Alabama

Chuck Lail February 2015

i Mar 11th No Comments by

What is the most important thing you are working on right now?

The number one challenge for our state continues to be access.  We have tremendous unmet need.  We are 1 of the 5 poorest states and have some of the worst health indicators.  To add to this, we have had several rural hospital closures in the past couple of years and Alabama did not expand Medicaid.  Many people have to go to adjacent communities for their care.

One positive development in the last couple of years is the development of the Alabama Partnership for Telehealth.  This is a great example of successful networking from our annual conference 2 years ago.  This partnership with Georgia’s telehealth initiative is focusing on cardiovascular telemedicine and telestroke.  We are really beginning to see the genesis of what will be a comprehensive program.

Other developments in our state that will hopefully provide some added resources for our office include the reestablishment of the state AHEC program, Regional Medicaid Organizations and a new DO school.

What is one characteristic you believe every SORH leader should possess?

You have to be dedicated and a bit of a salesman.  You need to sell the fact that there is a problem and then sell your program as part of the solution.  In a state environment where the resources are austere, you are often challenged to justify the worthiness of your initiatives and this requires marketing, promoting and perseverance.

What are you doing to ensure you continue to grow and develop as a SORH leader?

We are trying to be at the forefront of program developments, which is difficult since there is something new everyday.  We are trying to remain innovative in an environment of shrinking resources.  Our staff has a positive attitude, strong communication skills and the ability to work together as a team.

 

Promising Practices: NOSORH Partnership Funds Lead to Collaboration Between Alabama and Georgia SORHs to Support Rural Health Clinics: December 2013

i Mar 18th No Comments by

The Georgia and Alabama State Offices of Rural Health (SORHs) have been working together to help provide training and technical assistance to the 165 Rural Health Clinics (RHCs) in their states, which lack RHC associations. The SORHs are also engaging with their state rural health associations (RHAs) in the effort.

Over the last three years, RHCs in Georgia identified three issues they were struggling with: HIT implementation, technical assistance and ICD-10 conversion, according to Charles Owens, director of the GA SORH. There is no RHC association (RHCA) in the state, and Owens describes the RHCs there as “low-hanging fruit—under-represented, and begging for resources and technical assistance.

“So, in Georgia, we started hosting RHC meetings,” Owens said. “We then realized we could work with Alabama—I’m not sure who called who first. We frequently talk with the AL SORH about different issues since our states are similar and we have borders that cross over the state line.” The multi-state NOSORH networking funding was instrumental in moving them to the next level of collaboration, Owens said.

The first AL-GA RHC Conference was held in Opelika, Ala., last summer. The conference has been followed by a series of webinars that focus on RHC technical assistance. The first was on RHC compliance and regulation, the second was on RHC billing, and the last webinar, which will be held on December 10th, will be on RHC Medicare bad debt.

“Alabama would like to partner with Georgia to have another joint conference,” said Rob Boyles, Rural Programs Coordinator and Recruiter at the AL SORH. “However, funding is the main barrier. The joint conference in June would not have happened without the grant funding provided by NOSORH.”

Another barrier with multi-state collaboration, Owens said, is geography, particularly in larger states. “Georgia and Alabama border each other, but our RHCs in the extreme north points and the east coast of Georgia were reluctant to travel all the way across the state.” But, he added, the benefit of multi-state collaboration is “learning from nontraditional sources—it’s not the people you hear from everyday. So that’s why a lot of people, including the federal government, are encouraging us to do this.”

As a result of conference participant feedback, Boyles said, it was apparent that Alabama RHCs also desire training opportunities, particularly on ICD-10. The GA and AL RHAs, in coordination with the Association of Rural Health Professional Coders, have provided two, one-day training sessions. The AL RHA will also provide two, multi-day ICD-10 “bootcamp” sessions after the first of the year. (The AL SORH has had a special training tract for RHCs in its annual rural health conference for the past two years, co-sponsored by the AL RHA.)

Owens thinks that other SORHs should consider reaching out and supporting their RHCs when there is no state RHCA or when those associations are struggling. “This is something that SORHs can do and NOSORH can help with.” Owens said. “In the Southeast, the RHC organizations are small and struggle with finances, so it’s very reasonable that SORHs could serve those RHCAs, especially since they are never going to be very large administratively.”

Promising Practices: Alabama SORH Helps Lead the Charge for Telehealth Projects in the State: March 2014

i Mar 18th No Comments by

As part of an ongoing effort to promote and support telehealth projects in the state, the Alabama Office of Rural Health (AL SORH) has helped a Critical Access Hospital (CAH) attain funding for equipment that can facilitate telewound care locally for its patients.

