Telehealth Included in at least Two Areas of
VA Innovation Initiative (VAi2)
Mary Mosquera of Government HealthIT reported on June 08, 2010 “The Veterans Affairs Department will make $80 million available to test technology applications developed through a competition to find innovative solutions to VA’s most pressing healthcare challenges, including homelessness, expanding online healthcare and strategies for treating kidney disease on an outpatient basis.”
VA Announces Industry Innovation Competition
$80 Million Available for Private Sector Innovations
June 7, 2010 VA Press Release excerpted:
WASHINGTON – Secretary of Veterans Affairs Eric K. Shinseki announced today the opening of the Industry Innovation Competition by the Department of Veterans Affairs, the most recent effort under the VA Innovation Initiative. With this competition, VA seeks the best ideas from the private sector to address the department’s most important challenges.
“At VA, we are continually looking for new ways to improve the care and services we deliver,” said Secretary Shinseki. “Engaging the private sector to tap its expertise and find ways to leverage private-sector innovations, we can improve the quality, access and transparency in service to our Nation’s Veterans.”
The VA Innovation Initiative (VAi2) is a department-wide program that brings the most promising innovations to VA’s most important challenges by involving employees and the private sector in the creation of visionary solutions in service to Veterans.
Innovation is more than simply a collection of ideas,” said Jared Cohon, president of Carnegie Mellon University. “It requires close collaboration between academia, industry and government to produce solutions that make a meaningful impact on society. VAi2’s programs bring about exactly that kind of fruitful collaboration.”
“Creativity in the private sector generates a wealth of technology capability that can help drive VA forward,” said Dr. Peter Levin, senior advisor to the secretary and VA’s chief technology officer. “By targeting innovations that are nearing commercialization, the Industry Innovation Competition provides a bridge between creative ideas in the private sector and real-world deployments that improve the services we deliver.”
Public and private companies, entrepreneurs, universities and non-profits are encouraged to participate in the competition…
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This Broad Agency Announcement (BAA), solicitation number VA118-10-RP-0418, sponsored by the Veterans Affairs Innovation Initiative (VAi2) will provide support to the VAi2 Industry Innovation Competition (Industry-IC). The Industry-IC invites private sector companies, entrepreneurs and academic leaders to contribute ideas for innovations that increase Veteran access to VA services, reduce or control costs of delivering those services, enhance the performance of VA operations and improve the quality of service that Veterans and their families receive. Specifically, the proposed effort supports the acquisition of solutions submitted by industry in response to VAi2 solicitations. Note: In order to conduct business with the Government, contractors must be registered in the Central Contractor Registration (CCR) database.
It is anticipated that proposals submitted in response to this BAA shall fit into one or both of the following phases. Offerors shall indicate which phase applies to their submission, or that it is a combination proposal.
Development Proposals: New and untested ideas and technologies or novel customization and application of existing technologies with the potential to provide benefits outweighing all costs and which provide results that significantly exceed currently deployed solutions. Technologies and products submitted as Development Proposals shall achieve a working prototype or test system preferably within one year but preferably within two years.
Field Test Proposals: Products and solutions that have demonstrated significant value in commercial or other production environments but are new to the operating environment within Veterans Affairs. Solutions shall be repeatable and ready for small-scale deployment at the regional or VISN level. Should the results from small-scale deployment prove favorable, the solution shall be scalable to a VA-wide implementation. It is anticipated that this BAA fund the small-scale field testing.
The VA is looking for solutions which can be implemented and impact to the VA realized within a 12-24 months timeframe.
An industry day is scheduled via Webinar on June 16 2010. Information will be provided for each area of interest and questions from industry will be addressed. As it becomes available, additional Webinar information will be posted at http://www.fbo.gov/ and www.va.gov/vai2
Topic Number: 0002
Topic Title: Telehealth
Topic Detail: Broadly defined, Telehealth includes a wide range of technologies and solutions that connect caregivers and patients and improve the ability to prevent, diagnose and monitor health conditions, to manage treatments and to enable communication and intervention when required. Telehealth solutions can provide mobile caregivers with greater flexibility, allowing them to spend more time interacting with patients. Access to healthcare services can be enhanced for rural patients or for patients for whom travel to hospitals is difficult. Frequently, these services can improve the quality of care while lowering costs.
