NCQA: Health IT Can Be Tapped To Support Patient Engagement

Friday, April 25, 2014

Successful integration of patient engagement tools into health IT systems has "the potential to improve inefficient communication methods and change the dynamic of the relationship between the patient and health care system," according to a new report from the National Committee for Quality Assurance, EHR Intelligence reports. 

However, the report noted that there is not yet a complete framework for boosting patient engagement through health IT systems.

Details of Report

In a survey, the report authors identified six common themes of "opportunities and challenges" related to patient engagement through health IT:

• Patient engagement is an untapped opportunity with major potential, especially among marginalized groups;
• Health IT should adopt a user-based model that originates from the needs and preferences of patients;
• There is a dearth of evidence on the effectiveness of such tools;
• Patient-engagement tools should be integrated into overall health care IT systems;
• Patient and consumer trust needs to be fostered; and
• Leadership and collaboration among stakeholders are necessary to realize the full potential.

The report also detailed four activities that will help the industry identify and develop a cohesive strategy for patient engagement through health IT, including:

• Developing joint principles that will facilitate the design, creation and adoption of health IT tools that boost patient care, improve overall population health and lower health care costs;
• Creating and implementing an evaluation framework that focuses on investment and prioritizes consumer choice;
• Facilitating the creation of a unified health data integration strategy focused on patient engagement; and
• Demonstrating innovative ways to use IT tools for patient engagement.

Comments

In the report, the authors wrote that "[h]ealth IT tools for patient engagement are often disconnected from the health care system and in need of full integration across all opportunities for engagement." However, the report added that successful integration of patient engagement in health IT systems has "the potential to improve inefficient communication methods and change the dynamic of the relationship between the patient and health care system."

NCQA President Margaret O'Kane said the "core idea" of the report is that health IT "should be designed around the needs and preferences of patients." She added that "the question of how to link [health IT] and patient engagement is an area where a unified strategy is most needed" (Murphy,EHR Intelligence, 4/23).

http://www.ihealthbeat.org/articles/2014/4/25/ncqa-health-it-can-be-tapped-to-support-patient-engagement

NYC gets cash to link 6 million patients with their health records

6 million patients to get their health records linked

Seven New York City health systems have been awarded $7 million in efforts to spur data sharing initiatives and more effective patient recruitment for clinical trials. 

The funding, provided by the Patient-Centered Outcomes Research Institute, or PCORI, will establish a clinical data research network in New York City, one of 29 such networks nationwide, officials say. These networks together will form PCORnet, the National Patient-Center Clinical Research Network, a $93.5 million patient-centered research initiative. 

The New York City Clinical Data Research Network, or NYC-CDRN, is a consortium composed of 22 regional organizations. The network, officials explain, will share capabilities and develop systems to support data-networking efforts and advance patient-centered research. It will initially focus its efforts on identifying individuals with diabetes, obesity and cystic fibrosis, and will partner with patients and clinicians through disease-specific community workgroups. 

"This contract is an exciting opportunity for leading New York City institutions to work together, through patient-centered research, for the health of the people who live here," said Rainu Kaushal, MD, chair of Weill Cornell's department of healthcare policy and research and the project's principal investigator, in a press release. "It validates New York's infrastructural advances in clinical data sharing."

[See also: Kaiser eyes outcomes with new network.]

The NYC-CDRN builds on six existing National Institutes of Health Clinical and Translational Science Award Centers that already work on collaborative research, data sharing and patient engagement. The CTSA centers are at Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, College of Physicians and Surgeons at Columbia University, Icahn School of Medicine at Mount Sinai, NYU School of Medicine, Rockefeller University and Weill Cornell. The project also has received support from the New York State Department of Health and builds on infrastructure established by two New York health information exchanges, Healthix and the Bronx Regional Health Information Organization.

The NYC-CDRN network will link medical records for 6 million New York City residents, and all records will be anonymized to protect patient privacy. Over the next 18 months, award recipients will expand and improve their individuals systems and further work to standardize data. Project officials say the scale of the data-sharing between institutions will make it far easier and faster to enroll patients in clinical trials and conduct comparative effectiveness and clinical outcomes research. The goal is to allow patients and providers to have access to evidence-based information they can use to make clinical choices and ultimately to improve healthcare.

PCORI announced back in December it had approved $93.5 million to support the 29 clinical research data networks. 

Earlier this January, it was announced that Kaiser Permanente would be one of these 29 receiving $7 million to build a clinical network focused on obesity, cancer and heart disease.  

http://www.healthcareitnews.com/news/groups-get-cash-data-sharing-network

Healthcare software innovation: Why in-house accelerators are better

This post was originally published on Vector, Boston Children’s Hospital’s science & innovation blog.

Considering that Boston is home to some of the country’s best medical, scientific and technological minds, it is little surprise that the city has a vibrant startup ecosystem. That ecosystem lowers barriers to creating groundbreaking innovations, connecting innovators to funding, mentorship and human capital. Yet, it isn’t very well-suited to help health care software innovators, who face a unique set of challenges.

