SHARP Program ($60 million) - to support improvements in healthcare quality, safety, efficiency by “breakthrough” HIT advances

News Release

FOR IMMEDIATE RELEASE Friday, April 2, 2010

Contact: HHS Press Office (202) 690-6343

HHS Awards $144 Million in Recovery Act Funds to Institutions of Higher Education and Research to Address Critical Needs for the Widespread Adoption and Meaningful Use of Health Information Technology

Academia and the Research Community will support health providers by delivering more than 50,000 new health IT professionals to the workforce and addressing current and future barriers to achieving meaningful use of health IT

Washington, D. C.— Health and Human Services Secretary Kathleen Sebelius has enlisted the talent and resources of some of the nation’s leading universities, community colleges, and major research centers to advance the widespread adoption and meaningful use of health information technology (health IT).

Awards totaling $84 million to 16 universities and junior colleges will support training and development of more than 50,000 new health IT professionals. Additionally Strategic Health IT Advanced Research Projects (SHARP) awards totaling $60 million were provided to four advanced research institutions ($15 million each) to focus on solving current and future challenges that represent barriers to adoption and meaningful use of health IT. Both sets of awards are funded by the American Recovery and Reinvestment Act of 2009. Today’s awards are part of the $2 billion effort to achieve widespread meaningful use of health IT and provide for the use of an electronic health record (EHR) for each person in the United States by 2014.

“Training a cadre of new health IT professionals and breaking down barriers to the adoption of meaningful use of health IT are both critical to the national effort to use information technology to realize better patient care,” stated David Blumenthal, MD, MPP, national coordinator for health information technology. “The institutions receiving awards today will develop necessary roadmaps to help health care providers and hospitals implement and effectively use electronic health records.”

Workforce Award recipients, by program area, include:

Community College Consortia Program ($36 million):

The Community College Consortia Program provides assistance to five regional recipients to establish a multi-institutional consortium within each designated region. The five regional consortia will include 70 community colleges in total. Each college will create non-degree training programs that can be completed in six months or less by individuals with appropriate prior education and/or experience. First year grant awards are estimated at $36 million. An additional $34 million is available for year two funding of these programs after successful completion of a mid-project evaluation.

Institution	Amount of Award
Bellevue College Bellevue, Washington	$ 3,364,798
Cuyahoga Community College District Cleveland, Ohio	$ 7,531,403
Los Rios Community College District Sacramento, California	$ 5,435,587
Pitt Community College Winterville, North Carolina	$10,901,009
Tidewater Community College Norfolk, Virginia	$ 8,492,793

Curriculum Development Center ($10 million):

The Curriculum Development Centers will develop educational materials for key health IT topics to be used by the members of the Community College Consortia program. The materials will also be made available to institutions of higher education across the country. One of the centers will receive additional assistance to act as the National Training and Dissemination Center (NTDC) for the curriculum materials.

Institution	Amount of Award
University of Alabama at Birmingham Birmingham, Alabama	$1,820,000
The Trustees of Columbia University New York City, New York	$1,820,000
Duke University Durham, North Carolina	$1,820,000
Johns Hopkins University Baltimore, Maryland	$1,820,000
Oregon Health & Science University Portland, Oregon	$2,720,000*

*(Will also receive the NTDC awards)

University-Based Training Programs ($32 million):

The University-based training programs will produce trained professionals for vital, highly specialized health IT roles. Most trainees in these programs will complete intensive courses of study in 12-months or less and receive a university-issued certificate of advanced training.  Other trainees supported by these grants will study toward masters’ degrees.

Institution	Amount of Award
The Trustees of Columbia University New York City, New York	$3,786,677
University of Colorado Denver College of Nursing Denver, Colorado	$2,622,186
Duke University Durham, North Carolina	$2,167,121
George Washington University District of Columbia	$4,612,313
Indiana University Bloomington, Indiana	$1,406,469
Johns Hopkins University Baltimore, Maryland	$3,752,512
University of Minnesota Minneapolis-St. Paul, Minnesota	$5,145,705
Oregon Health & Science University Portland, Oregon	$3,085,812
Texas State University San Marcos, Texas	$5,421,205

Competency Examination Program ($6 million):

This program will support the development and initial administration of a set of health IT competency examinations. The program will create an objective measure to assess basic competency for individuals trained in short-term, non degree health IT programs and for members of the workforce seeking to demonstrate their competency in certain health IT workforce roles.