The Department of Veterans Affairs has been a leader in the deployment of Telehealth solutions for some time, and currently reaches thousands of veterans through services such as home health monitoring (see www.carecoordination.va.gov/telehealth for more information).
VA is interested in solutions that significantly extend and improve our ability to provide the right treatment in the right place at the right time, using technologies such as, but not limited to:
- Wireless communications
- Videoconferencing
- Imaging
- Remote sensing & monitoring
- Portable or wearable sensors
- Mobile devices
- Web-based services and patient portals
- Human factors, ergonomic and usability design
- Process and workflow design
Potential applications for Telehealth solutions are broad and varied, and we encourage the submission of proposals that have significant impact on the quality, access, cost and performance of the healthcare delivered to veterans. Example applications include, but are not limited to:
- Home Monitoring for Chronic Care: The ability to monitor patient vital statistics from a distance has existed for many years and has improved chronic care and disease management. However, the needs and expectations of both patients and caregivers continue to evolve, and Telehealth technology must evolve beyond the recording and reporting of key statistics. Functions such as real-time, two-way communication between patients and all members of the care team; self-management tools allowing patients to take an active role in their care, continuous, real-time and/or unobtrusive sensing & monitoring; delivery of educational content, integration of wireless mobile devices with Telehealth delivery and more can significantly extend the reach and scope of Telehealth services in the home environment.
- Home Monitoring for Severe or Challenging Disabilities: Veterans with severe disabilities may have care that is managed at home, but may further benefit from specialist recommendations for environmental modifications or other quality-of-life improvements based on continual home monitoring. Also, certain injuries (such as Traumatic Brain Injuries) and conditions (such as mental health) are difficult to diagnose and monitor through the measurement and analysis of traditional vital statistics. Long-term monitoring of diverse symptoms such as headaches, fatigue, memory function, depression, irritability, anxiety, etc. may be required. Changes in symptoms based on social environment such as family interaction and community involvement, or based on types & levels of activities such as physical exercise, home management, child rearing, work and recreation may be important to monitor. As a special case of Home Monitoring, solutions that involve creative methods to capture, record and communicate these kinds of difficult-to-capture symptoms are of interest.
- Home Monitoring for Acute Care: Acute hospital care may not always be the best solution for many patients. Factors from risk of additional infection to the emotional benefits of being in a familiar environment may make home-based care a preferred option. Home monitoring capabilities are a crucial part of enabling such options. Hospital@Home is an innovative approach that VA has employed for a number of years to provide hospital-like services to patients in their homes for such conditions as acute heart failure, pneumonia, and other conditions that can safely be managed at home with intensive support of a physician, nursing, and home infusion capability. Also, similar capabilities exist to remotely monitor patients in Intensive Care Unit settings. VA is interested innovative approaches that allow for the remote monitoring, in the home environment, of patients’ vital signs and that enable visual interaction between patients and caregivers. Proposed solutions must be capable of storing information in VA electronic medical records.
- Mobile Support for VA Preventive Care Coordinators: Preventive Care coordinators can improve care and reduce costs by serving multiple veterans outside of the hospital environment, capturing and reporting relevant data and interacting with patients to monitor overall well-being. However, a substantial amount of caregiver time involves routine data collection and recording, leaving less time for valuable patient interaction. Solutions that provide a capability to capture vital statistics and quickly transfer them to the Care Coordinator can significantly impact the quality of interaction between the Care Coordinator and the patient. As an illustrative example, a vest containing relevant sensors and monitors might capture vital statistics upon or prior to Care Coordinator arrival and transmit data to a mobile device carried by the Coordinator.
