1. Challenges & Successes Health Information Technology Perspectives of 3 Leaders A Rural Health Perspective Holly Jeffreys, DNP, APRN, FNP-BC

2. Access to Rural Health Care While 1/4 of the US population lives in rural areas, less than 10% of these areas have a primary health care provider. Rural Healthy People 2010: Literature Review (2012).

3. National Snapshot 15% of US adults report they do not have a place to receive care. Up to 12% of hospitalizations are avoidable with appropriate access to health care. RuralUrban Male Mortality Ages 1-24 80/100,00060/100,000 Female Mortality Ages 1-24 40/100,00030/100,000 Adults report Poor Health Conditions 28%21% National Rural Health Association Statistics, 2012

4. Rural IssueRural StatsUrban Stats 8 th Graders report smoking26.1%12.7% 12 th Graders report of driving while intoxicated 40%25% CVA (Stroke)1.5 X higher than urbanized areas Hypertension130 per 1000100 per 1000 Suicide overall men & women Mortality from Accidents60%48% Post AMI Morbidity (illness) and Mortality (death) Morbidity Mortality Up to 30% less Morbidity and Mortality for Post AMI National Rural Health Association Statistics, 2012.

5. Agency for Healthcare Research & Quality (AHRQ, 2012 Highlights) Health care quality and access are suboptimal, especially for minority and low-income groups. ● Overall quality is improving, access is getting worse, and disparities are not changing. ● Urgent attention is warranted to ensure continued improvements in: 1. Quality of diabetes care, maternal and child health care, and adverse events. 2. Disparities in cancer care. 3. Quality of care among states in the South.

6. Healthcare in TEXAS

7. What’s Different with Rural Health? Economic factors Cultural & social differences Quality improvement initiatives Primary Care Providers

8. Family Care Clinic  Mission: To promote the health and well-being of the local population by providing reliable, accessible, high- quality health care for people of all ages.  Vision: To become the trusted, resource and thriving health care center for Carson and surrounding counties.  To serve as a model clinic for rural areas lacking access to healthcare, and to eventually aid other areas in developing and supporting self-sustaining practices.

9. Panhandle, Texas Carson County 6,182 County Residents 2,425 Panhandle Residents 8,000 Patients Family Care Clinic of Panhandle

10. Family Care Clinic of Boys Ranch Boys Ranch, Texas Oldham County 2,065 County Residents 600 Boys Ranch Residents

11. HIT in Rural Health Challenges Internet / Ethernet reliability Connectivity to larger system(s) Patient engagement / participation in care Eligibility / Provider participation - Regulatory barriers HIPPA Successes Data reporting for patient & community education Data collection for preventive care & screening initiatives Quality Initiatives Telemedicine HIPPA