciting new $250mm HIT investment fund launched by GE Capital offers unprecedentedly aggressive and bullish HIT private equity joint venture. Ideas abound...

Posted via web from Connected Care Solutions

KeithHennessey.com » The legislative landscape for health care after House passage » Print

2009-11-09T20:10:00.001-08:00

The legislative landscape for health care after House passage

Posted By kbh On November 9, 2009 @ 12:45 pm In budget, featured, health | 8 Comments

The House passed their version of health care reform Saturday night on a 220-215 vote. Today I’m going to update my projections and analysis, and focus on upcoming “pivot points” in the health care debate.

Pass a partisan comprehensive bill through the House and through the regular Senate process with 60, leading to a law this year; (was 50% –> 40%)

Pass a partisan comprehensive bill through the House and through the reconciliation process with 51 Senate Democrats, leading to a law this year; (was 10% –> 20%)

Fall back to a much more limited bill that becomes law this year; (was 10% –> 20%)

No bill becomes law this year Congress. Process continues into next year. (was 29.99% –> 20%)

I have adjusted the scenarios based on two assumptions, making the new numbers not precisely comparable with the old:

I assume the Finance Committee bipartisan solution path is dead (I only had it at 0.01% chance last time); and

I assume virtually no chance of a signed law this year, so I have adapted the timeframes accordingly. I say this despite recent statements from the President and Leader Reid that they want/intend to get a law by 31 December.

Pivot points and the importance of recess

Pivot points (my term) are opportunities for legislative momentum to shift. These opportunities are to some extent predictable. This past week had four pivot points, which is extraordinary:

Election Day – loss of momentum for D’s;

the Senate Democratic Policy Lunch on Tuesday – loss of momentum for D’s;

Friday’s politically challenging employment report – loss of momentum for D’s; and

Saturday night’s House passage vote – momentum gain for D’s.

Sometimes a pivot point will pass without any noticeable change in the legislative outlook. But to the extent these dates/events are predictable, it at least tells you when to look for important shifts.

Here are obvious pivot points over the next few months:

every Tuesday after the Senate Democratic Policy Lunch;

whenever CBO releases its score of the Reid substitute amendment;

the Monday/Tuesday after Thanksgiving recess;

Friday, December 4th, when the next jobs report is released;

Th/F December 17-18, the end of the week before the Christmas recess;

the first week Members are back in DC after the holiday recess;

late January, for the President’s State of the Union Address.

The most potentially significant consequence of the slower schedule is that Members will be home for two long recesses before a bill might be completed. Will Members feel the same intensity of pressure they did in August? If so, that could greatly shift momentum.

Will Leader Reid will begin Senate floor consideration before Thanksgiving recess? If he does, then he will probably have to show his amendment to the world before that recess, and expose his Members to pressure on specific text over that short break. If he waits until after recess, his Members may have a slightly less painful Thanksgiving break, but at the expense of lost time on the backend and a lower probability of Senate passage before Christmas. I would expect him to try to “back up” final passage before the Christmas recess, by in effect telling the Senate around December 18th “you can go home for Christmas only after we’ve finished the bill.” The smell of jet fumes is usually enough to cause Members to vote aye on cloture to shut off a filibuster, but in this case I’m not so sure.

The three-part strategic question

In December Democratic leaders may face a two-part strategic question:

If we cannot hold 60 D’s, do we use reconciliation to pass a bill with 51, or instead go for 60 on a much more limited bill?

When do we make this decision?

Conference or ping pong?

My survey of (Republican) insiders is split on what Democrats may decide on (1), but nearly unanimous on question (2): almost all say this strategic shift would come in January at the earliest. The earliest projection was December 18th.

I assume liberals would prefer a reconciliation path that would probably produce a bill closer to the House-passed bill, at the price of painfully splitting off moderate Senate Democrats. This is a slash-and-burn partisan path, but may be the highest probability path to a signed law. I also assume moderate Democrats would prefer a scaled-back bill. We know Democratic moderates would support the Finance Committee reported bill, so if Senate liberals could swallow hard and wait for the next step, this would be the easiest path to Senate passage. Leader Reid tacked away from this when he announced his amendment would contain a strong public option.

If the Senate can pass a bill, Democratic leaders will need to wrestle with question (3).

Conference or ping pong?

Everyone knew the House would eventually pass something, given the enormous Democratic margin in the House. House Republicans were more effective in their resistance than I anticipated. This contributes to an apparent loss of momentum in the Senate. There are now two games ahead: Senate passage, and reconciling differences between the House and Senate.

In theory, if the Senate passes a bill, the chance of a law skyrockets. But the House passed its bill with a left-edge coalition – most of the Democratic no votes were from moderates. If the Senate passes a bill through regular order (with 60 votes), it will be relatively more moderate, and more compatible with an alliance on the other side of Pelosi’s caucus. This could be quiet difficult. How do Speaker Pelosi and Leader Reid work out differences between a bill that Lieberman, Nelson, and Lincoln support and one opposed by moderate House D’s? Splitting the difference may alienate both sides of the Democratic caucuses. We’re already starting to see lines drawn in the sand on abortion.

This is why some observers think Senate passage may lead to ping pong rather than a conference. Normally after the House and Senate pass versions of a bill, the body that votes second requests a conference with the other body and appoints a handful of members to be conferees. The second body then agrees to a conference and appoints its own conferees. The conferees negotiate and produce pretty much whatever new text they want, although they generally stay within the scope of the contents of the two bills. The conference report language must then be passed by both bodies to go to the President.

Ping pong is a colloquial term for skipping conference. The House-passed bill will soon arrive in the Senate. The Senate will presumably take up the House bill and amend it. If and when the Senate passes its version, it would not request a conference, and would not appoint conferees, but would instead send the amended bill back to the House. the House could then try to further amend the Senate bill, or just take it up and pass it. This ping pong can go back and forth a few times.

Conventional wisdom seems to be that House and Senate Democratic leaders are intensely focused on the downsides of a conference. It puts tremendous pressure on the leaders and conferees to resolve differences. It also gives House and Senate Republicans certain procedural opportunities to cause mischief before and during conference.

But ping pong has its own downsides. The minority, especially in the Senate, gets another crack at amending the bill. Smart money would bet today on ping pong rather than a conference, but I expect this to be revisited often over the next couple of months.

My projections

It is highly likely the legislative process will continue at least into January.

I am still projecting a 60% chance that a comprehensive bill becomes law this year, but I have shifted some of that 60% from the regular order path to the reconciliation path. By itself I’d never expect the Senate to shift to a reconciliation path after failing to get 60 – Senate-only logic says heck no, and the strain on Reid’s caucus would be too great. But if Democratic leaders are forced to shift away from regular order on a comprehensive bill, I would guess that Speaker Pelosi would push hard for the Senate to use reconciliation to produce a bill more compatible with the House-passed bill rather than dialing back expectations. This puts me at 40% regular order success, 20% reconciliation success, 20% fall back to a narrower bill, and a 20% chance the whole thing implodes. It’s the slow pace and the two intervening recesses that give me hope.

Insiders: Please send me your thoughts privately, especially if you disagree.

