OHN member awarded for innovative excellence

Mid-Columbia Medical Center chooses progressive, patient-centered approach

Contributed by Courtney Freitag, OHN Member Services Coordinator

A progressive, patient-centered  health care leader, Mid-Columbia Medical Center in The Dalles was presented with the prestigious Leader in Innovative Excellence award at the Rural Hospital Summit. Hosted by the Oregon Association of Hospitals and Health Systems (OAHHS) and the Oregon Office of Rural Health, Mid-Columbia was recognized for their quality, commitment to the community and cost containment efforts.
An OHN participant, both Mid-Columbia Medical Center and their wellness center Water’s Edge are expected to receive their Funding Commitment Letters in early August.

“This year’s recipients show tremendous promise for the future of rural health care in our state,” said Linda Lang, director of rural health services for OAHHS. “Mid-Columbia is really a model for other communities.”

With a patient-centered approach and a tradition for being progressive, the hospital continues to be a leader in Oregon’s patient-friendly medical care in the state’s smaller communities. This award is affirmation to the staff at MCMC that their daily work is being recognized.

“Given that we are a small, rural hospital, this award provides additional validity to the fact that we have always considered ourselves innovators on so many levels,” said Erick Larson, Vice President of Information Systems/CIO Health Care for the Mid-Columbia Region. “We can, and do, make a difference in our community.”

This year’s Rural Hospital Summit was the second annual event, working to raise awareness not only in rural communities, but statewide about the attributes of rural hospitals. Many hospitals and health care providers in the rural areas of Oregon are leading the way in best practices, Lang said.
Mid-Columbia is doing just that.

Last year, the facility fully transitioned to electronic access for patient records and health information. The ability to complete larger endeavors like these will be enhanced by MCMC’s connection to the Oregon Health Network.

“OHN will prove to be a valuable asset to extend our reach to other providers and health professionals needed to complement our patient’s care,” Larson said. 

The collaborative effort between Mid-Columbia’s board of directors and stakeholders resulted in the Community Health Record Project, another way the facility is working to benefit patients and their families.
The hospital has worked hard to create a fluid stream of information exchange between physicians, laboratories, radiology and emergency departments. With this Community Health Record Project, they will now reach out to benefit patients and the community beyond.

In 2009, Ahier and his team met with health care stakeholders throughout the state to begin establishing the region’s health information exchange. From that initial meeting, the Gorge Health Connect was formed to provide structure to the Community Health Record project and to help facilitate the necessary communication between the different entities. GHC’s mission is to improve consumer experience, enhance provider efficiency, and improve clinical outcomes via a secure, apolitical, value-based information exchange solution, Ahier said.

GHC is a non-profit entity with its own board representation from many hospitals, clinics and educational institutes, including Providence Hood River Hospital, Columbia Gorge Community College, North Central Public Health, and Hood River Public Health.

Mid-Columbia’s partnership with OHN will help further that mission.

“One of the things we promoted at the formation of GHC was that all of our members should be signed up with OHN to provide the capacity we will need to allow the meaningful exchange of relevant clinical information,” Ahier said .

With a world-class facility, Mid-Columbia hopes to utilize the OHN network and its participation to reach out to other providers in rural communities.

“By having additional resources available from which to consult with will make a big difference for our patients,” Larson added.

Aside from health information exchange, MCMC hopes to leverage this infrastructure to increase the ability to participate in telemedicine opportunities, provide care to more remote areas, and a Telestroke Initiative with OHSU in Portland.

“This [telestroke] initiative alone will increase our ability to effectively manage stroke patients at the time when they need it the most,” Larson added.

MCMC is also one of nine nationwide hospitals with “Planetree Patient-Centered Hospital” status. Planetree is a growing community of acute care hospitals, continuing care facilities and outpatient clinics across the globe within both rural and urban hospitals.

The team at MCMC continue to look toward the future and opportunities to continue their progressive approach.

“When health care dollars are scarce, innovation sometimes happens out of necessity,” Larson said.  “However, we believe there are ways to provide innovative excellence given any set of circumstances.”

Crossroads of telehealth in rural communities

Northwest Regional Telehealth Resource Center discusses future of telemedicine

Contributed by Christina Beach Thielst, Executive Director of NRTRC

Recent federal actions and several emerging trends are indicative of future change for healthcare and, more specifically, telehealth.  The convergence of the American Recovery and Reinvestment Act (ARRA) of 2009, Federal Communications Commission (FCC) Broadband Plan and recently passed health reform legislation – the Patient Protection and Affordable Care Act and the Reconciliation Act of 2010—has the potential to radically disrupt the U.S. healthcare system.

