Resources, Information and Distance-Learning Opportunities

CRHC supports events presented by other organizations.  Check out the following resources including topics on EMS, Improving Care Quality, Telemedicine, Medicare, best practices, logic models, conferences...

Collaborative Family Healthcare Association's 15th Annual Conference
October 10-12, 2013
Broomfield, CO

The CFHA Conference is for individuals and organizations interested in innovative and cost effective strategies for integrating behavioral health and medical health care delivery, improving patient outcomes, professional networking and provider training.

The audience includes medical and mental health providers and administrators who seek collaborative solutions to the complex challenges of patient care, as well as: physicians; psychologists; pharmacists; dentists; marriage and family therapists; social workers; nurses; other clinicians; teachers; researchers; consumers, patients and families.

Emergency Medical Services, Community Paramedicine Insights Forum (CPIF)
Cost: FREE
Date: Monday, May 20, 2013 Occurs 3rd Monday of each month
2:00-3:30 pm Central Time
Webinar

On a monthly basis, a 90 minute webinar-based call will be held that features an insightful presentation and a questions session based on experiences and lessons learned from efforts to establish a community paramedicine program somewhere in the U.S. There will also be a focused discussion on a particular "issue of the month", and an open discussion on issues or questions that participants wish to share.

A Community HIE: Optimizing Patient Care in a Secure Environment
Cost: FREE
Date: Wednesday, May 15, 2013
2:00-3:30 pm Central
Webinar

This webinar will feature and demonstrate a community health care provider's experience in developing a secure and effective health information exchange (HIE). Speakers will review legal, privacy and security and other issues involved with implementing HIE, as well as how patient care can be optimized through secure information exchange.

ACA's Opportunities for Improving Care Quality & Efficiency: A Three-Part Series
Cost: FREE
Wednesday, May 15, 2013
Webinar

HIMSS has developed a three part series exploring how the healthcare reform bill will transform mandates into real world patient care. Each session builds on the content from past sessions, which are available on demand.

1. Administrative Simplification and Operating Rules: An Update; 10:00-10:45 am Central Time
2. Gaining ROI By Implementing Federal Operating Rule; 11:00-11:45 am Central Time
3. Consumer Access to Data and the State Insurance Exchanges: An Update; 12:00-12:45 pm Central Time

What Does it Take to Run a Successful Telemedicine Program
Tuesday, May 21, 2013
1:00 p.m. - 2:00 p.m. Central
Webinar

With the advances in technology, telemedicine is no longer rocket science, but to run a successful telemedicine program still takes dedicated staff and knowledge of telehealth principles. During this webinar we will look at some of the challenges to running a successful telemedicine program, key attributes of successful programs and the new occupational roles being developed to support telemedicine programs.

Understanding Medicare Webinar
Cost: FREE
Tuesday, May 21, 2013 - Wednesday, May 22, 2013
12:00-2:00 pm Central Time
Webinar

This webinar is for those wanting to learn or refresh their knowledge of the fundamentals of the Medicare Program. This session runs May 21 to 22, 2013 and again September 17 to 18, 2013.

TeamSTEPPS Implementation: The Good, the Bad and the Ugly
Cost: FREE
Wednesday, May 8, 2013
Noon - 1:00 pm Central Time 
Webinar

Webinar will discuss the University of Washington's approach to implementing the TeamSTEPPS tools and strategies, UW's successes and failures with TeamSTEPPS, and offer lessons learned and strategies for success in using TeamSTEPPS to improve patient safety.

AHRQ: Logic Models Webinar 
Cost: FREE
Tuesday, June 4, 2013
Noon - 1:00 p.m. Central 
Webinar

Advanced Methods Webinars: Contributions to Planning, Executing, Analyzing, and Reporting Research on Delivery System Improvement.

LEAN 6 Sigma: Eliminating Variation in Data Collection: Repeatability, Reproducibility, & Attribute Agreement Analysis
Cost: FREE
Tuesday, May 14, 2013
11:00 a.m. - 12:00 p.m. Central Time
 Webinar

Bad data leads to bad decisions, so how can we know that the data we are collecting is correct and accurate? This presentation will teach participants how to eliminate variation and improve accuracy in their own internal data collection and inspection processes and is especially useful in organizations that rely on observational data for making decisions.