The unique and increasingly complex IT environment within health care institutions is one of the biggest barriers to the development of novel clinical software solutions. To start with, health care delivery IT environments boast complicated safeguards to keep medical information secure. In addition, as these environments grow in scope and complexity, keeping pace with advances in clinical technology, it becomes harder to incorporate new software. Breakthroughs that enable Boston Children’s Hospital to be a leader in robotic surgery, for example, also make it harder to design technologies that can easily integrate with a hospital’s IT system.

The clinical IT environment is further complicated by a myriad of regulatory requirements. Plotting a course through the IT complexity, while complying with stringent security and HIPAA requirements, can be daunting. Furthermore, the FDA may soon be regulating clinical mobile apps and novel software as it does medical devices and pharmaceuticals. With regulatory concerns and complexity, it’s not difficult to see why many potential health care software innovators can get stuck in the early stages of the innovation lifecycle.

And the IT environment is not the only challenge for innovators wanting to develop new clinical solutions. Innovators need not only time and resources, but also highly specialized technical skills. Typically, innovators will reach out to their institution’s IT developers for help—only to discover that those developers have limited bandwidth and are busy working on higher priority projects.

As a result, innovators may seek an external software development vendor to build the solution they have in mind. But finding the right vendor is not easy. And even when there is a good health care software developer with which to partner, there are hurdles to negotiating contracts—and that is assuming there is money available to pay for the work.

Looking inward for answers

At Boston Children’s Hospital, we have built a unique program to help free aspiring innovators from many of the traditional challenges in building new clinical IT software. Known as FastTrack Innovation in Technology (FIT), part of the hospital’s Innovation Acceleration Program, it offers annual software development awards in the form of time with a special team of Boston Children’s project managers, business analysts and software developers.

The FIT team can rapidly translate a clinician’s idea into functional software that can be piloted in the hospital setting—and generally does so more efficiently and at a lower cost than most traditional software development vendors. FIT solutions have ranged from clinical software to mobile apps, and from clinician to patient-oriented solutions. Here are three examples:

• A Twitter-inspired app, called BEAPPER, allows emergency department staff to easily share and update information about their patients in real time and to get lab results on their mobile device.

• Another mobile app, MyPassport, helps inpatients communicate with their clinicians, access their care plan and track their progress toward discharge.

• ALICE, a digital “smart board,” has replaced the white boards and hand notations Boston Children’s clinicians used to keep track of patients in each unit.

A harvest of solutions

Having an in-house incubator has allowed Boston Children’s to rapidly create and test novel software solutions. Because our FIT developers understand the hospital’s IT environment, their technologies integrate far more smoothly than most vendors’ solutions to the same problem.

Innovating around clinical software solutions has traditionally been difficult. Because we can provide dedicated healthcare software development resources, our staff’s ideas are bearing fruit and helping us to enhance the delivery of pediatric care. To see so many innovators embrace these resources is not only gratifying to all of us in the IAP, it is also tremendously beneficial to the people who matter most—our patients.

Read more: http://medcitynews.com/2014/01/healthcare-software-innovation-house-accelerators-better/#ixzz2rbV0pFKT

mHealth Alliance Honors Mobile Health Visionaries in First-Ever Awards Ceremony at mHealth Summit

WASHINGTON | December 10, 2013 |

The mHealth Alliance, an organization dedicated to advancing the use of mobile technologies to improve health outcomes in low- and middle-income countries, announced this evening the winners of the Holly Ladd mHealth Pioneer Award and the mHealth Alliance Collaboration Award. This marks the first time that the Alliance has extended these honors. Dr. Richard Gakuba of Rwanda received the Holly Ladd mHealth Pioneer Award, while the Ananya partnership of Bihar, India, received the mHealth Alliance Collaboration Award. The awards were presented at a dinner celebrating the Alliance's fifth anniversary, which coincides with the fifth annual mHealth Summit, of which the Alliance is an organizing partner.

"These awards are designed to honor visionaries in the field of the mHealth - individuals and organizations whose work serves as a shining example of what is possible when we use mobile technologies strategically to improve health outcomes in developing countries," said Dr. Patricia Mechael, executive director of the mHealth Alliance. "We are delighted to have the opportunity to honor these outstanding members of the mHealth community, and we're grateful to the co-sponsors that have made it possible to recognize them."

The Holly Ladd mHealth Pioneer Award is co-sponsored by the mHealth Alliance, FHI 360 and the Rockefeller Foundation, and it includes a $5,000 cash prize and covers travel expenses to bring Dr. Gakuba to the mHealth Summit.

The Holly Ladd mHealth Pioneer Award

Dr. Richard Gakuba, the former national e-Health coordinator of Rwanda, received the Holly Ladd mHealth Pioneer Award - named in honor of Holly Ladd, a champion of community building and skills transfer in mHealth. The award recognizes an individual who is advancing sustainable solutions for personal and community health empowerment through the use of mobile technology.

