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Rural Health Briefing, December 1, 2006
Page One
Support Available for CAH Finance Conference in Phoenix
CEOs and CFOs of Arizona critical access hospitals (CAH) are encouraged to attend a valuable conference on financial management in Phoenix, January 22-24, 2007. The event will focus on the unique environment of CAHS including expense management, financing strategies, capturing revenue and Chargemaster/cost reporting. The Health Finance Management Association is sponsoring this national conference. Click here for the full program. Registration is limited to 50.
The Arizona Rural Hospital Flexibility Program is offering to reimburse registration and travel costs for one person from each Arizona CAH (within a set allocation). Please contact Jim Laukes, jlaukes@u.arizona.edu or 520-626-0721 for more information.
Arizona Rural and Public Health Policy Forum on January 9
The annual Arizona Rural and Public Health Policy Forum will convene at the State Capitol in January 9 from 8:00 a.m.-4:00 p.m. Highlighted features are sessions to explore pending legislation, examine issues key to Arizona tribes and rural communities, discuss perspectives on Arizona health care reform and network on strategies to improve rural and public health systems.
The event is sponsored by the Rural Health Office, University of Arizona Mel and Enid Zuckerman College of Public Health, the Arizona Rural Health Association and the Arizona Public Health Association.
The registration fee of $45 includes handouts, continental breakfast and box lunch.Click here for details.
National News
1. Flex Quality Activities Reviewed
2. Social Medicine in the 21st Century
3. Mixed Reaction to “Harmonized” HIT Standards
4. Sustainable Health Information Exchanges
5. Flu Blog Spreading
6. Beta Testing Office EHR7. Improving Patient Safety in Hospitals
8. Immunization Educational Tools
9. 2007 Rural Health Fellows Named
10. Evaluating Efficiency of EHR Systems
11. FCCs Rural Health Care Pilot
Across Arizona
1. Work-based Learning at IHS and Tribal Hospitals
2. Border Health Summit Report
3. AzHHA Offers Patient Safety Training4. AHCCCS Billing 101 for IHS and Tribal Providers
Grants and Opportunities
1. The Emerging Leaders in Public Health
2. Global Health and Human Rights Award
3. Healthy Start: Eliminating Disparities in Perinatal Health (Border and Alaska)
4. Cultural Competence Leadership Fellowships
5. CDC Conference Grants for Public Health
Calendar
- December 10-13, 18th Annual National Forum on Quality Improvement in Health Care, Orlando, Florida
- December 12, Electronic Medical Records Roadshow, Phoenix
- December 12-14, 22nd Annual ITCA Indian Child and Family Conference, Fountain Hills, Arizona
- December 15, Grant Funding for a Community Hospital, free audioconference, 11:00 a.m. Tucson time
- January 9, 2007, Rural Health Policy Forum, Phoenix
- January 18-19,2007 Racial and Ethnic Health Disparities: Schools and Graduate Programs of Public Health Respond as Engaged Institutions, Tucson
- January 21-24, 2007, 20th Annual Rural Health Care Leadership Conference, Phoenix
- January 29-30, 2007, Analyzing the Latest EMR Developments, Boston
- January 31-February 7, 2007 Spreading Change: From Collaboratives to Campaigns and Beyond, Cambridge, Massachusetts
- February 5-6, 2007, Engaging Physicians in a Shared Quality Agenda, Cambridge, Massachusetts
- February 12-14, 2007, The Clock is Ticking for Rural America: A Behavioral Health and Safety Conference, Sioux Falls, South Dakota
- March 7-9, 2007, Spring Training for Health Champions, New Orleans
Mark Your Calendar
June 6-8, 2007, 5th Annual Western Region Flex Conference, Jackson Hole, Wyoming
National News
Flex Quality Activities Reviewed
A new briefing paper examines quality improvement activities of the Flex program proposed by 45 states during fiscal year 2005. The paper describes projects and activities that were requested. Some of the activities were a continuation of existing activities, while others were new. The paper organizes the activities by categories: improving clinical, operational, and financial performance; financial and organizational performance; promoting a culture of quality improvement; participating in national quality efforts; implementing HIT systems; and addressing patient safety and satisfaction issues.
Click here for the 48 page report, Quality and Performance Improvement Grant Activities Under the Flex Program.