(photo credit: Speaker Pelosi’s site ^[1])

Article printed from KeithHennessey.com: http://keithhennessey.com

URL to article: http://keithhennessey.com/2009/11/09/after-house-passage/

URLs in this post:
[1] Speaker Pelosi’s site: http://www.speaker.gov/newsroom/photogallery?id=0009

Click here to print.

via keithhennessey.com

Analyzing the impact of the House vote to pass health reform this past weekend.

Posted via web from Connected Care Solutions

KeithHennessey.com » The legislative landscape for health care after House passage » Print

2009-11-09T20:09:00.001-08:00

The legislative landscape for health care after House passage

Posted By kbh On November 9, 2009 @ 12:45 pm In budget, featured, health | 8 Comments

The House passed their version of health care reform Saturday night on a 220-215 vote. Today I’m going to update my projections and analysis, and focus on upcoming “pivot points” in the health care debate.

Pass a partisan comprehensive bill through the House and through the regular Senate process with 60, leading to a law this year; (was 50% –> 40%)

Pass a partisan comprehensive bill through the House and through the reconciliation process with 51 Senate Democrats, leading to a law this year; (was 10% –> 20%)

Fall back to a much more limited bill that becomes law this year; (was 10% –> 20%)

No bill becomes law this year Congress. Process continues into next year. (was 29.99% –> 20%)

I have adjusted the scenarios based on two assumptions, making the new numbers not precisely comparable with the old:

I assume the Finance Committee bipartisan solution path is dead (I only had it at 0.01% chance last time); and

I assume virtually no chance of a signed law this year, so I have adapted the timeframes accordingly. I say this despite recent statements from the President and Leader Reid that they want/intend to get a law by 31 December.

Pivot points and the importance of recess

Pivot points (my term) are opportunities for legislative momentum to shift. These opportunities are to some extent predictable. This past week had four pivot points, which is extraordinary:

Election Day – loss of momentum for D’s;

the Senate Democratic Policy Lunch on Tuesday – loss of momentum for D’s;

Friday’s politically challenging employment report – loss of momentum for D’s; and

Saturday night’s House passage vote – momentum gain for D’s.

Sometimes a pivot point will pass without any noticeable change in the legislative outlook. But to the extent these dates/events are predictable, it at least tells you when to look for important shifts.

Here are obvious pivot points over the next few months:

every Tuesday after the Senate Democratic Policy Lunch;

whenever CBO releases its score of the Reid substitute amendment;

the Monday/Tuesday after Thanksgiving recess;

Friday, December 4th, when the next jobs report is released;

Th/F December 17-18, the end of the week before the Christmas recess;

the first week Members are back in DC after the holiday recess;

late January, for the President’s State of the Union Address.

The most potentially significant consequence of the slower schedule is that Members will be home for two long recesses before a bill might be completed. Will Members feel the same intensity of pressure they did in August? If so, that could greatly shift momentum.

Will Leader Reid will begin Senate floor consideration before Thanksgiving recess? If he does, then he will probably have to show his amendment to the world before that recess, and expose his Members to pressure on specific text over that short break. If he waits until after recess, his Members may have a slightly less painful Thanksgiving break, but at the expense of lost time on the backend and a lower probability of Senate passage before Christmas. I would expect him to try to “back up” final passage before the Christmas recess, by in effect telling the Senate around December 18th “you can go home for Christmas only after we’ve finished the bill.” The smell of jet fumes is usually enough to cause Members to vote aye on cloture to shut off a filibuster, but in this case I’m not so sure.

The three-part strategic question

In December Democratic leaders may face a two-part strategic question:

If we cannot hold 60 D’s, do we use reconciliation to pass a bill with 51, or instead go for 60 on a much more limited bill?

When do we make this decision?

Conference or ping pong?

My survey of (Republican) insiders is split on what Democrats may decide on (1), but nearly unanimous on question (2): almost all say this strategic shift would come in January at the earliest. The earliest projection was December 18th.

I assume liberals would prefer a reconciliation path that would probably produce a bill closer to the House-passed bill, at the price of painfully splitting off moderate Senate Democrats. This is a slash-and-burn partisan path, but may be the highest probability path to a signed law. I also assume moderate Democrats would prefer a scaled-back bill. We know Democratic moderates would support the Finance Committee reported bill, so if Senate liberals could swallow hard and wait for the next step, this would be the easiest path to Senate passage. Leader Reid tacked away from this when he announced his amendment would contain a strong public option.

If the Senate can pass a bill, Democratic leaders will need to wrestle with question (3).

Conference or ping pong?

Everyone knew the House would eventually pass something, given the enormous Democratic margin in the House. House Republicans were more effective in their resistance than I anticipated. This contributes to an apparent loss of momentum in the Senate. There are now two games ahead: Senate passage, and reconciling differences between the House and Senate.

In theory, if the Senate passes a bill, the chance of a law skyrockets. But the House passed its bill with a left-edge coalition – most of the Democratic no votes were from moderates. If the Senate passes a bill through regular order (with 60 votes), it will be relatively more moderate, and more compatible with an alliance on the other side of Pelosi’s caucus. This could be quiet difficult. How do Speaker Pelosi and Leader Reid work out differences between a bill that Lieberman, Nelson, and Lincoln support and one opposed by moderate House D’s? Splitting the difference may alienate both sides of the Democratic caucuses. We’re already starting to see lines drawn in the sand on abortion.

This is why some observers think Senate passage may lead to ping pong rather than a conference. Normally after the House and Senate pass versions of a bill, the body that votes second requests a conference with the other body and appoints a handful of members to be conferees. The second body then agrees to a conference and appoints its own conferees. The conferees negotiate and produce pretty much whatever new text they want, although they generally stay within the scope of the contents of the two bills. The conference report language must then be passed by both bodies to go to the President.

Ping pong is a colloquial term for skipping conference. The House-passed bill will soon arrive in the Senate. The Senate will presumably take up the House bill and amend it. If and when the Senate passes its version, it would not request a conference, and would not appoint conferees, but would instead send the amended bill back to the House. the House could then try to further amend the Senate bill, or just take it up and pass it. This ping pong can go back and forth a few times.

Conventional wisdom seems to be that House and Senate Democratic leaders are intensely focused on the downsides of a conference. It puts tremendous pressure on the leaders and conferees to resolve differences. It also gives House and Senate Republicans certain procedural opportunities to cause mischief before and during conference.

But ping pong has its own downsides. The minority, especially in the Senate, gets another crack at amending the bill. Smart money would bet today on ping pong rather than a conference, but I expect this to be revisited often over the next couple of months.

My projections

It is highly likely the legislative process will continue at least into January.

I am still projecting a 60% chance that a comprehensive bill becomes law this year, but I have shifted some of that 60% from the regular order path to the reconciliation path. By itself I’d never expect the Senate to shift to a reconciliation path after failing to get 60 – Senate-only logic says heck no, and the strain on Reid’s caucus would be too great. But if Democratic leaders are forced to shift away from regular order on a comprehensive bill, I would guess that Speaker Pelosi would push hard for the Senate to use reconciliation to produce a bill more compatible with the House-passed bill rather than dialing back expectations. This puts me at 40% regular order success, 20% reconciliation success, 20% fall back to a narrower bill, and a 20% chance the whole thing implodes. It’s the slow pace and the two intervening recesses that give me hope.

Insiders: Please send me your thoughts privately, especially if you disagree.

