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Winter 2010 Quarterly Newsletter CONTENTS: Director's Column Partner Focus Community Focus Special Feature WINTER 2010 Printable PDF (PDF: 275KB/10pgs) Email Mary Ann Radigan at email@example.com or call 651-201-3855 with comments. We invite you to forward this newsletter to your colleagues. photo courtesy of Lorry Colaizy DIRECTOR'S COLUMN PLACE “When the fire siren wails, two dozen of my neighbors and I act as one, on behalf of the community....” This quote, from Population:485 author and EMT Michael Perry, captures the values that support the social web and safety net that maintains our well-being from rural townships to urban neighborhoods. Perry’s engaging book recounts his move home to small town Wisconsin, where he joins the volunteer fire and rescue squad and reconnects both socially and spiritually by responding with his Mark Schoenbaum comrades to the emergencies of neighbors and even family. Perry threads the humor and absurdity of daily life with his fire and rescue stories to paint the connections that hold his community together in both danger and celebration. http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM] Winter 2010 Quarterly Newsletter Policymakers, planners and other leaders are getting smarter about building this wisdom about roots and community connections into our evolving health care system. There’s an article in this issue of the Quarterly about the latest development in Minnesota’s growing health care homes program, which originated in the 2008 state health reform law. Health care homes intentionally build in ongoing interactions with their patients. In both name and execution, health care homes include the steady link between people that we find in our other community institutions. Research is starting to show that health care homes achieve improved access, better outcomes and lower costs. In other words, staying more closely connected to patients is effective health care delivery. Community health workers are another growing field that shows the value of these principles. Employed by dozens of health and human service organizations, community health workers come from the communities they serve. They navigate, advocate and bridge the gap between the health care system and underserved communities. These themes are coming full circle with the arrival on the scene of a new role called the community paramedic, an approach that combines the health care skills of our paramedics with their knowledge and commitment to their communities. As one of the earliest community-based health care professions, emergency medical staff have great potential to contribute to filling in some of the health services gaps in our communities. Community paramedics have demonstrated their value in other countries and states, and a first class of community paramedics has been trained in Minnesota. Michael Perry describes his small town fire squad’s response as “my people acting on behalf of our people.” With a growing recognition of the importance of community in redesigning our health system, we have one more reason to be hopeful we’ll achieve the system transformation we’re seeking. As always, please let us know how we at the Office of Rural Health and Primary Care can help you sustain and improve health care in your community. Mark Schoenbaum is director of the Office of Rural Health and Primary Care and can be reached at firstname.lastname@example.org or 651-201-3859. top of page PARTNER FOCUS EXPLORING CAREERS IN SCRUBS CAMPS by Heather Orfe, HealthForce Minnesota HealthForce Minnesota is using innovative camps to build interest in health care as the current workforce retires and the need for health care specialists and Scrubs Camp shows us what skilled workers in rural communities increases. we will encounter while working in health care. Charting a Future Through Scrubs Camp http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM] Winter 2010 Quarterly Newsletter Since 2008, high school students from throughout the state have come together for HealthForce Minnesota “Scrub Camp” at Winona State University to interviewed Bryce Kloeck and explore college and a future in health care. Malia Wittman about Scrubs Students entering grades nine through 12 Camp. engage in hands-on sessions, tour medical Bryce Kloeck is a student at Sibley facilities, and network with health care East Senior High School in professionals and fellow students. They Arlington, Minnesota. He has examine careers in dentistry, nursing, public attended Scrubs Camp for the past health, emergency medical services, wilderness two summers. medicine, laboratory science, athletic training and many others. Q: What were some Scrubs Camp highlights? A: The surgical team from Winona Health came to camp and taught us about all the different jobs needed to run an operating room. The best part though was when they put us in full surgical scrubs: masks, gowns, gloves, hats and booties. Another memorable experience was our trip to Whitewater State Park to learn from Native American herbalist Paul Red Elk. l to r: Amanda Driesch, Stephanie Josselyn, Mathew Cochrane, Q: Why did you choose to attend Robby Williams, Bryce Kloeckl Scrubs Camp? Programming for Scrubs Camp changes every A: My experiences at Scrubs Camp year. At Scrubs Camp 2010, public health was were great. I want to go into the the focus. Nathan Kendrick, a state laboratory medical field, but before attending training coordinator for the Public Health was unsure of what exactly I’d like Laboratory Division of the Minnesota to pursue as