Archive for November 17, 2012

Social Media Monitoring May Detect Biological Outbreaks

Social media will soon be used as an early detection tool for biological attacks. The U.S. Department of Homeland Security (DHS) hired Accenture to conduct a one-year, $3 million test that will attempt to spot public health trends using the data available in open social networks, company officials announced Nov. 8. Such a program would serve to help solve problems like the 2001 anthrax letters, 2003 SARS outbreak, 2009 bird flu pandemic and 2011 nuclear emergency in Japan, reported.

President Barack Obama called for a solution that would allow early detection of such outbreaks in July in a National Strategy for Biosuveillance. “This strategy further articulates that when the collection and sharing of this essential information is prioritized, decision-making can be expedited at all

levels of government and beyond,” he wrote. “While other activities are integral to everyday local biosurveillance efforts that can and should continue, our strategy calls for a national focus on fewer issues so that more can be achieved collectively. Our approach also seeks to inspire new thinking and revised methodologies to ‘forecast’ that which we cannot yet prove, so that timely decisions can be made to save lives and reduce impacts during an emergency incident.”

A similar program led by the DHS, which attempts to use social networks to identify terrorist plots, caused some House members to sue the DHS over perceived Fourth Amendment violations. The DHS, however, contended that standards were in place to protect the privacy of the innocent. The collection of personal information was only for a narrowly defined group of people, DHS officials said in testimony, and the information was publicly available to begin with.

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Bicycle Modeling Tool to Aid Infrastructure Development Decisions

Some city planners in California will have access to a new tool next year that could help in planning infrastructure upgrades. A bicycle model tool being developed by the Association of Monterey Bay Area Governments (AMBAG) will allow officials in Monterey, San Benito and Santa Cruz counties to see how proposed bike route changes could affect greenhouse gas emissions and create biker benefits like time saved. The tool is scheduled to be completed February 2013.

“What we hope to get from the tool is a measure of the effectiveness of adding a new bike facility or improving an existing bike facility,” Project Manager Anais Schenk said. “The mission of AMBAG as a whole, and any metropolitan planning organization, is to reduce greenhouse gas emissions in the region, and the way we do that is to encourage mode switches from driving alone to modes that have a lesser impact on our environment.”

The tool’s initial bike path data was partially supplied by bikers who used the CycleTracks app, which reported trip data of people who biked to work (no recreational bike data is used in the model). The app, which Government Technology reported on last year, was originally developed by the San Francisco County Transportation Authority and used by AMBAG with help from a $125,000 grant from the Monterey Bay Unified Air Pollution Control District.

In addition to providing a baseline of data for the development of the bike model, Schenk said the app also collects “basic demographic information on the user, which we find very useful to help calibrate the model.” While the researchers assumed that most bike path users were between the ages of 13 and 40, seeing data to verify their assumptions was useful.

Initial data collection from the CycleTracks app also produced an unexpected result, Schenk said. Researchers expected greater decreases in greenhouse gas emissions with the development of improved bike paths. One way to account for that result, she said, is that the distance between the workplace and home for many people spans a distance too great for all but the most “hardcore cyclists” to cover. The lesson from this is a land-use argument for putting more jobs closer to where people live, said Schenk.

While the bike model tool is scheduled for completion next year, the team has a few enhancements it would like to implement after the initial release of the software. One of the biggest changes, Schenk said, is that while the tool is now being developed as locally run software, the team would like to make the tool Web-based so users can run it without having to install software.

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Lessons from Idaho’s Medicaid Readiness Project