"In just a few short years, the mHealth Alliance has been instrumental in making mHealth ubiquitous in global health. It demonstrates how philanthropic dollars, leveraged at the right moment, can catalyze entire fields," said Dr. Judith Rodin, President of The Rockefeller Foundation. "This progress has been further possible through visionary champions around the world like Dr. Richard Gakuba, who recognized the potential of mHealth and eHealth, and demonstrated how it can help transform health systems anywhere."

Dr. Gakuba was honored for his pioneering work, which has led to the creation and implementation of a national e-Health strategy for Rwanda. This strategy has created a regulatory environment that is enabling mHealth projects and programs to flourish and scale. Dr. Gakuba's work has helped to optimize the effectiveness of health care delivery and made health services more affordable in Rwanda.

"FHI 360 is honored to support the Holly Ladd mHealth Pioneer Award this year," said Albert J. Siemens, Ph.D., Chief Executive Officer of FHI 360. "The award acknowledges Holly's vision of how communication technology can transform the lives of millions of people around the globe. It celebrates her outstanding leadership and passion that have been an inspiration for so many."

Holly Ladd was the Director of SATELLIFE, which pioneered access to peer-reviewed medical and public health information for health care workers in developing communities via electronic-based information technology and low-earth orbit satellites. A true innovator in the development of systems to support health workers and strengthen health systems, Holly trusted the passion of health care workers to overcome a lack of familiarity with computers. When SATELLIFE joined FHI 360 in 2011, Holly redoubled her commitment to using mobile technology to expand knowledge, build human capacity and improve lives. The Holly Ladd mHealth Pioneer Award celebrates her innovation, compassion and magnanimity.

The mHealth Alliance Collaboration Award

The mHealth Alliance Collaboration Award was presented to the partners in the Ananya project, which is using mobile technologies in Bihar, India, to extend health information and services to families living beyond the reach of formal health facilities. The Collaboration Award recognizes individuals and/or organizations whose work through partnership has contributed significantly to advancing the field. The mHealth Alliance, itself, was created based on the vision that deepened collaboration and convening among members of the mHealth community could help overcome key obstacles in bringing effective mHealth products, projects, policies and programs to scale.

Ananya was honored for its ground-breaking model, including integrated approaches to achieving the Millennium Development Goals related to maternal and child health. The Government of Bihar (the Social Welfare Department and the Health Department), the Bill and Melinda Gates Foundation, BBC Media Action, CARE, Dimagi, the Grameen Foundation and World Health Partners will be recognized collectively for their innovative work that stands out as a leading example of an effective mHealth project operating at scale.

Note: Dr. Richard Gakuba will speak at mHealth+SocialGood, an event being held at the mHealth Summit on Tuesday, December 10th at 12 p.m. EST. This event will also be live streamed via www.mhealthsummit.org. Several members of the Ananya partnership will also be speaking at an mHealth Summit session held on Tuesday, December 10th at 5 p.m. EST. Both events will offer opportunities to hear directly from the award recipients and learn more about their work.

http://www.mhealthnews.com/press-release/mhealth-alliance-honors-mobile-health-visionaries-first-ever-awards-ceremony-mhealth

PROPELLER KEEPS ASTHMATICS OUT OF THE ER BY HARNESSING THE INTERNET OF THINGS

http://www.fastcompany.com/3021901/internet-of-things/propeller-keeps-asthmatics-out-of-the-er-by-harnessing-the-internet-of-th?partner=rss

AN INHALER WITH A SENSOR ON TOP BEAMS DATA TO DOCTORS THAT HELPS REDUCE EMERGENCY ROOM VISITS AND LOWERS HEALTH CARE COSTS.

BY LEAH HUNTER

Earlier this year, 498 asthma patients in California were split into two test groups. One group puffed their inhalers normally. But the second group was given a sensor that attaches to the top of the inhaler and beams data about their usage back to Dr. Rajan Merchant of Woodland Health Care. Each day, Dr. Merchant scans a list of several hundred patients to find the handful that need to be contacted for an office follow-up.

“Whenever there was a change in patients that require care, we would contact them either on the phone or have them come in,” Merchant told Fast Company. The patients in the control group also received sensors, but neither they nor their doctors were given access to the data. “We would see as them as usual when their symptoms were triggered or for their scheduled appointments.”

Propeller Sensor

This is one of the earliest clinical trials that will show how the so-called Internet of things--a vast array of small but interconnected devices that allow unprecedented levels of communication--could have an impact far more meaningful than automating your home lighting system. The asthma sensor is made by Propeller Health, and it recognizes what type of medication is being used, along with when and where symptoms are triggered. The data is shared with an app that tracks where and when each puff of medicine is discharged, and users can receive weekly updates via text message. It also tracks symptoms, triggers, and location, triangulating them so that you and your doctor can start to see what causes attacks. Are you in a high smog area? Is your bedroom too dusty? Do you use the rescue medication more in September when you’re burning leaves?

