A rural healthcare organization located in the northernmost part of Maine turned to EMTS for help in finding a company that would allow for the continuation of the Point of Care program utilizing new and updated glucometers for blood glucose levels.

EMTS (www.emtsolutions.biz), a national partner of NCHN (National Cooperative of Health Networks), first met the hospital’s CFO at an introductory meeting with representatives from Synernet in late October 2013. Synernet is an outsourced provider of healthcare services primarily to hospitals, physician practices and surgical centers. They are owned by a number of Maine hospitals including this facility. Synernet met EMTS in April of 2013 at the NCHN Meeting in New Orleans. NCHN (National Cooperative of Healthcare Networks) has a master agreement with EMTS for their Capital Equipment Services in which Synernet was eligible to participate. EMTS signed an agreement with Synernet in 2013 geared to help their members and owners save money on capital equipment acquisition and related service.

In early November the hospital reached out to EMTS because the glucometer equipment that was currently being used at the hospital was being removed from the marketplace on 12/31/2013 and the hospital needed some help exploring alternatives. This was the first project being submitted to EMTS utilizing the recently signed Synernet/NCHN Agreement.

EMTS coordinated a conference call with the CFO and DON to discuss this project. During the call it was learned that a proposal had been submitted by a new national supplier in late September and it was determined based on the discussion that the hospital would like to look at alternatives available in the market. Through their extensive market knowledge and historical purchase database, EMTS determined that there were 3 primary companies in this marketplace, and initiated contact with each potential vendor.

It soon became evident that due to the large manufacturer pulling out of the business at years end, the remaining companies did not want to commit or have the resources to get this project completed prior to 12/31/2013. This was compounded by the fact that this hospital was “extremely rural” and access to the site was difficult. Overall, this project was a challenge from the start, with many moving parts and complications, but EMTS was successfully able to work through the process over several weeks and phone meetings.

Ultimately, EMTS was able to provide multiple options for the new glucometers that were integrated with the hospital’s existing information system. These options included capital purchase and reagent amortization with savings ranging from 10% to 36% over the original project that was submitted. The hospital ended up electing the reagent rental option and in doing so received the latest technology, title to the equipment after the term and direct cost savings in excess of $10,000.00. Most importantly, the Point of Care program was implemented prior to the 12/31/2013 and the continuum of care never suffered.

For More information on this case study, or to discuss in detail how EMTS can help your organization maximize your current capital budget, please contact:

EMTS - Larry Cantarano, VP Strategic Sourcing, Ph. 720-420-7966, lcantarano@emtsolutions.biz

Synernet - Mike Hutchins, Director of Clinical Engineering, Ph. 207-771-3420, mhutchins@synernet.net

Yesterday, I read an article my monthly Prevention magazine (January 2014, always running a bit behind on personal reading!) and I thought, how much does this sound like Network Leaders?  “You feel like you’re running in 90 directions at once – but never the right one.”  How does this sound like you?  I certainly related to the comment!  This time of year is a busy time for NCHN.  We are nearing the end of our fiscal year, so that brings on some additional tasks – like budget development for 2014; updating membership dues assessment form, reviewing our work plan and seeing where we have fallen short of goals and celebrating where we may have exceeded goals.  And then of course the Annual Educational Conference, at least we have a breather on this event, as it has been moved to June, but we are still very busy with all those conference details and planning.  We had planned to include the conference announcement in today’s issue, but still have a few final details to confirm, so look for a special conference email announcement later this week.  I can share with you the theme, “2014 NCHN Educational Conference – Your Gateway to Innovation, Leadership and Collaboration” and I can assure you the event will have a lot of exciting presentations, networking opportunities, sharing of ideas and fun!  So, save the date now, June 17-20, 2014 and plan to join us in St. Louis. 

So, back to the Prevention article – Dr. Pam Peeke offered following advice on the challenge we all face of trying to do too much!  She recommended “Adapt & Adjust.”  To do this, sit still for 10-15 minutes a day. (I know, got to find those 10-15 minutes). Call it your “quiet time” – sit quickly and check in with your breathing, focus on your breathing, and calm your mind. “Don’t ‘think’ your thoughts – let them drift away as you concentrate on deep, slow, rhythmic breathing.”