(photo credit: Speaker Pelosi’s site ^[1])

Article printed from KeithHennessey.com: http://keithhennessey.com

URL to article: http://keithhennessey.com/2009/11/09/after-house-passage/

URLs in this post:
[1] Speaker Pelosi’s site: http://www.speaker.gov/newsroom/photogallery?id=0009

Click here to print.

via keithhennessey.com

Analyzing the impact of the House vote to pass health reform this past weekend.

Posted via web from Connected Care Solutions

GE Healthymagination Fund - Investment Platform

2009-11-09T19:45:00.003-08:00

Investment Platform

The Healthymagination Fund draws on capabilities from across GE Healthcare, GE Capital and GE Global Research and has a global footprint. The investment committee is comprised of senior leaders of these groups.

via healthymaginationfund.com

Exciting new $250mm HIT investment fund launched by GE Capital offers unprecedentedly aggressive and bullish HIT private equity joint venture. Ideas abound...

Posted via web from Connected Care Solutions

GE Healthymagination Fund - Investment Platform

2009-11-09T19:45:00.001-08:00

Investment Platform

The Healthymagination Fund draws on capabilities from across GE Healthcare, GE Capital and GE Global Research and has a global footprint. The investment committee is comprised of senior leaders of these groups.

via healthymaginationfund.com

Exciting new $250mm HIT investment fund launched by GE Capital offers unprecedentedly aggressive and bullish HIT private equity joint venture. Ideas abound...

Posted via web from Connected Care Solutions

Stimulus creates huge demand for HIT professionals | FierceHealthIT.com

2009-11-09T19:32:00.001-08:00

With all the new money flowing into health IT, particularly with the $35 billion or so in federal money (a net $19 billion after accounting for expected efficiency savings) for electronic health records, someone's going to have to build, install, deploy and train people to use the systems, right? Studies estimate that there was a need for 10,000 to 15,000 new health IT professionals nationwide, but those were conducted before the enactment of the federal stimulus back in February. So there's clearly a huge demand for a health IT workforce, Health Leaders Media reports.

More recently, the an American Hospital Association survey found that 25 percent of responding organizations are shorthanded when it comes to IT staff and expertise. However, the economic downturn that has left so many talented IT professionals unemployed could provide an unprecedented opportunity for healthcare. "We have to figure out a strategy to take IT professionals from other disciplines and orient them to healthcare, and then look at the educational system and the places where they are training people who are specializing in healthcare issues to beginning to look at healthcare IT as a piece of the curriculum," says AHA spokesman Rick Wade.

While these seasoned IT pros can be of immediate help in building secure infrastructure, they will have to be trained for the unique needs of healthcare. "It's all about understanding clinical business processes," says Alex Rodriguez, CIO of St. Elizabeth Healthcare in Edgewood, Ky. "That is the separation-being able to have the communication skills to dive into how the business processes work, the communication skills and the thinking skills to determine how the new technology applications are going to be used," he explains to Health Leaders.

While the increased demand could drive up salaries, Rodriguez says people are looking for professional growth and stability in these trying times, so hospitals may not have to break the bank when augmenting their health IT staff.

For more on the staffing implications of the stimulus:
- take a look at this Health Leaders Media story

Related Articles:
Blumenthal: Conversion to EMR will create 50,000 new HIM jobs
Economic woes or not, it's full speed ahead for AHIMA '09
Many more HIT pros needed as EMRs roll out

via fiercehealthit.com

Musings on HIT, health reform message management and the twenty-second amendment...

Health IT is not getting the attention in needs from the senior White House officials and it must be elevated to a central issue during the next phase in the legislative process to pass health reform - The Senate. Health IT has always been the most directly attractive core element of the president's plan, but it has been missing from the fundamental arguments made directly to the American people, a critical error in strategy as it may be the only idea with little resistance on either side of the aisle. Not only is health information technology politically popular, its also one of the very few threads of the larger and infinitely more complex health reform debate that nearly every consumer can understand at a high level.

'Connected Care' and 'Telemedicine' provide the most obvious opportunity to create an emotional investment among voters in the "meat and potatoes" of how Obama's reform initiative will accelerate the modernization medical business. Rahm would be wise to shift debate whenever possible on Sunday circuit away from the billion dollar price tags that currently dominates the discussion and onto the opportunities available for jobs, higher quality health care, and a "smarter" society - steal it from IBM's most recent commercials if you must.

If voters believe that a plan exists that would achieve hyper-saturation of new bioinformatics-driven hardware and software products for consumers - mobile hardware and software needed to facilitate telemedicine services at the level of individual practices and regional health systems - re-election is a slam dunk and the twenty-second amendment (Presidential Term-Limits) could be justifiably revisited. While a lifetime of Barack is a nausating thought, the twenty-second amendment was a mistake and a strong argument could be made that it has prevented the most qualified man in America from re-entering public service - Bill Clinton. Without any legitimate reasoning as to why ambition and uncharacteristic success at a young age should somehow deprive great leaders from leading. Nobody benefits from suppression of genius under any circumstances.

Posted via web from Connected Care Solutions

E-Bridge East Baton Rouge EMS Telemedicine Overview

2009-11-05T21:29:00.001-08:00

Check out this SlideShare Presentation on East Baton Rouge Parish EMS Dept's Wireless Pre-hospital Telemedicine Pilot Program.

E Bridge Ems Telemedicine Overview

View more presentations from Brian Edwards.

American Recovery and Reinvestment Act : Unprecedented Opportunity for Health IT

2009-10-29T11:34:00.000-07:00

Image via Wikipedia

Health Information Technology and Economic and Clinical Health Act of 2009 (HITECH Act)

It has long been legislative practice in Washington, DC to package many large spending bills together in an omnibus package that gets passed with one vote by all members, rather than debate and vote on each measure independently. These practices are especially popular when one party has the near invincible majority in both houses, not to mention an overwhelmingly popular president in the White House. Obama's American Recovery and Reinvestment Act (ARRA) is essentially an omnibus spending bill under the guise of a "stimulus package". The bundling of the HITECH Act, which radically alters the framework for implementing and managing electronic health records and general health care policy, into a spending bill sold to the American people as an "investment" in modernizing the national infrastructure and creating jobs is clever and near the top of early administration accomplishments.

Obama's first 100 days could easily be described by the phrase penned by Latin poet Hoarce carpe diem, popularly translated to mean "seize the day". The complete excerpt from the original poem reads, carpe diem quam minimum credula "seize the day and have no trust in tomorrow". I believe this completely captures Obama's mindset as he proactively spearheads efforts from the Oval Office to regain control during a time of economic crisis and reinstate confidence in the capitalist system. The purpose driven and institutionally significant changes embedded in the fine print of the ARRA shows quite clear that Obama and his Chief of Staff Rahm Emanuel seek to swiftly and indefinitely create a system that functions in a fundamentally different manner across all aspects of society and government.

Telemedicine: CMS definition and reimbursement guidelines

2009-10-08T12:34:00.001-07:00

Quoted directly from Centers for Medicare and Medicaid Services website:

Telemedicine

For purposes of Medicaid, telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient's health. Electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. Telemedicine is viewed as a cost-effective alternative to the more traditional face-to-face way of providing medical care (e.g., face-to-face consultations or examinations between provider and patient) that states may choose to cover. This definition is modeled on Medicare's definition of telehealth services located at 42 CFR 410.78. Note that the Federal Medicaid statute (Title XIX of the Social Security Act) does not recognize telemedicine as a distinct service.