Institution	Amount of Award
Northern Virginia Community College Annandale, Virginia	$6,000,000

Strategic Health IT Advanced Research Projects (SHARP) Program ($60 million):

The SHARP program recognizes the critical importance of research to support improvements in the quality, safety, and efficiency of healthcare by creating “breakthrough” advances in information technology. The SHARP program targets four areas where improvements in technology are needed. The four SHARP award recipients, their areas of research focus and funding are:

• University of Illinois at Urbana-Champaign, Ill. - Security of Health Information Technology – Developing security and risk mitigation policies and the technologies necessary to build and preserve the public trust as Health IT systems gain widespread use. $15 million.
• The University of Texas Health Science Center at Houston, Texas - Patient-Centered Cognitive Support – Harnessing the power of Health IT so that it integrates with, enhances and supports clinicians’ reasoning and decision-making. $15 million.
• President and Fellows of Harvard College, Boston, Mass. - Healthcare Application and Network Platform Architectures – Developing new and improved architectures that will leverage benefits of today’s architecture and focus on the flexibility and scalability needs for the future to address significant increases in capture, storage and analysis of data. $15 million.
• Mayo Clinic, Rochester, Minn. – Secondary Use of EHR Data– Strategies to make use of data that will be stored in EHRs for improving the overall quality of health care, while maintaining data privacy and security. $15 million.

Information about the HITECH awards available through the workforce development program is available athttp://HealthIT.HHS.gov/ and www.grants.gov.

For information about other HHS Recovery Act programs, see http://www.hhs.gov/recovery.

###

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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Last revised: April 02, 2010

Good law from tragic facts--Congress, the FDA, and preemption

Good law from tragic facts--Congress, the FDA, and preemption.
Annas GJ.
N Engl J Med. 2009 Sep 17;361(12):1206-11. No abstract available.
PMID: 19759383 [PubMed - indexed for MEDLINE]
Related Articles


The New York Times heralded "A Win for Injured Patients,"¹ while the Wall Street Journal said that the U.S. Supreme Court was "Pre-empting Drug Innovation."² To the New York Times, the Court's decision in Wyeth v. Levine was "wise and surprising."¹ To the Wall Street Journal, it was a "defeat for drug innovation and public health"²; the editorial expressed surprise because the Supreme Court had earlier ruled that Congress had preempted state civil lawsuits alleging device misbranding, and many persons thought that the Court had turned relentlessly pro-business and would therefore also rule that civil lawsuits alleging drug misbranding . . . [Full Text of this Article]
The Facts in Wyeth
The Law of Preemption
"Tragic Facts"
Preemption after Wyeth

Source Information
From the Department of Health Law, Bioethics, and Human Rights, Boston University School of Public Health, Boston.
References

1. A win for injured patients. New York Times. March 5, 2009. 
2. Pre-empting drug innovation. Wall Street Journal. March 5, 2009:A16.
3. Rosen J. Supreme Court, Inc. New York Times Magazine. March 16, 2008.
4. Wyeth v. Levine, 129 U.S. 1187 (2009).
5. Curfman GD, Morrissey S, Drazen JM. Why doctors should worry about preemption. N Engl J Med 2008;359:1-3. [Free Full Text]
6. Northern Securities v. United States, 193 U.S. 197, 400 (1904).
7. Glantz LH, Annas GJ. The FDA, preemption, and the Supreme Court. N Engl J Med 2008;358:1883-1885. [Free Full Text]
8. Kennedy D. Misbegotten preemptions. Science 2008;320:585-585. [Free Full Text]
9. Warning signs. Nature 2008;452:254-254. [Medline]
10. Committee on the Assessment of the US Drug-Safety System. The future of drug safety: promoting and protecting the health of the public. Washington, DC: National Academies Press, 2007.
11. Psaty BM, Burke SP. Protecting the health of the public -- Institute of Medicine recommendations on drug safety. N Engl J Med 2006;355:1753-1755. [Free Full Text]
12. Gilhooley M. Drug preemption and the need to reform the FDA consultation process. Am J Law Med 2008;34:539-561. [Web of Science][Medline]
13. Wyeth v. Levine, 944 A.2d 179 (Vt. 2006).
14. Riegel v. Medtronic, 128 U.S. 999 (2008).
15. 71 C.F.R. 3922 (2006).
16. Geier v. American Honda Motor Co., 529 U.S. 861 (2000).
17. Curfman GD, Morrissey S, Drazen JM. The Medical Device Safety Act of 2009. N Engl J Med 2009;360:1550-1551. [Free Full Text]
18. Obama B. Memorandum for the heads of executive departments and agencies: preemption. Washington, DC: White House, May 20, 2009. (Accessed August 27, 2009, at http://www.whitehouse.gov/the_press_office/Presidential-Memorandum-Regarding-Preemption/.)

