Health and Human Services office seeks comments on “Meaningful Use” regulation on accessing Electronic Health Records

Technology has changed the way we receive and store our information. The transition from paper records to Electronic Health Records (EHR) has the potential to improve the delivery of health care for all Americans. Currently the Health and Human Services Office on Disability is advising the disability community to weigh in on EHR policies and standards which are being implemented and developed.

The following are some details on what is currently happening:

“In late December, the Centers for Medicaid and Medicare Services (CMS) released a notice of proposed rulemaking that defined how health care providers can demonstrate “meaningful use” of electronic health records that would qualify themselves for Federal incentive payments made available under the American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111–5).   At the same time, the Office of the National Coordinator (ONC) for Health Information Technology released an interim final rule describing certification standards for Electronic Health Records (EHR) technology.”

On January 13, 2010, a 60-day public comment period was launched and published in the Federal Register.

You have the opportunity to share your insights and suggestions about the accessibility of electronic health records and the above question with the Office of the National Coordinator. To be assured consideration written or electronic comments for both the ONC interim final rule and the CMS Notice of Proposed Rulemaking must be received at one of the below addresses  no later than 5 p.m. on March 15, 2010.

1. Electronically. You may submit your comments electronically to http://www.regulations.gov. Follow the instructions for “Comment or Submission” or “More Search Options” to find the information collection document(s) accepting comments.

2. By regular mail. You may mail written comments to the following address: CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development, Attention: Document Identifier/OMB Control Number, Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850

For more information visit the Health and Human Services Department at  http://www.hhs.gov/

Let’s face it, science is cool. The research that is now accomplished on a daily basis was inconceivable fifty years ago. Technology seems to be advancing at an exponential rate. Advancements in accurate disease screening, improved medications and even cures are becoming real possibilities. For the first time ever, a real-time death of a retinal nerve cell in Alzheimer’s disease was recorded.  The results of this important research means a simple and inexpensive eye test could be developed to aid in the early detection and diagnosis of major neurological diseases such as Alzheimer’s.

The research, led by Professors Francesca Codeiro and Stephen Moss, published their findings and demonstrated how their new technique enables retinal, and therefore brain cell death, to be directly measured in real-time. The technique uses a customized laser ophthalmoscope, which is usually reserved for lab use rather than in live animals.

Professor Cordiero said: “The death of nerve cells is the key event in all neurodegenerative disorders – but until now it has not been possible to study cell death in real time. This technique means we should be able to directly observe retinal cell death in patients, which has a number of advantages in terms of effective diagnosis…Currently, the biggest obstacle to research into new treatments for neurodegenerative disease is the lack of a technique where the brain’s response to new treatments can be directly assessed – this technique could potentially help overcome that.”

She added: “Few people realize that the retina is a direct, albeit thin, extension of the brain. It is entirely possible that in the future a visit to a high-street optician to check on your eyesight will also be a check on the state of your brain.” The future of science and technology holds many wonders and sights yet to be seen. It’s exciting to dream of a world of flying cars and eye exams that check both your brain and vision. As this new research shows, that might not be so far fetched after all.  Like I said, science is cool.

Cocktails are adorned with everything from chunks of fruit and tropical umbrellas to chocolate swirls and sugared rims. The sweet libations are notorious for tasting delicious, for going down smooth and for frankly killing brain cells. While most of us enjoy a bartender’s concoction every now and then, scientist have found, in preliminary research, a different kind of cocktail that may restore brain function.

A carefully proportioned cocktail of three components that naturally occur in the body—uridine, choline, and omega-3 fatty acid DHA—may help restore brain synapses for people diagnosed with Alzheimer’s. Low synapses are associated with memory loss and language deterioration which are common symptoms of Alzheimer’s disease.

The new nutritional drink, called Souvenaid, could be available in pharmacies as early as next year. It will be labeled a “medical food” which requires it is consumed with the guidance of a physician. Co-author of the study Dr. Richard Wurtman, professor at the Massachusetts Institute of Technology, says the drink’s components “are already found in the body and have been shown to be safe. But taking a supplement of any one of them will not have the same beneficial effect. Together in the right proportions, the cocktail increases the production of fatty constituents and proteins needed for synapses. Drinking the combination of these nutrients is akin to pregnant women taking folic acid supplements. It’s not that they are deficient in these nutrients, but the addition of more of them carries benefits.”

We should all hope that this research proves to be a helpful aid to those suffering from Alzheimer’s disease. As they say at the end of a toast, bottoms up!

