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Health Management Technology News
  April 2, 2014
In this issue:
 

► New interactive video to protect research subjects and reduce misconduct in clinical research

► Sound off on today's healthcare companies and trends!

► HMT Exclusive: Getting the most from an analytics solution

► Researchers develop technique to measure quantity, risks of engineered nanomaterials delivered to cells

► L.A. County grapples with healthcare for remaining uninsured

► Health care sign-ups surge toward 7M

► Gaming technology saves millions for Spanish healthcare


New interactive video to protect research subjects and reduce misconduct in clinical research

The Research Clinic, a Web-based interactive training video aimed at teaching clinical and social researchers how to better protect research subjects and avoid research misconduct, was released by the U.S. Department of Health and Human Services’ Office of Research Integrity (ORI) and Office for Human Research Protections (OHRP).

The video lets the viewer assume the role of one of four characters and determine the outcome of the storyline by selecting decision-making choices for each playable character.  The characters are:

  • A principal investigator (PI), a busy oncologist who must balance doing what he thinks is best for his patients and his research;
  • A clinical research coordinator, an overworked nurse who works for a PI  who pressures her to falsify data and violate  study protocols;
  • A research assistant who has difficulties obtaining informed consent and following research protocols; and
  • An Institutional Review Board (IRB) chair who is tasked with ensuring that research subjects and the integrity of the research enterprise are protected while dealing with a culture resistant to change.

The viewer is presented with various scenarios. For each scenario, the viewer is asked to choose from among courses of action, each of which leads to a different outcome. The video can be used to teach researchers how to avoid research misconduct and violating regulations enacted to protect human subjects in research studies.

About one-third of ORI’s research misconduct findings relate to clinical research studies.  The unique pressures in a clinical research setting may lead to falsification, fabrication or plagiarism of data by members of a research team.  When serious violations of human subject protections occur, it is possible that falsification and fabrication of data may go unidentified. The video highlights scenarios to help identify research misconduct in the clinical setting and provides solutions to help researchers avoid such missteps.

“We suspect research misconduct in clinical research may be underreported because review of clinical research data often focuses on issues other than falsification, fabrication or plagiarism,” said Don Wright, MD, MPH, ORI acting director.

Read the full HHS press release here ► 

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Sound off on today's healthcare companies and trends!

Help us rank the healthcare industry’s “best” suppliers in key product, service and technology areas. We will report your shared opinions in an upcoming issue of Health Management Technology.

Begin by clicking the link here ► 

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HMT Exclusive: Getting the most from an analytics solution

Big data refers to the volume and variety of information being generated and the speed at which it is being moved in and out of systems. In the hospital setting, massive amounts of clinical, financial and operational information are generated with every transaction, interaction and observation between caregivers and patients, payers, and employers. Each piece of information created has the potential to improve decision making in new and innovative ways. But accessing that data is often a challenge, since much of it is fragmented, locked in silos and disparate systems, preventing departments from being able to effectively interpret and collaborate on the information in a meaningful way.

In today’s healthcare market, the ability to analyze, understand and act on that real-time information is more important than ever. An analytics solution offers organizations the means to integrate and manage large volumes and collections of structured and unstructured data and content. By tying together information and linking it to outcomes, analytics tell an organization where it has been, where it stands today and, most importantly, where it is headed in the future.

Read the full HMT Online Feature here ► 

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Researchers develop technique to measure quantity, risks of engineered nanomaterials delivered to cells

Thousands of consumer products containing engineered nanoparticles — microscopic particles found in everyday items from cosmetics and clothing to building materials — enter the market every year. Concerns about possible environmental health and safety issues of these nano-enabled products continue to grow with scientists struggling to come up with fast, cheap, and easy-to-use cellular screening systems to determine possible hazards of vast libraries of engineered nanomaterials. However, determining how much exposure to engineered nanoparticles could be unsafe for humans requires precise knowledge of the amount (dose) of nanomaterials interacting with cells and tissues such as lungs and skin.

With chemicals, this is easy to do but when it comes to nanoparticles suspended in physiological media, this is not trivial. Engineered nanoparticles in biological media interact with serum proteins and form larger agglomerates which alter both their so called effective density and active surface area and ultimately define their delivery to cell dose and bio-interactions. This behavior has tremendous implications not only in measuring the exact amount of nanomaterials interacting with cells and tissue but also in defining hazard rankings of various engineered nanomaterials (ENMs). As a result, thousands of published cellular screening assays are difficult to interpret and use for risk assessment purposes.