a career. Now it’s a Department of Health, offered his energetic toss up between neurosurgery and personality and content expertise to Scrubs otolaryngology, neither of which I Camp students. Students learned what public was considering before attending health laboratorians do when concerns like camp. influenza and biological and chemical terrorism Q: Do you recommend Scrubs threats arise. While learning about Camp? epidemiology, students conducted a simulated A: I highly recommend it to any foodborne disease outbreak investigation student thinking about pursuing a focusing on the importance of critical thinking. career in health care; not only Students also performed dipstick urine analysis; because it’s a great experience, but observed how blood glucose levels are tested; also because we learned a lot while and conducted simulated blood gas, chemistry, having fun and meeting new people hematology and coagulation testing. who have similar interests. Scrubs Camp does a good job of showing us what we will encounter while working in health care. Q: What was your experience like at Scrubs Camp? A: I had a great time. There were always activities planned for us. I enjoyed meeting new people, seeing http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM] Winter 2010 Quarterly Newsletter cadavers and visiting so many new places I would have never gone if it were not for camp. I left camp with Malia Wittman studied wilderness medicine at Scrubs Camp such an insight into the medical field. I also enjoyed getting to Students immerse themselves in the world of experience a college setting and all medicine at camp, but to add to their practical of the hands-on activities. knowledge, they also live on a college campus. Malia Wittman, now a first-year Experiencing college life is especially important student at St. Cloud State University for first-generation college bound students and from Andover, attended Scrubs for those unsure about attending college. Camp 2010 after being awarded a Broadening Interests for all Ages scholarship from HealthForce Minnesota at the spring leadership Scrubs Camp has sparked interest beyond high conference of the Health school students. To accommodate the Occupations Students of America enthusiasm of middle school students, (HOSA)—the health science student HealthForce Minnesota offers Health Career organization. Day Camps in Mankato and Rochester. The Q: Do you think other students Career Day Camps reinforce the importance of would enjoy Scrubs Camp? math and science and jump-start thoughts A: Anyone thinking about a career in about career possibilities. the medical field would really have a Adult Scrubs Camp introduces unemployed, great time and learn a lot, too. underemployed and dislocated workers to Attending camp let me see that careers in demand. In 2010, Adult Scrubs there are so many opportunities out Camps were held in Pipestone, Rochester and there, you just have to have an St. Cloud. open mind and be willing to explore them. Scrubs Camp helped me Reaching out Around the State figure out what I wanted to do with my life. I think it can do the same for The 2011 WSU Scrubs Camp is June 26-July 1. anyone who attends. Space is limited so early registration is advised. Scholarships are available, but limited; those Q: How did attending Scrubs Camp interested in sponsoring a student can contact help you to determine your future? the Rochester office at 507-280-5034 or Sonya A: Coming into camp, I intended to McNamara, sciences career and technical pursue a nursing major. Now I have education coordinator, at changed my major and plan on email@example.com. transferring to the University of Minnesota for the dental hygiene Scrubs Camp is designed to be replicated in program. other communities across the state. To host a camp in your community, contact Jane Foote, HealthForce Minnesota executive director, at firstname.lastname@example.org. And if you are a health care professional interested in sharing your passion for your career at a Scrubs Camp, contact the Rochester office at 507-280-5034. http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM] Winter 2010 Quarterly Newsletter Complete information is online at http://www.healthforceminnesota.org/. top of page COMMUNITY FOCUS MINNESOTA TO TRAIN OVER 500 HEALTH CARE IT PROFESSIONALS Estimates indicate a national shortfall over the next five years of approximately 51,000 health information technology workers qualified to meet the needs of hospitals and physicians moving to electronic health care systems. Four schools in Minnesota are part of a nationwide effort to ensure health care facilities and medical practices meet the requirements of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Normandale Community College is part of the Midwestern Consortium Health IT Short-Term Training Program. The University of Minnesota - Twin Cities, the College of St. Scholastica, and the University of Minnesota - Crookston make up the University Partnership for Health Informatics. Midwestern Consortium Health IT Short-Term Training Program Normandale Community College is one of 17 colleges in the Midwest Consortium using a common HIT curriculum. “Our goal is to create a skilled workforce to support the adoption of EHRs, exchange of health information and the redesign of workflows within health care settings to gain quality and efficiency while protecting privacy and security,” said Sunny Ainley, director of Normandale’s Center for Applied Learning. Normandale’s program—Minnesota Health Information Technology (MnHIT)— focuses on job-specific training. MnHIT