HRSA Administrator Mary K. Wakefield PhD presented an update stressing the healthcare changes facing clinicians in terms of EMRs and telehealth, models for coordinated care, medical homes, and finding solutions for workforce issues. She made her remarks at the Fall Conference of the Northwest Regional Primary Care Association and the Community Health Association of Mountain/Plains States.
Dr Wakefield explained how telehealth is being used to help veterans at HRSA. Since Virginia, Montana, and Alaska have the highest proportion of veteran residents, each state will receive about $300,000 in grants to implement or upgrade telehealth capabilities for veterans.
The grants administered by the Office for the Advancement of Telehealth, will be used for telehealth equipment and to develop EHRs to be compatible with the VA’s Veterans Health Information Systems and Technology Architecture system.
There is growing recognition that team-based healthcare can help to improve the quality of care and at the same time keep costs in check. The Institute of Medicine explicitly mentions that providers need to improve coordination and communication within and across organizations.
Recently Secretary Sebelius announced a continuing HRSA grant to the University of Minnesota Academic Health Center to establish a new Coordinating Center for Interprofessional Education and Collaborative Practice. The Center not only will act as a one stop resource but will also support research, data collection, and analysis.
This five year $4 million initiative will pilot projects at eleven affiliated academic sites around the country. In addition, four private philanthropies have committed an additional $8.6 million to support the Center’s projects. The philanthropies are the Josiah Macy Jr. Foundation, Robert Wood Johnson Foundation, John A. Hartford Foundation, and Gordon and Betty Moore Foundation.
Another new approach receiving attention involves the development of medical home models targeting specific patient populations. States have been actively involved and two states Oregon and Colorado are supporting clinical networks through their primary care associations where they are collaborating and sharing best practices related to patient-centered medical homes. In Oregon, 18 out of 25 health center grantees have achieved state-based patient-centered medical home recognition.
Medical home models can target specific patient populations such as the rapidly growing elderly population. In November 2011, HRSA and CMS began a three year demonstration called the FQHC Advanced Primary Care Practice Demonstration” to support health centers to serve as integrated health homes for Medicare beneficiaries.
Under this demonstration program, 500 participating health center sites are transforming to advanced primary care practices to provide targeted accessible, continuous, and coordinated family-centered care for Medicare patients.
Several of HRSA’s actions are directly linked to workforce issues. For example, the National Center for Health Workforce Analysis was created to provide long-term planning to enable federal and state policymakers to better prioritize workforce investments.
The National Center has just awarded a contract that will analyze the impact that the ACA’s expansion of coverage is going to have on primary care workforce shortages. As Dr. Wakefield stressed, the characteristics of the healthcare workforce impact healthcare delivery everywhere. These characteristics include the supply and distribution of clinicians as well as the quality and orientation of their training.
Over $455 million has been funded to support the training of new primary care providers by 2015. The National Health Service Corps is the largest HRSA program to boost the supply and distribution of primary care clinicians. Today, the Corps has nearly 10,000 primary care professionals practicing in medically underserved areas nationwide.
Also, the Corp has taken another step and has established a new Jobs Center which is accessible from any computer, smart phone, or tablet and allows doctors, nurses, and other providers to take virtual visits to prospective rural and urban communities seeking to hire clinicians.