EHR AND MEANINGFULUSE BOOT CAMP
June 27, 2013
11:30am-5:00pm Mountain Time
Double Tree Hotel, Westminster, CO
Bootcamp

Attend the free EHR & Meaningful Use Boot Camp and learn how to incorporate Meaningful Use objectives into your practice to increase efficiency, improve patient outcomes and make the most of the expense and time you put into your EHR adoption. Presented by CORHIO, with David Ginsberg as the featured speaker.

Update from the CEO: Engagement in 2012

As the year starts to come to a close and I think of the accomplishments of the Colorado Rural Health Center team, I know these accomplishments would not have been possible without the engagement of our members, sponsors and partners. This year CRHC tracked over fifteen bills and was successful in the passage of our first piece of major legislation, House Bill 1052 concerning the collection of health care workforce data from healthcare professionals. Thank you to our Policy and Legislative Committee for lending us your time and expertise. We are looking forward to the 2013 session and encourage you to continue to share your voice. As you think about sharing your voice, many communities engaged in Community Health Needs Assessments through our STRIDES Program. These communities took engagement and collaboration to a new level with Critical Access Hospitals, Rural Health Clinics, Federally Qualified Health Centers, and public health participation. As new partnerships are formed CRHC encourages you to continue to reach out to your community members and together you can continue to innovate and accomplish great things. As Dan Heath says, “Identify the bright spots and grow them!” One bright spot that should be pointed out is CRHC staff placed thirteen providers in safety net communities in Colorado. With the workforce shortages that Colorado is facing we are proud of these placements and the ability to contribute to the healthcare of the community. Rural communities have always had a strong sense of connection and collaboration. This collaboration can be seen through the participation of fourteen Critical Access Hospitals and six Rural Health Clinics in CRHC’s Improving Communications and Readmissions (iCARE) Program. In 2012, the participating hospitals readmission rate was only 2.8%. Some of the innovative interventions that were put into place are standing orders for pneumonia vaccinations, collaboration with social workers to follow-up with patients discharged to ensure understanding of medications and instructions, scheduling of appointments with the Primary Care Office, and home visits conducted by the Director of Nursing for patients that do not have an identified primary care physician. Finally, rural hospitals and clinics have been heavily engaged in implementing electronic medical records and remain committed. To date, 18 rural hospitals and 18 rural clinics have attested to stage 1 meaningful use. Congrats to all! I wish everyone Happy Holidays and CRHC staff look forward to working with each of you in the new year to identify your Bright Spots!

Save the Date: April 3-5, 2013

The Forum is a two-day conference that will bring together participants from all over Colorado and the surrounding states. It serves as an essential educational, training, and networking event for all safety net clinics, members of the clinic team, and other interested parties. This is the 13th annual Forum, and the fourth year in which Colorado Rural Health Center has partnered with ClinicNET to put on the event. This partnership allows an expanded reach which includes other states and clinic types in order to address the issues facing all safety net providers.

More information will be released as the event nears - registration will open at the end of December.

Location Information

Sheraton Denver West Hotel
360 Union Boulevard
Lakewood, CO 80228

Meaningful Use 'Boot Camp' Presented by CORHIO

CORHIO is hosting a free half-day "boot camp" seminar for health care professionals who are in one of the following stages of EHR adoption:

• Considering the purchase of an electronic health record (EHR) system
• Need assistance understanding or achieving Meaningful Use objectives (have already purchased an EHR system)

At the conclusion of this boot camp you will be able to:

• Select the right certified EHR technology for your practice
• Complete your HIPAA Security Risk analysis as part of the 15 core measures of Meaningful Use
• Incorporate Meaningful Use in your practice's workflow

When:
September 27, 2012
1:00 PM - 7:00 PM

Where:
Doubletree by Hilton Hotel Denver - Thornton
83 E. 120th Avenue
Thornton, CO , 80233

Agenda:

• 1:00pm to 2:45pm - "Meaningful Use 101"
• 3:00pm - Concurrent sessions (please choose one):
  • "Completing Your HIPAA Security Risk Analysis" presented by David Ginsberg, Colorado state's leading authority on HIPAA Privacy & Security Compliance
  • "Selecting an EHR Vendor" presented by Tracy Rue, Health IT Transformation Consultant
• 4:30pm to 7:00pm - EHR vendor showcase & demos

Registration is required to attend this event. Click here to register. Click here for more information.