will train 300 students in one of four roles in health information technology over the next 18 months: Clinician/practitioner consultant EHR/application trainer Implementation support specialist Practice workflow and information management redesign specialist. The six-month program would normally cost students $1,650; however, federal financial assistance is covering all but $500. All courses are available online to support students who live in rural areas or who would otherwise be prevented from attending in person. The first cohort began in September and the second in January. “This program is a professional level, industry training program to prepare individuals to work successfully in the HIT environment,” said Ainley. To be eligible for this short-term program, students must have experience in information technology or information system, medical records, health information management, medical billing, a hospital business office or as a clinical practitioner. Applications will be accepted for the fall 2011 cohort through August 2011. http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM] Winter 2010 Quarterly Newsletter “We are continuing to support the career and employment success of our graduates with the CareerHITrac program, which includes trainings, guidance, informational interviews, referrals and on-site experiences,” said Ainley. She also noted that nearly half of current enrollees are unemployed professionals seeking new opportunities in the field of health information technology. University Partnership for Health Informatics University Partnership for Health Informatics (UP-HI), a university-based training program, was also created to educate new health professionals who can assist in the transition from paper to digital records—patients’ electronic health records, prescriptions, best treatments/therapies and more. “Our federal government is emphasizing that we need to infuse the workforce with specialists in health informatics. This is a very broad term describing the use of technology in health and health care delivery, enabling health care professionals to do a better job delivering care. HIT also addresses the capture and archival of data to better treat, diagnose and manage disease and wellness,” explained Julie Jacko, Ph.D., principal investigator and director of UP-HI. UP-HI programs are offered at the College of St. Scholastica in the School of Nursing and School of Health Sciences. The Health Informatics Graduate Program, the School of Nursing, the Department of Public Health and the Department of Computer Science are offering UP-HI programs at the University of Minnesota-Twin Cities. UP-HI at the University of Minnesota- Crookston includes the health informatics programs in software engineering, information technology management and applied health. A total of 237 students will be accepted over the next three years to study in one of the six areas identified by the Office of the National Coordinator as areas of workforce need: Clinician/public health leader Health information management and exchange specialist Health information privacy and security specialist Research and development scientist Programmer and software engineer Health information technology subspecialist. Certificates and degrees within UP-HI are a minimum of six months long and a maximum of 24 months long, and are offered online, allowing students to be recruited regionally and nationally. Many students are already working in public health or health care and are clinicians, engineers or computer scientists. Type I programs, which include certificates and the Master of Health Informatics degree, are completed in one year or less. Type II programs offer Master of Science degrees, and are completed within two years. Students who apply and are accepted as UP-HI Scholars, are eligible to receive tuition funding; some are eligible for stipend funding as well. http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM] Winter 2010 Quarterly Newsletter More information is available on the ORHPC website. top of page SPECIAL FEATURE CMS SELECTS MINNESOTA FOR MULTI-PAYER ADVANCED PRIMARY CARE PRACTICE DEMONSTRATION Including Medicare as payer for certified health care homes is a critical step for rural Minnesota by Leyla Kokmen, Health Reform communications coordinator, Minnesota Department of Health Last fall, the Centers for Medicare and Medicaid Services selected Minnesota as one of eight states to participate in the Multi-payer Advanced Primary Care Practice (MAPCP) demonstration project. This demonstration will add Medicare to Minnesota’s existing multi-payer health care home initiative as a payer for certified health care homes. The demonstration project, which covers Medicare fee-for-service beneficiaries, is expected to begin in mid-2011 and last for three years. In order to participate in the demonstration, providers must be certified as health care homes by the Minnesota Department of Health (MDH). During the demonstration period, the state anticipates that certified health care homes will serve more than 225,000 Medicare beneficiaries. The demonstration funds will go directly from Medicare to health care homes for care coordination services. Redesigning Care Benefits Rural Seniors Minnesota’s health care homes initiative, part of the 2008 health reform law, is a redesign of primary care that emphasizes a team approach and puts the patient at the center of care. This model highlights access, communication and continuous quality improvement. It aims to improve health outcomes, the patient experience of care and, ultimately, the