Social Medicine in the 21st Century
The Public Library of Science Medicine has issued their Social Medicine Collection, featuring research, essays, policy papers, and debate examining social and cultural aspects of medicine and health and socioeconomic determinants of disease. The collection features contributions from renowned authors such as: Leon Eisenberg , Paul Farmer, David Satcher, Arthur Kleinman and Nancy Scheper-Hughes with highlights on the health disparities, the social context of migrant health and cultural competence.
Click here to go there.
Mixed Reaction to “Harmonized” HIT Standards
The federally sponsored Health Information Technology Standards Panel (HTSP) has delivered its first set of 30 harmonized standards to the American Health Information Community (AHIC) to mixed reactions. Senior officials from two of the federal agencies (Defense and Veterans Affairs) that are expected to implement the standards praised the work but aren't ready to put them into practice until they are reviewed and tested. Others said the standards were flawed because they were influenced too much by vendors.
The panel was asked to select standards that would be needed for using health IT to carry out three scenarios:
- Patient registration and medication history – the kind of information patients typically provide by filling out a form on a clipboard.
- Rapid transmission of data from doctors and emergency rooms to support biosurveillance that would alert officials to a disease outbreak.
- Electronic delivery of lab test results to doctors.
The panel’s job was not to develop or adopt new standards but to harmonize existing ones by identifying the best for each use case.
Adapted from Government Health IT, November 1, 2006
Sustainable Health Information Exchanges
eHealth Initiative has released a new tool for planning a health information exchange (HIE). The Value and Financing module of the Connecting Communities Toolkit provides guidance on the elements of an HIE structure that translate into a sustainable business model. The issue of financing is the greatest challenge to organizations engaged in health information exchange. Financing issues include start up costs, revenue generation and value realization for long term sustainability.
This tool is designed to provide insight into elements of HIE structure that translate into financially successful models. This information can be used by groups in the planning or early operational stages.
Click here for free registration and access.
Flu Blog Spreading
The American Public Health Association is hosting a flu blog. It offers background information on avian and pandemic influenza and advice on how to prepare yourself and your communities. Current postings include information about H5N1 flu strain, food safety, school preparedness and prevention tips. Archives stretch back to July 2006.
Click here.
Beta Testing Office EHR
Developed through a collaborative effort of CMS and the Veterans Health Administration, VistA-Office EHR is based on the VistA hospital information system first developed by the Department of Veterans Affairs more than 20 years ago. VistA-Office EHR (VOE) includes many core VistA functions such as: clinical order entry; standard progress note templates; results reporting; interfaces to existing practice management / billing systems; and, support for disease management, using clinical reminders
A Beta Site evaluation process is now underway. The software is being tested in a small number of physician offices.
Click here for more information or to obtain an evaluation copy of VOE.
Improving Patient Safety in Hospitals
Practical tips for promoting a culture of patient safety, limiting shifts for medical residents and interns, and adopting interventions to reduce cases of ventilator-associated pneumonia and catheter-related urinary tract infections are among the evidence-based research findings that AHRQ has compiled to help hospitals provide the highest quality care. A new tipsheet, 10 Patient Safety Tips for Hospitals, covers activities including how to reduce the likelihood of fatigue-related mistakes, ensuring safety in intensive care units (ICUs), using technology to improve clinical care, and more. Each tip provides a brief synopsis of key data or findings from AHRQ-supported research to help organizations recognize the benefit of changing their current practices.
Click here for details.
Immunization Educational Tools
The 2006 Immunizations Tool Kit will assist providers to educate patients and employees on the need for influenza and pneumococcal vaccinations. It includes a colorful brochure, poster, fact sheet, and a chart sticker that can be useful in many venues. These were developed by the Oklahoma Foundation for Medical Quality and can be downloaded at no cost.
Click here for details.
2007 Rural Health Fellows Named
Fifteen developing rural leaders have been selected for the National Rural Health Association (NRHA) Rural Health Fellows Program. After the completion of a competitive review process, they were selected to participate in this year-long, intensive program. The NRHA has partnered with Healthcare Performance Solutions, which has a record of success in training rural healthcare providers.
Among the Fellows is Rhonda Johnson, formerly a board member of the Arizona Rural Health Association.