- VA has offered patients group visits (Doctor Interactive Group Medical Appointments – DIGMA) for almost 10 years. These group interactions with healthcare providers optimize care for patients with similar chronic conditions, such as diabetes, and foster an environment where patients can coach and mutually support each other in the management of their chronic disease. VA would like to explore virtual options to provide a similar environment for patients that cannot or choose not to travel for such care. These solutions may employ social networking tools that would allow patients to drop-in to a virtual group visit in a secure environment. These solutions should allow for the capture of some information into VA’s electronic medical record, such as patient documentation and the collection of health information relevant to the encounter.
- Online Care: Veterans currently have access to online services through My HealtheVet (www.myhealth.va.gov ), where they can access trusted, secure and current health and benefits information and may be able to access Personal Health Records and functions such as prescription refill. However, web-based technology offers the opportunity to provide significant new services such as real-time interaction with caregivers via video, text chat and/or telephone. VA wishes to explore options that would allow for either synchronous or asynchronous communication between patients and clinicians or administrative staff, in ways that protect patient confidentiality and privacy. Where possible, integration of new online services with the existing MyHealtheVet should be considered. It should be noted that VA has some experience with providing online services, such as video monitoring, on a small scale. Therefore, proposals that demonstrate point solutions via individual prototypes may not be as valuable as proposals that involve fully integrated solutions and scalable platforms.
- Communication Tools that allow Clinician-to-Clinician interaction: VA has an advanced electronic health record, but lacks tools that improve clinician to clinician communication, particularly over significant distances. VA would like to provide the capability to staff to be able to communicate with each other about sensitive patient care information in a secure environment that protects patient confidentiality and privacy. These tools might provide either synchronous or asynchronous capability to request urgent help with patient care issues or to communicate more routine information that might not otherwise specifically be in the medical record. For example, such a tool might be used by a physician in an acute care setting (hospital or emergency room) to communicate with the patient’s primary care team, notifying them of the visit or discharge, with specific concerns or follow up requirements. Ideally, this tool could be used by both VA staff as well as clinicians outside of VA to communicate with VA staff. These tools should ideally fit into the normal work flow of VA staff (possibly from within the VA electronic medical record).
Topic Number: 0003
Topic Title: Expansion of Polytrauma Rehabilitation Services
Topic Detail: Rehabilitation services encompass a broad range of therapies and treatments which provide maximum reduction of physical or mental disability and restoration of a patient to their optimal functional level. Service delivery models vary by range of providers and environments of care, which include but are not limited to provider offices, freestanding outpatient clinics, medical centers, nursing homes, patient homes, and may involve remote/Telehealth interventions. Regardless of provider type or treatment setting, an effective individualized rehabilitation plan, developed following a comprehensive evaluation, can help patients restore function and cope with deficits that have not otherwise been reversed by medical care.
The Department of Veterans Affairs has been a leader in the provision of rehabilitation services across multiple spectrums of care. Rehabilitation services provide the core disciplines in the Polytrauma System of Care (see www.polytrauma.va.gov) which was established to provide specialized comprehensive inter-disciplinary rehabilitation care to veterans and returning service members with polytraumatic injuries.
