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 protected]
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....”
Mark Schoenbaum
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
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 [email protected] or 651-201-3859.
top of page
PARTNER FOCUS
EXPLORING CAREERS IN SCRUBS CAMPS
by Heather Orfe, HealthForce Minnesota
Scrubs Camp shows us what
we will encounter while working
in health care.
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
skilled workers in rural communities increases.
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
“Scrub Camp” at Winona State University to
explore college and a future in health care.
Students entering grades nine through 12
engage in hands-on sessions, tour medical
facilities, and network with health care
professionals and fellow students. They
examine careers in dentistry, nursing, public
health, emergency medical services, wilderness
medicine, laboratory science, athletic training
and many others.
HealthForce Minnesota
interviewed Bryce Kloeck and
Malia Wittman about Scrubs
Camp.
Bryce Kloeck is a student at Sibley
East Senior High School in
Arlington, Minnesota. He has
attended Scrubs Camp for the past
two summers.
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,
Robby Williams, Bryce Kloeckl
Q: Why did you choose to attend
Scrubs Camp?
Programming for Scrubs Camp changes every
year. At Scrubs Camp 2010, public health was
the focus. Nathan Kendrick, a state laboratory
training coordinator for the Public Health
Laboratory Division of the Minnesota
Department of Health, offered his energetic
personality and content expertise to Scrubs
Camp students. Students learned what public
health laboratorians do when concerns like
influenza and biological and chemical terrorism
threats arise. While learning about
epidemiology, students conducted a simulated
foodborne disease outbreak investigation
focusing on the importance of critical thinking.
Students also performed dipstick urine analysis;
observed how blood glucose levels are tested;
and conducted simulated blood gas, chemistry,
hematology and coagulation testing.
A: My experiences at Scrubs Camp
were great. I want to go into the
medical field, but before attending
was unsure of what exactly I’d like
to pursue as a career. Now it’s a
toss up between neurosurgery and
otolaryngology, neither of which I
was considering before attending
camp.
Q: Do you recommend Scrubs
Camp?
A: I highly recommend it to any
student thinking about pursuing a
career in health care; not only
because it’s a great experience, but
also because we learned a lot while
having fun and meeting new people
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
medicine at camp, but to add to their practical
knowledge, they also live on a college campus.
Experiencing college life is especially important
for first-generation college bound students and
for those unsure about attending college.
experience a college setting and all
of the hands-on activities.
Malia Wittman, now a first-year
student at St. Cloud State University
from Andover, attended Scrubs
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
school students. To accommodate the
enthusiasm of middle school students,
HealthForce Minnesota offers Health Career
Day Camps in Mankato and Rochester. The
Career Day Camps reinforce the importance of
math and science and jump-start thoughts
about career possibilities.
conference of the Health
Occupations Students of America
(HOSA)—the health science student
organization.
Q: Do you think other students
would enjoy Scrubs Camp?
A: Anyone thinking about a career in
the medical field would really have a
Adult Scrubs Camp introduces unemployed,
underemployed and dislocated workers to
careers in demand. In 2010, Adult Scrubs
Camps were held in Pipestone, Rochester and
St. Cloud.
Reaching out Around the State
The 2011 WSU Scrubs Camp is June 26-July 1.
Space is limited so early registration is advised.
Scholarships are available, but limited; those
interested in sponsoring a student can contact
the Rochester office at 507-280-5034 or Sonya
McNamara, sciences career and technical
education coordinator, at
[email protected]. great time and learn a lot, too.
Attending camp let me see that
there are so many opportunities out
there, you just have to have an
open mind and be willing to explore
them. Scrubs Camp helped me
figure out what I wanted to do with
my life. I think it can do the same for
anyone who attends.
Q: How did attending Scrubs Camp
help you to determine your future?
A: Coming into camp, I intended to
pursue a nursing major. Now I have
changed my major and plan on
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 [email protected]. 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 MinnesotaCrookston 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]