Attendees at the 2nd Annual Rural Hospital Info-Tech Workshop left with gigabytes of great information. Each presenter brought with them some much needed insight on several high-profile technologies that hospitals are either considering or have recently decided to adopt. We want to thank all our sponsors, the companies who made their experts available to us for the day: Creative Healthcare Systems, Diagnostic Health Services, Hospital Networks Management, Optio Software and TMF Health Quality Institute.
      To start, Robb Litvak and Angela Hewitt of Optio Software explained how electronic health records can work and be used as a central location for the collection and distribution of health information. They talked about where the federal government is headed and how automating hospital records collection, storage and distribution can achieve significant productivity gains as well as cost savings.
      Next, Bruce Hammond of DHS gave a very thorough overview of picture archival and storage or PAC systems. Much of his presentation was devoted to the explanation of the technology behind PACS, but he also researched the many differences between various systems and showed how best PACS can contribute to the improvement of a rural hospital’s radiological services.
      After lunch, Phil Amelung and Steve Everest of CHS tried to bring clarity to the Regional Health Information Organization (RHIO) discussion. Since RHIO development is still quite ongoing, much of their presentation focused on a few good examples of provider groups that have gone ahead with network development. The presentation showed there are still many questions and very little, if any, funding is available right now. Still, according to Steve, it is important that hospitals be aware of these efforts and get involved now before eligibility and standards have been permanently set.
      Up next, Larry Krupala introduced Glen Bason of the Department of State Health Services to show those in attendance how the Public Health Information Networkor PHIN can enhance efforts to report and retrieve critical information about threats to the public health. PHIN includes the much talked about Health Alert Network, but also disease surveillance, EMSystems and WebEOC. Later in the same presentation, Randy Zunke talked about how these and other services were now being offered to the members of the Alliance.
      To round out the program, Adonica Benesh of the TMF Health Quality Institute gave a quick overview of one of their newest initiatives. Though QIOs don’t normally delve into I.T., the 8th scope of work included an assessment that would help hospitals determine their readiness for barcoding and computerized physician order entry or CPOE. Initial results show that participating hospitals still have a lot of work to do in order to effectively implement these complex technologies.

The President is readying for a major push to computerize the nation's medical records, including what is expected to be between $100 million and $200 million in funding for the program in the federal budget he will propose next month.
      Senators Frist and Clinton teamed up last year on legislation to try to move the U.S. toward a more comprehensive network of electronic medical records. Yet despite the high-profile bipartisan backing, Congress has failed to agree on standards for the technology or how to fund it. Advocates say electronic medical records could save $140 billion a year in health care expenses on things like file clerks and space for file cabinets, while also saving tens of thousands of lives each year by reducing medical errors.
      "We're really ready to step up in 2006 for a pretty aggressive agenda," the Bush administration's national coordinator for health information technology, David Brailer, told The New York Sun. "The president loves this topic," added Dr. Brailer, who was appointed to his post at the Department of Health and Human Services in 2004 under an executive order to achieve "widespread deployment" of electronic medical records within 10 years.
      Dr. Brailer told the Sun that later this month the administration will start by unveiling "breakthrough" health information technology initiatives that may be completed by year's end, increasing the issue's visibility among the American public. The initiatives include nationwide computerized personal medication histories, so that a doctor anywhere in the country can know what medications a patient is taking before treating him; providing "secure messaging" to allow for private e-mail and other electronic correspondence directly between doctors and patients, and "bio surveillance," which uses computerized records to monitor disease outbreaks and provide earlier detection and better treatment of pandemics or bioterrorism attacks.
      In Washington, the biggest dispute over the health care industry's switch to electronic records is whether the government should finance or merely regulate it. If Washington bankrolls the upgrade, further disagreement arises over what form financial assistance to doctors should take. On a national scale, "We're more than $100 billion from here to where we need to end up," Dr. Brailer said. Another likely 2008 presidential contender and a former speaker of the House, Newt Gingrich, has advocated spending $7 billion a year on computerized medical records.
      There is bipartisan agreement that the federal government needs to set standards for the technology. When it comes to funding, however, Democrats typically advocate the use of direct grants and Republicans an incentive based approach, said a spokesman for the Senate Health Committee, Craig Orfield.
      Among the senators most active on the issue, Senators Frist and Clinton have advocated direct government grants. The two leading members of the Senate's Health Committee, Senator Enzi, a Republican of Wyoming, and Senator Kennedy, a Democrat of Massachusetts, have pushed for loans, according to Senate staff. Senator Grassley, a Republican of Iowa, and Senator Baucus, a Democrat of Montana, joined Enzi and Kennedy to press for incentives for computerized medical records as part of Medicare payments.
      According to the Sun, Dr. Brailer cautioned that ultimately the American public would be paying for the technology, either as taxpayers or consumers. The main question, Dr. Brailer said, was through whose hands the money would be funneled - the government's, doctors', employers', or health insurance plans'. "Therein lie all the political questions," he said.