When you use the rescue medication it sends a text. 'We see you used your rescue information. We hope you’re okay.'

“The app prompts you for triggers," says Propeller's chief marketing officer Erica St. Angel. "When you use the rescue medication it sends a text, 'We see you used your rescue information. We hope you’re okay--when you’re feeling better, enter your trigger information. Like were you near a cat, was there mold, or was it cold outside?'" Over time that helps patients get smarter about when to take a preemptive puff.

Collecting and analyzing data from multiple individual asthmatics in a community unlocks another layer of potential for Propeller as well. The company partnered with the Weather Channel to monitor the air quality index in cities like Louisville, Kentucky, where they also teamed up with the city to give out free sensors to residents with asthma. “With many more users you can start to overlay other types of geospatial information, pollution, where the parks are, and create really dense and cool maps,” St. Angel says. “In Louisville you start to see time-based information--there is construction on the freeway right now, so asthma attacks are up.”

Around 26 million people suffer from asthma in the United States, according to the Centers for Disease Control (CDC). The annual cost of treating this condition is estimated at $50 billion. It has been calculated that if patient treatment could be better monitored, 80% of all asthma-related hospitalization could be avoided, and the mortality rate from asthma could be reduced by 20%.

Propeller's solution works even for people without smartphones. Through a partnership with Qualcomm Life, the inhaler sensor can be paired with a hub that plugs into the wall and transmits data. Patients using the hub receive an email with updates about their health. Propeller will even mail updates to people without Internet access. "Or we do phone calls," says Propeller CEO and cofounder David Van Sickle. "We have an asthma educator on staff for that reason.”

“I can care less about the technology,” Van Sickle says. “What we care about is improving outcomes to give people more asthma-free days.”

The early results show that the sensor is having a positive effect. Dr. Merchant, who has no financial relationship to Propeller or the foundation funding the study, released the first set of findings last week. Patients using the Propeller sensor on their inhalers had slightly fewer emergency room visits than the control group (0.103 versus 0.141 per person per year), and significantly fewer inpatient days (0.087 per person versus 0.225 among the control group).

Patients being monitored remotely with the Propellor sensors saved nearly $700 compared to the previous year for the same patients.

While that impact may appear to be small, it is measurable when applied to health spending, which is also being tracked historically for the test groups. The patients being monitored remotely with the Propellor sensors were on track to save nearly $700 compared to the previous year. “That was the biggest advantage,” says Merchant. “Both the hospital visits and the costs.”

The Propeller study is still young--this is the first quarter worth of results, and it doesn't wrap up until May of next year--but these are promising early results. And there's built-in incentive for doctors and hospitals to adopt the system. Regulatory changes taking effect in 2014 will, under Medicare's Hospital Readmissions Reduction Program, financially penalize hospitals that readmit patients with the chronic lung disease COPD within 30 days of their original stay. In January, Propeller is introducing a version of their sensor and app made specifically for patients suffering from COPD. “If you go to the hospital for COPD and are discharged but have to come back, there are penalties for the hospital--even if you go home stable,” says St. Angel. “This creates a driver for physicians to use the app to monitor and understand what is going on in the home environment.”

Telemedicine conference speakers say technology to connect patients, doctors is "effective and efficient" | jacksonville.com

By Charlie Patton

Telemedicine, the delivery of health care services using technology such as video conferencing, is “a cost-effective, hassle free and patient centered” approach to health care.

That’s the message State Rep. Cary Pigman and a dozen other speakers delivered Tuesday during the 2013-2014 Telemedicine Public Policy Symposium, held at the Mayo Clinic’s Jacksonville campus.

The symposium was hosted by State Rep. Mia Jones of Jacksonville and by Pigman, an emergency physician. After the conference, Jones said she and Pigman plan to co-sponsor a bill that would require Medicaid and private insurers in Florida to reimburse health care providers who treat patients using telemedicine. Currently, 21 states have such legislation.

Telemedicine “is effective and efficient,” said Anne Burdick, the associate dean for Telehealth and Clinical Outreach at the University of Miami Miller School of Medicine. “It should be reimbursed.”

“So much of what we do in health care is directed toward rescue,” Pigman said. “This would enable [physicians] to do more maintenance and preservation.”

Jeff Wacksman, practice operations director for Mobile Physician Services, which provides in-home visits to homebound patients in the Tampa Bay area, noted that 5 percent of Medicaid patients account for 54 percent of Medicaid spending.

One major reason the care of those patients is so expensive is that “they are accessing health care at its most expensive point” by showing up often in emergency rooms.

Providing new ways for such people to access health care could save a lot of money, he said. In fact, if the law were changed to allow homebound patients anywhere in the state to be treated in their homes using telemedicine approaches, the state could save billions, Wacksman said.

Toree Malasanos, a pediatric endocrinologist who is director of the Florida Initiative in Telehealth and Education at the University of Florida, said that using telemedicine techniques to treat kids with diabetes at a clinic in Daytona Beach had resulted in a 70 percent drop in emergency room visits and an 88 percent decrease in hospitalizations.

