Government & Policy

FCC Commissioner Brendan Carr has announced the agency will vote to advance a $100 million Connected Care Pilot Program, enabling telehealth expansion for low-income Americans nationwide. WHY IT MATTERS Speaking in rural Laurel Fork, Virginia, Carr announced that the new funding is meant to increase access to care to patients and veterans in remote areas such as Appalachia. “With advances in telemedicine, healthcare is no longer limited to the confines of traditional brick and mortar healthcare facilities,” said Carr in a statement. "I think the FCC should support this new trend towards connected care, which is the healthcare equivalent of moving from Blockbuster to Netflix. That’s why the FCC will vote to advance my $100 million pilot program at our July 10 meeting." He added that the program will "focus on ensuring that low-income Americans and veterans can access this technology, particularly in rural communities like Laurel Fork, where the nearest hospital is in a different state, access to telehealth can make a life-saving difference." FCC is set to vote on a notice of proposed rulemaking next month that will seek comment on several potential provisions, including $100 million in Universal Service Fund support that will help rural providers to defray the cost of offering remote care to low-income patients, including people in medically underserved areas and veterans. The NPRM would also seek support for new pilot projects to seek innovation diabetes management, the opioid crisis, high-risk pregnancies, pediatric heart disease and cancer, according to the FCC. It would also offer an 85 percent discount on qualifying services for three years, along with efforts to assess the benefits, costs and savings enabled by telehealth and remote monitoring tools. THE LARGER TREND Connected care technologies have already enabled cost efficiencies with the management of chronic conditions, the FCC points out. It estimates that more widespread use of remote patient monitoring and virtual visits could save the American healthcare system $305 billion each year. Moreover, it would enable better health outcomes. The agency noted a study of 20 RPM trials that found a 20 percent reduction in all-cause mortality and a 15 percent reduction in heart failure-related hospitalizations. Another initiative showed a 46 percent reduction in ER visits, a 53 percent decrease in inpatient admissions and a 25 percent shorter length of stay. As evidence of telehealth's benefits, the FCC pointed to a pilot project in the Mississippi Delta that resulted in nearly $700,000 in annual savings thanks to reduced readmissions. It also noted big ROI in a recent virtual care study in the Northeast, where every dollar spent on remote monitoring resulted in a $3.30 savings. ON THE RECORD But better health is the true value of telemedicine, and "in Laurel Fork, telehealth is already delivering results," said Carr from the Virginia press conference. "Diabetes patients here that participated in a remote telehealth program saw their A1C levels decline by 2.2 points on average, which significantly reduced their risk of renal disease, heart disease and death caused by those conditions. "Through the Connected Care Pilot Program, the FCC can build on the success of projects like these, which are helping create a model for the adoption of connected care technologies and bridging the doctor divide in rural America," he said. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Healthcare IT News is a publication of HIMSS Media.

MidCentral District Health Board (DHB) has published one of New Zealand’s first district-wide digital health strategies. Called Te Awa, the five-year strategy is collectively endorsed by the DHB, Central PHO, Manawhenua Hauora, the Clinical Council and the Consumer Council in the region and was developed after extensive district engagement and consultation. An introductory message says that developing and using digital technology “will help us to improve access to services, to address and minimise health inequality, to improve the quality and safety of our services, and to increase the control people in our district have over their own health”. The strategy has four guiding principles, which are: people-powered; one district; information sharing; and being a good digital health steward. The objectives of the strategy are to digitise the consumer, families and whānau experience with improved access to information and to digitise end-to-end processes, allowing the smooth flow of information between services and across organisational boundaries. It aims for better interconnected communications and collaboration, as well as better use of data for planning and decision making. Also, inclusive information management and stable and secure ICT services. Steve Miller, chief digital officer MidCentral DHB, said Te Awa is a people/ whānau – centred strategy with a focus on wellness, which makes interagency collaboration key to its success. “With over 60 percent of a person’s heath being attributed to various social determinates, it’s important we collectively engage in collaborative co-design as a system to enable quality living, healthy lives and well communities,” he explained. The strategy has seven strategic portfolios with multi-year funding pathways, allowing a more agile delivery method for the projects within them. “We are seeking to take a more ‘learn and adapt’ approach to accelerate value delivery and better manage risk by breaking initiatives into smaller three-monthly cycles,” Miller said. The portfolios are; consumers, families and whānau-centred; workforce management; innovation; data and analytics; knowledge management; business management; infrastructure and IT services. Miller said the strategy seeks to rationalise a large number of existing suppliers and applications and to develop a co-investment partnership approach with industry to accelerate the district’s digital transformation. MidCentral DHB has been chosen by the Ministry of Health to pilot four HIMSS digital maturity assessments from August this year. Miller says the results will help determine the organisation’s areas of focus to get the best results. This article first appeared on eHealthNews.nz.

HIMSS, Sequoia Project and others weigh in on Draft 2 of the Trusted Exchange Framework and Common Agreement, urging caution that it not disrupt existing HIE processes.

UK finance innovation ecosystem will promote collaboration with industry to ensure new technologies meet NHS priorities.

The plant is now able to manufacture molybdenum-99, the decay product of technetium-99m, which is used in nuclear medicine procedures worldwide.