PCMH: 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. 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
• A systems-based approach to quality and safety

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.

Read the full joint Colorado Rural Health Center and ClinicNet paper here

ICD 10 Online Training - Rural Health Organizations

ICD-10 Online Training for Coders, Billers, Auditors, & All Healthcare Professionals

• Too busy to go to ICD-10 training?
• Perhaps, you’ve attended ICD-10 Workshops, but would love additional training?
• Is your budget stretched thin already -- and you wish you could find an unbelievable bargain for your staff to learn ICD-10 and how to become proficient with the rules and regulations of the future?
• If you answered yes to any of the above questions, CRHC can help now!!

Take advantage of this opportunity to enroll in the following online courses that will prepare you and your organization for the successful transition to ICD 10. These courses will provide you with history, structure, functions, guidelines and the terminology needed to ensure accurate and efficient billing processes. Whether you are a new coder, an advanced coder with years of experience, or a health care provider -- you will find value in this timely information. For more information on a specific course, please click here. If you are employed by a Colorado Critical Access Hospital (CAH) or a rural PPS hospital with less than 49 beds, you are currently participating in the FY2011 SHIP Grant Program – and -- your online classes are FREE to all hospital staff! Click here to get started now! If you are a Rural Health Center (RHC) or other rural health care facility in Colorado, please click here for a class listing and the opportunities available to you! CEU’s are available for all classes. Don’t wait. . .get started today! For more information or questions, please contact Danette Swanson, HIT Program Coordinator, at ds@coruralhealth.org

Free tool: Outpatient surgery and observation

 This pocket card available from HCPro provides “points to remember” when it comes to outpatient surgery as well as information on the appropriate use of observation services. Click here to download the pocket card.

Rural Relevance Under Healthcare Reform

iVantage Health Analytics released a quarterly update to their ongoing tracking study monitoring the rerformance of rural healthcare under the Affordable Care Act. Summary findings from research conducted by iVantage shed new, multi-dimensional light on the rural healthcare delivery system using: the latest Medicare Shared Savings data files; the first nationwide hospital rating system to evaluate community and rural hospitals including all 1,326 Critical Access Hospitals; and the industry’s largest proprietary rural Emergency Department database.

The misunderstanding that rural hospitals are more costly, inefficient and have lower quality and satisfaction is empirically challenged. More importantly as providers and developers seek to address the New Healthcare using innovative delivery models, the rural setting must be better understood and included in any strategy for patient-centered care. Read more and download the full study here.

HPSA scores: What does it mean to me and my clinic?

Living and working in rural Colorado, you have most likely encountered the acronym, H-P-S-A. For many clinic administrators and providers, you are proficient in the world of HPSA scores and know exactly what a Health Professional Shortage Area score means and why it is important to you and your clinic. For those of you who probably have heard this word and know that it is significant to you and the work that your particular clinic does, but are not positive why, we hope the explanation below can shed some light and give you a reason to pay a little more attention to the benefits of having one.

What exactly is a HPSA score? This score is a federal designation assigned to a geographic area, population group (such as low-income), correctional facility, state or county mental health hospital, or public or nonprofit facility that can demonstrate a shortage of health professionals in the service area. HPSAs can be created for primary medical care, dental health, or mental health. They reflect the level of provider shortage for a service area and are on a scale of 0 to 26, higher scores indicating higher relative need than lower scores.

What is the benefit of having a HPSA score? Your clinic may benefit from having a HPSA score in three ways. The first one is recruitment and retention. Your primary care physicians, Nurse Practitioners, Physician Assistants and Mental Health workers may be eligible to apply for loan repayment dollars through the Colorado Health Service Corps and National Health Service Corps loan repayment programs. Also by having a HPSA, you may be eligible to participate in the J-1 Visa waiver program. Secondly, your providers caring for patients on Medicare are eligible for the Medicare Incentive Program. This will provide them with a 10% monetary bonus on Medicare services billed. Lastly, if your clinic is located in a HPSA, you may be eligible to become a Certified Rural Health Clinic and receive cost-based reimbursement.