The 2007 Rural Health Fellows are:
_ Amy E. Wallace, Veterans Health Administration; White River Junction, Vermont
- Brooke P. Prince, Wallace Thomson Hospital; Union, South Carolina
- Harry S. Jasper, Garfield County Hospital District; Pomeroy, Washington
- Heather Bonser-Bishop, North Coast Clinics Network; Eureka, California
- Kelly J. Johnson, Heartland Rural Health Network; Avon Park, Florida
- Melanie Koch, Massac Memorial Hospital; Metropolis, Illinois
- Patricia K. Dobbins, Hendry and Glades County Health Departments; Fort Myers, Florida
- Patricia M. Gonzalez, California State Rural Health Association; Sacramento, California
- Rebecca Love, Maryland State Office of Rural Health; Silver Spring, Maryland
- Rhonda M. Johnson, University of Alaska-Anchorage; Anchorage, Alaska
- Sandra J. Hovorak, Health for All, Inc.; Bryan, Texas
- Sheryl Lowe, Community Advocates for Rural Elders Partnership; Port Angeles, Washington
- Suzanne Rector, Mid-Valley Hospital; Omak, Washington
- Wes Thompson, Excelsior Springs Medical Center; Excelsior Springs, Missouri
- William B. Wallace, Veteran's Health Administration; White River Junction, Vermont
Evaluating Efficiency of EHR Systems
AHRQs National Resource Center for Health Information Technology offers a Time and Motion Resource Kit, a set of state-of-the-art resources that will help with workflow analysis. They can help determine if new technologies create efficiencies in your hospital or just more work.
The Kit includes:
• A customizable Microsoft Access® database and user's guide to measure the time-and-motion impacts of an ambulatory EHR.
• Two additional examples of time and motion tools that are being currently developed by AHRQ grantees. In this way, you can find out how other grantees like yourself are working with—and learning from—this valuable new workflow analysis tool.
Click here to go there.
FCCs Rural Health Care Pilot
The Rural Health Care Pilot Program launched by the FCC could significantly increase access to telehealth and telemedicine services through state- and region-wide broadband networks by funding up to 85% of the costs. Eligible for funding are initial network design studies, transmission facilities, costs of advanced telecommunications and information services, and optional costs of connecting the network to Internet2.
This pilot program focuses on creating regional and state-wide networks rather than individual links between urban and rural networks. It is estimated that $55-60 million will be available in Funding Year 2006 and again in 2007.
Click here for more details.
Across Arizona
Work-based Learning at IHS and Tribal Hospitals
The Robert wood Johnson Foundation (RWJF) has awarded a substantial , three year grant to reach frontline workers at IHS and Tribal hospitals. The project will use telehealth technology and work-based learning in curricular areas of public health practice, communication, leadership and career advancement. It also continues efforts to reach out to other professions (like nursing) and interprofessional teams.
Directors are Drs. Cruz Begay and Roger Bounds of Northern Arizona University. Pathways into Health will provide oversight. This funding is part of the workplace quality initiative at RWJF.
Click here for more details.
Border Health Summit Report
Tucson played host to HRSAs August 22-24, 2006 Border Health Summit. The proceedings are now online. Presentations extend across a wide range of issues including workforce, HIV/AIDS, pandemic preparedness, diabetes, tuberculosis, models of collaboration and program evaluation. Lynda Bergsma of the Rural Health Office, UA Zuckerman College of Public Health presented on Border Health in Arizona.
Challenges and action recommendations are outlined on the basis of state-by-state breakout sessions.
Click here for the website.
AzHHA Offers Patient Safety Training
An intensive training program on patient safety will be offered in spring and fall of 2007 by the Arizona Hospital and Healthcare Association (AzHHA). Meeting dates for the spring program in Phoenix are March 8 and 9, April 12 and 13, and May 10 and 11. Each session will include hands-on projects and homework assignments. It is directed to patient safety officers, quality directors, risk managers and executives.
AzHHA partnered with Healthcare Performance Improvement to create this comprehensive training, Science of Safety.
Applications are being accepted until January 31, 2007.
Click here for further information.
AHCCCS Billing 101 for IHS and Tribal Providers
A training session will be offered in Phoenix on January 8 to provide practical information on appropriate AHCCCS billing procedures for IHS and Tribal providers. The topics to be covered are:
* Eligibility & enrollment;
* Covered services;
* Prior authorization;
* Claims submission; and
* Provider registration.
Use of the AHCCCS online system to check eligibility, claims status, prior authorizations, and payment remittance advises will also be covered.
Additional resources, such as the AHCCCS Billing Manual for IHS/Tribal Providers and the AHCCCS Medical Policy Manual will be discussed.