North Middlesex University Hospital NHS Trust has announced it will invest more than $15m over the next three years to revolutionise its clinical systems and improve patient care. Part of the investment comes from NHS Digital, which awarded $6.3m to the hospital trust as part of the flagship global digital exemplar progamme, while the other $8.9m will be funded by the trust. North Middlesex will act as a ‘fast follower’ to the Royal Free London NHS Foundation Trust, by helping it to establish a model which can be rolled out across the NHS more broadly. The Royal Free will share its experience of being a digitally advanced trust and work with North Middlesex to create blueprints to enable other trusts to follow in its footsteps. WHY IT MATTERS North Middlesex University Hospital serves more than 350,000 people living in the London boroughs of Enfield and Haringey and surrounding areas. The trust hopes the investment will enable it to improve staff access to clinical information in order to improve decision-making and deliver safer and more effective care. It plans to invest in technology which will enable patients to better manage their own health and interact with health professionals through video consultations. North Middlesex is also aiming to provide better data that can be used to improve quality, efficiency and patient outcomes, and improve the way clinical systems across north central London interact so that clinicians can better manage patient care. To help deliver this programme of work, the trust will work in collaboration with System C Healthcare and JAC Computer Services. WHAT'S THE CONTEXT There are 17 acute trusts being supported by NHS England to become global digital exemplars, which can deliver improvements in the quality of care through the world-class use of digital technologies and information. Each of these has one or two ‘fast followers’ which support the spread of best practice and innovation. It was recently reported that the Salford Royal NHS Foundation Trust, a global digital exemplar, is using EMRAM as a benchmarking tool to help drive its ongoing digital transformation strategy. ON THE RECORD Maria Kane, chief executive of North Middlesex University Hospital NHS Trust, said: "With a rising demand for our services, we need to think differently about how we deliver patient care. “This investment will help us make the best use of digital technology so that we can improve the way we work and transform our services so that they better meet the needs of our local community."

The group wants to advance the ability of augmented intelligence to enhance care, boost population health, drive value and improve physician satisfaction.

Erik Gerritsen, vice minister of the Ministry of Health, Welfare and Sport in the Netherlands, had a simple message for delegates on the second day of the HIMSS & Health 2.0 European conference in Helsinki this evening: there is an urgent need to address the “global interoperability crisis” facing healthcare. Governments need to step up, Gerritsen said, and move away from the approach adopted in the past, where the health IT industry was left alone to try and "fix" the interoperability challenge. “What I see is a global market failure in achieving meaningful interoperability. "What I see now is that, with all our technological advancements, people are still dying because we are not able to get the right electronic information in the right place at the right time," he said. "And I see hospitals being forced to select a specific EHR system because their data is locked into their vendor’s closed ecosystem. "I see nurses and doctors burning out and leaving healthcare behind because the technology doesn’t work for, but against them," he added. "I see desperate patients starting lawsuits to be able to get their own medical data because healthcare organisations are not willing or not able to provide their data to them." His comments echoed the remarks of patient advocates at the event, as well as governmental figures from other European countries calling on all stakeholders to work together and ensure healthcare does not, as Gerritsen put it, continue to miss out on the “digital revolution”, with fax machines and paper still common in many organisations - and "extinct everywhere but healthcare".  Empowered citizens and healthcare professionals The problem, however, is not the lack of having a vision in place or the lack of usable technology; it's implementing and scaling good solutions, Gerritsen said. The vice minister emphasised that health innovation needed to be "accelerated" to ensure that the right care is delivered at the right time. For this to happen, there is a need for empowered citizens, with access to the tools needed to be in control of their own health, and empowered healthcare professionals.  The vice minister acknowledged, however, that government is often seen as “the opposite of inspiration, slowing down innovation with needless red tape and bureauracy”. But he added: "As governments, we have a responsibility to serve the interests of all our citizens, to ensure that everyone is able to participate in today’s society, no matter their background. “People don’t do whatever you say, but they will follow what they see you do." Norway health tech CEO receives achievement award The evening keynote also saw Kathrine Myhre, chief executive of Norway Health Tech, receive the HIMSS Future 50 European Achievement Award. Myhre is the founder of Norway Health Tech, previously known as the Oslo Medtech Cluster, which brings together over 200 members from the digital health industry, providers, local authorities, R&D organisations and investors. “To ensure the growth of digital health into its full potential, we need leaders who can constantly push to improve the quality in treatment and care by developing and industrialising world-class health solutions through members and ecosystems,” said Sean Roberts, HIMSS EMEA vice president. “Kathrine Myhre is one such thought leader and a role model.” HIMSS launches nursing informatics community HIMSS, owner of Healthcare IT News, also launched today its European Nursing Informatics Community, in collaboration with the Finnish Nurses Association, the International Council of Nurses and the European Health Management Association. "Throughout our ongoing engagement with healthcare providers and the broader European community membership, we have recognised that nurses are the closest to the gaps in care representing the human link between technology and patients," said Angela Velkova, HIMSS director of communities and strategic relations. "Therefore, digitally empowered nurses will directly translate in improved delivery of care to the benefit of citizens and entire communities."

Päivi Sillanaukee put emphasis on the need for international co-operation at the HIMSS & Health 2.0 European conference.