Telemedicine conference speakers say technology to connect patients, doctors is "effective and efficient" | jacksonville.com

Manhattan U.S. Attorney Announces Charges Against Eight Individuals In Connection With $2.3 Million Bribery And Kickback Scheme To Secure Business From A Medical Cost-Management Company

Source- http://www.justice.gov/usao/nys/pressreleases/July13/DharayanetalArrestPR.php

FOR IMMEDIATE RELEASE

Wednesday, July 17, 2013

One Executive Has Pled Guilty to Accepting Bribes and Kickbacks

Preet Bharara, the United States Attorney for the Southern District of New York, Thomas O’Donnell, the Special Agent-in-Charge of the New York Office of the U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”), and Steven G. Hughes, the Special Agent-in-Charge of the New York Office of the U.S. Secret Service today announced charges against eight individuals for their alleged involvement in a lucrative scheme in which information technology vendors paid over $2.3 million in bribes and kickbacks to secure business from executives of a Manhattan-based medical cost management company (the “New York Company”). The defendants charged with paying the bribes and kickbacks are SARVESH DHARAYAN, SANJAY GUPTA, VENKATA ATLURI, RANGARAJAN KUMAR, VADAN KUMAR KOPALLE, and DARREN SIRIANI. The defendants charged with receiving the bribes and kickbacks are ANIL SINGH and KEITH BUSH. DHARAYAN, GUPTA, KOPPALLE, and SIRIANI were arrested this morning at their homes in New Jersey, and were presented in Manhattan federal court this afternoon before U.S. Magistrate Judge James L. Cott. SINGH, who was previously arrested in April 2013, pled guilty to honest services fraud and other charges before U.S. District Judge Denise L. Cote on July 11, 2013. BUSH, who was also arrested previously on July 12, 2013, is next scheduled to appear in court for a pretrial conference on August 15, 2013. ATLURI and KUMAR are not yet in custody.

Manhattan U.S. Attorney Preet Bharara said: “For the eight defendants charged in this multi-million dollar scheme, bribes and kickbacks were allegedly the cost they imposed for doing business with this medical-cost management company. As today’s charges detail, the defendants achieved their years-long fraud through fake companies, sham invoices and made-up consulting services. Today’s actions underscore our commitment to work with our law enforcement partners to bring to justice individuals who break the law out of greed.”

HHS-OIG Special Agent-in-Charge Thomas O’Donnell said: “This scheme was motivated by greed and it deprived its victim, a company in the health care field, of the honest labor of its employees. We will continue to aggressively investigate those who pay kickbacks and bribes to gain an advantage in the public and private health care sectors.”

USSS Special Agent-in-Charge Steven G. Hughes said: “The Secret Service continues to enjoy its partnership with the New York Office of the U.S. Department of Health and Human Services, Office of Inspector General. We find partnerships such as this to be an effective way to share resources and stop criminals from continuing to engage in fraudulent schemes.”

According to the allegations contained in the Complaint, the Informations filed against BUSH and SINGH, and other statements made in Manhattan federal court:

SINGH was employed as a Senior Vice President and the Chief Information Officer at the New York Company, which provided nation-wide medical cost management solutions including, among other things, medical reimbursement services, and BUSH was employed as the company’s Director of Database Administration. SINGH and BUSH had considerable influence over the selection of vendors, specifically vendors of database administrators (“DBAs”), hired by the New York Company.

From 2008 to September 2012, various individuals collectively paid over $2.3 million in money and other benefits to SINGH and BUSH in exchange for SINGH’s and BUSH’s agreement to steer millions of dollars of the New York Company’s DBA business to them. Specifically, as alleged:

• DHARAYAN, the owner of a New Jersey information technology company (“Vendor 1”) and GUPTA, an employee of Vendor 1, paid approximately $1,722,620 in kickbacks and bribes to BUSH and SINGH in exchange for receiving DBA business from the New York Company. From 2010 to 2012, the New York Company paid Vendor 1 approximately $6,625,479.20 for placing DBAs with the New York Company.
• ATLURI, the owner of another New Jersey information technology company (“Vendor 2”), paid approximately $190,436.75 in kickbacks and bribes to BUSH and SINGH in exchange for receiving DBA business from the New York Company. From 2008 to 2012, the New York Company paid Vendor 2 approximately $11,495,804.88 for placing DBAs with the New York Company.
• KUMAR paid approximately $247,634 in kickbacks and bribes to BUSH and SINGH in exchange for their agreement to steer DBA business to another New Jersey information technology company (“Vendor 3”). From 2009 to 2012, the New York Company paid Vendor 3 approximately $2,593,210.38 for placing DBAs with the New York Company.
• KOPALLE, who was in charge of delivery and operations at a Texas information technology company (“Vendor 4”), paid approximately $142,967.50 in kickbacks and bribes to BUSH and SINGH in exchange for receiving DBA business from the New York Company. From 2009 to 2010, the New York Company paid Vendor 4 approximately $1,035,660 for placing DBAs with the New York Company.
• SIRIANI, the owner and operator of another New Jersey information technology company (“Vendor 5”) paid approximately $23,000 to $29,000 in cash kickbacks and bribes to BUSH and SINGH in exchange for receiving business from the New York Company. SIRIANI also paid for hotel rooms in Las Vegas and Costa Rica, deep sea fishing, massages, sports tickets, and other things, all in exchange for receiving business from the New York Company. From 2008 to 2012, the New York Company paid Vendor 5 approximately $1,177,600.91 for various services and products.

