Special Delivery: August 2011

Letter from COO

Last week’s CRHC Annual Conference was a big success. It was gratifying to see and meet so many people and to hear such positive comments about the conference – the subject matter, the speakers, the accommodations, the food, and the networking. I also received positive feedback from the exhibitors who felt that they made some good contacts. My sincere thanks go to a talented and hardworking staff who teamed up to deliver an excellent conference.

Many people especially enjoyed the 20th anniversary celebration reception. We saw a meaningful and sometimes moving video that tells the story of the CRHC and portrays its value to the health of rural Coloradans. It was a great time to celebrate what this organization has been, is, and will continue to be in the future.

During the week, we will be adding the presentations from the conference to our website, so please check for those updates using the login information provided at the conference. We will soon have the video posted as well.

Thanks to all who attended. I look forward to working with you in the future.

Happy Safety Net Clinic Week!

Colorado State Governor John Hickenlooper has proclaimed August 22-26 as the second annual Safety Net Clinic Week!

Sponsored by ClinicNET and the Colorado Rural Health Center, the week is devoted to educating the public and policy makers about these vitally important health care clinics - Community-Funded Safety Net Clinics (CSNCs) and federally certified Rural Health Clinics (RHCs). During the week, state representatives will be visiting rural communities throughout Colorado.

Contact Sara Schmitt or Alicia Haywood for more information.

Patient-Centered Medical Home: An Overview and Colorado’s Landscape

A Patient-Centered Medical Home (PCMH) is not a place but a concept. PCMH facilitates partnerships between individual patients, their personal physicians or care providers, and the patient’s family. It is a way of coordinating all health services in a quality, cost-effective and accessible manner through use of a team approach to health care that is centered on patient and family needs.

This type of patient centered care is often created in some manner by default in rural and safety-net communities, but is not always cohesive or well documented. Additionally, team-centered care is especially important given significant workforce constraints in most rural communities where physician-led care may not be available. The Patient-Centered Medical Home encompasses five functions and attributes:

Patient-centered

Comprehensive care

Coordinated care

Continuous access

Quality care delivered in a PCMH model is enabled by health information technology, health information exchange and the use of registries and other tools to assure that patients get culturally and linguistically appropriate care when and where they need it, provided at an appropriate health literacy level. For uninsured and underinsured patients, especially those with chronic diseases and complex needs, this philosophy allows for continuity of care with better outcomes and potential decrease in utilization of urgent and emergent care services. ClinicNET and the Colorado Rural Health Center (CRHC) support the PCMH model and provide services to assist clinics in pursuing PCMH certification or designation.

Colorado Health Benefit Exchange Board Updates

The Colorado Health Benefits Exchange (COHBE) board will hold its next meeting this Thursday, August 11th from 9:30 AM – 1:00 PM in the Legislative Services Building (200 E. 14th Ave., across the street from the State Capitol). It has not been determined if the meeting will be broadcast on the web.

The by-laws committee of the Exchange Board had a conference call yesterday to discuss legal counsel and the process for developing the by-laws. Committee members Steve Erkenbrack, Ken Lund, and Richard Betts will make recommendations to the Board during its meeting Thursday. The Board is also expected to appoint a Chair.

The workgroups continue to meet. To follow their work or to join a group, check out the Colorado Health Institute’s website, or contact Alicia at CRHC for more details.

The Colorado Center on Law and Policy, John Snow, Inc. and CoPIRG are holding focus groups around the state with likely Exchange users to test their perceptions and expectations for the marketplace. CRHC will post the information learned from those meetings when the report is available.

Joel Ario, the Director of the Office of Insurance Exchanges at the U.S. Department of Health and Human Services resigned. Ario’s deputy Tim Hill and Steve Larsen, Director for the Center for Consumer Information and Insurance Oversight, will lead the Exchange after Ario’s departure Sept. 23rd.

Peter Marcus of The Colorado Statesman, a weekly nonpartisan political paper, wrote a great article yesterday detailing the Board’s process to date and some of the controversy surrounding its appointments and funding. Click here to read the article.

Work, Education and Lifelong Learning Simulation (WELLS) Center

Highly specialized training for rural hospitals in Colorado: Training is investment in health care training and patient safety

A training initiative from the University of Colorado Hospital (UCH) and Colorado Division of Labor and Employment (CDLE) will provide customized, no-cost medical training to Colorado's rural health care providers. The initiative, made possible by CDLE funds, will offer highly sophisticated simulation training using technology from the WELLS Center located on the Anschutz Medical Campus and operated by UCH. The training will be available solely to 29 Critical Access Hospitals in rural Colorado.

The WELLS Center provides education and training for health care workers using life-sized mannequins, otherwise known as human patient simulators. The center has the ability to recreate real-life situations and demonstrate alternate ways of reacting to improve outcomes and hospital safety. The "patients" can be programmed to simulate a wide variety of scenarios that test both clinical and critical-thinking skills. Each patient simulator breathes, has a pulse, heart and lung sounds, and responds to appropriate stimuli. The mannequins can be programmed for almost any clinical situation including child birth, heart attacks and head injuries.

