AATP Interactive

AHRQ To Support Health Information Technology Projects To Improve Patient Safety And Quality Of Care

As part of a larger initiative to support investments in information technology in the nation's health care delivery system, the Agency for Healthcare Research and Quality today announced that it is seeking applications for approximately 100 grants to plan, implement, and demonstrate the value of health information technology to improve patient safety and quality of care. These grants will be part of a $50 million portfolio of grants, contracts, and other activities to demonstrate the role of health information technology to improve patient safety and the quality of care.

The RFA emphasizes the importance of community partnerships. AHRQ will provide up to 50 percent of the total costs in matching funds, not to exceed $500,000 per year, for each project. Letters of intent are
due February 22, 2004, and applications are due April 22, 2004. For further information, go to the NIH Guide at http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-011.html

In addition, at least $5 million is expected to be used to support applicants from rural and small communities. Projects can last up to 1 year, and applicants may request budgets of up to $200,000 in total costs. Letters of intent are due March 22, 2004, and applications are due April 22, 2004. For further information, go to the NIH Guide at
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-010.html

Demonstrating the value derived from the adoption, diffusion, and use of health information technology will be the focus of the third RFA, awarding approximately $10 million to up to 20 new grantees. The objective of these projects will be to provide health care facilities and providers with the information they need to make informed clinical and purchasing decisions about using health information technology.

Applicants may request budgets of up to $500,000 per year in total costs. Letters of intent are due March 22, 2004, and applications are due April 22, 2004. For further information, go to the NIH Guide at
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-012.html

Reducing Medical Errors Requires National Computerized Information Systems

A new report by the Institute of Medicine of the National Academies states that "to significantly reduce the tens of thousands of deaths and injuries caused by medical errors every year, health care organizations must adopt information technology systems that are capable of collecting and sharing essential health information on patients and their care."

To facilitate the routine use of electronic health records, the health care sector must develop and use standardized formats for these records, which allow providers to record information about patients' health at the point of care. In addition, uniform formats and data standards for reporting information on near misses -- mishaps that were caught before harm occurred -- as well as events caused by mistakes must be developed and adopted so that the industry can learn how to prevent future errors.

Here is the full report Patient Safety: Achieving a New Standard for Care

Online Patient Communication Options

Physician practices find email communication improves productivity and generates income

The Online Patient-Provider Communication project provides a detailed review of electronic communication tools available to physician practices of all sizes; case study summaries on how single, multi-site, and integrated delivery systems use these tools; and vendor lists offering various online communication solutions. In this projet, physicians use email with patients to discuss symptoms and treatment, determine the necessity of office visits, respond to billing inquiries, provide test results, and schedule appointments.

Stand-alone products require the least amount of technical savvy and investment. Integrated systems that link to existing electronic medical record (EMR) and practice management systems require more extensive hardware, software, and networking set-up.

Where stand-alone products that require a PC, software, and an Internet connection enable online communication; integrated systems bring online messaging, patient demographics, and medical records all into one place. Such systems make workflow across the practice more seamless.

Costs range from $50 monthly subscriptions for simple email accounts to advanced EMR products that start at $10,000 per physician workstation. Mechanisms available to assure online security include encryption software that makes it difficult for intercepted messages to be read by unauthorized persons.

For more info see the California Healthcare Foundation

Sharing Resources - The Real Internet

The way the Internet was meant to be. Open sharing of information, software, video, music, ideas and news. A recent article in Wired describes Ibiblio, "one of the Web's oldest and largest digital libraries, has all this and much, much more -- and all of it is completely free to visitors, thanks to backing from the University of North Carolina at Chapel Hill and technology companies like Linux distributor Red Hat."

Ibiblio's staff and contributors rescue documents, videos, audio and image files from dusty archives or attics where few could view them and put them on the Web, where anyone with an Internet connection can retrieve the information. The library also gives Web space to those who can't host their own sites due to political or financial considerations.

Ibiblio averages about 3 million information requests per day, and the contributor-maintained collections are expanding daily. There are no restricted areas and visitors can critique or add information to an existing collection, or create and manage their own collection of information.

"Basically, if you want to share information about almost any subject, ibiblio will be happy to host you for free," said director Paul Jones. "The only rules are that whatever you want to share must be noncommercial, legal and have some value to other people. We'd like to demonstrate that the best way to protect and preserve so-called intellectual property is to share it freely with everyone," said Jones. "Shared information is enhanced and improved, so its value can only increase. Hoarded knowledge just stagnates."

Or you might just want to download some free software. Ibiblio offers new upgrades for one of the many open-source software projects e.g. Linux. It also offers downloadable books. For example:

Thinking in Java
A step-by-step guide

How to Think Like a Computer Scientist - How to Think in Java

How to Think Like a Computer Scientist - Python Version

Thinking in C++
From basic keywords and programming principles to more advanced topics

How to Think Like a Computer Scientist - C++ Advanced Placement Version
An online textbook of C++

or perhaps

Old Eclectic Books and Journals of Traditional Medicines

Southwest School of Botanical Medicine

Discover the rest for yourself...

Wearable Voice Communication System

Providence Portland Medical Center has ventured into wireless communication with the Vocera Wearable Voice Communication System.
In a hospital-wide effort to improve patient care through efficient clinical communication, Providence Portland Medical Center, part of Providence Health System, engaged Datavision to deliver the first phase of deploying a Vocera(TM) communications solution.