According to Dr. Peeke, these “quiet time” sessions, practiced once or twice a day, will strengthen your prefrontal cortex, the executive center of your brain. This helps you make the right decisions more easily, filter out time-wasting temptations, and zero in on tasks you designate as important. Think of the impact this could have on your day!  More easily made decisions for your network and zeroing in on those important tasks!  Dr. Peeke went on to say that you’ll begin to sink deeper into sensory experiences that you’re missing now – food will taste better, you’ll see things more clearly, and life will be richer. Regularly practicing the art of stilling your thoughts will strengthen your vigilance and concentration, so you can begin to prioritize your long-term goals over short-term distractions.  Her article also has some other suggestions on how to stick to your health goals with life gets in the way.  You can send questions to Dr. Peeke to askdrpeeke@prevention.com 

Ok, I think I’ll try this new strategy, so I’m going to take a “quiet time.” Let me know if you tried and how you are feeling in a couple of weeks! 

Oh yeah, also Happy Spring – so looking forward to its arrival on Thursday!

As folks across the nation dig out from reoccurring winter storms and thoughts turn to spring and warmer weather, a group of NCHN members are busy planning NCHN’s 20^th Annual Educational Conference. The event will be one of the best networking and educational opportunity for health network leaders across the country. The Conference Planning Committee received more presentation proposals than ever before!  Registration information and lodging reservation details will be available in the next eNews!  Also, watch for information about exhibit and sponsorship opportunities. Eight NCHN members have already step forward with a donation to support the keynote speaker program.  It is not too late to add your support to the 2014 Conference.  If you are interested, please just let me know.

This year the Conference is June 17-20 in St. Louis, Missouri.  On Tuesday, June 17, a pre-conference workshop, “Network Collaboration Workshop:  How to Add Value to your Network and Promote Health within Your Community” will be offer by the National Rural Health Resource Center. The Network Collaboration Workshop is a 4 hour interactive session providing specific skills development, peer discussion, and practice opportunities designed for rural health network leaders to support their work in building meaningful and impactful collaborations. Collaboration is one of the keys to success in our changing health care environment and being a capable and effective collaboration leader is becoming increasingly important. Specifically, rural health provider organizations, network members, are preparing themselves for changes in health care, such as, care transitions, telemedicine, health information exchange, patient engagement, and a primary care provider focus. Networks are called to meet their members’ needs with effective collaboration. During the workshop, there will be a focus on Leading Collaboration and Building Trust in Collaborative Partnerships. Specific How-To training will be supplemented with interactive discussion and a panel of peers describing their collaboration challenges, successes, and lessons learned.

NCHN is looking for a few good network leaders interested in becoming involved in the management and governance of the Association.  Information about Director positions will be distributed within the next few days.  If you have thought about how you could become more involved in NCHN and expand your leadership skills from your network to the national level, please consider serving as a Director. NCHN’s Board of Directors is comprised of NCHN members, serving as volunteer Directors and are elected by their peers. 

And, we are attempting one last push to complete the member phone interviews. Thanks to the approximately 80% of members that have participated in an interview.  We would like to achieve 100% participation in this process, so if you have not been interviewed, we will be in touch.  Please take the time to give us your feedback! 

I wanted to share with you some preliminary results of the phone interviews that Christy and I have been conducting with the membership.  We thank the 33 members that gave us a small portion of your busy time to participate in the phone interview.  We would love to talk to the 14 members that we have been unable to connect with so far.  If you have not been interviewed and have some time this week, please let me know.

So, from the 69% of the membership that we talked with we heard the following about top NCHN services; relevant news and information; and suggestions for new programs.  The Membership Committee will be reviewing the results of the phone interviews and making recommendations to the Board.  If you would like to be involved in this process by serving on the Membership Committee, please let me know.

Here’s what we heard from you:

Top Service

1. Annual Educational Conference

News and Information that is most relevant

• What other networks are doing

Top Suggestions for New Programs/Services

(RE: “What kind of services can we offer that would make the membership more valuable to you and to your network members?”)

