1. THE CRITICAL ACCESS HOSPITAL NETWORK’S RURAL HEALTH INFORMATION TECHNOLOGY PROJECT Sue Deitz, MPH

2. Rural Network in Eastern Washington Established in 2002 with HRSA Network Development Grant Program

3. Our Members 7 Public Hospital Districts  7 Rural Hospitals, of which 6 are Critical Access Hospitals  12 Rural Health Clinics Mission - To improve the health of our communities by creating an infrastructure designed to stabilize and strengthen the local rural health system. Columbia County Health System

4. Purpose of CAHN  Collaborate/share limited resources.  Capitalize on economies of scale.  Strengthen care coordination among rural and urban settings.  Optimize delivery systems and health outcome with use of health information exchange.  Chronic Disease Management and Measurement Performance Reporting  Aggregate data to learn from each other.

5. Rural Health Disparities WALincol n Pend Oreill e GrantGarfiel d Columbi a Spokan e (urban) In percent WALincoln Pend Oreille GrantGarfieldColumbia Spokane (urban) Percent 65 or older13222112.12324.813 Median Age3747 31.6494836 Have Bachelor degree31191714.624.618.729 Unemployment6.67.610.99.67.810.27.3 Diabetes8129817169 Heart disease59871096 Obesity (BMI= >30)27323138313828 High cholesterol40474543504839 Health Disparities in Rural Network Counties compared to Urban/State (2012)

6. Our Initiatives  Care Coordination and Care Transitions  Patient Centered Medical Home  Tele Health Services  Primary Care and Behavioral Health Integration  County Coalitions and Regional Collaborations  Chronic Disease Management and Measurement Performance Reporting

7. Patient Centered Medical Home  Management of chronic conditions  Use of IT tools/ integrated systems  Emphasis on team based care  Transition from episode-based medicine to person-based health  Supports value based purchasing  Emphasis on collaboration with regional stakeholders

8. Population Health Tools

9. Regional Population Health Measurement De-Identified Aggregated Central Data Repository

10. Impact/ ROI Population Health Data  Population based benchmark/goals chronic disease management (e.g. LDL, BP, A1c)  Inpatient admission rates/ED visits for populations with chronic diseases  Readmission rates after 30 days discharge  Provider satisfaction towards project interventions  Per visit revenue from increase in preventive procedures, labs and screenings triggered by CINA

11. Primary Care & Behavioral Health Integration  Co-Locating  Identify high utilizers of care and develop “hot spotting” solutions  Use team approach to care with mental health providers partnering with primary care providers  Use of telehealth  Build local solutions and partnerships

12. Collaborative Partnerships

13. Thank you Sue Deitz, MPH Director, Critical Access Hospital Network suefox@sandpoint.net (208) 610-0937