According to the Complaint, DHARAYAN, GUPTA, ATLURI, KUMAR, and KOPALLE paid the kickbacks and bribes through conduit companies established by BUSH and SINGH for the very purpose of disguising the true nature and origin of the illegal payments. To further conceal the bribery and kickback scheme, BUSH and SINGH sent false invoices to the conduit companies for consulting services that never occurred. Many of the kickbacks and bribes were paid pursuant to these false invoices.

*                      *                      *

DHARAYAN, 42, of Edison, New Jersey, GUPTA, 38 of East Windsor, New Jersey, ATLURI, 41, of Monmouth Junction, New Jersey, KUMAR, 47, of Monroe, New Jersey, KOPALLE, 43, of Edison, New Jersey, and SIRIANI, 45, of Matawan, New Jersey, were each charged with one count of conspiracy to commit honest services fraud, which carries a maximum term of 20 years in prison, one count of conspiracy to violate the Travel Act, which carries a maximum term of five years in prison, one count of honest services fraud, which carries a maximum term of 20 years in prison, and one count of violating the Travel Act, which carries a maximum term of five years in prison. DHARAYAN, GUPTA, ATLURI, KUMAR, and KOPALLE were also charged with one count of conspiracy to commit money laundering, which carries a maximum term of 20 years in prison.

SINGH, 40, a resident of East Brunswick, New Jersey pled guilty to one count each of conspiracy to commit honest services fraud, conspiracy to violate the Travel Act, honest services fraud, violating the Travel Act, and conspiracy to commit money laundering. He faces a maximum penalty of 70 years in prison on all counts. BUSH, 41, a resident of Rahway, New Jersey, is charged with one count each of conspiracy to commit honest services fraud, conspiracy to violate the Travel Act, honest services fraud, violating the Travel Act, and conspiracy to commit money laundering. He also faces a maximum penalty of 70 years in prison if convicted on all counts.

Mr. Bharara praised the outstanding efforts of HHS-OIG and the U.S. Secret Service in the investigation. He also thanked the New York Company for its assistance and cooperation in the investigation.

This case is being handled by the Office’s Complex Frauds Unit. Assistant U.S. Attorney Jason P. Hernandez is in charge of the prosecution. Assistant U.S. Attorney Christine Magdo of the Office’s Asset Forfeiture Unit is responsible for the forfeiture aspects of the case.

The charges and allegations contained in the Complaint and the Information filed against BUSH are merely accusations, and the defendants are presumed innocent unless and until proven guilty.

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Capital BlueCross challenges student developers nationwide to create web or mobile applications that improve health care

HARRISBURG, Pa., July 17, 2013 - Capital BlueCross is challenging student developers nationwide to create web-based tools or mobile applications that enrich the health care consumer experience. Winning entries can earn one of three prizes totaling $30,000.

Titled Blue Innovates, the challenge is an opportunity for students 18 years of age or older to bring their innovative ideas to life in one of three categories:

Financial: Applications that assist health care consumers in finding, accessing, organizing, simplifying, understanding or minimizing health care expenditures.

Telemedical: Technology that provides consumers with affordable and high quality health care while saving time and money.

Experiential: Tools that help consumers have a more personalized and satisfying health care experience and that enhance their well-being.

"As a leader in the health care industry, Capital BlueCross is seeking to develop new solutions that will meet the evolving needs of consumers who want to interact with health care like every other retail experience," said Donna K. Lencki, Capital BlueCross chief marketing officer. "We recognize there are a lot of talented people looking for an outlet to showcase their ideas and creativity. Blue Innovates allows us to tap into the minds of'millennials' to drive innovation in a rapidly changing industry to help consumers better understand and navigate the health care system for the best possible outcomes. We are delighted to kick-off this challenge."

Students may use their preferred tools, programming languages and technologies to develop a unique solution. All entries for Blue Innovates must be submitted by Nov. 22, 2013. Winners will be announced by Dec. 20, 2013. Entries must be original work created by the developer who is submitting the application for consideration.

To get started, students can visit Blue Innovates to register and review contest rules. Developers can also use the online forum on the Blue Innovates web site for support and advice throughout the process.

The developer of the first-place winning application will receive $15,000, while the second and third place winners will receive $10,000 and $5,000 respectively.