In the last few months we have seen several rural and frontier counties lose their HPSA scores. Every three years, Colorado’s State Primary Care Office (PCO) evaluates the HPSA designations in Colorado and re-assigns scores based on specific criteria. Part of the criteria that is often misinterpreted by clinics and their providers are the reporting of numbers of hours spent by providers providing direct patient care in the medical setting. It is important when submitting patient numbers to the PCO that your providers are submitting only hours spent directly caring for patients and the time spent charting and following up with those patients. Practice management, personnel management and administrative duties should not be counted. Incorrect reporting could indicate there is less need than there is in reality.

On a positive note, Gunnison County has recently been given a HPSA score! Congratulations to Dr. John Tarr at Gunnison Health Department for working tirelessly with the assistance of Colorado Rural Health Center’s Quality Improvement Specialist, Kathryn Steele, and the Primary Care Office to obtain a score for Gunnison County!

For more information on HPSA score designation, contact Kitty Stevens at the PCO at kitty.stevens@state.co.us, 303.692.2298.

For more information on the benefits of having a HPSA score, contact the Colorado Rural Health Center at info@coruralhealth.org, 303.832.7493.

CEO Update - The Forum 2012

The Forum 2012 is a two and a half day conference beginning on April 11 that will bring together participants from all over the region. It serves as an essential educational, training, and networking event for all safety net clinics, members of the clinic team, and other interested parties. The Colorado Rural Health Center and ClinicNET have partnered to present The Forum.

The agenda is packed with dozens of speakers on topics from Health Policy to Accountable Care Organizations. Since we advocate on your behalf both at the State and Federal levels, we welcome your attendance at the Health Policy session so that we may exchange information.

If you represent a rural health clinic and attend both Emergency Preparedness sessions, then your clinic may be eligible for additional reimbursement! We look forward to your participation at The Forum 2012!

Event Info:

• Date: April 11-13, 2012
• Registration: click here to register online now!
  *early bird discount has been extended through March 21st!
• Hotel and Location:
• Sheraton Denver West Hotel
  360 Union Blvd. Lakewood, CO 80228
• Booking a Room: make your hotel reservations online or call 888.627.7027 and use group code RHD11A to get the discount - extended through March 26!
• Sponsors and Exhibitors: Download the form online and email the completed form to cr@coruralhealth.org to reserve your space.

Grant Opportunity for Rural Areas

You could be eligible for a grant up to $500,000 to support distance learning and telemedicine services at your organization. The Distance Learning and Telemedicine (DLT) Grant is funded by the U.S. Department of Agriculture and is a competitive grant with around 100 awards each year. This grant targets rural areas in our country and funds programs that are interested in implementing distance learning and/ or telemedicine in rural areas to increase access to clinical and/or educational services. The focus is on using the unique capabilities of telecommunications to connect rural areas to each other and to the world, thus overcoming the effects of remoteness and low population density.

Some Distance Learning applications include:

• Real-time educational courses
• Virtual field trips
• Interactions with outside experts
• Mentoring and tutoring of distant students
• Collaborative projects
• Access to remote resources
• Staff development programs

Some Telemedicine applications include:

• Telehomecare
• Telestroke
• Telepsychiatry
• Virtual ICU
• Telepharmacy
• Teledentistry

TECHFunds Resource Center and Solutionz Conferencing Grant Program Services have partnered together to assist organizations like yours with applying for and securing grant funding to support your distance learning and telemedicine needs, providing as much or as little assistance as needed, including grantwriting services.

To obtain additional information about the DLT grant program you can visit their website or contact Irene Alvarez directly at Irene@techfundsresourcecenter.com.

Rural Medicine Speakers Needed for Practice Essentials Program

Do you have a family, internal medicine, pediatric or OB/GYN physician in your rural practice that enjoys public speaking, advocating for rural health and LOVES what they do? If so, please let them know we would be honored to host them at this year’s Practice Essentials program put on by COPIC and have them speak about their rural medicine experience.