“Right now, money is tight in Alabama,“ said Debra Robbins, SORH Program Manager. “There are very limited state funds. But we still can help facilitate telehealth.” For example, the AL SORH had some SHIP money leftover last year, Robbins said, which they are using to reimburse Washington County Hospital (WCH), a CAH in a very rural part of the state. The SHIP grant paid for half of the cost of telemedicine equipment and the hospital paid the balance.

“They had patients both in the hospital and coming into the hospital with wounds that needed care,” Robbins said. “Many of those patients had to be transferred to a tertiary hospital 62 miles away to see a wound care specialist. They realized they could do wound care consultations via telehealth. The hospital is hoping to save $80,000/year, but if it proves to be saving them $20,000/year, it will still be worth it.” The initial service will provide wound care for inpatients, swing bed patients and nursing home patients.

“We’re also trying to connect them with other services they can use telehealth equipment for besides wound care,” Robbins said. “For example, we’re trying to connect them with a telepsychiatrist out of Mobile. Right now, if a psychiatric patient presents to the hospital, an ER physician has to help them; telepsychiatry would help them have true psychiatric care.” Future plans include writing a case study that will document the hospital’s savings and return on their investment, and the resulting level of patient satisfaction.

The AL SORH also routinely collaborates with the Alabama Partnership for Telehealth (APT) and is currently supporting an agreement between a large tertiary hospital and five rural hospitals for telestroke (stroke care via telehealth). “Our relationship with the APT is one of collaboration and support, since it will help alleviate physician shortages in rural areas,” said Robert Boyles, AL SORH Rural Programs Coordinator and Recruiter. “We believe you have to market the technology, as so many people in our state are unaware of how it could benefit them.”

In addition, the AL SORH is trying to teach CAHs in the state that telehealth doesn’t necessarily involve expensive equipment or a big initial investment. “Cost can be detrimental to telehealth,” Boyles said. “If you want a mobile cart with tilt and pan capability, Bluetooth capable stethoscope and otoscope, you’re talking an amount approaching $30,000. But you may be able to get by with a laptop or equipment you already have.”

Alabama SORH Helps Lead the Charge for Telehealth Projects in the State

i Mar 6th No Comments by

As part of an ongoing effort to promote and support telehealth projects in the state, the Alabama Office of Rural Health (AL SORH) has helped a Critical Access Hospital (CAH) attain funding for equipment that can facilitate telewound care locallyfor its patients. “Right now, money is tight in Alabama,“ said Debra Robbins, SORH Program Manager. “There are very limited state funds. But we still can help facilitate telehealth.” For example, the AL SORH had some SHIP money leftover last year, Robbins said, which they are using to reimburse Washington County Hospital (WCH), a CAH in a very rural part of the state. The SHIP grant paid for half of the cost of telemedicine equipment and the hospital paid the balance.

“They had patients both in the hospital and coming into the hospital with wounds that needed care,” Robbins said. “Many of those patients had to be transferred to a tertiary hospital 62 miles away to see a wound care specialist. They realized they could do wound care consultations via telehealth. The hospital is hoping to save $80,000/year, but if it proves to be saving them $20,000/year, it will still be worth it.” The initial service will provide wound care for inpatients, swing bed patients and nursing home patients.

“We’re also trying to connect them with other services they can use telehealth equipment for besides wound care,” Robbins said. “For example, we’re trying to connect them with a telepsychiatrist out of Mobile. Right now, if a psychiatric patient presents to the hospital, an ER physician has to help them; telepsychiatry would help them have true psychiatric care.” Future plans include writing a case study that will document the hospital’s savings and return on their investment, and the resulting level of patient satisfaction.

The AL SORH also routinely collaborates with the Alabama Partnership for Telehealth (APT) and is currently supporting an agreement between a large tertiary hospital and five rural hospitals for telestroke (stroke care via telehealth). “Our relationship with the APT is one of collaboration and support, since it will help alleviate physician shortages in rural areas,” said Robert Boyles, AL SORH Rural Programs Coordinator and Recruiter. “We believe you have to market the technology, as so many people in our state are unaware of how it could benefit them.”

In addition, the AL SORH is trying to teach CAHs in the state that telehealth doesn’t necessarily involve expensive equipment or a big initial investment. “Cost can be detrimental to telehealth,” Boyles said. “If you want a mobile cart with tilt and pan capability, Bluetooth capable stethoscope and otoscope, you’re talking an amount approaching $30,000. But you may be able to get by with a laptop or equipment you already have.”

Back to March Branch

Alabama-Georgia Joint Rural Health Clinic Project (C. Lail)

i Feb 12th No Comments by

Alabama-Georgia Joint Rural Health Clinic Project (C. Lail)

NOSORH Partnership Funds Lead to Collaboration Between Alabama and Georgia SORHs

i Jan 16th No Comments by

NOSORH Partnership Funds Lead to Collaboration Between Alabama and Georgia SORHs – The Branch: December 2013