Health Information Technology in Rural Arizona: A Tool to Improve Healthcare Workforce Recruitment a

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Health Information Technology in Rural Arizona
A Tool to Improve Healthcare Workforce
Recruitment and Retention, Quality Education

• Marshall Smith, MD, PhD
• Medical Director of Telemedicine
• Banner Health Arizona Region

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HIT in Rural Arizona

• Quality Through Collaboration
• The Future of Rural Health Care
• Committee on The Future
• of Rural Health Care, 2005

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HIT in Rural Arizona

• Compared with urban communities, rural
  communities tend to have fewer health care
  organization and professionals of all types, less
  choice and competition between them, and broad
  variation in their availability at the local
  level.

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HIT in Rural Arizona

• Appropriate use of Information and
  Communications Technology can bridge distances by
  providing more immediate access to clinical
  knowledge, specialized expertise, and services
  not readily available in sparsely populated
  areas.

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HIT in Rural Arizona

• Examples of Health Information Technology being
  employed today in Arizona
• What the future holds

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HIT in Rural Arizona

• Examples of Health Information Technology being
  employed today in Arizona
• High risk obstetrical support
• Trauma support

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HIT in Rural Arizona

• High risk obstetrical support
• ObGyn Grand Rounds on Arizona Telemedicine
  Network

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HIT in Rural Arizona

• High risk obstetrical support
• Presently fetal ultrasounds from Navajo Nations
  are being read by maternal fetal medicine
  specialists at Banner Good Samaritan
• Soon to have real time obstetrical and fetal
  ultrasound consultation availability

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HIT in Rural Arizona

• High Risk
• Obstetrical
• Support

Reading fetal ultrasound from Tuba City
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HIT in Rural Arizona

• Next month full time Labor and Delivery
  ultrasound suite will be completed at Banner Good
  Samaritan
• Will provide remote real time patient
  consultations and ultrasound reads

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HIT in Rural Arizona

• Examples of Health Information Technology being
  employed today in Arizona
• High risk obstetrical support
• Trauma support

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HIT in Rural Arizona

• Trauma Support November, 2004
• A small baby was rushed by paramedics to the
  hospital in Douglas, Az. The baby was in shock,
  having lost almost two-thirds of her blood from
  multiple injuries. She was minutes from death and
  the nearest trauma centre was in Tucson, more
  than 100 miles away

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HIT in Rural Arizona

• Trauma Support
• The trauma surgeon Dr Rifat at UMC in Tucson was
  consulted via telemedicine and walked the team
  through the resuscitation, saving the babys
  life..

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HIT in Rural Arizona

• Trauma Support
•  Trauma is the leading cause of death up to age
  44 in the US.
•  The mortality of an injury sustained in the
  rural area is substantially greater vs. urban
  areas.
•  The development of trauma center and systems
  reduces the preventable mortality by 30.

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HIT in Rural Arizona

• Rural Trauma Team Development Course
• Developed by American College of Surgeons
• Focus of the course is to help rural facilities
  plan and prepare for the care of injured patients
  based on their local resources and capabilities

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HIT in Rural Arizona

• Rural Trauma Team Development Course
• The RTTDC encourages the development of a system
  involving pre-hospital personnel, rural clinic
  and hospital personnel at all levels ( both
  clinical and not), transferring agencies as well
  as the trauma centers

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HIT in Rural Arizona

• Rural Trauma Team Development Course
• Arizona is in the early stages of developing a
  trauma support system, and RTTDC has given Banner
  Good Sam the opportunity to participate and
  support  the rural communities of Arizona

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HIT in Rural Arizona

• Rural Trauma Team Development Course
• Arizona is in the early stages of developing a
  trauma support system, and RTTDC has given Banner
  Good Sam the opportunity to participate and
  support  the rural communities of Arizona

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HIT in Rural Arizona

• We make it clear that rural facilities are not
  alone, and we will help them with advice over the
  phone as well as try to help find a place to send
  these complicated patients.

Dr Corey Detlets, trauma surgeon Director of
Trauma Surgeons Banner Good Samaritan
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HIT in Rural Arizona

• Rural Trauma Team Development Course
• Banner good Sam has given 8 classes, at 7
  different rural facilities to nearly 200
  students.
• So far here have been about 50 total courses
  throughout the country to about 1000 students.

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HIT in Rural Arizona

• Plans are to also start providing real time
  trauma support from Banner Good Samaritan trauma
  service via telemedicine

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HIT in Rural Arizona

• Emergency Departments in rural hospitals
  supported by Banner Colorado

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HIT in Rural Arizona

• Emergency Departments in rural hospitals
  supported by Banner Colorado

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HIT in Rural Arizona

• Emergency Departments in rural hospitals
  supported by Banner Colorado

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HIT in Rural Arizona

• Emergency Departments in rural hospitals
  supported by Banner Colorado

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HIT in Rural Arizona

• Emergency Departments in rural hospitals
  supported by Banner Colorado

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HIT in Rural Arizona

• Emergency Departments in rural hospitals
  supported by Banner Colorado

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HIT in Rural Arizona

• Banner Good Samaritan Medical Center is building
  a simulation training center for healthcare
  providers
• Will be training nurses, physicians, paramedical
  support
• This will include team training, e.g., code
  arrest, trauma support, critical care support

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HIT in Rural Arizona

• This type of training uses computerized
  mannequins for realistic simulation training

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HIT in Rural Arizona
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HIT in Rural Arizona

• The Banner Good Sam Simulation Center is
  partnering with PHI/Air Evac, a medical air
  transport company
• PHI has developed a mobile training vehicle
  containing a training mannequin and can be moved
  from location to location for provider training

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HIT in Rural Arizona
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HIT in Rural Arizona
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HIT in Rural Arizona

• The Banner Good Sam Simulation Center provides
  trauma training exercises for rural providers and
  teams, without having to leave their facility
• Goal is to be able run courses concurrently for
  several rural facilities for various types of
  simulation training exercises

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HIT in Rural Arizona

• Examples of Health Information Technology being
  employed today in Arizona
• What the future holds

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HIT in Rural Arizona

• Banner Good Samaritan Simulation and Training
  (SimET) Center

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HIT in Rural Arizona

• Telesurgery support
• Simulation surgical training remotely

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HIT in Rural Arizona

• Telesurgery support
• Remote
• Intraoperative Consultations

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HIT in Rural Arizona

• Robotic
• Surgery

Da Vinci Robot from Intuitive Surgical
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HIT in Rural Arizona

• Operation Lindberg

Professor Jacques Marescaux
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HIT in Rural Arizona

• Performs routine telesurgery to North Bend,
  Canada, distance of 300 miles

Dr. Mehran Anvari, MD McMaster University,
Toronto Canada
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HIT in Rural Arizona

• Someday we will be able to have specialists
  support, or perform, surgeries remotely in rural
  areas of Arizona, allowing patients to remain in
  their communities with their families and support
  systems.

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Health Information Technology in Rural
ArizonaThank you!

• Marshall Smith, MD, PhD
• Mark.Smith_at_Bannerhealth.com