Practice Essentials is a daylong workshop for Colorado’s physician residents to prepare them for work and life after residency. This will be a wonderful opportunity for your providers to motivate residents to ‘go rural’ and give you a chance to plug your own practice’s physician openings. There will be four different dates beginning in April and ending in June. Please email us at cpr@coruralhealth.org for more information. All travel and meal costs will be reimbursed by the Colorado Rural Health Center.

Premature Twins Delivered At New Middle Park Medical Center

In a county where babies are not routinely born, a set of premature twins were delivered at the new Middle Park Medical Center in Granby on Sunday.

Babies are rarely born in Grand County due to the population, the lack of neonatal facilities and a full-time OBGYN. The last baby born in the county was in spring of 2010, when paramedics delivered a baby in the ambulance on Highway 9 at mile marker 128 en-route to Summit County. According to Grand County EMS, about one baby per-year is born here, either in a medical facility, in an ambulance, or in one instance a few years ago, on the woman's bathroom floor of the Winter Park McDonald's.

Read more about this instance of incredible teamwork between rural Middle Park Medical Center, Grand County EMS, and Children's Hospital Colorado.

Grand Opening at Middle Park Medical Center

The grand opening of Middle Park Medical Center (MPMC) was held mid-December with a ceremony very well attended by the community. The new medical facility includes 10 computer-friendly patient exam rooms on one side of the building, with special consideration given to visiting specialist’s needs. On the other side of the building is the lab, mammography, imaging, emergency room, and two in-patient beds. Central scheduling for labs, imaging, and other services creates a very efficient workflow.

MPMC is owned and operated by Kremmling Memorial Hospital District with locations in Kremmling and Granby and is committed to helping improve the quality, availability and access to health care to the residents of the region, while working to keep costs down and improve the sustainability of care to those they serve. MPMC provides hospital and health care related services to roughly 15,000 residents of Jackson, Summit and Grand Counties, and to thousands more who come to the area to recreate and work.

NPR on CAHs: An Overlooked Perspective

by Brock Slabach, National Rural Health Association

The December 8 NPR piece produced by Kaiser Health News (KHN) didn’t report that Medicare costs are lower for rural patients than their urban counterparts. Medicare spends 4.5% less per beneficiary for rural residents compared to those living in urban areas, according to a recent Stroudwater report which used 2008 Dartmouth Atlas data. The value that rural providers (including Hood Memorial Hospital in Amite, La.) bring to the Medicare program is evident, even including alternative payment methodologies applied to small, rural facilities. Closing Critical Access Hospitals (CAHs) and sending their patients to large, urban hospitals will in fact not save money, but cost more.

Rural communities struggle with disproportionate share of poverty, obesity and chronic conditions when compared to an urban environment. Independent studies have affirmed the quality of rural health care providers. For example, rural hospitals have lower risk-adjusted rates of potential safety-related events (Jollife, 2003), rural hospitals have significantly lower adverse event rates than urban counterparts (Whitener and McGranahan, 2003) and rural hospitals have significantly lower rates of post-operative hip fracture, hemorrhage and hematoma (Cromartie, 2002).

The article accurately portrays the difficulty that small, rural hospital administrators have in running a hospital located in a rural environment. NRHA congratulates Hoppie Jones, Hood Memorial CEO, for doing an outstanding job in the midst of daunting circumstances.

Fall 2011 CROP Awardees Announced!

Congratulations to these providers, who were awarded Colorado Rural Outreach Program (CROP) retention grants!