Scientists at the Center for Nanotechnology and Nanotoxicology at Harvard School of Public Health (HSPH) have discovered a fast, simple, and inexpensive method to measure the effective density of engineered nanoparticles in physiological fluids, thereby making it possible to accurately determine the amount of nanomaterials that come into contact with cells and tissue in culture.

The method, referred to as the Volumetric Centrifugation Method (VCM), will be published in the March 28, 2014 Nature Communications.

Read the full Harvard School of Public Health
here
► 

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L.A. County grapples with healthcare for remaining uninsured

One long period of Obamacare hand-wringing in Los Angeles County will end Monday, as the window for residents to enroll in mandatory healthcare coverage comes to a close. But less than 24 hours later, county elected officials will be confronted with another politically sensitive facet of the nation's healthcare overhaul: how to manage roughly a million people, many of them poor or undocumented, who will remain uninsured either because they aren't eligible or failed to enroll.

Unlike some other counties in California, which are sidestepping the issue and leaving the problem largely to nonprofit free clinics, Los Angeles has committed to providing residents without coverage some system of government-supported medical care.

But the debate over what that care will look like — and how it will be funded — is only now getting started.

The county plans to set up a managed-care-like system for some uninsured residents, but advocates question whether the effort to get patients assigned to community clinics — and out of emergency rooms — will be enough. They plan to gather Tuesday before the county Board of Supervisors' weekly meeting and push for additional funding to expand the program.

"People want to sign up," said Tom Holler, co-executive director of One LA, a coalition of churches, synagogues and nonprofits that has been working to increase access to healthcare. "That's why we have to ask the county for more money."

Read the full Los Angeles Times article here ► 

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Health care sign-ups surge toward 7M

A surge of interest and last-minute technical glitches marked the final day of enrollment in health insurance through federal and state websites Monday, as a target once thought out of reach — 7 million enrollees — was on the verge of being reached.

Late Monday, a government official told USA TODAY that the administration is on track to sign up 7 million people by the midnight deadline. The official spoke on condition of anonymity because officials were not authorized to speak before the enrollees were all counted.

It is likely to be weeks before there is a final, official tally of how many people signed up for insurance under President Obama's signature Affordable Care Act as the administration has said will continue to work with late arriving applicants to get them covered.

Last week, Obama said 6 million people had enrolled in health insurance, and the number of sign-ups continued to rise over the weekend and into Monday.

The 7 million target was approached despite a series of glitches that struck Monday.

The federal HealthCare.gov website went down early Monday for four hours for what Health and Human Services Department officials called routine maintenance. Outages and intermittent delays hampered customers throughout the day, as more than 2 million people visited the site and more than 1 million had called the call centers by 8 p.m.

At one time, HHS spokeswoman Joanne Peters said, more than 125,000 people were using the site simultaneously. Officials with the federal and state exchanges said those who tried but couldn't complete the enrollment process would be allowed to finish this week and still be considered to have met the deadline. Users of the federal site just need to show they made a "good faith" effort to enroll to get an extension.

"We have been completely overwhelmed," said Liz Lee, community impact director for United Way, from her office in Cocoa, Fla. "We got to the point where we were booked up solid two weeks ago."

Read the full USA Today article here ► 

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Gaming technology saves millions for Spanish healthcare

In Spain’s Basque Country patients with chronic diseases including asthma, diabetes and arthritis are turning on their Xbox games consoles with their doctors’ approval. They are using a system called Teki which has been developed for the Basque health authorities by IT consultants Accenture.

Teki takes advantage of the Kinect system on Xbox which has a video camera that tracks a gamer’s movement so they can interact with games without a joystick or controller. The off-the-shelf technology means that patients can be monitored in their homes but also interact with health professionals without constant visits to a clinic or hospital.

Teki is part of a larger move towards using the phone and internet for interacting with the health system. During the first year of the project, Accenture estimates there was a €50 million saving through reducing the number of visits to hospitals. Some 18 per cent of primary care interactions in the Basque Country now happen online or over the phone.

Irishman Sean Shine is Accenture’s senior managing director for health and public service, and has been involved in major healthcare technology projects around the world in recent years including Teki.

He says “connected health” – where medical records are stored electronically and then linked up so that trends in the overall system can be spotted – is key to getting the most out of technology in the health system. Accenture is involved in connected health projects in Australia, Norway, Singapore and the US but Shine says they are not the sole preserve of wealthy countries with well-funded health systems.

Read the full Irish Times article here ► 

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