The clinical staff at Providence Portland Medical Center is faced with communication challenges that many major hospitals face; the highly mobile staff, annoyance of overhead paging, and the need to be hands-free. After a review of available alternatives, the management team at Providence Portland Medical Center has determined that Vocera's hands-free, wearable communication system addresses these challenges.

The Vocera Communications System provides hands-free, voice-activated communications within 802.11b-networked buildings or campuses. Aimed at mobile workers in hospitals, retail operations, and other industries, the system will allow users to interact with each other instantly and make decisions quickly with simple voice commands.

Vocera Communications Badge is a wearable device that weighs less than two ounces and can easily be clipped to a shirt pocket or worn on a lanyard. It enables instant two-way voice conversation without the need to remember a phone number or manipulate a handset.

Sounds a bit like the Star Trek communicator!

Here is a video about Vocera, a brochure and their white paper on instant voice communication.

Brain-computer interfaces

New research into how signals from the brain can be captured by a computer or other device to carry out an individual’s command may allow people with motor disabilities to more fully communicate and function in their daily lives.

Brain-computer interfaces (BCIs) using new wireless technology have shown advances in BCI-based movement control. Research in technologies for obtaining brain signals for BCI applications has led to the development of implantable BCI devices that could be used by people with severe motor disabilities.

Groundbreaking work conducted by Douglas J. Weber, PhD, at the University of Alberta, Edmonton, Canada, and his colleagues has led to the development of an implantable microelectrode array that can record neural sensory responses resulting from movements of the leg. The investigators have developed an analysis technique that allows accurate prediction of leg positions from the patterns of recorded neural activity.

The technique relies on the fact that multiple sensors acting together provide the central nervous system with important feedback for controlling movement. For example, sensors called muscle spindles that are embedded in muscle fibers measure the length and speed of muscle stretch, while other sensors in the skin respond to stretch and pressure. When an individual is paralyzed by injury or disease, neural signals from these sensors cannot reach the brain, and thus cannot be used to control motor responses. Paralysis also keeps neural signals originating in the motor regions of the brain from reaching the muscles.

The work of Weber and his colleagues shows that it is possible to extract feedback information from the body’s natural sensors that could then be used to control a prosthetic device, allowing an individual to regain some command and control of his or her own movements.

A sterile surgical procedure is used to implant arrays of 36 microelectrodes into the dorsal root ganglion, part of the spinal nerve that contains the nerve cell bodies that house these natural sensors. Historically, it was difficult to record from these sensors because their cell bodies are located in this difficult-to-reach nerve bundle entering the spinal cord. The wires from the microelectrode array are led out through the skin to a small electrical conductor. The procedure allows simultaneous recordings from many sensory nerves during normal motor activities such as walking. A digital camera tracks the position of the leg, and a mathematical analysis relates the sensory activity to leg movement. The investigators found that fewer than 10 neurons are needed to accurately predict the path of the leg. This finding is encouraging because it suggests that a small number of neurons could provide the feedback signals needed to control a prosthetic device.

Other investigators are developing wireless devices for recording neural activity. Groups from Brown University in Providence, R.I., and the Jet Propulsion Laboratory (JPL) in Pasadena, Calif., have both developed wireless implantable devices that use advanced microelectronic technology that eliminates the shortfalls of currently available neural recording systems.

These results are being presented at the Society for Neuroscience 2003 Annual Meeting.

Wearable Computers

The 7th International Symposium on Wearable Computers (ISWC'03) took place Oct October 21-23, 2003.
According to the press release "In the past six months, the stocks of publicly traded wearable computer companies have risen 100-400%! In Europe and Asia, funding for research in wearable computers has increased substantially, and wearable devices are becoming mainstream. Cellular phones, wristwatches, and MP3 players from major manufacturers are now reaching computational functionality that was once only demonstrated in research laboratories. Specialized wearable computers are addressing niche markets in inventory control, package routing, and even parking ticket issuing by the New York police. If wearable computing is becoming a reality today, where will the future lead?

The IEEE International Symposium on Wearable Computers (ISWC) remains at the forefront of mobile computing technology. Academics, industrialists, military and government officials, and the fashion industry will gather for three days October 21-23 in White Plains, NY to discuss the latest research results, demonstrate their latest gadgets, and exhibit current products in the seventh annual convocation of the conference.

Some of the slides of tutorials are available as well as some video.

A sample of the topics discussed are listed below. Next year this should be on our 'must attend list'.

- Applications of wearable systems in consumer, industrial, medical, educational, and military domains.
- Use of wearable computers as components of larger systems, such as augmented reality systems, training systems, or systems designed to support collaborative work.
- Hardware, including wearable system design, input devices, wearable displays, batteries, techniques for power management and heat dissipation, industrial design, and manufacturing issues.
- Software architectures, including ones that allow wearable computers to exploit surrounding infrastructure.
- Human interfaces, including hands-free approaches, speech-based interaction, sensory augmentation, human-centered robotics, user modeling, user evaluation, and health issues.
- Networks, including wireless networks, on-body networks, and support for interaction with other wearables and the Internet.
- Experimental research that rigorously compares using wearables to other methods or technologies for performing the same task, such as traditional methods or handheld computers.
- Operating systems, including such issues as scheduling, security, and power management.
- Social implications and privacy issues.
- Wearable computing for people with disabilities.

Wow!