VA is interested in technological solutions that assist in the provision of evidence based practice through enhanced access to treatment algorithms and the expansion of remote assistive technology monitoring services, regardless of treatment location. This effort will help to bridge geographic distances and improve our ability to provide the right treatment in the right place at the right time. For these efforts, we are interested in using technologies such as, but not limited to:
Portable interfaces to computerized medical records
- Real time bi-directional data exchange
- Interactive/responsive programming to user entries
- Wireless communications
- Videoconferencing
- Remote sensing & monitoring
- Portable or wearable sensors
- Mobile devices
- Web-based services and patient portals
- Human factors, ergonomic and usability design
- Process and workflow design
Potential applications for rehabilitation services are broad and varied, and we encourage the submission of proposals that have significant impact on the quality, access, cost and performance of the health care delivered to veterans. Example applications include, but are not limited to:
- Dynamic Treatment Algorithms: Collaboration among VA, Department of Defense, and private sector has expanded the availability of evidence-based clinical practice guidelines in rehabilitation focused treatment areas which include but are not limited to mild TBI, low back pain, cerebrovascular accidents, dysphagia, and amputation. Provider utilization of these clinical practice guidelines/decision trees for emerging areas of practice through technology based interfaces is still not maximized. Technology should be sensitive and responsive to the actions of the providers such that treatment recommendations and contraindications are provided, practice patterns are captured and monitored, and outcomes are stored for analysis. The expansion of this monitoring should include not only the immediate clinical setting, but may also extend to the patients home for regular follow up. Consideration should be given to provider collaboration and outreach in dealing with complex cases through technological solutions which permit real time exchange of data between multiple locations working on the same evaluation; interaction between patient (self completed surveys), and multiple providers; and documentation/storage of the results in a central location. Consideration should also be given to self-management tools which would allow patients to take an active role in their care and delivery of appropriate educational content based on patient feedback/status.
- Home Monitoring for severe or challenging disabilities: Veterans with severe disabilities may have care that is managed at home, but may further benefit from specialist recommendations for environmental modifications or other quality-of-life improvements based on continual home monitoring. Also, certain injuries (such as Traumatic Brain Injuries) and conditions (such as mental health) are difficult to diagnose and monitor through the measurement and analysis of traditional vital statistics. Long-term monitoring of diverse symptoms such as headaches, fatigue, memory function, depression, irritability, anxiety, etc. may be required. Changes in symptoms based on social environment such as family interaction and community involvement, or based on types & levels of activities such as physical exercise, home management, child rearing, work and recreation may be important to monitor. As a special case of Home Monitoring, solutions that involve creative methods to capture, record and communicate these kinds of difficult-to-capture symptoms are of interest.
- Symptom-Based Medication Guidance: The prevalence of patients with symptoms related to TBI has led to increased research and collaboration on developing treatment recommendations for patients who may have experienced a mild, moderate or severe TBI. Medication recommendations based on reported symptoms are available, and technology can enhance the communication of these recommendations and their utilization by providers caring for these patients. This technology should be mobile, dynamic, and reactive based on changes in patient status and provider entries. Solutions should be able to store, analyze and respond to data entered into the system, alerting providers to any potential recommendations or contraindications. Consideration should also be given to provider collaboration and outreach in dealing with complex cases through technological solutions which permit real time exchange of data between multiple locations working on the same evaluation; interaction between patient (self completed surveys), and multiple providers; and documentation/storage of the results in a central location. Expansion of technological solutions in this area will assist in improving care and reducing costs through remote patient interactions and adherence to evidence based practice.
- Assistive Technology (AT): Veterans are currently provided with a variety of assistive technology devices, including augmentative communication devices, environmental control units, cognitive devices, specialized mobility devices, etc. Initial evaluation and training occurs at the prescribing clinic. Often training needs change or do not become apparent until this technology is used in the home for a period of time. VA is interested in mechanisms to monitor use, provide ongoing follow-up and training, and further evaluate the AT needs of Veterans remotely in their homes. Consideration should also be given to provider collaboration and outreach in dealing with complex cases through technological solutions which permit real time exchange of data between multiple locations working on the same evaluation; interaction between patient (self completed surveys), and multiple providers; and documentation/storage of the results in a central location.
ADDITIONAL TOPICS
Topic Number: 0001
Topic Title: Addressing Veteran Homelessness via Innovative Housing Technology
Topic Number: 0004
Topic Title: Adverse Drug Event Trigger Tool: Reducing Adverse Drug Events for our Nation’s Veterans
Topic Number: 0005
Topic Title: Integrated Business Accelerator
Topic Number: 0006
Topic Title: Dialysis & Kidney Replacement