Rural hospitals in Colorado treat high-risk patients but health care workers may not see those patients very often. The WELLS Center will provide four hours of training at no-cost to workers in rural hospitals to prepare for low-volume, high-risk events without exposing any patients to risk. The center can provide training at its facility on the Anschutz Medical Campus. WELLS Center staff also can provide on-site training focusing on interaction and communication at the hospital as well as that particular hospital's processes and systems.

For more information on this training program, contact Heidi Miller, Business Specialist at the WELLS Center, 720-848-5444 or via email at Heidi.miller@uch.edu.

Med schools seek right fit for rural practice

Family physician Frank Swisher, DO, is up every day at 4:30 a.m. to see patients at the nearby hospital before heading to his office. He works an average of 80 hours a week at his solo practice in Jane Lew, W.Va., a rural town with a population of less than 500. Many patients drive more than an hour to see him, and he's always on call.

But Dr. Swisher loves his community and his patients, and he says there are many rewards to being a small-town doctor. "You get to know the patients better," he said. "I know their families, where they work and the kind of work they do. I'll see grandkids, parents and grandparents."

Small-town doctors throughout the U.S. say they are drawn to rural practice for the sense of community and personal connections with patients. Yet physician shortages have been a persistent problem in rural America for decades.

Medical schools nationwide are trying to tackle the problem. In the past decade, many have developed programs aimed at steering physicians toward rural practice. "Medical schools all around the country have developed rural-track programs," said Randy Longenecker, MD, clinical professor of family medicine and assistant dean for Rural Medical Education at Ohio State University College of Medicine.

UnitedHealth Group Report Identifies Innovative Solutions for Rural Health Care Coverage, Access and Quality Challenges

Rural Americans experience more chronic health conditions such as diabetes and heart disease than urban and suburban residents, have greater difficulties accessing high-quality care, and from 2014 millions more of them will likely participate in Medicaid and government-subsidized insurance, according to a new paper released today by the UnitedHealth Center for Health Reform & Modernization.

At the same time, more use of technology, such as broadband access that would increase telehealth solutions, can help ease strain on the system and further promote healthier outcomes in rural communities.

The paper, titled “Modernizing Rural Health Care: Coverage, Quality and Innovation,” explores how health reform implementation, particularly health insurance expansion, will increase the need for innovative care models and points to technology and a stronger role for rural primary care as promising solutions. It also reports the results of a new Harris Interactive survey of 2,000 patients and more than 1,000 primary physicians in rural and urban areas.

“The next few years will be times of considerable stress on rural health care, but also times of great opportunity, since across the country there are already impressive examples of high-quality care, tailored to the distinctive needs of the local community,” said Simon Stevens, UnitedHealth Group executive vice president and chairman of the UnitedHealth Center for Health Reform & Modernization. “The challenge for all involved in rural America now is to build on that track record of innovation and self-reliance, so as to ensure that all Americans – wherever they live – can live their lives to the healthiest and fullest extent possible.”

CCHIT offers certifications for 'homegrown' EHRs

Certification of electronic health record products is the first step toward achieving meaningful use. But what if you are a healthcare system operating under legacy software, customized commercial products or homegrown EHR systems that would cost hundreds of millions to replace with a new product already certified by the vendor? Some healthcare organizations, particularly teaching hospitals, have discovered that certifying their own system through a special CCHIT program is the best alternative.

The Certification Commission for Health Information Technology (CCHIT) announced last week that five new organizations joined Beth Israel Deaconess Medical Center in certifying complete or modular EHRs under its EHR Alternative Certification for Healthcare Providers, or EACH, an ONC-ATCB 2011/2012 certification program for already-installed EHR technology. They are: Health Management Associates, New York University Langone Medical Center, Northwestern University, Tenet Healthsystem Medical and the University of North Carolina Health Care.

“There are many myths about what is required to achieve certification and meaningful use,” said John Halamka, MD, Beth Israel Deaconess’s chief information officer. "The major challenge is not technology; it’s education. Partner as soon as you can with an authorized testing and certification body and get educated about the requirements because you will find it’s quite doable,” he said.

Read the full article.

Dental Event in Morgan County

The Colorado Mission of Mercy, or COMOM, is scheduled for October 21 & 22 in Brush. This event aims to serve adults of all ages, as well as children, but particularly aims to treat patients who are unable to afford care. This large scale 2-day dental clinic will have more than 100 dental chairs, and will see an estimated 1,500 patients for cleanings, fillings, root canals and extractions. Spanish, Somali, and American Sign Language interpreters will be available. While the event is primarily targeted at Morgan, Kit Carson, Lincoln, Logan, Phillips, Sedgwick, Washington, and Yuma Counties, no one will be turned away based on geographic location.

In addition to getting the word out to patients, COMOM is looking for volunteers to make this event a success, including all sorts of health professionals, as well as general volunteers to help make this event a success! For more information, or to volunteer, visit the website.