Other potential disruptors include widespread attention to the cost-benefit analysis of care processes and treatment (outcomes-based medicine), reimbursement models favoring preventive care and bundled payments, as well as provider shortages, significant payor technology investments and the emergence of the next generation of mobile devices. Also at play are an aging population, the growing popularity of medical tourism and shifting consumer expectations of healthcare.

The reasons for slow adoption rates and underutilization of telemedicine are varied. Among the most significant is that the benefits of its use most often accrue to others, rather than to the provider or network of providers who assume the upfront and ongoing costs. Also frequently cited are high equipment costs, outdated regulations and reimbursement limitations.

Emerging Telehealth Opportunities

There are opportunities on the horizon that will likely improve telemedicine utilization rates. For example, ARRA allocates $19 billion for adoption of health information technology (IT) systems and promotion of electronic health information exchange (HIE).  The Health Information Technology for Economic Clinical Health (HITECH) Act also creates funding opportunities to support the advancement of health IT.

Existing telehealth networks will also benefit from ARRA and HITECH. Participating in related incentive programs, capitalizing on funding opportunities and achieving meaningful use of health IT requires hospitals and physicians to have broadband Internet access.  However, commercial T1 lines are prohibitively expensive in rural areas. In fact, it is estimated that 93 million residents and 3,600 small physician offices in these regions don’t have broadband access.

Because they can deliver more affordable equivalent access, this presents a very real opportunity for telehealth networks to expand their value to members and the community by connecting rural and remote providers to the Internet across existing infrastructures.  It also presents new partnership opportunities that will enable telehealth networks to expand those infrastructures and increase connection speeds.
Further, while telehealth and health IT initiatives have historically operated on relatively separate tracks with limited crossover, their goals and activities are complimentary and truly synergistic. This is especially true of the broader systems-based approach to delivery of care.

For example, telehealth networks provide the infrastructure that enables Internet access and drives HIE in areas where commercial broadband is lacking or cost-prohibitive.   Correspondingly, health IT offers enabling components for remote care and provides complimentary tools and systems, such as electronic health records (EHRs) and digital data/information sharing.

We are approaching the intersection of telehealth, EHRs and HIE.  At this crossroad, we can expect to see this interdependence become more pronounced as more common ground is realized, shared visions are established and opportunities for mutual support and collaboration are identified.  This will lead to converged paths, more efficient use of resources and the integration of health information and telehealth technologies.

Drivers of Change

The Office of the National Coordinator (ONC), FCC and federal reform legislation will be key drivers of radical change that ultimately leads to an alignment of telehealth and health IT.  The healthcare system and stakeholder (providers, payors, employers, suppliers, consumers, etc.) response to those changes will likely result in an expansion of the role of telemedicine, remote monitoring and other telehealth applications. For example, many stakeholders will be seeking technology tools that increase efficiencies, expand access to care and reduce costs – which are some of the primary benefits of telemedicine.

Leveraging and expanding existing telehealth network infrastructures will deliver to providers, particularly those in remote and rural areas, the affordable broadband connections they need to achieve meaningful use and avoid financial penalties.

For its part, the FCC, through its National Broadband Plan, established healthcare as a national priority and laid out its plan for driving broader adoption of and innovation in e-care technologies.  The plan addresses outdated regulations and establishes funding to help providers purchase services and build out broadband networks in areas where connections are lacking or are insufficient to support video consultations and EHRs.
The FCC has also recognized the important role of mobile devices, remote monitoring and interoperability. It estimates that remote monitoring of vital signs and EHRs alone can generate savings of $700 billion over the next 15-25 years.

Clearly, consumers are turning to the Internet with rapidly increasing frequency too seek out information on symptoms, diseases and conditions, and then discussing their findings with their physician and/or other healthcare providers. As such, they are demanding broadband Internet access to help them do so more efficiently. This will lead to better health choices and enable them to better manage their healthcare dollars and find the best care at the lowest price -- even if it means traveling to other communities, states or countries.

Consumers are also demanding more affordable healthcare, as well as access to their personal health information on their home computers and/or mobile devices. Many also welcomes the opportunity for remote monitoring of their medical conditions and is seeking ways to participate in online self-diagnostic questionnaires. 

We can expect telemedicine and remote monitoring to play a significant role in the healthcare delivery system of the future.  Existing telehealth networks will prove to be an important resource for providers who want to enhance service offerings, improve efficiency with remote care applications and/or participate in HIE.  Their involvement in HIE initiatives will lead to the next generation of interoperability and a blended vision for both health IT and telehealth.  It will also lead to a transformation of the telehealth infrastructure into the highway for electronic health records and information exchange for many rural and remote areas.

To receive a complete copy of the report, contact Christina Thiels, ThielsC@nrtrc.org.