affordability of health care. The MAPCP demonstration is particularly important to clinics and clinicians in rural Minnesota. In some rural counties, more than 30 percent of the population is 65 or older—more than double the state average. Because seniors as a group often have higher health care usage, Medicare can often be the central driver of the health care system in rural areas. “Selecting Minnesota to participate in the Medicare demonstration is an important step toward achieving critical mass in the state's goal of transforming primary care through health care homes,” said Marie Maes-Voreis, health care homes program manager at MDH. “Having Medicare as a payer can be an important incentive for rural providers to become certified as health care homes.” As of December 2010, MDH had certified 47 health care homes, representing a broad range, both geographically and in clinic size and scope. They are in several regions of the state, include both urban and rural clinics, and range http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM] Winter 2010 Quarterly Newsletter from single-physician clinics to large systems. The 47 certified health care homes represent 428 clinicians. An additional 105 clinics, representing about 1,270 clinicians, are working toward certification. Participating in the Demonstration All certified health care homes may participate in the MAPCP demonstration; there is not a separate application process to participate. The state’s goal is to have 150 practices participate in the demonstration in the first year, 250 in the second year, and 340 in the third year. CMS will use Minnesota's existing payment methodology for care coordination reimbursements for qualifying Medicare beneficiaries. Payment is based on the patient’s level of complexity. The billing mechanism will be the same one that certified health care homes currently use to bill for services provided to Minnesota Health Care Program enrollees. "The addition of funding through Medicare makes it more feasible for primary care practices to do the work of transforming to health care homes for all of their patients, regardless of their insurance,” said Ross Owen, manager of care delivery reform at the Minnesota Department of Human Services (DHS). “It sends a common message across the market about the kind of health care we are interested in buying in Minnesota.” MDH and DHS jointly applied for the demonstration project. To develop the strongest possible application, MDH and DHS health care homes staff convened an advisory group of stakeholders with Medicare expertise to provide guidance on key strategic issues. The group of more than 25 stakeholders represented professional associations, consumer organizations, health care providers, health plans, local public health, community service organizations and higher education. The University of Minnesota School of Public Health also contracted with the state to develop a detailed analysis, which showed that the state’s participation in the demonstration project would be budget neutral. Measuring Outcomes The purpose of the demonstration is to evaluate advanced primary care practices, also known as medical homes or health care homes, and see if these multi-payer initiatives can reduce unjustified variation in utilization and expenditures (including in the Medicare program); improve the safety, effectiveness, timeliness and efficiency of health care; increase shared decision making by patients; and increase the availability and delivery of evidence-based care in historically underserved areas. Minnesota joins Maine, Michigan, New York, North Carolina, Pennsylvania, Rhode Island and Vermont in the demonstration. The demonstration requires that Minnesota participate as a collaborative partner with CMS in a comprehensive evaluation process that will focus on primary care results in improved clinical quality, better patient experience and improved affordability of health care delivery for Minnesotans. The application also served as the impetus for Minnesota to join Colorado, Maine, Massachusetts, New Hampshire, Pennsylvania, Rhode Island and Vermont to initiate a framework for a multi-state learning health system with common metrics, shared learning and rapid cycle data-guided improvement of their respective medical home models. These states plan to use common http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM] Winter 2010 Quarterly Newsletter measures and comparative effectiveness to guide their delivery system reforms, providing the best opportunity to evolve models that are clinically and financially effective for a successful CMS demonstration. More information is on the MDH Health Care Homes - Medicare Payment website. top of page VIEW ONLINE ALL PREVIOUS ISSUES OF THE OFFICE OF RURAL HEALTH AND PRIMARY CARE PUBLICATIONS. Minnesota Office of Rural Health and Primary Care P. O. Box 64882 St. Paul, Minnesota 55164-0882 Phone 651-201-3838 Toll free in Minnesota 800-366-5424 Fax: 651-201-3830 TDD: 651-201-5797 www.health.state.mn.us/divs/orhpc SAVE THE DATE: THE MINNESOTA RURAL HEALTH CONFERENCE IS JUNE 27-28 IN DULUTH MISSION: To promote access to quality health care for rural and underserved urban Minnesotans. From our unique position within state government, we work as partners with communities, providers, policymakers and other organizations. Together, we develop innovative approaches and tailor our tools and resources to the diverse populations we serve http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/winter.html[2/8/2011 2:14:24 PM]
"Winter 2010 Quarterly Newsletter"