Reaching an eligibility decision on the same day a customer applies for services — not 20 to 30 days later — is more than wishful thinking. It’s a reality in Idaho, where just over 70 percent of SNAP applicants and half of Medicaid applicants get same-day eligibility decisions.This is the story of how Idaho is creating a new model of service delivery. Extending its heritage of family-centered service, the Idaho Department of Health and Welfare is taking a cautious and prepared approach to the Affordable Care Act (ACA) through its Medicaid Readiness Project. The Department sees the law as a springboard to change — streamlined eligibility determination with integrity that delivers lasting human and business value.Implement immediate improvements early and often.Make improvements that have immediate business value and increase business capacity.Implement incremental end-to-end business changes for constant functional validation. Increase decision making at the first point of contact with the customer. Define business changes at the process level.Resolve conflicts in circumstances and verification in every customer interaction.Reduce non-productive tasks and reduce administrative costs.Leverage unprecedented 90-10 federal funding. Use 90-10 funding for core improvements to benefit all programs and services.Facing Ever-Escalating DemandsThe health and human services community has faced significant challenges in recent years. The economic downturn has driven huge increases in caseloads for SNAP, cash assistance and Medicaid programs. Budget cuts and federal oversight only intensify mounting administrative pressures. Idaho has not been immune. In fact, the state saw a 123 percent increase in food stamp caseloads between 2007 and 2010 — the second highest growth rate in the nation.When the ACA was signed into law in 2010, it was introduced into this complex environment. Already overwhelmed, many health and human services practitioners viewed the responsibility of implementing such sweeping change as daunting, if not impossible. While states are taking their own approaches to implementation, confusion is common. What do the new rules mean? How must enabling technologies change? What must be done to accommodate growing Medicaid rolls? For many, questions outnumber answers. Turning an Obstacle into OpportunityThe Idaho Department of Health and Welfare found a pragmatic answer. Working thoughtfully and strategically amid uncertainty over the law’s future, the Department sees the ACA as an opportunity to reinvent eligibility processes and modernize service delivery structures — welcomed outcomes no matter what happens with the ACA. Grappling with the ACA challenges shared by other states, Idaho had an “aha” moment. The Department realized that within the complexity of the law is a fundamental focus on streamlining and modernizing Medicaid eligibility determinations. For example, the ACA provides new paths for verifying household information and making eligibility decisions in real time, which reduces the red tape for both agencies and families, improves same day service, and decreases backlogs and paperwork for staff. What’s more, the ACA improves eligibility determination at both application and redetermination points, which drives integrity in decision making and reduces the number of administrative closures. Focusing on the processes without getting weighed down by the policies, it became clear that these process improvements aligned with the Department’s own modernization agenda. More specifically, there was a common thread with the Department’s commitment to work as a customer-focused, process-driven organization that provides same day service, minimizes churn, maximizes retention, reduces administrative burdens and costs, relieves staff workload and improves timely service to Idaho’s families. A forward-thinking approach was born from this commonality. Why not use the ACA to improve Medicaid eligibility and transform eligibility determination across all programs—extending the work that was already being done?Transforming the Business Model (a critical first step)The first step for Idaho was to clearly define a service delivery model that effectively and accurately delivered decisions and services. Idaho’s “New Service Delivery” model was then coupled with new ACA eligibility stipulations to provide an overarching service delivery design supporting all eligibility programs. The model incorporates fundamental and transformational redesigns, lowers operating costs, and improves program integrity by:• Resolving information and making eligibility decisions on the day of application.• Bringing eligibility decision makers “to the front”—they are the first contact. • Seeking all necessary information to verify a family’s status.• Operating from a customer’s perspective rather than from a program or service perspective. • Providing “informed choice” to help customers understand their application options.• Managing customer volume and traffic to match decision-making resources.• Tracking all case management tasks with auto-alerts only when actions are needed.Taking a Cautious and Prepared ApproachOnce developed, this business model informed decisions around planned ACA technology and system changes, positioning Idaho to leverage available 90-10 federal funding while realizing immediate and incremental wins throughout the life of the project.After reviewing pending rule changes, Idaho designed a three-phase, 23-month project centered on ACA requirements that began in February 2012. This Medicaid Readiness Project is allowing the state to move forward on aspects of the legislation that will provide immediate value while taking a wait-and-see approach to unresolved issues. It is also an example for other states to gain ideas for process changes, technology pursuits and rule interpretation while taking advantage of time-limited federal funding opportunities. The initiative includes the following phases:Modernization. This modernizes eligibility and payments systems in line with ACA requirements for online access, simplified application processes and improved verification systems. Focusing on modernization early can minimize future costs of administering Medicaid to a caseload that could almost double if ACA remains and creates a foundation for sustained capacity and performance improvements. This phase will take a bulk of the time and funding but all functionality will benefit all programs and will be value added improvements to the eligibility process despite pending policy or rule changes.Medicaid Expansion. The Supreme Court gave options to states around the expansion of Medicaid to new eligible populations, Idaho is seriously assessing the costs and benefits associated with this new optional piece of ACA. The expansion phase of Idaho’s Project was purposely placed later in the project to ensure a decision by the Supreme Court could help inform long term decision making at the state level and allow time for all Medicaid requirements and options to be clearly assessed. The timing of this phased approach also allows political and budget questions to be fully vetted to ensure clear support for the Department’s approach to Medicaid expansion.  Connection. Once all decisions related to the first two phases are fully vetted, Idaho will focus on the requirement for Medicaid systems to connect to a health insurance exchange.By taking an opportunistic ACA approach that drives necessary outcomes no matter Idaho’s decision to expand Medicaid or build a state or federal exchange, Idaho is providing eligible, low-income families with service access and continuity to help families find stability and greater self-sufficiency with less administrative burden for all and at a lower administrative cost.Lori Wolf and Greg Kunz are deputy administrators of the Idaho Division of Welfare — Department of Health & Welfare; Debora Morris is the public assistance lead for Accenture’s Human Services Group for North America.This article was published previously in Policy & Practice, the journal of the American Public Human Service Association.