Distant or Hub Site means the site at which the physician or other licensed practitioner delivering the service is located at the time the service is provided via telecommunications system.

Originating or Spoke site means the location of the Medicaid patient at the time the service being furnished via a telecommunications system occurs. Telepresenters may be needed to facilitate the delivery of this service.

Asynchronous or "Store and Forward" means transferring data from one site to another through the use of a camera or similar device that records (stores) an image that is sent (forwarded) via telecommunication to another site for consultation. Asynchronous or "store and forward" applications would not meet the above definition of telemedicine--see telehealth.

Reimbursement/Billing—Reimbursement for Medicaid covered services, including those with telemedicine applications, must satisfy federal requirements of efficiency, economy and quality of care. With this in mind, States are encouraged to use the flexibility inherent in federal law to create innovative payment methodologies for services that incorporate telemedicine technology. For example, States may reimburse the physician or other licensed practitioner at the distant site and reimburse a facility fee to the originating site. States can also reimburse any additional costs such as technical support, transmission charges, and equipment. These add-on costs can be incorporated into the fee-for-service rates or separately reimbursed as an administrative cost by the state. If they are separately billed and reimbursed, the costs must be linked to a covered Medicaid service. While telemedicine is not considered a distinct Medicaid service, any State wishing to cover/reimburse for telemedicine services should submit a State Plan Amendment to the Centers for Medicare and Medicaid Services for approval.

Medical Codes—States may select from a variety of HCPCS codes (T1014 and Q3014), CPT codes and modifiers (GT, U1-UD) in order to identify, track and reimburse for telemedicine services.

Telehealth (or Telemonitoring) is the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision and information across distance.

Telehealth includes such technologies as telephones, facsimile machines, electronic mail systems, and remote patient monitoring devices which are used to collect and transmit patient data for monitoring and interpretation. While they do not meet the Medicaid definition of telemedicine they are often considered under the broad umbrella of telehealth services. Even though such technologies are not considered "telemedicine," they may nevertheless be covered and reimbursed as part of a Medicaid coverable service under section 1905(a) of the Social Security Act such as laboratory service, x-ray service or physician services.

Other Considerations:
Medicaid guidelines require all providers to practice within the scope of their state practice act. Some States have enacted legislation which requires providers using telemedicine technology across state lines to have a valid state license in the state where the patient is located. Any such requirements or restrictions placed by the State are binding under current Medicaid rules. Medicare Conditions of Participation (COPs) applicable to settings such as long-term care facilities, and hospitals may also impact reimbursement for services provided via telemedicine technology. For instance, the Medicare COPs for long-term care facilities require physician visits at set intervals. Current regulations require that the physician must be physically present in the same room as the patient during the visit. This requirement must also be met for Medicaid to pay for services provided to Medicaid eligible patients while in a Medicare or Medicaid certified facility. Similarly, federal regulations require face-to-face visits for home health, and telemedicine cannot be used as a substitute for those visits. However, a telemedicine encounter may be used as a supplement to the required face-to-face visits.

Anyone eager to make a business out of remote care and telemedicine technologies must carefully read, re-read, and ultimately memorize the one-page guidelines above if they hope to remain a sustainable investment in the current environment. In my estimation, the most valuable by-product of a Billion-dollar US Connected Health sector will be its utility as a stimulant of hyper-innovation. Without a business plan and patient care protocols/procedures that achieve 75-100% reimbursement rates from CMS, any telemedicine program is doomed to be a money-pit regardless of the altruistic motives of its proponents. The entrepreneur who will emerge best-of-breed in telemedicine will be he/she who finds the shortest path to demonstrating "Meaningful Use" in the form of real improvement in patient outcomes.

Posted via web from Connected Care Solutions

Image via Wikipedia

Telemedicine allows for long-distance diagnoses

2009-10-08T00:54:00.001-07:00

Link: Telemedicine allows for long-distance diagnoses - The Washington Times.
As mentioned in an earlier post, 4 years ago Telemedicine was in its infancy, perhaps used for monitoring status of patients with pacemakers... Now, according to this article in the Washington Times, Dr. Kenneth Bird, a Harvard professor affiliated with Massachusetts General Hospital, innovated an approach to patient care using monitors and remote access to hospitals to examine, diagnose and treat his patients.
Also, according to the article, patients are wearing monitors that can be remotely tracked and physicians can be notified and/or paged when necessary. Telemedicine (a.k.a. Telehealth) is not a substitute for direct patient care, but rather, it is an augmentation to the existing delivery of care. That said, installation/implementation can be a huge expense (ranging between $2.5 and $3.5 million), so larger hospitals are more likely to implement remote monitoring.
The article continues with explanation of "concierge" medicine approaches, which are light years ahead of the status quo. The benefits to patients is purportedly rapid care from providers, from home or within a specialized, technology enabled facility.
It's an interesting thought, and another example of how technologies can be used to improve patient care if used appropriately. That said, there are likely significant privacy and security issues related to the "transaction" between patient and providers. For more information about HIPAA Requirements, The HIPAA Privacy Rule, The Security Rule, or The HITECH Act visit The Online HIPAA Survival Guide.
And, if you are interested in keeping current on the issues, sign up for the FREE HITECH/HIPAA Compliance Newsletter.

via feedproxy.google.com

Courtesy of Healthcare & Technology Blog (By: Deborah Leyva): http://www.myhealthtechblog.com/2009/10/telemedicine-allows-for-long-distance-diagnoses.html

Telemedicine (Telehealth) is starting to get the attention it deserves, but innovation will not occur in a vacuum of unsustainable business models. Until self-sustainability for for telemedicine initiatives is achieved and replicated on a widespread basis it will not be as significant in the provision of care as it should be.

Posted via web from Connected Care Solutions

AHRQ Report: Consumers Need to be Empowered in Health IT Debate

2009-09-19T04:31:00.001-07:00

via scribd.com

A new study out the Agency for Healthcare Research and Quality (AHRQ) suggests that by excluding consumers from the broader implementation of health information technologies, the medical community is marginalizing themselves and prolonging the time it will take to reach high levels of consumer adoption. Just another reason to add to the list of flawed approaches/perspectives on information technology among health professionals, though quite possibly the one issue that if addressed effectively could make all of the other impediments to ubiquitous adoption of highly advanced IT systems evaporate in the face of overwhelming consumer demand.

Posted via web from Connected Care Solutions

BreakThrough: Teletherapy startup gaining some mainstream popularity, but business model is very misleading

2009-09-19T02:13:00.001-07:00

From the website of telemedicine startup BreakThrough:

Overview
BreakThrough connects mental health professionals with clients through secure video, phone, and web.

We have a mental health epidemic
More than 57 million Americans – one in four adults – have a diagnosed mental illness. Tens of millions more struggle with stress and relationship issues. Institutions such as hospitals, prisons, schools, companies, health plans, and veterans centers are overcrowded with patients needing help, but growing costs and shrinking budgets are decimating quality of care.
Even though seventy to eighty percent of patients with mental illness improve with treatment, patients remain woefully underserved. Two–thirds of Americans with a mental illness do not receive treatment due to cost, stigma, inconvenience, and low access, particularly in rural areas. This is despite Americans spending $121 billion on mental health and substance abuse treatment.