About Capital BlueCross

In 2013, Capital BlueCross is celebrating 75 years of serving central Pennsylvania and Lehigh Valley residents and businesses as the region's leading health insurer. Through its family of companies, Capital BlueCross brings innovative services and clinical solutions to the marketplace. Committed to delivering medical value to its communities, Capital BlueCross focuses on improving patient satisfaction, enhancing quality of care and reducing costs. The company continues to lead the change in the industry by meeting the evolving health needs of its customers, most recently by entering the retail market and building a first-of-its-kind health and wellness store called Capital Blue. Headquartered in Harrisburg, Pa., Capital BlueCross is an independent licensee of the Blue Cross and Blue Shield Association, employing more than 1,800 people. More information about Capital BlueCross can be found at capbluecross.com.

http://m.bwwgeeksworld.com/article/Capital-BlueCross-challenges-student-developers-nationwide-to-create-web-or-mobile-applications-that-improve-health-care-20130717

The Big Data Conference -

Co-located with Cloud Connect Chicago

In 2020, data production will be 44 times greater than it was in 2009. (Source)

Are you ready to transform your business with data?

Attend The Big Data Conference, October 21 – 23 in Chicago and take part in a world-class event designed for business and technology professionals charged with developing their company’s big data strategies.

The Big Data Conference provides three days of comprehensive content for every IT, marketing or digital professional seeking to capitalize on the boom in data volume, variety and velocity. Through the examination of large enterprise case studies bringing the practical application of big data techniques to life, The Big Data Conference fills a gap in the US market for businesses looking to capitalize on the big data opportunity and look for efficient solutions to manage the ever growing amount of structured and unstructured data.

Why Attend?

For companies, the big data movement represents an opportunity to identify correlations, connect new dots, and unlock unprecedented business opportunities. But how do businesses get started? And who should own big data initiatives that straddle the entire organization?

There’s no doubt that big Data is growing fast; each year, the generation of global data is doubling, and as it does so it becomes increasingly challenging to manage, interpret, store and secure. As data sets become more complex, standard database management tools and traditional data processing applications aren’t equipped to process and analyze these enormous data sets in their respective domain. This data is often accessed from different sources and is therefore difficult to utilize to its maximum potential.

But the big data market is not just about technologies & platforms – it’s about creating new opportunities and solving problems. Smart companies seeking to set a holistic big data strategy and discover ways big data technology can be an enabler to business solutions need an independent forum to engage, learn and glean best practices.

The Big Data Conference provides three days of comprehensive content for every IT, marketing or digital professional seeking to capitalize on the boom in data volume, variety and velocity. Through the examination of large enterprise case studies bringing the practical application of big data techniques to life, the Big Data Conference fills a gap in the US market for businesses looking to capitalize on the big data opportunity and look for efficient solutions to manage the ever growing amount of structured and unstructured data.

Topics to include:

• Large enterprise case studies
• The big picture: A lifecycle for big data management
• Structuring the organization to take advantage of big data
• Setting a big data strategy
• Data visualization & interfaces
• Domain-specific data types centered on people, money, time, and location
• Hadoop and other big data platforms & architectures

Target Audience – An exclusive group of 150 Big Data Decision Makers:

• Marketing & other line of business executives
• CTO, CIO & technology executives
• Technology strategists & enterprise architects
• Business & technology leaders seeking to drive new business opportunities & outcomes through big data
• Mid to large-sized companies
• Enterprise spanning diverse major industries

The Big Data Conference -

Wrapping up Phase 1: New data bolsters the general direction of innovation over the next five years

PwC concludes Phase 1 of its Mobile Innovations Forecast, in which we have examined trends in the performance of core components of mobile devices and infrastructure. Based on new data for these components, our fundamental assessment is that the rate of performance increases for these seven enabling components of mobile innovation—memory, application processor, storage, infrastructure speed, device speed, imaging and display technology—is expected to decelerate only slightly between 2011 and 2016, relative to 2007 to 2011.

Continuing advances in display technology, imaging, infrastructure speed and application processors (quad versus single purpose strategy more than performance per se) appear more closely tied to mobile innovation bursts.

We do see a potential trouble spot with the coming introduction of ultra high definition (UHD) video. Will the massive data streams produced by UHD overwhelm the other components? We explore that issue in the article. On the other hand, we are enthused by the early breakthroughs demonstrated by smartphones that use contextual information to deliver new value to owners. And a major question as we move into Phase 2 of our exploration of mobile innovation is how many mobile operating systems (OS) and associated app store ecosystems will survive to relevancy by 2016?

Figure 5: Index component changes

 

This forecast exists within PwC’s framework for understanding various dynamics driving the broader technology sector today, a framework that suggests ways technology companies might navigate disruptions that are rich in opportunity.

Our coverage of the vast mobile ecosystem is an ongoing project comprising four phases. Phase 1 examined the performance improvements of existing technology components. Phase 2, launching soon, covers new capabilities being added to mobile devices. Phase 3 will review compelling new use cases. And Phase 4 will cover new business models.