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Massachusetts HIE Enters Phase 2

On Oct. 16, Massachusetts Gov. Deval Patrick sent a record between an Eastern Massachusetts hospital and a Western Massachusetts hospital, officially opening up the Statewide Healthcare Information Exchange (HIE), called the MassHIway. Now the state is working aggressively toward phase two.

Phase one began with implementing “push” transactions, because they are easy from both a policy and technology perspective, wrote Dr. John D. Halamka, CIO of the Beth Israel Deaconess Medical Center, CIO and dean for technology at Harvard Medical School and Chairman of the New England Health Electronic Data Interchange Network, in a recent blog post.

The next step, he wrote, will be “pull” transactions, and “rather than declare that the standards are not ready, the informatics challenges are too great, and the consent models are too complex, we’re just moving forward with an aggressive timeline to get it done in 12-18 months.”

According to a recent slideshow presented by the state’s Executive Office of Health and Human Services that presents the phase two plans, a detailed sustainability model and tiered pricing were developed to subsidize small practices, which have limited resources and bandwidth for new projects.

The HHS slideshow also notes that comprehensive HIE services would cost a solo practitioner just $5 each month.

As work progresses and the HIE program in Massachusetts develops, Halamka will share the lessons his team learned and information about the technology they use. “It’s a great time for HIE in Massachusetts,” he wrote, “and I hope we can be a catalyst for wider push and pull HIE adoption in the country.”

Read Halamka’s full blog post on MedCity News.

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PracTutor launches the pre-registration to help students learn Math and English in an adaptive innovative way

Louisville, KY. September 08, 2012 – PracTutor ( is an adaptive learning platform to help students excel in Math and English. PracTutor was established with just one focus – THE STUDENT. PracTutor is trying to solve the challenge of how can we make any student love, learn and enjoy Math and English.

There are 39 million students in US in K-8 in public and private schools. Only 69% students make it to a high school and less than 70% to a college. Most of them falter at one of the numerous high school or college admission tests.  In college, majority of the students need to take remedial courses in Math and English. About 40% of the students take some form of Math and English training program to prepare for high school and more than 75% to prepare for college admission tests. The students get frustrated with the narrow focus of such trainings or possible interventions not available when needed. PracTutor experience is personalized and it understands the student’s strengths to challenge them more on their strengths and it understands their weaknesses to eliminate them.

PracTutor is virtually effortless and very intuitive for the student to use. It applies intelligent algorithms to understand the student’s abilities in Math and English and provide practice and training to strengthen their skills. This training is mapped to each and every standard of the common core curriculum. PracTutor involves the parents and the school teacher in the student’s progress and provides all the elements required for the success of the student. A private tutor can help the student whenever they need any help.

“I created PracTutor because I was frustrated after using quite a few after-school Math and English programs for my two sons in Grades 3 and 5, I felt there had to be a better way, a better product and not seeing one, decided to create one.”, said Vatsal Ghiya, co-founder, PracTutor.

“I have seen a lot of my cousins and sons and daughters on my friends struggle with Math and English with numerous programs they work on. All of the training programs seem to be missing one or several elements. We wanted to provide the entire ecosystem – a complete solution. That is what PracTutor is.”, said Hardik Parikh, co-founder and CEO, PracTutor.

PracTutor’s team comprises experts on Math and English from common core team, web designers, software developers, child psychologists, parents and school administrators.

PracTutor is in development right now and we would like to invite users for beta testing as soon as we have it out.

Watch what we do at

Take a tour of the product at –

Pre-register using this link –

About PracTutor

Started in April -2012, PracTutor ( is an adaptive learning platform to help students excel in Math and English. PracTutor is part of emPower Training Solutions ( that has been providing online compliance solutions to 100+ healthcare practices and hospitals since the last 4 years.

To learn more about PracTutor follow us at:

12806 Townepark Way
Louisville, KY 40243-2311

Hardik Parikh, Co-founder and CEO
12806 Townepark Way,
Louisville, KY 40243-2311
Direct (502) 400-9374
Twitter: @hardikvparikh

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