Healthcare Education: A Collaboration Model Michelle Welch, O.D. NSU Oklahoma College of Optometry October, 2013

Interprofessional Education – Keys to our system Relationship with Cherokee Nation Geographical distribution of our clinical facilities in a rural area

Our clinical services are primarily directed to a contractual agreement with the Cherokee Nation. This relationship has grown phenomenally in the past twenty years to now include all vision and eyecare services for the nation.

Cherokee Nation The Cherokee Nation operates a network of eight (8) health centers and one (1) hospital in the tribe’s jurisdictional boundaries, serving more than 130,000 eligible patients. Cherokee Nation Health Services provide services for approximately 750,000 patient visits annually.

The Oklahoma College of Optometry currently has ten sites in which we provide clinical care. The geographical distribution of these clinics covers the northeastern quadrant of the state of Oklahoma.

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Cherokee Nation Currently NSUOCO providing around 55,000 patient encounters per year in all the facilities Eyecare full time in Nowata, Salina, Stilwell, Jay Sallisaw, Muskogee, Vinita, and Hastings. Diabetes Exams in Bartlesville NSUOCO facility provides care for secondary and tertiary needs of tribal member Retinal Specialist at NSU once per month to provide care

Eight Rural Eye Program (REP) Clinics Redbird Smith Health Center Sallisaw, Oklahoma Wilma P. Mankiller Health Center Stilwell, Oklahoma

Sam Hider Health Center REP Clinics Sam Hider Health Center Jay, Oklahoma Amo Health Center Salina, Oklahoma

REP Clinics Will Rogers Health Center Nowata, Oklahoma Three Rivers Health Center Muskogee, Oklahoma

Vinita Health Center Vinita, Oklahoma

Rural Eye Program Clinics Students usually see around 6 – 10 patients per day Mostly we focus on primary care. Secondary and tertiary care provided at the NSU facility We try to save patients a trip elsewhere when possible Serve most of the patients, most of the time

Rural Eye Program Clinics REP clinics are located within community based ambulatory care centers With the centers are GP, lab, radiology, pharmacy, some have dental, behavioral health, dietician We have complete access to the patients EHR for systemic care/meds

Aspects of Cherokee Nation relationship – Fully integrated into the health care system Full representation and voting membership on the Cherokee Nation Medical Executive Committee Membership on Hospital and Clinical Committees Membership on the Cherokee Nation Institutional Review Board Membership on other healthcare initiatives and committees throughout Cherokee Nation (ex, CN Headstart) The college isn’t alone in these areas of service. Many optometrists in the state have roles in their local medical community. There are optometrists in 70 of the 77 counties in Oklahoma - and I would encourage discussions with those in your area to see how collaboration can help to serve the health of the patients in your area. The patient’s eyecare home and the patient’s medical home working together would be the ideal goal to achieve.

Aspects unique to relationship with a Native American tribe in a rural environment Cultural sensitivity Assurance of quality health care throughout entire system Viewed as a vital and integral part of the health care team and the responsibilities that go with that Trust and assurance that the relationship never violates the cultural values held dear by the Cherokee Nation

Benefits of Relationship with College Located in Tahlequah Shared goals and values Immediate access to primary, secondary and tertiary providers Immediate access to state of the art equipment located at the College Extremely diverse spectrum of eye and vision care provided due to an academic affiliation Patient quality of life greatly enhanced due to access to care in their home areas

The Future? Met with Cherokee Nation Medical Director in charge of their other educational endeavors Hope to attend IPEC as a team next fall They are expanding education in areas of Family Practice, Nursing, Pharmacy Discussing ways to integrate further……