The solution of telemedicine
Telepsychiatry and teletherapy – mental health services delivered through secure video, phone, and web – have emerged as effective, affordable, convenient, and safe methods of treating stress and mental illness. Telemedicine has several substantial benefits:

Effectiveness:
over fifteen years of research confirm that telemedicine is as effective as in–person treatment. This is particularly true in psychiatry and clinical psychology where much of the treatment is doctor–patient communication. Click here for a list of research studies on the effectiveness of telemedicine.

Convenience:
fifty percent of therapy clients drop out after a few sessions, but research shows teletherapy can boost retention to over ninety percent. Because clients can hold sessions anywhere with phone or internet access, they are much more likely to go and stay in treatment. BreakThrough supports sessions via video, phone, email, and live chat.

Affordability:
telemedicine sessions can cost ten to fifty percent less due to reduced overhead, travel time, and staffing needs. On BreakThrough, providers set rates that are almost always more affordable than in–office visits.

Access:
research shows the fit between clients and mental health providers is essential to positive outcomes. Most people will not travel to a provider beyond fifty miles, but telemedicine lets clients work with the best licensed provider regardless of location. BreakThrough clients can find providers on a wide variety of criteria, including price, reputation, location, gender, experience, credentials, and more.

Confidentiality:
eighty percent of therapy clients worry about the stigma of treatment. To protect clients, BreakThrough requires minimal information, enabling treatment with a level of discreteness and security not possible with in–person treatment.

Peer support:
the support of friends, family, and other patients is essential to long–term recovery. BreakThrough offers forums, group sessions, and seminars to enable peers to support each other no matter where they live.

Telemedicine is legal and expanding
Telepsychiatry and teletherapy are legal and regulated by state–specific guidelines. Government and licensing boards are also rapidly evolving legislation to expand telemedicine access.
To protect providers and meet the highest levels of regulatory compliance, we currently allow providers to see clients only in states where the provider is licensed. Providers can typically apply for licensure in multiple states, either directly through state licensing boards or third–party services that streamline the application process.

Telemedicine is reimburseable
Since 2004, Medicare and the AMA have issued CPT codes to identify and reimburse telepsychiatry and teletherapy services. A list of eligible services and codes include:

Individual psychotherapy: CPT 90804 – 90809

Consultations: CPT 99241 – 99255

Office or other outpatient visits: CPT 99201 – 99215

Pharmacologic management: CPT 90862

Psychiatric diagnostic interview examination:CPT 90801

Neurobehavioral status examination: CPT 96116

CPT code descriptions can be found on the American Medical Association's CPT directory. The modifier GT may be necessary to identify that services were delivered via telemedicine. For Medicare reimbursement, clients generally must receive treatment at an eligible originating site, such as a doctor's office, hospital, nursing facility, mental health clinic, or similar facility. Private payers often do not have the same locality restrictions. More details on reimbursement are available through the American Telemedicine Association.

via breakthrough.com

The premise underlying the business model for BreakThrough may well be sound, particularly the evidence presented supporting the positive impact of teletherapy on psychiatric patient outcomes. However, the increase in quality of treatment via telemedicine is irrelevant without a method for sustaining the provision of treatment through reimbursement of attending psychiatrists.

The assertion that "Telemedicine is reimbursable" made in the final section above, while accurate technically, is misleading in that eligibility to be reimbursed and actually recouping fees for services provided are two entirely different issues. The CPT codes provided by the BreakThrough founders are a distraction from the real challenge of processing and collecting payment, which is overcoming the fact that CPT codes are very often (more often than not) ignored because of the GT modifier and the advanced standards of practice that must be met to be eligible under Medicare reimbursement policy.

Medicare mandates clearly that telemedicine services are only eligible for reimbursement when there is a two-way video transmission that allows doctor and patient to each see the other. Any health professional will tell you that private insurers will always follow Medicare's guidance when it comes to establishing standards of eligibility for reimbursement.

This is going to create a major obstacle for the well intentioned and otherwise exciting startup to achieve widespread adoption amongst mental health providers, as they are not likely to adopt therapeutic practices without demonstrable evidence that reimbursement above a significant percentage of total consults is achievable. I wish the BreakThrough team the best of luck!!

Posted via web from Connected Care Solutions

'Connected Health' Could Trim Costs by 40 Percent

2009-09-18T20:44:00.001-07:00

A new survey released by the Massachusetts Medical Device Industry Council (MassMEDIC) and Cambridge Consultants, a technology product design and development firm, finds that a patient-centered and coordinated approach to healthcare could save billions of dollars. The survey also indicates care coordination will reduce wasteful spending in defensive medicine, inefficient claims processing, medical errors and emergency room services.

http://www.healthcareitnews.com/news/survey-connected-health-could-cut-healthcare-costs-40-percent

via healthcaregoesmobile.com

It makes little sense to me that the current debate in DC about health reform presupposes that the health care business is fundamentally unsustainable, as it has yet to adopt many of the most widely recognized enhancements in operational efficiency that have redefined nearly every other information intensive industry in America since the early 1990's. If 40-percent of costs can be trimmed without totally overhauling the system, which would leave 1/6th of our economy to exist in a vacuum for several years as we wait to see if our blind overhaul worked, I think this must be allowed to play itself out as it did in every other market. If any policy measures are useful at this stage in the modernization of health care, they are gradual, incentive-based measures that would help break-through barriers created within the medical community by undefined guidelines and a perception that such innovative activity would involve too much risk. Several programs launched through the stimulus package were a good start, but will be much less consequential if too much is done too soon by politicians focused not on patient care, but rather on their personal legacies.

Posted via web from Connected Care Solutions

National Coalition for Health Integration (NCHI): Bringing order to the chaotic health information technology through grid computing

2009-09-18T20:10:00.001-07:00

via scribd.com

The National Coalition for Health Integration (NCHI) initiative is an ambitious attempt to establish a truly interoperable environment for linking independent health information technology projects around the US through an open framework. With an all-star team of business and scientific directors funded entirely through private donations made by its principal founder, billionaire pharmaceutical entrepreneur Patrick Soon-Shiong, M.D., NCHI seeks to establish "virtual organizations" which combine numerous disparate health organizations across all sub-specialties and functional purposes (i.e. billing, administration, health records, etc.) without concern for traditional geographic constraints. It utilizes in an unprecedented fashion institutes of higher education and their leading academic innovators in bio-informatics and grid computing. Truly a revolutionary initiative which will undoubtedly emerge as a major foundational element of any long-term improvement in the delivery of quality care. (www.nchiconnect.org)

Posted via web from Connected Care Solutions

Larry Summers: "The average supermarket has more information technology than the average doctor's office"

2009-08-15T09:56:00.000-07:00

Larry Summers made this point on Meet the Press this morning while defending the American Recovery and Reinvestment Act (ARRA) and the massive investment made by several federal agencies over the next five years. Sadly, he is not exaggerating at all. What a sad reality, but why overhaul the entire system from the foundation up without first assessing the impact of this $58B+ investment on the physicians and their willingness to adapt to the 21st century?

Why is "insurance reform" more important that tort reform? You cannot even put the health care business in the same league as the grocery sector when it comes to information technology adoption, the single greatest factor in the cost savings and productivity increases across nearly every other sector of the American economy for the last 15 years, but we can somehow call it a failed industry and support wholesale restructuring?? I cannot believe anyone still supports Obama's nonsense.