The session will take place at AHCCS Administration, 701 E. Jefferson St., 3rd Floor, Gold Room. There is no charge but seating is limited. Please register by December 29 to 602-417-4792 or brandi.bernal@axahcccs.gov.
Grants and Opportunities
Note: Technical assistance is available for the development of grant proposals and other funding applications from the professional staff of the Rural Health Office and the State Office of Rural Health Program. Please contact Jennifer Peters.
The Emerging Leaders in Public Health
Application deadline: December 16, 2006
The Emerging Leaders in Public Health fellowship is designed to prepare the next generation of public health leaders. The curriculum offers skills necessary for leading and managing in a turbulent public health environment: Dealing with crises in finances, human resources, and communications, 360 degree assessments, One-on-one executive coaching, Individual development planning, Action learning teams and Complex case study project.
Click here for complete details.
Global Health and Human Rights Award
Nomination deadline: January 15, 2007
The Jonathan Mann Award for Global Health and Human Rights was established to highlight the vital link between health and human rights. Sponsored by four founding organizations, Association François-Xavier Bagnoud, Doctors of the World, John Snow, Inc. and the Global Health Council, the award is bestowed annually to a leading practitioner in health and human rights and comes with a financial reward to help recipients pursue their work.
Click here for details.
Healthy Start: Eliminating Disparities in Perinatal Health (Border and Alaska)
HRSA-07-010
Application Deadline: January 27, 2007
The Healthy Start program intends to address disparities in perinatal health including disparities experienced by Hispanics, American Indians, African-Americans, Asian/Pacific Islanders, and immigrant populations. Differences in perinatal health indicators may occur by virtue of education, income, disability, or living in rural/isolated areas. To address disparities, it is anticipated that the proposed scope of project services will cover the pregnancy and interconceptional phases for women and infants residing in the proposed project area. In order to promote longer interconceptional periods and prevent relapses of risk behaviors, the woman and infant are to be followed through the infant’s second year of life and/or two years following delivery.
In addition, this funding is to be used to enhance the capacity of the community’s perinatal service system which will also help meet the goal of reducing ethnic, racial, and other disparities in perinatal health.
Core service interventions to be included are direct outreach, case management, health education, interconceptional care, and screening for depression.
Click here for complete details.
Cultural Competence Leadership Fellowships
Application deadline: January 30, 2007
The Health Research and Educational Trust and the Institute for Diversity in Health Management (IFD), in partnership with the National Center for Healthcare Leadership (NCHL), Health Forum, and the American Hospital Association (AHA), are accepting applications for the Cultural Competence Leadership Fellowship. Now in its second year, the program equips participants with critical skills to lead their organizations in providing safe, high quality care to multicultural patients and communities. Fellows explore practical approaches to assessing organizational competence, enhancing patient-provider interaction, and using systems approaches to reduce disparities. Community practitioners and teams are encouraged to apply.
Click here for details.
CDC Conference Grants for Public Health
Application deadlines: March 7, 2007
The purpose of CDCs’ conference support funding is to provide partial support for specific non-Federal conferences in the areas of health promotion and disease prevention information and education programs, and applied research. $2.6 million in total funding is expected to be made in approximately 100 awards.
Click here for details.
Contact Your Representatives
a. Arizona Congressional Delegation: Links to Arizona members of the U.S. House of Representatives are available at: U.S. Representatives. Links to Arizona members of the U.S. Senate are available at: U.S. Senate
b. Arizona State Legislators: Available through the Arizona Legislative Information System (ALIS): Call 1-800-352-8404 or follow links at Arizona Legislature.
Important Links
Editor's Note: This online newsletter is a project of the Arizona Rural Hospital Flexibility Program, housed in the Rural Health Office at the UA Zuckerman College of Public Health, and supported, in part, through a grant from HRSA (Office of Rural Health Policy). The Rural Hospital Flexibility Program was created by Congress to improve the financial viability and stability of health care in rural areas, including creation of a new designation for rural hospitals as Critical Access Hospitals (CAHs). Designated CAHs are eligible for cost-based reimbursement for services provided to Medicare patients. In some states, including Arizona, additional reimbursement is also available for CAH services provided to Medicaid patients.
Your questions (or answers) are always welcome. Please send them as well as address changes to Jim Laukes, Editor, Rural Health Briefing.
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