Community Tools Are Available to Combat the Higher Rates of Childhood Obesity In Rural Areas

The Altarum Institute, a nonprofit health-systems research and consulting organization, reported today that children living in rural areas are about 25 percent more likely to be overweight or obese than children in urban areas. Rural communities have come up with several strategies to battle childhood obesity. 

According to Sarah Lifsey and Karah Mantinan of the Altarum Institute, studies have found that there is little open public space in rural areas, often because of a lack of a strong government to provide and maintain such public spaces. They also cite research showing that rural children are also at increased risk of poverty compared to children in cities or suburbs, and face lower access to healthcare, lower levels of physical activity and lower-quality food.  Many rural families who lack access to fresh and healthy foods live in “food deserts,” Studies have found poverty and childhood obesity are more likely in rural food deserts.

Tools are available to help with this planning such as the Rural Active Living Assessment Tools, developed by the Robert Wood Johnson Foundation. Other resources include the Rural Assistance Center, funded by the U.S. Department of Health and Human Services Rural Initiative, which features a Rural Obesity Prevention Toolkit developed by the Nutrition Obesity Research Center’s Walsh Center for Rural Analysis, as well as a resource guide for rural areas developed by the University of North Carolina’s Active Living by Design.

Read the article in the Lane Report.

Rural Physicians More Likely to Participate in QI Efforts and Discuss Cost of Care with Patients

A new study in the National Rural Health Association’s Journal of Rural Health finds rural primary care physicians are more likely to participate in quality improvement activities than their urban counterparts. According to Alan Morgan, CEO of the National Rural Health Association, “Quality healthcare can be found in rural towns all across America. Rural primary care often faces significant challenges with equal or better patient outcomes. It’s time to start looking at what’s done right in rural.” 

A survey of 2,000 rural and urban family practitioners indicated that while rural communities may have fewer training options, rural primary care physicians are significantly more likely to participate in quality improvement activities. The study also found that rural physicians were more likely to agree that physicians should discuss the costs of care with their patients and to report having added Medicaid or uninsured patients during the preceding year.

The peer-reviewed article on the study can be found here (a subscription may be required).

 

Colorado Network of Health Alliances, A Statewide Learning Network Convened by CCMU

In dozens of communities across Colorado, formal health alliances are using collective impact approaches to tackle the major social issues of healthcare. Some of the alliances have been around for decades and others are just now exploring formalization, but all of them are working on a common agenda, using collaborative leadership strategies, to improve the local healthcare system and ensure access to care for all community members.

Since 2012, the Colorado Coalition for the Medically Underserved (CCMU) has convened these alliances in a statewide learning network called the Colorado Network of Health Alliances. Last week, CCMU published a year-in-review document, Progress & Possibilities, detailing the first year of the network, including current membership (21 alliances) and highlights of the work being done by these groups. They also identified three strategies for local healthcare change that are common across the members of the Colorado Network of Health Alliances:

1. Developing Healthcare Leadership for Change – Health alliances are on the front lines of identifying and developing champions for healthcare change in communities across Colorado. These organizations have the unique ability to bring diverse and high-powered leaders and stakeholders together to work toward common goals.
2. Increasing Access to the Healthcare System – Health alliances are working hard to catalyze new healthcare access points, to maximize enrollment in new health insurance coverage options, and planning to care for the needs of Coloradans who will remain uninsured after the Affordable Care Act is implemented.
3. Improving and Strengthening the Healthcare System – Through formal alliances, health and community leaders across the state are constantly searching for ways to coordinate services, limit duplication, and pool resources.

Read the full report here.

Policy Options to Cut Emergency Department Costs

For nearly 50 years, emergency rooms have been fingered as a major source of excessive healthcare costs. And while some newer research has challenged the idea that a large proportion of patients visit the emergency room for routine problems, many payers and policy makers continue to focus on these patients as a major source of wasteful spending.

For a new study published in The Journal of the American Medical Association, researchers reviewed the records from almost 35,000 patient visits to emergency departments across the country. In just 6 percent of cases, the patient was discharged and could have been treated in a healthcare provider’s office. 

History has shown that limiting payments based on discharge diagnoses has been largely unsuccessful. However, other policy options are being tested around the country. Beginning last summer, emergency departments in Washington state established programs to educate patients on how to access care, as well as other measures designed to improve care, including statewide guidelines on prescribing narcotics, shared electronic health and prescription information, and regularly updated reports on how emergency department resources are utilized. The policy has already resulted in significant changes and a projected savings of over $31 million by the end of the fiscal year. Read more here.

Improving Quality and Patient Safety for Vulnerable Populations

Dr. Bruce Siegel is the President and CEO of the National Association of Public Hospitals and Health Systems (NAPH), and is a contributor to the Learning Health System Commentary Series of the Institute of Medicine (IOM) Roundtable on Value & Science- Driven Health Care.  Authored commentaries in the IOM Series draw on the experience and expertise of field leaders to highlight health and healthcare innovations they feel have the potential, if engaged at scale, to foster transformative progress toward the continuously improving and learning health system envisioned by the IOM.  Statements are personal, and are not those of the IOM or the National Academies.

In this commentary, Dr. Siegel describes NAPH’s current efforts to improve the disproportionate burden of hospitalization and poor health outcomes for the nation’s safety-net patients. Read his discussion on several concepts central to continuously improving care, including the importance of integrated, coordinated patient care across various care delivery settings here.

ONC Goal: 1,000 Rural Hospital Meaningful Users by End of 2014

The Office of the National Coordinator for Health IT has set an ambitious goal of 1,000 rural hospitals becoming meaningful users of health IT by the end of 2014.  Despite the budgetary and work force challenges rural hospitals face, they are making steady progress on health information technology adoption. Between 2009 and 2011 the rural provider EHR adoption rate more than doubled. To speed adoption and share best practices, ONC created the Rural Community of Practice (CoP) and has recruited and convened leaders with expertise to roll out pilot projects. Its 10 subcommittees track the key challenges rural hospitals face.  Read the full article by David Raths, Healthcare Informatics.