2003-2004 Annual Rrport

Message To Our Friends

In this report, you will read about how independent rural healthcare providers came together under a shared conviction to preserve quality local healthcare. Through this partnership, multiple challenges are being addressed.

Collaborative performance improvement projects and reduction in medication errors.
Expansion and integration of health information technology services throughout the partnership and bringing medical education and training to physicians and caregivers through electronic media.
Reducing supply costs through group purchasing.
Collaborative administrative and clinical planning, including HIPAA compliance, access to primary care, joint recruitment and feasibility of outreach specialty clinics.

The Partnership has made significant progress in addressing these challenges and in so doing, the partnership has developed a stronger and more cohesive relationship. These strengths will help the Partnership to succeed in meeting the more difficult goals associated with the establishment of a regional electronic health record , a decentralized pharmacy system and performance improvement initiatives.

We hope you will find this annual report to be informative and thought provoking and that it will increase support and enthusiasm for the Partnership.

Sincerely,
Louis Ditzel
President SVRHP

Our History

In 2001, Bucktail Medical Center, Jersey Shore Hospital and Muncy Valley Hospital converted to Critical Access Hospital (CAH) status. As CAH's, each hospital had to establish a referral agreement with a tertiary care hospital in their service area. Each selected The Williamsport Hospital to fulfill this needed role. Through this process, these hospitals affirmed their shared conviction to preserve quality local healthcare, and identified common challenges. The challenges identified were:

a reduction in reimbursement levels in the previous decade,
a shift from inpatient to outpatient care,
difficulty in recruitment and retention of physicians, nurses, pharmacists, radiology and medical technologists, and other allied health professions.
Modest assets and financial reserves that limited their ability to maintain facilities and invest in state of the art health information technology.

In the summer of 2001, with the assistance of the Pennsylvania Office of Rural Health (PORH), hospital leaders met to discuss the formation of a rural health partnership. By fall, a larger exploratory meeting of potential members was held to define the benefits and obligations of membership. As a result, a unanimous decision to continue the formation process was made and a steering committee established to move it forward. Expertise and funding to initiate the project was provided by the PORH through a Flex grant. This allowed the group to retain the services of an interim director, Ms. Louise Reese, from the firm of Dixon-Odum PLLC of Clarksburg, West Virginia, a nationally known expert in rural partnerships. Ms. Reese guided the network in establishing a democratic governance structure, analyzing the health status of the region, defining the mission, and developing the initial goals and objects of the network. Thus the Susquehanna Valley Rural Health Partnership (SVRHP) was created. Its service region was defined as Clinton, Lycoming and Sullivan counties.

In April 2002, the members of the SVRHP formally incorporated and applied for 501C3 (independent not for profit) status. This was granted in July 2002. During this same period, membership expanded to include the Northcentral Pennsylvania Area Health Education Center (NCAHEC) and the Lycoming County Medical Society. NCAHEC's mission is to assist rural communities meet their primary health needs by facilitating recruitment, retention, education and training of providers of primary health care. The Lycoming County Medical Society is the only medical society in the service region, and is dedicated to the preservation of local quality healthcare.

In June, an application to the Health Resources and Services Administration was submitted for a Rural Health Network Development grant. The grant was awarded, one of 20 throughout the county, in September for three years with total funding of $600,000.

Initial Goals

Through its strategic planning process, the SVHRP has identified the following goals:

Stabilize primary care capacity and increase access to primary care;
Provide improved access to healthcare information technology and learning resources for care providers;
Enhance quality of care through a performance improvement initiative utilizing the balanced scorecard methodology;
Enhance quality of care through joint administrative and clinical planning, addressing issues such as HIPAA, recruitment and retention, and education; and,
Create a sustainable rural health partnership with a diversified fund development plan.

These mutually reinforcing focus areas demonstrate the mission and vision of the partnership.

Benefits to the communities served:

Improvement in patient care through an integrated electronic information system that will allow even the most rural health care providers in the network to access accurate medical record information instantaneously;
Improved access to specialty physicians via this information system;
Development of a referral network that expedites patient care; and
Improved patient care by establishing information systems that reduce medical error and increase provider/staff time to patients;

Basic Partnership Functions

Service - The SVRHP believes there are multiple areas in which a network approach to problem solving would be beneficial. The SVRHP investigates the feasibility of providing needed services to the members as they are identified. To date, SVRHP has provided grant writing and administrative services to members on an individual basis.

Purchasing - The SVRHP has established an affiliate agreement with the Voluntary Hospital Association (VHA) for volume discounts on supplies such as pharmaceuticals, medical and surgical supplies, and business products.

SVHRP has facilitated the integrated purchasing of information technology products and services leading to affordable implementation of a regional health network.

SVRHP has facilitated cost savings for individual entities through the solicitation of competitive proposals.

Advocacy - The SVRHP represents a large rural area of Pennsylvania, a majority of the healthcare providers in the region and a large rural consumer base. The SVRHP must inspire and work collaboratively with other rural voices to change system practices that disadvantage rural communities and destabilize their health care system.

Accomplishments To Date:

SVRHP has:

Secured consultant services for members to implement HIPAA standards;
Responded to a radiologist shortage in the region by establishing a Picture Archiving Communication System (PACS) at Jersey Shore Hospital. This technology allowed the sole radiology group in the region to conduct final reads of films in two member facilities maximizing this limited provider resource while improving patient care;
Established Pharmacy Workgroup who with the assistance of the PORH conducted an in-depth feasibility and financial analysis of creating a remote decentralized pharmacy system that utilizes automated dispensing units;
Established affiliate purchasing agreement with Voluntary Hospital Association (VHA);
Presented to the Institute of Medicine (IOM), the Rural Hospital Flex Program and HRSA Network Grantees meetings in 2004;
Created an IT integration map and implementation plan which includes:
- Established a Local Area Network (LAN) at Bucktail Medical Center;
- Established videoconferencing at all member hospitals;
- Provided Soarian clinical and financial diffusions to Jersey Shore Hospital and,
- Established CareTracker at Bucktail Medical Center
Submitted a grant to Agency Healthcare Research Quality (AHRQ) for continued IT diffusion of Computerized Physician Order Entry (CPOE) and remote decentralized pharmacy system.
Support of Jersey Shore facility project.