Primary Prevention NOW !! [That's evidence-based health education for cost-savings]

http://maynardclark.spaces.live.com

The signature I sign in health care petitions is the signature that  includes the clarification that I would support universal inclusion that is truly caring for health, not merely managing disease, and that I believed we could afford to guarantee THAT kind of healthcare as a fundamental right IF we include primary prevention that is behaviorally-oriented and evidence-based.

Ensuring healthy vegetarian (read vegan) meal options (along with suitable health education that sees the benefits of plant-based diets) for students, we cannot deliver the experiential knowledge of what health-supporting eating actually is (and providing a health-aware future for those young citizens going forward).

Men with hypertension may effectively reduce that hypertension with whole grains and bran

Whole grains, bran may fight hypertension in men
U. S. News & World Report as reported by HealthDay News, August 28, 2009 – By Steven Reinberg
Harvard researchers that found that whole grain foods and foods high in bran bring a boost to heart health. Although the study focused on men, data from the Women's Health Study is consistent with the results. Lead researcher Dr. Alan J. Flint, Harvard School of Public Health research scientist and project director of the Health Professionals Follow-up Study, comments.
http://health.usnews.com/articles/health/healthday/2009/08/28/whole-grains-bran-may-fight-hypertension-in-men.html

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Whole Grains, Bran May Fight Hypertension in Men

New findings replicate similar data for women, experts say

Posted August 28, 2009

By Steven Reinberg
HealthDay Reporter
FRIDAY, Aug. 28 (HealthDay News) -- Men, want to keep high blood pressure at bay? Try reaching for whole grains.
That's the message from a Harvard study that found that whole grain foods and foods high in bran bring a boost to heart health. Although this study is among men, data from the Women's Health Study found similar results, the researchers say.

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"Whole grains as a part of a prudent, balanced diet may help promote cardiovascular health," said lead researcher Dr. Alan J. Flint, project director at Harvard School of Public Health of the Health Professionals Follow-Up Study, on which the new analysis was based. "Higher intake of whole grains was associated with a lower risk of hypertension in our cohort of over 31,000 men," Flint said.
The report is published in the September issue of the American Journal of Clinical Nutrition.
For the study, Flint's team collected data on 31,684 men who participated in the Health Professionals Follow-Up Study. When these men were enrolled in the study, none had high blood pressure, cancer, heart disease or had had a stroke.
During 18 years of follow-up, over 9,200 men developed high blood pressure. The researchers found that men who ate the highest amount of whole grains were 19 percent less likely to develop high blood pressure compared with men who ate the least amount of whole grains.
In addition, men who ate the most bran reduced their risk of developing high blood pressure by 15 percent compared with men who ate the least bran, the study found.
Flint noted that these findings remained even after adjusting their data for other healthy lifestyle and diet factors. "When the associations persist despite these adjustments, as in the current analysis, it supports the conclusion that it is not due to these other factors," he said.
There have been several suggestions as to why whole grains seem to have an effect on blood pressure. These include improved insulin sensitivity, reduced food intake, lower blood sugar, better control of high blood pressure and less need for blood pressure medications, the researchers noted.
The authors say the findings could help in evaluating diet guidelines to help lower blood pressure.
Connecticut-based nutritionist Samantha Heller agreed that whole grains are an important part of a healthy diet.
"Whole grains have nutrients and antioxidants that are important for good health and they help manage insulin response," Heller said. "People who eat whole grains seem to have lower incidents of diseases like diabetes," she said.
Since whole grains also help manage weight, they seem to reduce the risk of heart disease, she said.
However, Dr. Harlan M. Krumholz, the Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health at Yale University School of Medicine doesn't think this finding has any implications for dietary guidelines.
"This epidemiologic study is an interesting academic study but lacks any policy implications," Krumholz said. "We do not know whether enriching your diet with fiber will have any benefit on the development of hypertension," he said.
More information
For more information on a healthy diet, visit the U.S. Department of Agriculture .

