Need: With the nearest hospital more than an hour away, the local community health center in rural Jackman, Maine struggled to maintain its ability to offer 24/7 care to due to staffing and budgetary challenges.
Intervention: Critical Access Integrated Paramedics provide urgent care to patients after hours and on weekends.
Results: The Jackman Community Health Center has been able to offer round-the-clock care to clinic patients, while also increasing the level of EMS service available to the community.
Need: Evidenced-based intervention to improve function and quality of life for patients with chronic obstructive pulmonary disease and other chronic lower respiratory conditions.
Intervention: Pulmonary rehabilitation program implementation in 1989.
Results: Compared to a national average of only about 3% of referred Medicare beneficiaries actually enrolling in pulmonary rehabilitation, 60% of the program's referred patients enroll. Averaging around 15 patients/year completing the program, a large combined cardiac and pulmonary rehabilitation maintenance population averages 8,000 visits/year.
Need: To address intimate partner violence (IPV) in primary care settings as a health concern. To increase healthcare providers' professional understanding about its prevalence and adverse impacts on patient health.
Intervention: In partnership with Safer Futures, Tides of Change provides an advocate at a local health clinic to give confidential services to IPV survivors and training to medical staff. The advocate uses curriculum and other materials designed by Futures Without Violence.
Results: Healthcare providers at the clinic reported increased understanding of IPV and its impact on health. As a result, IPV advocates received an increase in referrals from healthcare providers. Patients experiencing IPV reported a reduction in chronic, toxic stress and improved overall health after receiving advocacy services.
Need: Population health approach to decreasing area deaths from cardiovascular disease.
Intervention: A health system-level investment in level II cardiac catheterization services and the required specialized cardiology workforce.
Results: Since August 2018, the Avita Health System in north central Ohio has provided local cardiovascular services that have decreased hospital transfers, increased care coordination, and provided education and prevention activities that, with time, will impact population health cardiovascular outcomes.
Need: Coordinated approach to healthcare delivery in central and southern West Virginia.
Intervention: Creation of a nonprofit organization that focused on quality and collaboration.
Results: With an ability to provide services that meet the evolving needs of patients, providers, and communities, the organization provides unique services, such as a credentialing service and web-based data sharing care management tool.
Need: Improve healthcare access for school-aged children in a rural and underserved Indiana county.
Intervention: Working with several rural school districts and the state's rural health association, an Indiana county healthcare system used school-based telehealth to expand access for acute illness.
Results: As of May 2019, Greene County General Hospital in rural Linton, Indiana, has expanded primary care access by offering school-based telehealth in 2 elementary and 1 middle school in 3 of the county's 5 school districts.
Need: Rural areas in Mississippi often lack adequate access to specialty healthcare services such as emergency medicine, stroke neurology, pediatric specialists and psychiatrists.
Intervention: The University of Mississippi Medical Center created the Center for Telehealth to deliver quality specialty services through telehealth video conferencing and remote monitoring tools to the underserved areas of Mississippi.
Results: The program has been successfully implemented throughout many of the state's rural hospitals and has reduced transfers and geographic barriers for patients.
Need: Due to the opioid crisis, Austin, Indiana has seen the largest concentrated outbreak of HIV in rural America's recent history. Since 2015, over 200 residents have been diagnosed with the virus.
Intervention: Foundations Family Medicine began offering testing and treatment services for HIV, hepatitis C, and opioid/substance use disorder. Education, care coordination and behavioral health services were also offered as an integrated part of their primary care clinic.
Results: Although the virus continues to spread throughout Scott County, the rate has significantly decreased, outdoing national suppression rates by a large margin (76% compared to national average of 49%).