Excellence in Rural Health Care <ul><ul><li>Choctaw Nation Health Services Authority </li></ul></ul><ul><ul><li>Choctaw Na...
11/07/11 <ul><li>10.5 Counties </li></ul><ul><li>Approximately 13,000 square miles or over eight (8) million acres </li></...
Choctaw Nation Health  Care Clinics 41 Miles 45 Miles 50 Miles 94 Miles 87 Miles 92 Miles 106 Miles
CNHSA Profile <ul><li>Talihina Headquarters </li></ul><ul><ul><li>Hospital, Primary Care & Multispecialty Clinics, Behavio...
Telemedicine Background <ul><li>Initially in the State network </li></ul><ul><li>HRSA Outreach Grant in 1998 to expand spe...
Obstacles & Mistakes <ul><li>Initial focus on Primary Care attempts </li></ul><ul><li>Focus on specialist services that wo...
Telemedicine Development Keys <ul><li>Specialist Providers began to buy-in and realize the value to themselves and patient...
Telemedicine Today <ul><li>Diagnostic Imaging Associates </li></ul><ul><ul><li>System-wide Tele-Radiology Services  </li><...
Telemedicine Today <ul><li>Texas Southwestern College of Medicine  </li></ul><ul><ul><li>Memory Clinic (Alzhiemer’s diagno...
Tele-Health Education <ul><li>OUHSC – RN to BSN, BSN, MSN, MBA  </li></ul><ul><li>ECU – RN, BSN, MSN </li></ul><ul><li>OSU...
Next Steps <ul><li>Limited Primary Care  </li></ul><ul><ul><li>Limited primary care for specific purposes in remote locati...
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Choctaw Nation Health Services Authority Update

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Presented at InnoTech Oklahoma by Skip Leader on 11-3-2011. All rights reserved.

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Choctaw Nation Health Services Authority Update