The human body is mostly made up of water. Recently a team of Italian researchers studied the effects water had on the brain, and its link to Alzheimer’s and dementia. They measured the motion of water inside the hippocampus using cutting-edge brain-imaging tests. The scans showed people 50 and older with higher water motion did worse on simple tests measuring visual-spatial memory.

Multiple tests were used in the study to measure memory capabilities. Previous research did not link the volume of the hippocampus to performance on memory tests however the researchers used a type of analysis called diffusion tensor imaging. This is what lead researchers to find that subjects with high level of diffusivity in the hippocampus scored poorly on memory tests. While scientists aren’t sure why the increase in water would affect memory it does add new information to mounting research in the fight against Alzheimer’s.

In a related editorial Norbert Schuff, researcher of the Center for Imaging of Neurodegenerative Disease at the Veterans Affairs Medical Center in San Francisco said the study could become a valuable tool for detecting early Alzheimer’s. He adds, “As better medications become available, it will be essential to identify individuals at high risk for the disease not only early but also as accurately as possible so that treatment interventions can be most effective.”

As we age our bodies inevitably deteriorate and fortunately or not we are living longer than ever. The unforeseen ripple effect of the coming “gray wave” will be a spike in the need for caregivers. In a study funded by the MetLife Foundation found that almost one third of the US adult population plays a caregiver role.

The statistics reported in December in Caregiving in the U.S. 2009, found that 65.7 million people act as caregivers of the elderly and children with special needs. Caregiving required on average 20 hour per week. The findings also found that caregivers are predominantly female (66%) and an average of 48 years old. The study also revealed that both caregivers of adults and their recipients are now older than they were five years ago. The primary reasons people need care are no surprise old age (12%), Alzheimer’s disease (10%), mental/emotional illness cancer, heart disease and stroke.

An unfortunate side effect of being a personal attendant is that one in six caregivers reported that care giving has had a negative impact on their health. Neil Hunt, president and CEO of the National Alliance for Caregiving, says, “The shift to an older population of caregivers’ points to a real need for assistance for these individuals from family, friends, employers and social service programs. With more support for caregiving, older and disabled people would be able to do what is so important to them to remain in their own homes with those they love.”

New research suggests leptin, a hormone that regulates the appetite, may guard against Alzheimer’s disease. The study was inspired by previous data relating body weight to the risk of Alzheimer’s disease. Other studies have shown that people with Alzheimer’s had lower leptin levels. However, studies didn’t conclude which came first, the lower leptin levels or the declining mental function. In the research, leptin not only produced a feeling of satiety but also had a positive effect on the hippocampus, the portion of the brain that plays a role in aspects of memory.

In a study of 785 participants over 7.7 years, leptin and Alzheimer’s diagnoses were tracked. Researchers found that higher leptin levels were associated with lower incidence of Alzheimer’s and other forms of dementia. The 25 percent of participants with the lowest leptin levels had a 25 percent risk of developing Alzheimer’s compared to only six percent for those with the highest leptin levels. Lead author Dr. Sudha Seshadri says, “We’re not recommending that anyone get leptin to increase leptin levels until other cohort studies substantiate our findings.” While they cannot say what effect leptin has on the aging brain, it does support past evidence that there may be a correlation between the chemicals produced by the brain when gaining or losing weight and Alzheimer’s disease.

A recent study published in the journal Neurology, contains evidence supporting the theory that cancers and neurological disorders are less likely to occur together. Theories and studies have been growing the past several years when researchers first noticed patients with Parkinson’s disease are affected by cancer less often. More recently a study contained evidence that people with multiple sclerosis have fewer tumors.

Lead author Dr. Catherine M. Roe and Dr. Maria Behrens evaluated data on more than 3,000 people age 65 and older. At the beginning of the study, 164 people had been diagnosed with Alzheimer’s and 522 with cancer. During the study 478 developed dementia and 376 developed invasive cancer. During the study, which monitored dementia for an average of 5.4 years and 8.3 years for cancer, showed those with Alzehimer’s at the start of the study were 69 per cent less likely to be hospitalized for cancer. Additionally, Caucasian people who had cancer when the study began were 43 per cent less likely to develop Alzheimer’s later.

The authors concluded, “ If there truly is an inverse association, it gives us one more way of finding out what’s going wrong in both cancer and Alzheimer’s, and that could lead us to new ways to treat either condition.”

