ElderWeb

The British National Health Service (NHS) has unveiled a pilot of an online "best practices" health library which will be available to both professionals and patients over the Internet. The National electronic Library for Health (NeLH) is expected to be fully functional by March 2002. The role of the NeLH will be to provide health care professionals and the public (through NHS Direct Online and the New Library Network) with knowledge and know-how to support health care related decisions.

The NeLH aims to become one of the great libraries of the world. It will provide easy access to best, current knowledge and know-how; improve health and healthcare, clinical practice & patient choice; and will be available via NHSnet and the Internet. The library's goal in its first phase it is to provide clinicians with access to information within 15 seconds, with a longer term goal of reducing the wait to one second. One of the main features of the library will be its ability to act as a quality filter so that the data accessed through the site, for both clinicians and the public, will not only be the best current knowledge, but will also be free from bias and conflict of interest.

Health Minister Allan Rock and Dr.Yves Morin, member of the Governing Council of the Canadian Institutes of Health Research (CIHR), today announced health research grants of over $4.6 million, including funding of $856,000 for an important evaluative study on health care delivery for the elderly.

The Research Centre in Gerontology and Geriatrics of the Sherbrooke Geriatric University Institute will receive funding of over $856,000 from Health Canada's National Health Research and Development Program (NHRDP) for a study which will evaluate the implementation and impact of mechanisms and tools designed to improve the integration of care and services for the frail elderly.

Health Minister Allan Rock announced Health Canada's intention to develop a new regulatory approach for Canadians to access marihuana for medical purposes. This will address some of the issues relating to transparency of the process and a clear definition of medical necessity that stemmed from the decision by the Court of Appeal for Ontario in the case of R. v. Parker, rendered on July 31, 2000. The new regulatory approach will define the circumstances, and the manner in which the use of marihuana for medical purposes will be authorized.

The matter of an appeal on the narrow legal issues raised by the Parker decision is still under consideration. Whether or not leave to appeal the case is sought, the move to establish this new regulatory approach will go ahead. Issues raised by key stakeholders will be considered as the regulatory process is developed.

Until the new regulatory approach is in place, Canadians can continue to apply for an exemption for medical purposes under Section 56 of the Controlled Drugs and Substances Act with the support of their medical practitioner. An interim guidance document and application form are available online.

To date, marihuana is not approved as a drug in any country in the world. Health Canada is funding research activities which will lead to the scientific data necessary to evaluate the safety and effectiveness of marihuana for medical purposes in the future.

At a joint White House meeting, President Clinton and British Prime Minister Tony Blair announced that the human genome has been deciphered by public and private research efforts of the international Human Genome Project and Celera Genomics Corporation. The Human Genome Project is a joint project of HHS, DOE, and international partners in the United Kingdom, France, Germany, Japan, China.

The White House press release said that, as a result of this research, scientists will be able to use the working draft of the human genome to alert patients that they are at risk for certain diseases, reliably predict the course of disease, precisely diagnose disease and ensure the most effective treatment is used, and develop new treatments at the molecular level.

Alterations in our genes are responsible for an estimated 5,000 hereditary diseases, such as Huntington?s disease, cystic fibrosis, and sickle cell anemia, and influence the development of thousands of other diseases. Connecting a gene with a disease has historically been a slow and imprecise process, but genome research makes it possible to discover and describe genes in just a few days. It took 9 years to discover the gene responsible for cystic fibrosis but a gene for Parkinson?s disease was mapped in only 9 days, largely because of the coordinated efforts of genome research.

Celera Genomics was responsible for the research done in the private sector, and has devoted $1 billion to this research effort. Celera CEO and lead researcher J. Craig Ventor stated, "The method used by Celera has determined the genetic code of five individuals. We have sequenced from the genomes of three females and two males who have identified themselves as Hispanic, Asian, Caucasian, or African American. We did this initial sampling, not in an exclusionary way, but out of respect for the diversity that is America, and to help illustrate that the concept of race has no genetic or scientific basis. In the five Celera genomes there is no way to tell one ethnicity from another."

Today President Clinton will issue an Executive Memorandum directing the Medicare program to revise its payment policy and immediately begin to explicitly reimburse providers for the cost of routine patient care associated with participation in clinical trials, and to take additional action to promote the participation of Medicare beneficiaries in clinical trials for all diseases.

Citing studies which show that seniors' participation in clinical trials is alarmingly low, Clinton indicated that Medicare must improve its reimbursement policy to encourage better participation.

Current Medicare reimbursement policies often discourage seniors from participating in clinical trials, since neither the participants nor the clinical trial investigators can be sure whether or not Medicare will cover the cost of the care provided. Medicare beneficiaries who take parts in these trials must assume that they will have to pay these costs out of pocket, discouraging them from participation. The uncertain reimbursement policies also mean that investigators and research centers may be reluctant to recruit Medicare beneficiaries into these trials.

Clinton's executive order will revise Medicare program guidance to explicitly authorize payment for routine patient care costs associated with clinical trials. This week, the Health Care Financing Administration (HCFA) will inform all claims processing contractors that Medicare will immediately begin to reimburse for the routine patient care costs as well as costs due to medical complications associated with participation in a clinical trial. In addition, HCFA will launch activities to increase beneficiary awareness of the new coverage option, including adding information on clinical trial coverage to the Medicare handbook and posting information on their website.

Older adults have substantially increased vulnerabilities with increasing age. They suffer more severe traffic injuries than younger people, require longer hospital stays from fall-related injuries, and their injury-related mortality rises rapidly after age 75. Of the older adults who are hospitalized with hip fracture, about half are unable to return home or live independently after the fracture, resulting in a tremendous loss in their quality of life and an increase in the cost of care. A new National Resource Center on Aging and Injury has been created to serve provide a central database for information on falls and other injuries which impact older people. The site also includes lots of information for families and caregivers on how to prevent falls and injuries. The center is a joint effort between the San Diego State University Center on Aging and the American Society on Aging.