Dept of Labor Grant Announcement: Training a 21st Century Health Care Workforce

2009-07-31T02:28:00.000-07:00

The Department of Labor (DoL) has released $225 million in the form of grants for job training in emerging and in-demand health care sectors such as health information technology, nursing and applied care. Below you will find a summary of the grant opportunity as well as the full text of the DoL guidelines issued in the Federal Register. The money is part of the American Recovery and Reinvestment Act, popular known as the "stimulus", which was passed by Congress in February and was among the first official acts of the Obama Administration.

Little detail of how the funds were to be spent was provided in the original legislation and federal agencies have largely sought to direct money toward areas of the economy determined to have the greatest potential return on investment. The decision to use stimulus funds to retrain an American workforce that is currently experiencing levels of unemployment not seen since the early 1980's makes a lot of sense, particularly when that retraining is focused on jobs in technology-intensive industries.

The industry in the greatest need of skilled information technology and otherwise technically proficient new workers is the health care sector, which has been the slowest of the major American industries to adopt information technology into its best practices in a meaningful way. This failure to keep pace with the general rate of innovation across the economy as a whole, especially across other similarly information intensive industries such as banking, is a significant contributor to the unrelenting rise in the cost of care at the center of the current health care reform debate in DC. Before radical industry restructuring is undertaken, it would be wise to wait and see how the major investments currently under deployment in innovating and modernizing the industry impact escalating costs. One need look no further than the experiences of other American industries to see the cost-benefit of ubiquitous IT adoption and the tremendous impact this cost savings has had on innovation generally.

Summary - Dept of Labor ETA HC HG Grants Fact Sheet

ARRA - Dept of Labor Grant Notice (SGA-DFA-PY-09-01-1)

Tech Tags: Stimulus ARRA Health+Policy Health+IT Grants Jobs Health+Care

HR 3200: America’s Affordable Health Choices Act of 2009 (Full Text)

2009-07-14T22:06:00.000-07:00

(Cross-posted at The World We'll Inherit)

Below is the final proposal for health care reform issued by the Democratic House of Representatives today, which Speaker Nancy Pelosi confidently asserted she could pass by the end of the summer session. That's right, we only have about four weeks to digest, debate, amend and vote on this 1018-page piece of legislation which seeks to fundamentally redefine the rules of our nation's largest industry. Turns out "change" sucks a whole lot more than the status quo sometimes.

Would love to hear everyone's thoughts...

HR 3200 - America’s Affordable Health Choices Act of 2009

Tech Tags: Health+Policy Health+Reform Health+Care Connected+Care Health+Blogs HR+3200

Report to the President on Guidelines for Upcoming Comparative Effectiveness Research Grants

2009-07-14T22:02:00.000-07:00

The Annual Report on Comparative Effectiveness Research contains information describing current Federal activities on comparative effectiveness research and recommendations for such research conducted or supported from funds made available by the Recovery Act (Full Text). $1.1B in grant funds, allocated to the Dept of Health and Human Services in the ARRA, will be released shortly under RFP through the NIH, AHRQ and HHS.

DHHS Comparative Effectiveness Plan

Tech Tags: AHRQ HHS NIH Comparative+Effectiveness+Research Stimulus ARRA Health+Policy

Health Information Technology State Legislation Database

2009-06-30T22:57:00.000-07:00

The National Conference of State Legislatures has a public database of health information technology related legislation that has been brought up for debate or enacted state-by-state. The database includes legislation from 2007 to the present and search results include a link to the most recent PDF of the bill itself, the sponsor(s), last action, status and a summary. For example, a search for all states and the topic "telemedicine" returned nine bills in six different states. One of the results was for a bill first proposed in the Colorado State Senate and ultimately enacted read as follows:

SB 196		(Last Update: 9/23/2008)
Sponsor:		Hagedorn
Session Year:		2007
Bill Type:		Senate Bill Date of Last Action: 5/24/2007 Status: Enacted
Topics:		Health Information Exchange \| Study Commission/Taskforce \| Telemedicine
Citation:		SB 196
Summary:		Creates the health information technology advisory committee and establishes membership. The committee is charged with developing a long-range health information technology plan, on or before Jan. 1, 2009, for health care information technology that includes use of electronic medical records, computerized clinical support systems, computerized physician order entry, regional health information organization, data privacy and security measures; and achieves interoperability among health information technology systems. Requires the committee to pursue an interstate compact between, but not limited to, Arizona, Kansas, Montana, Oklahoma, New Mexico, North Dakota, South Dakota, Utah, and Wyoming to allow for interstate exchange of health data. Provides for telemedicine reimbursement in the state’s medical assistance programs for home health care services or home and community based services that are otherwise eligible for reimbursement.

Very interesting resource for start-ups and consultancies looking to plot strategies for pursuing deals in the booming health IT sector at the state and local levels. Certain states are clearly better suited legislatively for pursuing advanced health communications projects because either they have clearly defined medicare reimbursement programs for tele-care, or incentives in place for physicians to adopt electronic medical records, or a number of other highly attractive programs that are easily found using this database!

Kennedy-Dodd Health Reform Bill: Mandates and Subsidies

2009-06-16T01:56:00.000-07:00

Below I have shared a terrific outline of the Democratic health care reform package, which has been dubbed the Kennedy-Dodd Health Care Reform Bill, as it currently reads. The outline was written by Keith Hennessey and makes several very excellent points about the truly disruptive nature of this legislation, which is supported by the president, were it to pass in its current form. I have also embedded the full text of the bill as it exists today for those of you who are interested.

KeithHennessey.com » Understanding the Kennedy health care bill

Here are 15 things to know about the draft Kennedy-Dodd health bill.

The Kennedy-Dodd bill would create an individual mandate requiring
you to buy a “qualified” health insurance plan, as defined by the
government. If you don’t have “qualified” health insurance for a given
month, you will pay a new Federal tax. Incredibly, the amount and
structure of this new tax is left to the discretion of the Secretaries
of Treasury and Health and Human Services (HHS), whose only guidance is
“to establish the minimum practicable amount that can accomplish the
goal of enhancing participation in qualifying coverage (as so defined).” The new Medical Advisory Council (see #3D) could exempt classes of people from this new tax. To avoid this tax, you would have to report your health insurance information for each month of the prior year to the Secretary of HHS, along with “any such other information as the Secretary may prescribe.”

The bill would also create an employer mandate. Employers would have to offer insurance to their employees. Employers would have to pay at least a certain percentage (TBD) of the premium, and at least a certain dollar amount (TBD). Any employer that did not would pay a new tax. Again, the amount and structure of the tax is left to the discretion of the Secretaries of Treasury and HHS. Small employers (TBD) would be exempt.