Awardee	Provider Type	Type of Award	Award Amount
Colorado West, Inc.	Psychiatrist	Loan Repayment	$10,000
Grand County EMS	EMS/Prehospital Care	Loan Repayment	$4,170
Kremmling Memorial Hospital District	Physical Therapist	Loan Repayment	$4,876
Rio Grande Hospital	Emergency Room Physician	Loan Repayment	$10,000
Valley-Wide Health Systems, Inc.	Physical Therapist	Loan Repayment	$5,000
TOTAL AWARDS		Fall 2011	$34,047.00

Flex Monitoring Team responds to JAMA report on quality of care at CAHs

The Flex Monitoring Team, the nation's leading experts on rural health care quality, has prepared a detailed analysis of last week's JAMA report on quality of care at critical access hospitals (CAH) which concluded that compared with non-Critical Access Hospitals (CAH), CAH’s had fewer clinical capabilities, worse measured process of care, and higher mortality rates for patients with AMI, CHF or Pneumonia. “The report is simply deficient when it comes to understanding the basic role of a Critical Access Hospital within a rural community,” said Alan Morgan, National Rural Health Association CEO. “The current quality measurement systems available do not adequately reflect the core work of what rural hospitals do on a daily basis.”

Funded by HRSA, the Flex Team has provided detailed national and state reports on CAH quality for the past six years. Their numerous reports document the substantial progress in quality improvement that CAHs have made during that time frame, as well as areas in which there is still room for improvement. Click here to view the Flex Team's response to the JAMA report.

CRHC has been working with the 29 CAHs in Colorado for over 10 years on quality improvement activities including the Quality Network, 100,000 Lives Campaign, 5 Million Lives Campaign, Quality Health Indicators (QHi) Benchmarking, and iCARE (Improving Communication & Readmission). For more information on CRHC’s CAH quality improvement programs, contact Jen Dunn, CAH Program Manager at jd@coruralhealth.org.

More than 150,000 New Adults to Qualify for Medicaid in 2012 - Are You Prepared?

By Aubrey Hill, CCMU

In 2012, Colorado will be offering Medicaid for adults without dependent children, who have been categorically ineligible for the program in the past. According to the Colorado Health Institute, 157,805 Colorado adults without dependent children with incomes up to 100% of the federal poverty level are currently uninsured and are likely to be eligible for this program.

Thanks to great foresight on the part of our legislature, an historic expansion will occur in the state’s Medicaid program to provide coverage for this population with funding from a hospital provider fee and federal matching dollars. When it is fully implemented, it will cover uninsured adults without dependents between 19 and 65 years of age with incomes of up to $900 a month (for a single adult).

In the interest of ensuring this expansion’s success, the Colorado Coalition for the Medically Underserved has established the Connect to Coverage, Connect to Care Campaign. The Connect Campaign is a group of stakeholder organizations working together to support the expansion as the state works to develop and implement it, and the Colorado Rural Health Center has been playing an active role in this group.

Read more about how the Connect Campaign is following the state’s progress to ensure effective decision-making.

Panel recommends giving hospitals more time to go from paper to electronic records

Source: Denver Business Journal

A federal advisory panel is recommending that the government give hospitals and doctors offices an additional two years to get their electronic medical record systems in order. The Health Information Technology Committee, which advises the U.S. Department of Health and Human Services, voted 12-5 Wednesday June 8 to recommend that the department push its deadline for stage 2 “meaningful use” requirements from next year to 2014.

“Meaningful use” refers to a wide range of guidelines aimed at making sure health care providers are properly using electronic health records in their day-to-day operations, which supporters claim will reduce medical errors, improve overall patient care and save money. Failure to meet meaningful-use standards could lead to cuts in Medicare reimbursement, starting in 2014. Continue reading...

Making Integrated Care the Standard in Colorado

By Cassidy Smith, Public Policy Officer, Colorado Health Foundation

Integrated care health services engage individuals and their caregivers in the full range of physical, psychological, social, preventive and therapeutic factors needed for a healthy life. Integrated care has become "all the rage" in Colorado health circles. To illustrate the proliferation of the concept, the Colorado Behavioral Healthcare Council mapped some of the numerous efforts underway to integrate physical health and behavioral health care services.

Supporting the delivery of integrated care is a funding priority for the Colorado Health Foundation. Yet, while grantees rave about the positive impact integrated care has had on Coloradans' health, they consistently report it is difficult to maintain these kinds of services.

Read more about how the Colorado Health Foundation, Collaborative Family Healthcare Association, Colorado Psychological Association and the Colorado Association of Family Physicians are working together to make integrated care health services a sustainable option for Colorado providers.