It’s the busiest time of the year at the TORCH office, the run-up to what we feel will be our best meeting ever. The Texas Conference of Rural and Community Hospitals is always a great opportunity to network with peers and meet with the companies that have rurally relevant products and services for hospitals and other healthcare providers. However, it’s our long list of well-qualified experts and speakers that you are likely to spend the most time with and your time will indeed be well spent. Join us on our odyssey!
     This year we will blast off with our advocacy updates and a look toward the future. Sandy Lutz and Kelly Barnes with the firm PricewaterhouseCoopers will be presenting Healthcast 2020. Then Thomas Rowley will follow-up with the view from the Rural Policy and Research Institute. Three advocacy updates will be given by NRHA, TORCH and TAPA and lastly Joe Gagen will be back at our conference to talk about the strategy of becoming an effective advocate.
      Day two will send you into orbit as you begin a Search for Intelligent Life in the Universe with Kevin Reed and Fletcher Brown. Next, you’ll hear about the new and improved Alliance and then on to a new TORCH mission, the Rural Hospital Leadership and Management Institute. Following the Annual Awards Luncheon, Thomas Leary of HIMSS will give us the inside scoop on federal I.T. initiatives. Then its on to the galaxy of concurrent educational sessions and some dedicated exhibit hall time.
      On the third day, we start with the Membership Meeting and then we’ll receive Dr. Randy Farris, the Regional Administrator for CMS in Texas. The CPA panelis our next destination, as Larry Anderson, Brandon Durbin and Bill Parrish share their keen insights on recent changes to all hospital payment programs. Valarie Lopez of Uvalde Memorial Hospital will close out our program with advice about how best to work with CFOs. Then it’s touchdown for 2006!
      Our 2006 program brochure should make landing at your hospital very soon. In the meantime, please be sure to mark your calendar for April 5, 6 & 7 at the Hotel Inter-Continental in Dallas.

The Texas Department of State Health Services (DSHS) Office of EMS and Trauma Systems Coordination (OEMS/TS) is pleased to announce that the application for the FY 2006 Designated Trauma Facilities and Emergency Medical Services (DTF/EMS) Account - Hospital Allocation has been finalized and is posted on the web. Additionally, the application was mailed to the administrator of all designated hospitals with cc's to the Trauma Coordinator/Trauma Program Manager.
       To be eligible for the FY06 allocation, a hospital must be a designated trauma facility by the application due date or meet "in active pursuit" of trauma designation requirements by the application due date.The application must be postmarked no later than March 17, 2006.

"In active pursuit" requirements:

• Submit a letter of intent to designate as a trauma facility;
• Submit a trauma designation application;
• Submit data to the State EMS/Trauma Registry;
• Participate in the appropriate Regional Advisory Council; and
• Provide evidence that a hospital trauma performance improvement committee has been developed.

FY06 funds will again be distributed in the following manner:

• Fifteen percent of the total amount of funds available for the Hospital Allocation will be divided equally among all eligible applicants.
• The remaining 85% of the Hospital Allocation funds will be distributed to eligible hospitals based on the percentage of uncompensated trauma care a hospital provides in relation to the total uncompensated care provided by all the eligible hospitals that apply for the Hospital Allocation.

The trauma care funding program enacted by HB 3588, 78th Texas Legislature, stipulates that 96% of the funds accumulated in the DTF/EMS Account be distributed to eligible Texas hospitals to reimburse a portion of their uncompensated trauma care. Since the inception of the account in 2003, OEMS/TS distributed $64,000,000 from the DTF/EMS Account to 234 eligible Texas hospitals to reimburse a portion of their uncompensated trauma care provided. All eligible hospitals that applied received a minimum of $11,686 in FY 2004 and $29,596.86 in FY 2005.
      For additional information regarding "in active pursuit" of trauma designation requirements, please contact Kim Petty at 512-834-6700 ext. 2346 or Gina Pickard at ext. 2457. The application for the FY 2006 DTF/EMS Account can be found at: www.tdh.state.tx.us/hcqs/ems/FY06DTFEMSHospUncomptedTraumaCareApp.htm.