In the Kennedy-Dodd bill, the government would define a qualified plan:
1. All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.
2. A qualified plan would have to meet one of three levels of standardized cost-sharing defined by the government, “gold, silver, and bronze.” Details TBD.
3. Plans would be required to cover a list of preventive services approved by the Federal government.
4. A qualified plan would have to cover “essential health benefits,” as defined by a new Medical Advisory Council (MAC), appointed by the Secretary of Health and Human Services. The MAC would determine what items and services are “essential benefits.” The MAC would have to include items and services in at least the following categories: ambulatory patient services, emergency services, hospitalization, maternity and new born care, medical and surgical, mental health, prescription drugs, rehab and lab services, preventive/wellness services, pediatric services, and anything else the MAC thought appropriate.
5. The MAC would also define what “affordable and available coverage” is for different income levels, affecting who has to pay the tax if they don’t buy health insurance. The MAC’s rules would go into effect unless Congress passed a joint resolution (under a fast-track process) to turn them off.
Health insurance plans could not charge higher premiums for risky behaviors: “Such rate shall not vary by health status-related factors, … or any other factor not described in paragraph (1).” Smokers, drinkers, drug users, and those in terrible physical shape would all have their premiums subsidized by the healthy.

Guaranteed issue and renewal combined with modified community rating would dramatically increase premiums for the overwhelming majority of those Americans who now have private health insurance. New Jersey is the best example of health insurance mandates gone wild. In the name of protecting their citizens, premiums are extremely high to cover the cross-subsidization of those who are uninsurable.

The bill would expand Medicaid to cover everyone up to 150% of poverty, with the Federal government paying all incremental costs (no State share). This means adding childless adults with income below 150% of the poverty line.

People from 150% of poverty up to 500% (!!) would get their health insurance subsidized (on a sliding scale). If this were in effect in 2009, a family of four with income of $110,000 would get a small subsidy. The bill does not indicate the source of funds to finance these subsidies.

People in high cost areas (e.g., New York City, Boston, South Florida, Chicago, Los Angeles) would get much bigger subsidies than those in low cost areas (e.g., much of the rest of the country, especially in rural areas). The subsidies are calculated as a percentage of the “reference premium,” which is determined based on the cost of plans sold in that particular geographic area

There would be a “public plan option” of health insurance offered by the federal government. In this new government health plan, the federal government would pay health care providers Medicare rates + 10%. The +10% is clearly intended to attract short-term legislative support from medical providers. I hope they are not so naive that they think that differential would last.

Group health plans with 250 or fewer members would be prohibited from self-insuring. ERISA would only be for big businesses.

States would have to set up “gateways” (health insurance exchanges) to market only qualified health insurance plans. If they don’t, the Feds will set up a gateway for them.

Health insurance plans in existence before the law would not have to meet the new insurance standards. This creates a weird bifurcated system and means you would (probably) be subject to a different set of rules when you change jobs.

The bill does not specify what spending will be cut or what taxes will be raised to pay for the increased spending. That is presumably for the Finance Committee to determine, since it’s their jurisdiction.

The bill defines an “eligible individual” as “a citizen or national of the United States or an alien lawfully admitted to the United States for permanent residence or an alien lawfully present in the United States.”

The bill would create a new pot of money for state gateways to pay “navigators” to educate people about the new bill, distribute information about health plans, and help people enroll. Navigators receiving federal funds “may include … unions, …”

This would have severe effects on the more than 100 million Americans who have private health insurance today:

The government would mandate not only that you must buy health insurance, but what health insurance counts as “qualifying.”

Health insurance premiums would rise as a result of the law, meaning lower wages.

A government-appointed board would determine what items and services are “essential benefits” that your qualifying plan must cover.

You would find a tremendous new disincentive to switch jobs, because your new health insurance may be subject to the new rules and would therefore be significantly more expensive.

Those who keep themselves healthy would be subsidizing premiums for those with risky or unhealthy behaviors.

Far more than half of all Americans would be eligible for subsidies, but we have not yet been told who would pay the bill.

The Secretaries of Treasury and HHS would have unlimited discretion to impose new taxes on individuals and employers who do not comply with the new mandates.

The Secretary of HHS could mandate that you provide him or her with “any such other information as [he/she] may prescribe.”

Kennedy-Dodd Health Care Reform Bill (First Draft)

Publish at Scribd or explore others: Law & Government Business & Law kennedydodd health c christopher dodd

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Health Care Information Technology Must Come First

2009-06-08T10:09:00.000-07:00

President Obama has made no secret of his desire to forge ahead with ambitious health care reform legislation despite the economic crisis and soaring current account deficits with no end in sight. Obama wear's his philosophy on his sleeve: health care reform will be a central and unavoidable precursor to tightening federal spending over the long-term. I believe the president is absolutely correct, but I think he is putting the cart before the horse if he tries to overhaul the marketplace for health care providers before fully investing in and committing to the development of a nationwide health information technology foundation.

Information technology has transformed the fabric of civilization and industry in the US and around the world in ways unimaginable even 10 years ago. For the first time in history information is truly ubiquitous and free flowing. However, the largest US industry, Health Care, has largely failed to adopt IT in any meaningful way to enhance the quality of care received by patients. Despite this fundamental fallacy amongst health care providers, little more than token recognition has been paid to the matter by federal policymakers until very recently.

The recent American Recovery and Reinvestment Act (ARRA) was the first major federal injection of long-term capital ($48B+ over five years) into developing health IT infrastructure that is likely to have a real impact on patient outcomes. Physicians are offered real (though inadequate) incentives to adopt electronic health records and states are provided a true capital foundation upon which the technologies needed to expand coverage and value penetration. The stimulus funds are to be administered primarily by the newly formed Office of the National Coordinator (ONC) for Health Information Technology in the Department of Health and Human Services (HHS). However, it seems unlikely that this communications technology will be quickly adopted by providers and physicians, both of whom still lack any meaningful incentive to change.

I believe strongly that the marketplace for health insurance cannot experience fundamental reform until the broader health care industry has adopted the most basic value-added information technologies into the care delivery cycle and the true impact of this information flow on the quality of care can be quantified. To attempt radical health reform before this has been accomplished would be like prescribing treatment for a disease before assessing the patient's symptoms and issuing a diagnosis.

President Obama has a mandate to make sweeping changes to the way America is governed, this cannot be denied, and he appears to be intently focused on doing just that during the first two year of his presidency. It would be unfortunate if his party's legislative supramajority and his own impatience for gradual reform lead him to lose touch with realities of his capabilities as a mere mortal. Don't forget Mr President, "All glory is fleeting".

Weekly Address: President Obama Calls for Real Health Care Reform

Blog Rally: Raising Awareness for Public Participation in Healthcare X PRIZE Development

2009-06-01T07:12:00.000-07:00

Blog Rally (b’lôg răl’ē) adj.

A coordinated, simultaneous presentation of identical or similar material on numerous blogs for the purpose of engaging large numbers of readers and/or persuading them to adopt a certain position or take a certain action.
The simultaneous nature of a blog rally can create the result of joining the efforts of otherwise independent bloggers for an agreed-upon purpose.