CEO awarded for grassroots efforts

Asante Health System president and CEO recognized by AHA

Reprinted with permission from the OAHHS

The American Hospital Association (AHA), in partnership with the Oregon Association of Hospitals and Health Systems today awarded Roy Vinyard, president and CEO of Asante Health System in Medford, with the American Hospital Association Grassroots Champion Award.  As a 2010 Grassroots Champion, Vinyard is being recognized for his exceptional leadership in generating grassroots and community activity in support of a hospital’s mission.
 
The Partnership for Action Grassroots Champion Award was created to recognize those hospital leaders who most effectively educate community stakeholders and elected officials on how major policy issues affect the hospital’s vital role in the community, who have done an exemplary job in broadening the base of community support for the hospital, and is a tireless advocate for the hospital and its patients.
 
“We depend upon strong voices like yours to help tell the story of hospitals as cornerstones of the communities they serve,” said Rich Umbdenstock, AHA president and CEO.  “This award is a small token of our appreciation for your hard work and dedication to improving health and health care in America.”
 
Vinyard, who has been president and CEO since 1999, strongly believes in living up to his organization’s mission, “…to provide quality care, in a compassionate manner valued by the community.”  Governed by volunteer community leaders, Asante Health System is a two-hospital health system that is recognized in southern Oregon for its hospital services.  It is his compassionate leadership that is a testament to how grassroots activities begin in our own backyards.

Vinyard is active in the community having been involved with the Medford Rogue Rotary Club, Medford Chamber of Commerce and Southern Oregon University’s Advisory Board.  Additionally, he is a board member of OAHHS, a member of Oregon Hospital Political Action Committee (OHPAC) and the Oregon Health Leadership Task Force.
 
“This is a tremendous honor for Roy and the 4,000 dedicated employees associated Asante Health System.  This recognition represents the good work of all our hospital members, who on a daily basis commit their time, talent and treasure to advocating for their patients and their communities, as part of their mission to deliver superior health care services at a local level.  Leadership is the key to change and Roy embodies that quality,” commented Andy Davidson, president and CEO of OAHHS.
 
The award will be presented to one individual from each state with winners being chosen by the state association.  The 2010 honorees were recognized in late April at special Breakfast of Grassroots Champions at the AHA Annual Membership Meeting.  Vinyard was one of 52 individuals honored this year.

OHN finalizing volunteer Stakeholder Council

Over 40 applications received for three specialized workgroups            

Contributed by Kim Lamb, OHN Executive Director

As a new and growing organization—interacting with new participants, partners and stakeholders across the state—a common question continues to be raised: What’s next after a health care provider and educational institution joins the network?

Now that the network is live, how can participants really “connect” with other providers on the network to fully leverage their new OHN connection? What applications are and will be running on the network for participants to benefit from?

OHN is actively engaged in the final stages of Phase 1 which includes the actual construction of the core broadband infrastructure and securing our anchor tenants throughout the state through the FCC RHCPP subsidy.

However, Phase 2 is upon us and surrounds answering the core “What’s Next?” question.
To help answer that question and guide the future of OHN, we accepted state-wide applications from individuals to join our new thought leadership group called the Stakeholder Council. This  sub-group will be a primary responsibility of our core Planning Committee.  The Stakeholder Council’s sub-charter is to provide strategic input to the Planning Committee, and ultimately the OHN Board of Directors, through the development of well-vetted, mini-business plans or general recommendations.

“The OHN Planning Committee’s Stakeholder Council provides a unique opportunity for key stakeholders across the state to help define the services that OHN will develop which will best serve their unique business needs to ensure they are able to provide the best healthcare and health education,” said Bridget Haggerty, Planning Committee Chair and OHN Board of Directors member. “I feel privileged to have the opportunity to work with them to develop the infrastructure that will support healthy Oregonians.”

The Stakeholder Council will have three core work groups to prioritize and flush out:

• Identification and recommended action for current/future industry challenges
• Identification and prioritization of possible hosted services or solutions that would enhance the value of OHN for its participants
• Identification and clarification of what unmet needs exist in the industry. Explore and clarify if they can be effectively met through a partnership agreement or any one of OHN's state-wide stakeholders/partners
• Unanswered questions and needs requested of OHN by its participants

Each workgroup will be guided by the mission of OHN and the direction of the Planning Committee; and each will have a specific focus and purpose within the outlined review and recommendation process.  

“Overseen by the Planning Committee, this 3‐step R&D process is designed to leverage the best thought leadership from across the state,” said OHN Executive Director Kim Lamb. “Together and as a result of their combined efforts, the Stakeholder Council will help to identify, prioritize, legitimize and make strategic planning recommendations to the Board of Directors.”