• Peer to peer learning: Facilitate communication/networking among networks of similar structure, composition, and/or development

In order to reserve your space in one of the top three services of NCHN, make plans now to attend the 2014 NCHN Educational Conference, June 17-20, 2014 in St. Louis, MO.  The Conference Planning Committee reviewed 18 presentation proposals last week and were so excited about not only the quantity, but the quality of proposals received.   The hotel contract is in the final stages and lodging reservation information and registration details will be available by the middle of February. Please register early and make your room reservations, so that you can ensure your place at the 20^th Annual Conference!  We certainly have a lot to celebrate this year and want you to be a part of the celebration!

And, we really need your help in the area of news and information that you want to receive from NCHN – “what other networks are doing.”  We would love to have a network feature each issue, but you need to provide us with the information to develop such a column.  If you are interested in sharing information about a specific project or activity your network is addressing, please contact Christy.  She will be happy to work with you to develop a feature article.  Another way each one of you can contribute to this body of knowledge about networks is to complete and/or update your network profile on the NCHN website.  If you need assistance, please contact Christy.

Here are two upcoming events that provide the second top service members appreciate – networking opportunities:  

• Special Call on National Rural ACO model – Friday, January 24 @ 12:00 PM ET
• January Coffee/Tea Chat - Friday, January 31 @ 11:00 AM ET

As, we move forward in 2014, remember to take care of yourself!  We all have a lot of important work to do this year!

[From ORHP via NRHA]:

The Federal Office of Rural Health Policy (ORHP) is interested in hearing from you on how the Affordable Care Act (ACA) implementation is going in rural communities. Here are some sample question for you to help provide input on:

1.    Are rural hospitals, Critical Access Hospitals and Rural Health Clinics hearing of issues related to utilizing new private insurance or Medicaid expansion coverage from the Marketplace? 

2.    Are patients having trouble getting an appointment with a particular type of doctor? Any issues filling prescriptions? 

3.    Are your former patients without coverage now using their private insurance at your facility? Or are they seeking care elsewhere? 

4.    Are rural hospitals, Critical Access Hospitals and Rural Health Clinics hearing from patients that they aren't sure they are eligible for Medicaid? 

5.    Are patients bringing in eligibility notices that are confusing? 

6.    Is the patient's plan accepting claims for newly eligible individuals or is the provider getting EOBs that the individual is not enrolled in Medicaid or the plan? 

Coverage through the Marketplace or Medicaid Expansion has only just begun, but ORHP wants to stay ahead of issues that emerge.  I encourage you to pass along any observations through the ACA email inbox. 

Additionally, ORHP invites you to participate in their ongoing weekly office hours to share any thoughts, suggestions and concerns you may have.  The information for the call is below: 

ORHP ACA Office Hours

Wednesday, January 8, 2014
3-4 p.m. EST
Call-in Number: (800) 857-3749
Passcode: ORHPACA
Adobe Connect Session: https://hrsa.connectsolutions.com/orh1/

Can you even believe that it is almost the end of 2013?  I can remember my Mom saying quite often when I was a young girl, “The older you get, the faster time seems to go.”  Now, I think I totally understand what she was talking about, although back then it sounded kind of silly to me, especially when waiting for Christmas to come each year.  So, as we moved into the holiday season our hope, Christy and I, along with the Board of Directors, hope that this holiday season you are surrounded by friends, family and fun times.

And, as we look toward 2014, my challenge to you is to take the time to take care of yourself.  We all have very important work to do in the upcoming year. As the Affordable Care Act continues to be implemented, networks could and should be planning to play a major role.  This week on the Quarterly Informational Call we learned more about an advance payment model and how networks could become involved in a rural ACO.  In 2014, NCHN will be holding additional discussions on topics relevant to health networks. 

As we end 2013, this is the last eNews issue of the year, we thank you for your support.  Our last big activity of 2013 is completing member interviews. If you have not been interviewed yet, please contact Rebecca or Christy to schedule your interview before the end of the year! We look forward to continuing to serve you in 2014.  Some activities on tap for 2014 includes the Annual Educational Conference, June 18-20, in St. Louis, Missouri (Call for Presentations went out last week); Quarterly Informational Calls, continuation of the 2013 Leadership Learning Community, monthly Coffee/Tea Chats; list serve access for questions to your peers; and we will be conducting the Network Leader Salary and Benefit Survey.  I encourage you to take advantage of your membership benefits!  