One criticism of the study by Professor Clive Ballard, of the UK’s Alzheimer’s Society, is the possibility that Alzheimer’s could mask the symptoms of cancer and vice versa. In rebuttal Dr. Roe says, “If the decrease chance of cancer diagnosis was simply due to the fact that physicians don’t notice cancer in people with dementia, the decrease should have shown up for both the Alzheimer’s patients and those with vascular dementia, but the drop in cancer risk was only seen in those with Alzheimer’s.” Dr. Roe and Dr. Behrens plan to do a larger study investigating if Alzheimer’s disease is more strongly linked to specific cancers and how large or small that effect has on Alzheimer’s risk.

Apathy is defined as an absence or suppression of passion, emotion or excitement. For patients with Alzheimer’s and dementia this is one of the most common psychological problems. Determining if this symptom is medical or emotional has been a question scientists have been trying to answer. The Sahlgrenska Academy and University Hospital in Sweden revealed a patient study that concluded dementia patients with certain types of changes in the brain’s white matter are more likely to exhibit signs of apathy.

Changes in the brain’s white matter appear as blurred patches on CT and MRI images and are common among the elderly and dementia patients. These changes impact the neural pathways that run from this part of the brain to frontal lobes which control initiative and the ability to plan. The study involving 176 Alzheimer’s and dementia patients, 82 percent with changes in their white matter exhibited signs of apathy and just over half of the dementia patients suffer from lack of motivation. This study implies that indifference was far more common in patients with the white matter brain characteristics, suggesting that there may be a biological reason behind apathy.

Michael Jonsson, consulting psychiatrist at the University’s hospital’s memory clinic, says “Even though we think we know a bit about which pathways are affected in cases of apathy, we still need to find out more about the anatomy and chemistry behind the development of these symptoms. This is vital if we are to develop medication to treat apathy.”

Apathy reduces a patient’s quality of life. In combination with engaging and stimulating activities, perhaps medication can one day help cure the apathy of dementia patients and allow them to fully enjoy the remaining years of their life to its fullest potential.

According to the Journal of American College Health, four out of five college students drink, and half of these engage in heavy drinking. College has changed and alcohol is consumed at astonishing rates. To many students, drinking has become a game. These college “games” include drinking beer through a funnel and “flip-cup” which is basically a chugging competition. While some believe the consequences of alcohol consumption are limited to a hangover and failing grades, scientists have found the long term effects could damage more than your liver.

Previous research has shown that excessive alcohol consumption leads to loss of brain tissue and that binge drinking is linked to an increased risk of Alzheimer’s. Heavy drinking and smoking can lead to early-onset dementia. A study presented at the American Academy of Neurology’s annual meeting found a link to early onset dementia in heavy drinkers (more than two drinks a day) and heavy smokers (a pack of cigarettes or more a day). Heavy drinkers developed Alzheimer’s 4.8 years earlier and heavy smokers 2.3 years earlier.

Dr.Ranjan Daura, Director of Mount Sinai Medical Center for Alzheimer’s disease in Miami Beach, says “there is a bit of controversy about heavy drinking, specifically what “heavy” means.” One influential study, done in the Netherlands, defined moderate drinking as three or four drinks a day. “I suggest that more than two drinks a day is probably not a good idea” says Daura. Alcohol-related dementia is an under-recognized problem and some expect there to be a surge in dementia in future generations. Education and awareness of studies like this may help influence better decision making when it comes to alcohol consumption and mental health.

No one can argue that alcohol does not kill brain cells. The question we should ask ourselves is how many brain cells we would like to have left at the end of life’s journey? This holiday season, I’m thinking I’ll skip the spiked eggnog and enjoy a nice cup of apple cider!

Concussions are a common occurrence on the football field. Commissioning their own studies, the NFL has been actively supporting Alzheimer’s and dementia research and a new study by the St. Joseph’s Hospital and Medical Center shows promise in helping those who suffer brain damage with an innovative new treatment.

Therapeutic hypothermia is a medical treatment that lowers a patient’s temperature to reduce damage to tissue. A new technique being studied, called the endovascular intra-arterial cooling method, preserves the injured portion of the brain and minimizes damage.The damaged tissue is rapidly cooled while the rest of the brain and body remain at normal temperature.

Lead director of Neurosurgery Research, Mark Preul, MD, says, “The ability to cool a specific region of the brain allows us to protect the tissue and avoid risk of damage to other organs that can occur with the whole body hypothermia. This work is targeted currently at severe injuries to the brain like massive strokes or trauma, but it also means we could be able to offer a less invasive and specific approach to saving brain tissue. We’re working to develop ways to be more proactive about treating brain injuries like sports concussions that make have been under-treated in the past.”

 Link:

www.medicalnewstoday.com/articles/171017.php