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• Diets That Promote Health
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Tags: diabetes | diet and nutrition | high blood pressure | men's health

Animal byproducts in common medicines and over-the-counter preparations

Why doctors should inform their patients where the medicines comes from

My many readers will know - from my many blogs (one Yahoo! 360 blog, recently closed by Yahoo! - had 1.3 million readers) that (a) I am NOT A FAN OF NOMINAL RELIGIOUS IDENTIFICATION - (b) nor am I supportive of arbitrary defections of any kind to lower moral standards.

An infrequently recurring question on vegetarian medical discussion lists in including those on topical medical concerns, where some clinicians and medical trained professionals are signed up, is animal ingredients in common medications. Some great servants of the vegetarians community like the Michaels - Dr. Michael Greger and Dr. Michael Klaper, have tried to help us steer clear of common over-the-counter preparations with animal ingredients, as have some pro-animal organizations (not only PETA, but others, too). You'll noted that, to the discredit of both vegetarians and presumptive vegetarians who are clinicians who ought to know the products AND our ethical and moral scruples about animal byproducts, many clinicians - including nominal Hindus, nominal Jains, nominal Adventists, and others - have failed to engage in pro-active HELP and service to the vegetarian communities, though they MAY be uniquely qualified to do so. Is it laziness or a misshapen sense that their NEW 'higher calling' is professional loyalty, a a jingoistic chauvinism to their professional colleagues, even when the profession is doing the wrong thing.

Let's get one thing clear: NO product of ANY kind should have ANY kind of animal ingredient or byproduct in it.

Therefore, no MEDICAL product of ANY kind should have ANY kind of animal ingredient or byproduct in it.

There's wide-ranging ignorance of this moral truth, but medical and health professionals who are NOT ignorant have even less to say in their defense when they err than have those whose moral laziness merely REFLECTS the social backgrounds from which they come.

In a column in the New York Times this week, Randy Cohen fields a question from an anaesthetist.

Should the doctor ask a devoutly religious patient whether he minds that his anticoagulant (heparin) is derived from pigs?

In his reply, Randy Cohen suggests that the doctrine of informed consent requires the doctor to consider the non-medical preferences of the patient and to make sure Muslims, Jews, and vegetarians (like us) know where medicine to be used in their treatment is coming from.

That's a second best (or third best, or not good) standard at best, but that's what Randy Cohen offers. It's a standard that's been around, has been widely accepted by medical ethicists and others in our culture, and seems to work with little additional thought. After all, clinicians should have a laboratory 'sense of things' that would include routinely understanding the chemical nature of stuffs, stuffs used in clinical treatment.

Are you with us so far? Good!

So Randy Cohen, in his New York Times article a week or so ago, suggests that the doctor's role includes a duty to provide whatever information patients need in order to make decisions about, decide, and effectively manage or control their care. But some doubt that it is a doctor's responsibilityto take into account what they call "preferences" (because they don't clearly understand the moral status of animals d they dismissive discount or deny their personhood.

These deniers claim that the doctors' role is too greatly extended.

Dominic Wilkinson of the University of Oxford, on August 24, 2009, posed this scenario:

"Imagine a vegan who takes particular exception to drugs that have been tested in higher order primates. Is the doctor expected to ask about all possible preferences and provide corresponding advice about treatments that conform to these? If so, this seems to be unreasonably demanding."

Briton Wikinson goes on to distinguish what he terms "the normative force of different claims about information-giving" (in other words, different nuances have different moral claims and intellectual legitimacy):

"There is a difference between

1. what would be good for the doctor to do, and
2. what we should expect the doctor to do, and
3. what we should sanction the doctor if they don't do?

If your doctor knows that you are a devout religious adherent, and that you may have an objection to a medical product that they know contains animal products, the doctor should inform you that the drug she is about to prescribe is derived from pigs. It would be good for them do so (level 1 above)."

So far, so good.

"And if you ask your doctor - does this drug contain animal products then the doctor should (stronger - probably level 2, maybe 3) find out about the drug and let you know."

Here's where we can take issue:

"Whether we should expect them (2) if you haven't asked or sanction them (3) if they didn't tell you is less clear to me.

We might also note that there is another side to responsibility when it comes to personal preferences for different treatments. If your preference is idiosyncratic or unusual you, the patient, probably have a responsibility to find out which potential treatments may contain animal products, as well as to let your doctor know that you really don't want animal products (or blood products etc). On the other hand if the preference is very common within the population perhaps the onus should be on the doctor."