Merry Christmas and Happy New Year! 

I heard a story this past week about an art teacher and a little boy.  The art assignment was to draw a story on a piece of paper and turn it in to the teacher.  So, one little boy turned in a blank sheet of paper. The teacher looked at one side, blank, turned it over and looked at the other side, blank.  He asked the little boy, so tell me about this drawing, what is it?  The little boy responded that it is a cow eating grass.  The teacher’s response, “Oh really, will where is the grass?”  The little boy replied, “The cow ate it all up.”  “So, I see,” said the teacher, “then where is the cow?” The little boy replied, “she went to look for more grass.” 

As Network Leaders, we are always looking for more grass!  How do we sustain the network? Are there potential new products or services that the network should be offering? Are there additional organizations in the service area that should be members of the network? NCHN, your professional membership organization is also always looking for new grass.  We are currently in the mist of conducting phone interviews with all NCHN members.  This is the first such activity that NCHN has undertaken, at least in the past seven years and maybe the first time ever.  Everyone is busy.  We know grant deadlines are looming, but it is so important that we have 100% participate in this project.  As the NCHN Board of Directors, elected by you the membership, look toward the future, they need your input. 

As Christy and I are constantly out looking for grass, we need your feedback. What is working, what can we improve on, and what new opportunities should we be exploring to support your work as a network leader.  If you have not already responded to the email requesting a time and date for the phone call, please do so today, or just send us an email and say we are ready!  Please give us 30 minutes of your time before the end of 2013. 

I received some happy/sad news for networks over the weekend.  Leticia Manning, Program Coordinator for the HRSA Rural Health Network Development Program is leaving ORHP the first week December.  She is not leaving HRSA, but moving to Maternal and Child Health Bureau in the Division for Children with Special Health Care Needs.  Prior to coming to HRSA, she had worked on issues related to children with special health care needs and is excited to be returning to field.  She stated that she will truly miss the NCHN family, but knows that the relationships she has formed over the past four years will remain despite where her job posting will be.  Leticia has been an advocate for not only rural health, but specifically for health networks.  We will miss her, but wish her all the best in her new career adventure.  

The NCHN staff and Directors wish you and your family a safe and wonderful Thanksgiving holiday.  

Here we are in mid-August! For some folks that means the start of a new school year, start of a new college experience, beginning of the empty nest syndrome, and for others new arrivals! Congratulations to Director Stephen Stoddard and his family on the arrival of their new daughter, Jessica Faith.

This month I only want to share one thing – if you have not reacted to the release of the Office of the Inspector General of Health and Human Services (HHS) report on Friday concerning the Critical Access Hospital program, please do so immediately! Read the full report here (pdf).

Our partners at NRHA have been working full steam since early last Friday morning when the report was released.  Yesterday afternoon I listened in on a very informative phone discussion that laid out the facts about the CAH Program and provided tools and strategies for each one of us to review and use to prepare a response to the report to share with our elected officials. 

Here are some links to provide you with up to-date information, sample letters, and contact info to make those contacts: 

NRHA’s Government Affairs Page: http://www.ruralhealthweb.org/go/left/government-affairs/response-to-2013-oig-cah-report

NRHA’s Blog  (includes links to the media coverage of the report since release): http://blog.ruralhealthweb.org/2013/08/nrha-busy-setting-the-record-straight-on-cahs/  

Tim Size, Executive Director of Rural Wisconsin Hospital Cooperative – was at it early on Friday morning, posting comments to the numerous articles that are linked above in the NRHA Blog – Thanks for his dedication and support for rural health overall and particularly the CAH Program.  You can see his response at the bottom of this article in Kaiser Health News:  http://capsules.kaiserhealthnews.org/index.php/2013/08/hhs-watchdog-says-rural-hospital-program-needs-a-trim/ 

If you have any questions, need more information or what to discuss the potential impact if the report recommendations were fully implemented on your network, please let me know.    As we receive additional information about strategies and tools to assist you in responding to the report, we will pass them along to you through direct email updates. 

Enjoy the remainder of August! 