George N. Miller Jr., President/CEO of Provena St. Mary’s Hospital was nominated President Elect to the National Rural Health Association (NRHA). The NRHA is a national nonprofit membership organization with more than 10,000 members that provides leadership on rural health issues. The association’s mission is to improve the health and wellbeing of rural Americans and to provide leadership on rural health issues through advocacy, communications, education, research and leadership. The NRHA membership is made up of a diverse collection of individuals and organizations, all of which share the common bond of an interest in rural health.
      George N. Miller, Jr., has over 23 years experience in health care related administrative and financial management. Mr. Miller is very passionate about his profession and has served as the President/Chief Executive Officer of Provena St. Mary’s Hospital in Kankakee, IL (PSMH) since 2001. PSMH is a 210 beds hospital in the Provena Health System of Mokena, IL. He serves on the System Leadership Council of Provena Health. Before coming to Kankakee, Mr. Miller, served as the CEO of Christus Jasper Memorial Hospital in Jasper, Texas (CJMH). CJMH is a rural community hospital in the Christus Health System of Dallas, Texas.
      Mr. Miller’s passion for health care and his leadership skills, enable PSMH to win in successive years two national awards. In 2005, PSMH was selected as the Solucient’s Top 100 Hospitals in America Leadership Award for a 5-year period, the only Provena Health System hospital to achieve this honor. In 2004, PSMH received the prestigious J.D. Power and Associates Hospital of Distinction Award for outstanding Service Excellence.
      Mr. Miller is very active in his community; he is an active member of the Board of Directors of Provena St. Mary’s Hospital and the Foundation Board of Directors. He is a member of the Board of Directors of several community organizations that include the Kankakee Economic Development Corporation, the Bradley Bourbonnais Chamber of Commerce, the United Way, Economic Development Council, and the Salvation Army.
      Mr. Miller was nominated to this position by his healthcare peers across the nation as a visionary and advocate in the healthcare industry. This appointment took effect January 1, 2006.

As you know, TORCH recently completed its 15th year of dedicated service to the administrators, trustees and staff of our hospital members. To mark this occasion, we recently sent out multiple copies of our brand new Commemorative Report. We hope you will take this opportunity to share our rich history, as well as our operational performance, with trustees and other community leaders.
      The report is dedicated to all of the people and institutions that have given TORCH the support necessary to build a meaningful organization; one devoted solely to the preservation and success of rural and community hospitals in Texas. The information contained in this report demonstrates the value of TORCH membership, highlights the benefits of joining together with other rural hospitals and shows what can be accomplished through shared efforts.
      This publication was a labor of love and was made possible with the generous assistance of a great many people. We hope that you find it to be both a handy reference and a great story. Though TORCH’s impact goes well beyond our rural communities, the organization is determined to stay true to its roots and we look forward to being of service to you and your hospital at every opportunity.

The Centers for Medicare & Medicaid Services (CMS) has announced a new initiative designed to measure how satisfied providers in the fee-for-service (FFS) program are with the services of the contractors that are responsible for processing their claims, educating them about changes in Medicare policies, and responding to provider inquiries.
      The initiative, the Medicare Contractor Provider Satisfaction Survey (MCPSS) will be administered on an annual basis. It is designed to garner quantifiable data on provider satisfaction levels with key services performed by the 42 FFS contractors that process and pay more than $280 billion in Medicare claims each year.
      The MCPSS is one of the tools CMS will use to measure provider satisfaction levels, as a result of the Medicare Modernization Act (MMA) of 2003. It was developed with extensive input from providers, and information about the survey has been disseminated to providers through a variety of channels, including Open Door Forum conference calls with providers, and Medlearn Matters articles posted on the CMS website. CMS will conduct ongoing outreach to providers throughout the survey process.
      The MCPSS will query 25,000 randomly selected providers (e.g., physicians, suppliers, healthcare practitioners, and institutional providers), a statistically valid and representative sample of the 1.2 million who serve Medicare beneficiaries. Those providers selected to participate in the survey should have been notified by mail during the first week of January. The survey is designed so that it can be completed in less than a half hour. Survey responses can be submitted via a secure Web site, mail or fax and will be accepted through January 25, 2006. Further information about the MCPSS is available at: http://www.cms.hhs.gov/MCPSS/

Each year, participating hospitals receive a wealth of information about salary levels for staff positions throughout their organizations and best of all, it’s completely free. All you have to do is respond to the salary survey that was sent to all TORCH hospitals by Human Resources Healthcare Consultants on December 12th. The deadline for submission is now Wednesday, February 1, 2006.
      We would encourage each and every hospital member to participate in the survey process in order to ensure the validity and integrity of the resulting data. Each hospital that submits information is guaranteed to receive a free copy of the comprehensive report that is broken down by region, position, bed size and more. Your input is vital and always appreciated. Please take advantage of this free and exclusive membership benefit. If you have questions or did not receive the survey, please contact the TORCH office at 512-873-0045.

Sage Advice from a Fellow CEO >>

Bill Swanson, CEO of aerospace contractor Raytheon, has turned a lifetime's worth of executive wisdom into a handy pocket-size guide called Swanson's Unwritten Rules of Management. Swanson has a knack for making complex ideas easy to grasp. Corporate leaders swear by it -- but it isn’t for sale. We will be printing new rules in future editions of Frontline. You can also request your own copy at http://wwwxt.raytheon.com/communications/whs_rules/.
      Treat the name of your company as if it were your own. My father always said, "You were given a good name when you came into this world; return it the way you got it." A company's reputation is built on the actions of each employee. I spend a lot of time emphasizing ethics and integrity, but I humanize those issues by asking people to treat the company name the same way they do their family name. Anyone who would bring embarrassment to our name should find work somewhere else.

Northwest Texas Hospital Association
Abilene, July 12-14, 2006

Texas Association of Rural Health Clinics
Austin, August 9-11, 2006