Priorities in Healthcare Delivery in Eastern Montana #2, June 2, 2011
A DECLARATION OF CONSENSUS
CONSENSUS BUILDING FORUM: PRIORITIES IN HEALTHCARE DELIVERY IN EASTERN MONTANA
June 2, 2011 • Miles City, Montana
Conducted by: Global Health Equity Foundation, Holy Rosary Healthcare Foundation
Co-sponsored by: Montana Health Network
For the Benefit of Populations in Eastern Montana
Read Meeting Summary from Follow-Up on this Consensus Building Forum, held on September 9, 2011
A group of local healthcare practitioners, health leaders and experts convened a Consensus Building Forum, in which they explored various topics in the context of healthcare delivery in Eastern Montana. The groups sought to build consensus on how to approach the challenges and opportunities these topics presented to healthcare providers and their communities.
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1. Access to Health Education/Health Care/Preventive Services
Challenges & Priorities
- Barriers include a lack of primary care
- Focus on patient/community education, and on healthcare staff education is need
- Disseminate educational, credible information, especially to adolescents who get information from their peers
- Taking a regional approach like the Hospital Association Model.
Strategies & Solutions
- “Umbrella” for Eastern Montana (Public Health, Medical providers, Social services)
- Patient education can utilize multimedia, word of mouth, bathroom stall material, Midrivers Communications Channel
- Staff education can use tele-medicine and the internet
- Branding Eastern Montana website, featuring a Directory and Calendar
- Utilize Montana Health Network
Group Facilitator: Wendy Richards, Director, Custer County Public Health
Discussion Group Participants: Lisa Aisenbrey, Human Resources/Support Services Administrator, Sidney Health Center; Mary Biancalana, MS, CMTPT, LMT, Trigger Point Therapist, MYO Pain Relief Centers; Sylvia Danforth, Director, DEAP; Carleen Gaub, PA-C; Cathy Kirkpatrick, Field Representative, Senator Baucus; Sharon Wilcox, Director, Community Health Center
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2. Challenges Facing Healthcare Providers
Challenges & Priorities
- Coordination/Communication
- Telemedicine reimbursement
- Comfort level for patient & provider with utilizing tele-medicine as people like to be “touched” (hands-on)
- Housing
- Spouse wanting to move to our communities in Eastern MT
- On-call
- Remoteness
Strategies & Solutions
- Facilitate care of services from regional perspective (e.g., a Regional Coordinator for all services in Eastern MT)
- Regional hospitals share Coordinator cost
- Utilize Montana Health Network & Montana Hospital Association
- Arrange rotation shifts so provider can be off for a 1 – 2 week period
- Sponsor a student
- Grow our own
- Quit duplicating some services in larger facilities
- Capture money from industry (i.e., oil, coal) and retain a lobbyist who adocates for our needs
Group Facilitator: Nancy J. (Hansen) Rosaaen, CEO, Circle/McCone County Health Center
Discussion Group Participants: Cindra Stahl, MSU AHEC Office of Rural Health; Jennifer Doty, Physician Services Director, Sidney Health Center; Tish Guldborg, McCone County Health Center; James Guyer, MD, Riverstone Health; Ron Leonardi, MS, CMTPT, Myofascial Therapies Center; Jaci Phillips, FNP BC, Custer County Public Health; Corey Stapleton, Former State Senator; Ryan Tooke, CEO, Rosebud Healthcare Center
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3. Mental Illness and Behavioral Health
Challenges & Priorities
- Closed school system
- Relevancy and being up-to-date
Strategies & Solutions
- Utilize existing resources (NAMI for family teaching)
- Get school nurses back in the school system
- Educate providers (e.g., multimedia storytelling)
- Next steps: designate an organizational “captain” to combine forces
- Connect with Local Advisory Council in Miles City
Group Facilitator: Eleanor (Patty) Lavin, Eastern Montana Mental Health
Discussion Group Participants: Rani Alhafez, Intern, Synaptic Healthcare; Carla Bichler, Case Manager, Custer County Community Health Center; Kami Doughty, RN, Custer County Public Health; Dee Holley, Pharmacist, Keith Holmlund, Custer County Commission; Kara Phillips, Massage Therapist, Serenity Yoga & Massage Therapy; Lise Swenson, Filmmaker; Kim Wheadon, RN
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4. Health Management of the Aging Population
Challenges & Priorities
- Housing
- Technology
- Awareness of services
- Reimbursement for services
- Workforce
Strategies & Solutions
We could have an impact on technology, awareness of services and workforce. We can narrow our focus and combine and use appropriate technology to provide awareness. Appropriate technology includes high tech and low tech options.
Proposed action items:Facilitate care of services from regional perspective (e.g., a Regional Coordinator for all services in Eastern MT)
- assemble data on information
- identify distribution channels
- identify gaps in skills needed
- identify funding sources
- start projects
Group Facilitator: Chris Hopkins, VP Strategy, Montana Health Network
Discussion Group Participants: Mark Bichler, Extended Care Administrator, Holy Rosary Healthcare; Dolly Howell, Board Member, Custer County Community Health Center; Kim Jerke, RN, Custer County Public Health; Theresa Livers, Continuum of Care Administrator, Sidney Health Center; Steve Rice, Pastor – Lutheran; Penny Zimmerman, Regional Director, US Senator Jon Tester
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5. Technology and Multimedia
In the image below, Chris Hopkins leads a discussion about access and how technology can solve some healthcare access problems.
Challenges & Priorities
- EMR’s (cost to implement) and interoperability
- Politics
- Incentives for non-medical organizations
- Access to medical information
- Lack of implementation of tele-medicine
- Culture changes are needed to do things differently
- Lack of use of social media
- Economics
Strategies & Solutions
- Use multimedia
- Develop additional intake questionnaire to survey accessibility to technology in patient homes
- Leverage existing community health assessments (e.g., Holy Rosary)
- Develop “cyber-provider” triage capability on Facebook
- Put computer technology in every home: for Skype use, web, healthcare apps, email, etc.
Group Facilitator: Paul Cook, MD, MBA, CPA, CEO, Rocky Mountain Health Network
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We are looking forward to leveraging health-information technology. The Semantic Web project gives us a whole different way to conceptualize and to search for knowledge. We are setting up a pilot program using the City Health Department in Miles City. Among other issues, it will cover questions related to sexuality, adolescence, aging, and access to care. One of our community members who is a nurse is working to develop a social networking overlay for the semantic web technology.
—Paul Cook, MD, MHA, CPE, SCLA; CEO, Rocky Mountain Health Network
For a physician to take the kind of leadership role Dr. Alhafez has taken is unusual. He brought the idea of a consensus-building forum to us. The forum brings together community, healthcare, and business leaders to collaborate on setting priorities and identifying solutions. Dr. Alhafez’s leadership and perspective as a physician are highly valued. He has taken this project to a different level.
— Jackie Muri, Director Business Development, Strategy & Foundation, Holy Rosary Healthcare