Finally, Wilkinson quibbles further:

"As for the relevance of all of this for orthodox judaism, Randy Cohen notes that since Heparin is administered subcutaneously rather than orally it is apparently not proscribed."

Thinking here of being carried away kicking and screaming while refusing ill-intentioned treatment, I rephrase German Lutheran Pastor Martin Niemoller just a little:

First they came for the Muslims, but I wasn't a Muslim...

Then they came for the Orthodox Jews, but I wasn't an Orthodox Jew...

Then they can for the ethical vegans, and I wasn't an ethical vegan...

Then they came for me, kicking and screaming (and what did they want to do surreptitiously to MY body, about which I would object?)...

Let's put it this way:

Ethicists, particularly bioethicists should be thankful (or, if they don't believe in thankfulness, count themselves fortunate) to HAVE observant Muslims, Orthodox Jews, careful SDAs, self-caring body-owning feminists, and us ethical vegans BECAUSE we help to clarify the case that humans DO object to anyone's surreptitiously sneaking objectionable methods into their treatment and materials and substances into our bodies - in the same way we object to the USDA's approval of GMOs, irradiation, chemicalized agriculture, and more.

We should be THANKFUL that the woman's movement in the West and around the world has joined this chorus of these serious moral objections, and we should WELCOME American Republicanswho are yelling at the top of their lungs:

"Just one moment! What's going to be IN this treatment? What's going to be IN this health care program?"

We psychophysical unities of every stripe, brand, variety, background, persuasion, and pattern of human dignity demand no less than a transparent and open discussion of all these issues, even if it means that some well-intentioned measures can't be ramrodding into law quite so quickly.

Those who KNOW there is objection should be especially eager to fund research into NON-objectionable methods of caring for and preserving human health and for restoring it when illness and disease emerge (and for reducing and eliminating pain and providing proper care and treatment when that's the limit of suitable medical intervention).

We all know that the status quo in healthcare is not good enough, but it's more than access to currently-available treatments and their funding that's a mess. What is also all messed up is the WAY our society thinks about health and healthcare. I can give Ted Kennedy credit for noting that we ought to be paying doctors for keeping patients well, but I only puzzle whether or not we have trained these physicians to KEEP people well (when so much emphasis is placed on listening to complaints and treating post-diagnosisconditions.

Why not listyen to us? Of coruse, they ARE listening to us, and if it flies and flies far, they can claim it as their own.

And who should we be to com,plain if they DO develop treatment modalities that are agree of animal exploitation and abuse, focus first on primary prevention, emphasize a strong role for individual responsibility for health andsocial support for enabling that personal responsibility (safe and suitable exercise facilities in all workplace regions and residential areas, designing urban and suburban areas for exercise, and eliminating all subsidies for animal agriculture and making fresh produce afforcable and safe; shifting emphasis from high tech medicine to wards the low-hanging fruit of primary prevention, etc.). After all, what does it mean sociologically to be a servant of the greater public good, the good of all society? It means to serve wisely and effectively; it does NOT mean taking the credit. In the long run, the HEALTH of the people is FAR MORE IMPORTANT than the healthcare delivery of the people UNLESS that healthcare delivery PREVENTS the problems in the first place.

It is BETTER to have NOT suffered at all than to have suffered ravaging illness and disease, then, after costly treatment funded socially, to have recuperated (at least temporarily). Treatment costs money directly AND in lost productivity AND in lost happiness AND in suffering AND in grief for significant others and workplace colleagues. Being HEALTHY IS a savings. That's "IN THE NATURE OF THINGS" for all of us.

If you're looking for healthcare delivery savings, it's in keeping people well; that's why we're shifting to the IDEA of paying healthcare providers differently: paying healthcare systems (not just the doctors) for keeping people well.

In the search for cost savings, Peter Orszag should be exploring primary prevention. Shouldn't we all?

But don't put those animal ingredients in MY treatment protocols (and if we're well, we're less at risk for the medical violation of our bodies).

And the lowest common denominator, and thus the cheapest path for pharmaceutical companies, is to make ALL medicaments FREE of all animal ingredients and byproducts.

The ethicist (note point 3 above) told us that those who object the most should object the loudest because they're the ones who are hardest for the dulled mainstream to hear. We need to make OUR cases that we want an ethical and above-board system of providing health services to our species that don't violate the inherent rights of persons - nonhuman AND human.

And it's better to proactively make the case early than to resort to attorneys 'post-diagnosis' (after our bodies - and bodily rights - have been violated).

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