  1. 1. Excellence in Rural Health Care <ul><ul><li>Choctaw Nation Health Services Authority </li></ul></ul><ul><ul><li>Choctaw Nation of Oklahoma </li></ul></ul>
  2. 2. 11/07/11 <ul><li>10.5 Counties </li></ul><ul><li>Approximately 13,000 square miles or over eight (8) million acres </li></ul><ul><li>Area Size Comparison – State of Vermont </li></ul><ul><li>OKC – 2 to 4 hours </li></ul><ul><li>Tulsa – 1.5 to 4 hours </li></ul>CNHSA Geographic Structure
  3. 3. Choctaw Nation Health Care Clinics 41 Miles 45 Miles 50 Miles 94 Miles 87 Miles 92 Miles 106 Miles
  4. 4. CNHSA Profile <ul><li>Talihina Headquarters </li></ul><ul><ul><li>Hospital, Primary Care & Multispecialty Clinics, Behavioral Health Division, Chi Hullo Li, Recovery Center </li></ul></ul><ul><li>Northern Sites </li></ul><ul><ul><li>McAlester, Stigler & Poteau Clinics, Poteau Pharmacy Refill Center, Jones Academy School Infirmary Clinics </li></ul></ul><ul><li>Southern Sites </li></ul><ul><ul><li>Idabel, Broken Bow, Hugo & Atoka Clinics </li></ul></ul><ul><li>Total Encounters = 544,280 </li></ul><ul><li>Active Providers = 125 </li></ul><ul><li>Health Employees = 960 </li></ul><ul><li>Annual Budget = $108 million </li></ul>
  5. 5. Telemedicine Background <ul><li>Initially in the State network </li></ul><ul><li>HRSA Outreach Grant in 1998 to expand specialist services – Orthopedics, Cardiology, Ophthalmology and others </li></ul><ul><li>University of Oklahoma, Sparks Regional, Northeastern State University School of Optometry, OSU, Dean McGee Eye </li></ul><ul><li>Combined onsite & telemedicine </li></ul>
  6. 6. Obstacles & Mistakes <ul><li>Initial focus on Primary Care attempts </li></ul><ul><li>Focus on specialist services that work better on a face to face patient to doctor relationship </li></ul><ul><li>Setups for Telemedicine were not conducive for patient acceptance & participation </li></ul><ul><li>No solid “Clinics” arrangements </li></ul><ul><li>High turnover in Specialists </li></ul><ul><li>No local or personalized case management </li></ul><ul><li>Not managed well on our part </li></ul>
  7. 7. Telemedicine Development Keys <ul><li>Specialist Providers began to buy-in and realize the value to themselves and patients </li></ul><ul><li>Specialist Providers began to “LEAD” the process vs. fighting it or following it </li></ul><ul><li>We began to “help” vs. trying to force the process to happen </li></ul><ul><li>That is when a true partnership to help our patients began to emerge </li></ul><ul><li>Recognize things that do not work – Primary Care is not a good match for us </li></ul>
  8. 8. Telemedicine Today <ul><li>Diagnostic Imaging Associates </li></ul><ul><ul><li>System-wide Tele-Radiology Services </li></ul></ul><ul><li>Dean McGee Eye Institute </li></ul><ul><ul><li>Diabetic Retinal Eye Care </li></ul></ul><ul><li>OUHSC </li></ul><ul><ul><li>Pediatric Endocrinology – Dr. Copeland </li></ul></ul><ul><ul><li>Remote Fetal Ultrasound Services </li></ul></ul><ul><ul><li>Cardiology Eval & Intensive Care Medicine </li></ul></ul><ul><ul><li>Diabetes Research Center </li></ul></ul><ul><li>Sparks Regional </li></ul><ul><ul><li>Tele-Stroke & Neurology Services </li></ul></ul><ul><ul><li>Sleep Study Programs </li></ul></ul>
  9. 9. Telemedicine Today <ul><li>Texas Southwestern College of Medicine </li></ul><ul><ul><li>Memory Clinic (Alzhiemer’s diagnosis & detection) </li></ul></ul><ul><li>River Valley Orthopedic </li></ul><ul><ul><li>Orthopedic Diagnostics, Supervision & Follow up </li></ul></ul><ul><li>Oklahoma State University Center for Health Sciences </li></ul><ul><ul><li>Various Specialty Services available </li></ul></ul><ul><ul><li>Cardiology Evaluation Services </li></ul></ul><ul><li>Northeastern State University College of Optometry </li></ul><ul><li>SEAHEC – Medical Education programs with AHEC </li></ul><ul><li>Tele-Behavioral Health Services – Intra-system </li></ul><ul><li>Cardiology Diagnostic Services – Intra-system </li></ul>
  10. 10. Tele-Health Education <ul><li>OUHSC – RN to BSN, BSN, MSN, MBA </li></ul><ul><li>ECU – RN, BSN, MSN </li></ul><ul><li>OSU – Medical Student Training Rounds </li></ul><ul><li>KTC – LPN programs, Medical Assistants, Laboratory Phlebotomy, Radiology Tech & other health training </li></ul><ul><li>SEOSU – Various BS/BA programs </li></ul><ul><li>NSU – Optometry School Affiliation </li></ul><ul><li>CASC – Nursing Education Programs </li></ul><ul><li>Eastern State College – Nursing & medical programs </li></ul>
  11. 11. Next Steps <ul><li>Limited Primary Care </li></ul><ul><ul><li>Limited primary care for specific purposes in remote locations with no services </li></ul></ul><ul><ul><ul><li>Community Centers for elderly </li></ul></ul></ul><ul><ul><ul><li>Before school clinics </li></ul></ul></ul><ul><ul><ul><li>Medication review clinics </li></ul></ul></ul><ul><li>Primary Care – Electronic Medical Visits </li></ul><ul><ul><li>Dartmouth-Hitchcock Model – 12-14 years </li></ul></ul><ul><ul><li>It’s fast, efficient, low-cost, good medicine </li></ul></ul><ul><li>Coordination of Care – Multi-Tribal </li></ul><ul><ul><li>Using cloud databases to share same patient information to improve patient care and reduce duplicated cost </li></ul></ul><ul><li>Mobile & electronic accesses to assist patient care </li></ul>
  12. 12. Questions…Comments

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