Each volunteer will be asked for a one-year commitment, along with attending quarterly meetings (or more often as needed). The representation and expertise will be honed into three sub-groups;

Workgroup 1: Medical/Education/Health Care

This first group will be comprised of our clinical and education thought leaders. They will be tasked to identify, state and prioritize the medical/clinical and educational issues, trends and opportunities to present to Workgroup 2.

Workgroup 2: Information Technology (IT)

This second group will leverage the work and recommendations from Workgroup 1, and answer the question “How will we positively impact these recommended needs/opportunities/priorities technologically?” This group's vetted work and recommendations will then be forwarded on to Workgroup 3.

Workgroup 3: Business/Financial

This final group will take the work and recommendations of Workgroups 1 & 2 and work to clarify the sustainability of the final recommendations. It’s possible that the recommendations might ask for other state-wide stakeholders to address, OHN directly, or a variation thereof. This specific industry knowledge and required professional experience will give a unique perspective and help this three-step workgroup work together to identify new projects and initiatives, products and service offerings, and provide overarching strategic direction to OHN's Board of Directors.

The Planning Committee was thrilled to receive so many qualified applications and thanks everyone who took the time to submit a application. While we can’t accept everyone at this time, we’re very much looking forward to getting this committee think-tank process off the ground in the late summer/early fall and will keep everyone informed as to the group’s primary areas of focus and work.

List of participating sites on the network continues to grow

Participating member sites continue to be added to the Oregon Health Network. At press time, 34 sites had received their Funding Commitment Letters with 18 sites being monitored 24/7 by our Network Operations Center.

This summer, more than 100 new sites will be at various stages in the Request for Proposal process through the RHCPP. This information is updated weekly on our website, http://www.oregonhealthnet.org/join/active.
OHN continues to strive for excellence by providing high-speed, high-quality network capabilities to both rural and urban entities. Together, we are working to build the future of telemedicine and support the exchange of health information. This critical milestone has been attained due to your participation and support of Oregon and the FCC’s Rural Health Care Pilot Program.

Now is the time to reach out to your community partners, cultivate relationships, have dialogue and learn from each other. It will take the innovators and thought leadership state-wide to continue to grow OHN. 
Remember, this is your network. Together, we can achieve the best telehealth network and become a model for other states nationwide. 
 

OHN Looking for Volunteers

The Oregon Health Network is working very hard to get as many sites posted for RFP as possible over the next couple of months. We anticipate some 130 sites to come out for bid in the next 3 RFPs. That being said, our pool of volunteer RFP reviewers is beginning to dwindle. We would greatly appreciate any volunteers with a technical background to assist us in reviewing the vendor bids and helping to shape the future of the OHN Network. The review generally lasts two weeks and we provide thorough instruction on all facets of the RFP review process. Most reviews will take between 3-5 hours of your time, depending on your level of technical expertise and how many sites you would like to review for.

If you have any interest in participating or if you would just like to learn more, please contact Peter Trnavskis, our IT Project Manager, via email at ptrnavskis@oregonhealthnet.org.

Upcoming Industry Events

• PROPOSED RULE FOR CHANGING TELEHEALTH REIMBURSEMENT; COMMENT DEADLINE JULY 26
  This proposed rule would revise the conditions of participation (CoPs) for both hospitals and critical access hospitals (CAHs). These revisions would allow for a new credentialing and privileging process for physicians and practitioners providing telemedicine services. View complete PDF here.
  
• STATEWIDE STRATEGIC HIE PLAN REVIEW AND INPUT OPPORTUNITIES
  Stakeholder input on the Strategic Health Information Exchange (HIE) Plan will be gathered at six public meetings around the State, beginning with the June 17 meeting of the Health Information Technology Oversight Council (HITOC). Stakeholder engagement is an on-going process which includes surveys, community meetings, webinars, and a strategic workgroup. For more information, visit http://www.oregon.gov/OHPPR/HITOC/Newsletters/MayNL100521.pdf.
  MEDFORD: June 30 from 7:00-9:00 pm
  Rogue Valley Medical Center, Smullin Center Auditorium
  2825 E. Barnett Road
  THE DALLES: June 30 from 9:30-11:30 am
  Water's Edge Health & Wellness Center
  551 Lone Pine Blvd
  COOS BAY: July 13 from 8:30-10:30 am
  Bay Area Hospital, Myrtle Room
  1775 Thompson Road
  ROSEBURG: July 13 from 3:00-5:00 pm
  Cow Creek Tribal Government Offices (Conference Room)
  2371 NE Stephens Street
  BEND: July 14 from 1:00-3:00 pm
  St. Charles Medical Center
  2500 NE Neff Road