To learn more about mobile innovation in the next few years, read or download the full article.

http://www.pwc.com/gx/en/technology/mobile-innovation/phase-1-wrap-up.jhtml?WT.mc_id=email_6-13_mobile-innovations-forecast-social?WT.mc_id=sharebookmark_linkedin

Medicare Fraud Reduction Plan Introduced | Alton Daily News

Medicare Fraud Reduction Plan Introduced

WBGZ Radio 6/19/2013

By Jim Anderson - Illinois Radio Network

An Illinois congressman is taking another stab at reducing Medicare fraud. U.S. Rep. Peter Roskam (R-Wheaton) has introduced a bill to require the government to sniff out fraud in Medicare and Medicaid the same way credit card companies are alerted to suspicious activity. “It’s literally deploying technology that’s already used. This is not blue sky technology. This is not some brand-new, untried thing, but it is technology that is tried and true, and what we’re saying is it is time for the federal government to adopt this same technology,” he said at a news conference at Northwestern Memorial Hospital in Chicago.
Credit card companies use software that raises red flags if a card holder attempts to make purchases out of the country without having purchased a plane ticket or a hotel stay there, for example, or if someone tries to buy thousands of dollars’ worth of jewelry or electronics in a location far from home. Roskam says such a program could detect prescriptions that don’t match up with a prescribing doctor who has treated that patient, for example.

Roskam says fraud and waste in Medicare and Medicaid amounts to $60 billion annually – some of it with criminal intent, some of it just error – and this program could cut that in half.
The effort, which has bipartisan support in Congress, also has the backing of AARP. “It’s critical that Congress adopt responsible solutions that will save taxpayer dollars and improve the overall efficiency and cost-effectiveness of our nation’s health care system,” said Bob Gallo, Illinois state director of AARP.
Roskam has introduced a bill like this before, but has not yet found success.
(Copyright WBGZ Radio / www.AltonDailyNews.com)

Medicare Fraud Reduction Plan Introduced | Alton Daily News

Letting a Hundred Flowers Blossom: HCIA Round Two Provides $1 Billion to Test New Models of Care

 

Guest Contributor  |  June 12, 2013  |  Tags: funding, hcia

Jack Challis is the CEO and co-founder of CliniCast.
By virtually every measure, the United States’ healthcare system spends far too much for health outcomes that are sub-par in comparison to the rest of the developed world. Policy makers at the local, state and federal level agree that Americans should have better quality care and better health outcomes at significantly reduced prices, but very few agree on the specific changes that need to be made. Providers, health systems, government bodies, technologists and a host of others have put forward a multitude of proposals to reduce this systemic cost, which begs the question, which programs are worth implementing?
The Affordable Care Act addressed this issue by setting aside $10 billion over a 10-year period to fund Health Care Innovation Awards, grants specifically designed to test new models of delivering and paying for care. Each awardee receives between $1-30 million to prove out their model of delivering care over a three year period. The most successful programs could provide a template for deployment nationwide.
The first round of funding, announced last year, provided almost $900 million in funding for 107 programs. Several of these programs explicitly included technology for care coordination, telemedicine, medication reconciliation, decision support and shared decision making.  Information on the first group of awardees is available here: http://innovation.cms.gov/Files/x/HCIA-Project-Profiles.pdf
Now the Center for Medicare & Medicaid Services has announced Round Two of these awards, again funding roughly 100 programs with up to $1 billion in grants. The stated goals of this program include:

• Reducing cost for Medicare, Medicaid and CHIP beneficiaries in outpatient and /or post-acute settings
• Improving care for populations with specialized needs
• Testing approaches for specific types of providers to transform their financial and clinical models
• Improving health of populations through activities focused on engaging beneficiaries, prevention, wellness, and comprehensive care beyond the clinical setting.

These programs are expected to achieve real results: each must deliver value for patients within six months and achieve breakeven in three years.
Any organization with a well-developed idea to deliver better population health, better quality of care or reduced total cost of care should apply. While most applications will be from traditional organizations like provider groups or health systems, technology companies are particularly encouraged to apply. CMS will evaluate projects on five criteria:

• Design of proposed service and payment models
• Organizational capacity and management
• Projected return on investment
• Budget design
• Ability to measure, monitor and report results

Letters of Intent for the program are due June 28th with final applications due August 15. The three year award period begins April 2014.  More information is available from the HCIA Round 2 website: http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/Round-2.html
At CliniCast, we believe that technology has a strong role to play in supporting smarter, more cost-effective care. If you would like to know how technology might support your HCIA Round 2 application, I encourage you to contact me at jack@clinicast.net .
Jack Challis is the CEO and co-founder of CliniCast, a healthcare analytics startup building risk scores, cost scores and workflow tools to identify high risk patients, match patients to appropriate interventions and streamline workflow. By mining actionable insights from health data, CliniCast enables providers to optimize outcomes and minimize unnecessary costs.


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