We are entering an unprecedented season of change for the United States health care system. Americans are united by their desire to fundamentally reform our current system into one that delivers on the promise of freedom, equity, and best outcomes for best value. In this season of reform, we will see all kinds of ideas presented from all across the political spectrum. Many of these ideas will be prescriptive, and don’t harness the power of innovation to create the dramatic breakthroughs required to create a next generation health system.
We believe there is a better way.
This belief is founded in the idea that aligned incentives can be a powerful way to spur innovation and seek breakthrough ideas from the most unlikely sources. Many of the reform ideas being put forward may not include some of the best thinking, the collective experience, and the most meaningful ways to truly implement change. To address this issue, the X PRIZE Foundation, along with WellPoint Inc and WellPoint Foundation as sponsor, has introduced a $10MM prize for health care innovators to implement a new model of health. The focus of the prize is to increase health care value by 50% in a 10,000 person community over a three year period.
The Healthcare X PRIZE team has released an Initial Prize Design and is actively seeking public comment. We are hoping, and encouraging everyone at every opportunity, to engage in this effort to help design a system of care that can produce dramatic breakthroughs at both an individual vitality and community health level.
Here is your opportunity to contribute:

Download the Initial Prize Design
Share you comments regarding the prize concept, the measurement framework, and the likelihood of this prize to impact health and health care reform.
Share the Initial Prize Design document with as many of your health, innovation, design, technology, academic, business, political, and patient friends as you can to provide an opportunity for their participation

We hope this blog rally amplifies our efforts to solicit feedback from every source possible as we understand that innovation does not always have a corporate address. We hope your engagement starts a viral movement of interest driven by individual people who realize their voice can and must be included. Let’s ensure that all of us – and the people we love – can have a health system that aligns health finance, care delivery, and individual incentives in a way that optimizes individual vitality and community health. Together, we can ensure the best ideas are able to come forward in a transparent competition designed to accelerate health innovation. We look forward to your participation.

Special thanks to Paul Levy for both demonstrating the value of collaborative effort and suggesting we utilize a blog rally for this crowdsourcing effort. Participating bloggers and media include include:

Bob Coffield, Health Law Blog
Richard Elmore, Avance Healthcare
Vijay Goel, MD - Consumer Focused Healthcare
Vince Kuraitis, eManagement Blog
Paul Levy, Running a Hospital
Bertalan Mesko, Science Roll
Modern Healthcare
Bill Pomerantz, The Launch Pad
Amy Tenderich, Diabetes Mine
Fred Trotter, Open Source Hacktavist
Matthew Holt, The Healthcare Blog

HXP - Initial Prize Design_v1

Publish at Scribd or explore others: Health & Medicine Research health healthcare xp

Pandemic Flu in the Connected Age...

2009-05-02T19:13:00.000-07:00

The Federal government has launched an intensive web-driven campaign through a new platform at PandemicFlu.gov to disseminate information on potential pandemic-level flu outbreaks. Each state has its own sub-site linked into the broader federal platform, with an impressive coordination of relevant information across a large network of local interests.

Several other Federal, State and NGO information outlets have also done a great job of distributing tools to connected citizens that can be used to quickly share and discover information across web-based communities. Some examples include:

CDC Index of Public Health Social Media Tools
CDC YouTube Channel
CDC Swine Flu Portal
WHO Influenza A(H1N1)
CDC-TV (see below)

Red Cross Pandemic Influenza Portal

Social media tools are readily available to bloggers through both the CDC and the Department of Health and Human Services (HHS), which both have over a dozen unique embeddable widgets which automatically update with the latest public health information.

The State Department and DoD have information geared to American's living abroad or with global connections which may leave an individual particularly vulnerable.

State Department Pandemic Influenza Fact Sheet

DoD Pandemic Influenza Watchboard

Obama on Swine Flu

Race/Ethnicity	Number	Percentage
White	514,254	55.8
Black	32,452	3.5
Hispanic	46,214	5.0
Asian	113,585	12
American Native/Alaska Native	1,444	.02
Other	12,572	1.4
Unknown	201,383	22

Connected Care Blog

Toumaz has BIG day, announcing FDA approval & joint venture with physician billionaire Patrick Soon-Shiong

Toumaz has BIG day, announcing FDA approval & joint venture with physician billionaire Patrick Soon-Shiong

Three mHealth startups win Rock Health slots | FierceMobileHealthcare

Wireless applications makes monitoring health easy | CTIA-The Wireless Association® Blog

AMA - Total Physicians by Race/Ethnicity (2006)

Total Physicians by Race/Ethnicity - 2006

The American National Broadband Plan on Health Care: Opportunity in Abundant Supply | Broadband for America

Federal Telemedicine News: $125 Billion Budget Request

Monday, February 8, 2010

$125 Billion Budget Request

Breakthrough and Telehealth's Tipping Point

New Physician Adoption Statistics « Health IT Buzz

Video Conferencing saving lives in Irish Hospitals

Federal Telemedicine News: Grant Announcement Posted

Grant Announcement Posted

Personal Health Systems: A View from Across the Pond | Chillmark Research

Federal Telemedicine News: MHS IM/IT Plan Approved

MHS IM/IT Plan Approved

Privacy & Security of Personal Health Information | Chillmark Research

Healthcare IT Consultant Blog: Up to $43.2M to GE Healthcare for US Military Patient Monitoring Systems

Sunday, January 17, 2010

Up to $43.2M to GE Healthcare for US Military Patient Monitoring Systems

Billionaire Doctor Puts His Money Where His Mind Is...

Public Health Informatics Institute | phConnect.org

Public Health Information Network (PHIN) | Communities of Practice - CDC.gov

Welcome to the PHIN Community!

Distributed Systems Laboratory at UChicago | Main Page - CSWiki

Distributed Systems Laboratory (DSL) at University of Chicago

Grid, Distributed and Cloud Computing Resources

California hospital's implementation of open-source EHR bears watching | EHR Watch

Hilton Head Island Fire & Rescue STEMI Program - Understanding the Prehospital 12-lead ECG

GE Healthymagination Fund - Investment Platform

Investment Platform

KeithHennessey.com » The legislative landscape for health care after House passage » Print

Pivot points and the importance of recess

The three-part strategic question

Conference or ping pong?

My projections

KeithHennessey.com » The legislative landscape for health care after House passage » Print

Pivot points and the importance of recess

The three-part strategic question

Conference or ping pong?

My projections

GE Healthymagination Fund - Investment Platform

Investment Platform

GE Healthymagination Fund - Investment Platform

Investment Platform

Stimulus creates huge demand for HIT professionals | FierceHealthIT.com

E-Bridge East Baton Rouge EMS Telemedicine Overview

American Recovery and Reinvestment Act : Unprecedented Opportunity for Health IT

Telemedicine: CMS definition and reimbursement guidelines

Telemedicine allows for long-distance diagnoses

AHRQ Report: Consumers Need to be Empowered in Health IT Debate

BreakThrough: Teletherapy startup gaining some mainstream popularity, but business model is very misleading

Overview

We have a mental health epidemic

The solution of telemedicine

Effectiveness:

Convenience:

Affordability:

Access:

Confidentiality:

Peer support:

Telemedicine is legal and expanding

Telemedicine is reimburseable

'Connected Health' Could Trim Costs by 40 Percent

National Coalition for Health Integration (NCHI): Bringing order to the chaotic health information technology through grid computing

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Larry Summers: "The average supermarket has more information technology than the average doctor's office"

Dept of Labor Grant Announcement: Training a 21st Century Health Care Workforce

HR 3200: America’s Affordable Health Choices Act of 2009 (Full Text)

Report to the President on Guidelines for Upcoming Comparative Effectiveness Research Grants

Health Information Technology State Legislation Database

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Kennedy-Dodd Health Reform Bill: Mandates and Subsidies

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Health Care Information Technology Must Come First

Blog Rally: Raising Awareness for Public Participation in Healthcare X PRIZE Development

Pandemic Flu in the Connected Age...