Thanks to Darcy A. Czarnik Laurin, Executive Director, of the Thumb Rural Health Network, MI for sharing this quote from Ralph Marston, “True, effective leaders do not demand or proclaim or intimidate. They encourage, inspire, and lead by example. True leaders become leaders not because of their titles, but because of their work. Real leaders have no need to make promises, because it is already obvious to everyone that they get results. The world can always benefit from more good, effective leaders. You can make the choice to be one. Leadership is difficult and demanding, and often a thankless job. Yet without honest, authentic, effective leadership, the world would devolve into chaos. The job of a real leader is not to tell people what to do. The job of a real leader is to enable each and every person to be his or her absolute best, and to point all those people in a positive direction. You don’t need anyone’s permission to be a leader. All you have to do is to genuinely and respectfully make a positive difference in the lives of others.”

As network leaders, you all make positive differences in the lives of others. You encourage, inspire, and lead by example. NCHN’s mission is to support you in your role as Network Leader and we are pleased to announce a new resource that will allow you to make even more positive differences in the lives and work of your colleagues. We are looking for network leaders to serve on the NCHN Executive Coaching Team. We will be providing training next week, Tuesday, July 23 and again on August 13 for NCHN members interesting in serving their Association in this role.  Click here to learn more about the NCHN Executive Coaching Training. 

Thanks to everyone that completed the Coffee/Tea Chat Survey.  We have scheduled the Chats through December 2013, so check the NCHN Calendar of Events and watch for Save the Date messages in your inbox and read more about the July 31 Chat in this issue.

The Membership Benefit Survey is still open and we encourage you to complete. Thanks so much to the members that shared suggestions on how to improve the instrument.  We changed the required demographic information to optional to ensure confidentiality of members’ identity that complete the survey.  The more members that participate in this survey the better your Directors, Officers, and Committees can serve your needs.  Please give us five minutes of your time -- http://www.surveymonkey.com/s/2013MembershipBenefitsSurvey 

The second webinar of the HCAHPS Webinar Series was on July 9^th.  The session was excellent!  If you have hospitals as members of your network and you have not taken advantage of this program, I encourage you to take another look at it!  It is a wonderful educational series on HCAHPS and how to assist the hospital to increase their scores.  The first two sessions were recorded and can be viewed by appropriate hospital staff.  It is not too late to take advantage of this series. You can read more about the program here or give me or Christy a call at 540-352-2529 if you would like to discuss. 

I would also like to remind you of another NCHN benefit, the NCHN List Serve.  If you have a question or need information or an example, please send the request to me and I will be happy to post to the NCHN list serve.  And when questions are posted, please take the time to respond if you have information to share with your peers. 

Enjoy your summer!  We know lots of you are still planning and taking vacations. We will be looking for those photos of network leaders at play, send yours in today! 

Virtual Care Works has been working with a Denver-based pediatrics practice since October, 2012. The practice cares for patients from birth to college age and has experienced a large increase in behavioral issues, especially within the adolescent age group.

• Using the VCW Platform, the practice has been treating their behavioral patients remotely. The benefits for both the patient and the physician are many. One major plus is the providers feel their patients are more relaxed and open when they are at home in their own environment rather than in an office practice setting. Gathering more visual clues to a patient’s status when they are at home and “their guard may be down” is another often-cited benefit. Finally, the physicians report they are also able to gain in-depth feedback by the interaction with family members as they can now participate in the visit due to convenience of scheduling and location.
• Parents of the patients have been quite enthusiastic about the effectiveness of these meetings and are also thrilled with the reduced “windshield time” and reduced cost of gas not having to drive to the office for each meeting.

The bar for providing ‘Quality Care’ is being raised every day.  Not only through medical practice standards, but now by patient demand.  The HIPAA secure technology exists, majority of patients are already equipped, and now is the time to welcome TeleMedicine as the ‘Next Level of Care”.

Comments and questions are greatly appreciated!  Feel free to contact Jim Ward directly: (mailto:jim.ward@virtualcareworks.com)

About the Author
Jim Ward serves as Telhealth Specialist with Virtual Care Works. VCW is a secure, private broadband network enabling the practice of telemedicine, telebehavioral health and medical education as well as the exchange of protected patient data and medical images. VCW is a NCHN Business Partner.