On May 24, Keith Mueller, interim dean of the University of Iowa College of Public Health and director and chair of RUPRI’s Rural Health Initiatives, testified at a United States Senate Finance Committee Public Hearing on rural health. The hearing focused on challenges and opportunities in rural health care delivery.
The College of Public Health recently hosted the Mental Health First Aid Training Course. Julie Baker and Nancy Adrianse, both with the Iowa Primary Care Association in Urbandale, provided the 8-hour training. Diane Rohlman, associate professor of occupational and environmental health, with support from the CPH Diversity Committee, organized the training as part of her Topics in Agricultural and Rural Health course, which focused on mental health in rural areas this semester.
In addition to raising awareness about different types of mental illness, the Mental Health First Aid course provides participants with the key skills and resources necessary to help someone who is developing a mental health problem or experiencing a mental health crisis. These skills and resources include the identification of risk factors and warning signs for a range of mental health problems, as well as a 5-step action plan to help a person in crisis connect with appropriate professional help.
In attendance were 25 University of Iowa faculty, staff, and students who received certification in Mental Health First Aid upon completion of the training. Participants represented the Departments of Occupational and Environmental Health, Epidemiology, Public Health Administration, and Community and Behavioral Health in the College of Public Health, as well as the College of Liberal Arts and Sciences.
According to a post-training survey, 92 percent of respondents said that they found the training useful and 100 percent would recommend the training to others. Some feedback included: “The Mental Health First Aid course was very informative and I suggest it be added to the curriculum for all first-year students,” and “I think the information is useful to those who have no background in any of the mentioned mental health topics. This is useful as a basic primer. Though this should be mandatory for all faculty and staff.”
For more information about Mental Health First Aid, please visit their website at https://www.mentalhealthfirstaid.org/.
A recent paper from the Rural Policy Research Institute (RUPRI) Health Panel examines the progress of national health policy initiatives and the gaps that remain as they affect rural people, places, and providers.
According to Keith Mueller, RUPRI Health Panel Chair, professor of health management and policy, and interim dean at the University of Iowa College of Public Health, the paper lays out clear policy trajectories in seven major subject areas that can enhance access and affordability of high quality services in rural America into the future. The subject areas included are Medicare, Medicaid and CHIP, Insurance Coverage and Affordability, Quality, Health Care Finance and System Transformation, Workforce, and Population Health.
Each chapter begins with a summary of policy opportunities, followed by a background section on rural trends and challenges that summarizes rural-related policy advances and continued gaps. Each chapter concludes with a “Looking Ahead” section that highlights the most pressing issues in today’s rural health care system environment and suggests future policy directions related to each issue.
“We wanted to take a look at national policy initiatives such as Medicare, Medicaid, and insurance reform to take stock of progress made for rural communities and to develop clear statements of remaining challenges,” says Mueller. “Ultimately our goal is to help build a roadmap to achieve a high performance health system in all of rural America.”
A PDF of the paper is available at http://www.rupri.org/wp-content/uploads/TAKING-STOCK-2018.pdf
Co-authors are Charles Alfero, Hidalgo Medical Services (HMS); Dr. Andrew F. Coburn, University of Southern Maine; Dr. Jennifer P. Lundblad, Stratis Health; Dr. A. Clinton MacKinney, University of Iowa; Dr. Timothy D. McBride, Washington University in St. Louis; and Dr. Paula Weigel, University of Iowa.
This report was funded by the by the Leona M. and Harry B. Helmsley Charitable Trust, grant number 2017PG-RHC006.
Emergency department patients at rural hospitals using telemedicine see a clinician six minutes sooner than patients in hospitals that have no such technology, a new study from University of Iowa shows. And if that first clinician assessment is through a telemedicine encounter, the door-to-provider time is shortened by nearly 15 minutes, says study lead author Nicholas Mohr, MD, an emergency physician and associate professor at the Carver College of Medicine at the University of Iowa.
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Rural hospitals using telemedicine services reduce the time between patients entering the emergency department to receiving physician care by six minutes, according to a new study led by University of Iowa researchers.
The research team, headed by Nicholas Mohr, UI associate professor of emergency medicine and anesthesia, measured the impact of emergency department (ED)-based telemedicine services on timeliness of care in rural hospitals. The study looked at data collected from 14 hospitals in Iowa, Kansas, Nebraska, North Dakota, and South Dakota that subscribe to telemedicine services from a single ED-based telemedicine provider. The team matched 2,857 emergency department cases that used telemedicine services with non-telemedicine controls.
The results, published online Jan. 2 in Telemedicine and e-Health, showed that telemedicine decreased door-to-provider time by six minutes. This provider could be either a local provider physically assessing the patient or a telemedicine provider—whoever was available first. The first provider seeing the patient was a telemedicine provider in 41.7 percent of telemedicine encounters, and in these cases, telemedicine was 14.7 minutes earlier than local providers.
The researchers also noted that among patients who were transferred to other hospitals, ED length-of-stay at the first hospital was shorter in patients who had telemedicine consulted. The authors suggest that this reduced time may be due to remotely located staff completing administrative and charting tasks, allowing local staff to concentrate on patient care.
The study team included Tracy Young, Karisa Harland, and Marcia Ward from the University of Iowa; and Brian Skow, Amy Wittrock, and Amanda Bell from Avera eCare.
The project was supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services and the analysis was conducted by the Rural Telehealth Research Center at the University of Iowa.
In 2010, the National Organization of State Offices of Rural Health (NOSORH) created National Rural Health Day as a way to applaud the ongoing efforts, contributions, and collaborations occurring in rural communities to address the unique challenges in accessing and delivering health care services.
This year’s national events will highlight the Power of Rural. Here are a few ways to join in:
- Twitter Chats: Topics will focus on workforce development, the social determinants of health, and behavioral health Nov. 13-16.
- 30-Minute Webinars: Tune into three live webinars on rural health hot topics on Nov. 16.
- More events and info: https://nosorh.org/
CPH and Rural Health
In the College of Public Health, three Collective Areas of Excellence — Rural Health, Comparative Effectiveness Research, and Community Engagement — inform collegiate growth and innovation in research, academics, and outreach for public health impact.
We’re proud to be home to numerous experts, centers, studies, and projects that focus on the health and well-being of rural populations. Here’s just a sample of some of our recent work:
- Mueller discusses challenges facing rural hospitals
- Fluharty comments on the rural higher-ed crisis
- UI report addresses prescription opioid, heroin epidemic in Iowa
- Ward discusses NQF quality measurement framework plan for telehealth
- MPH student initiates new study on rural mental health care
- Janssen will discuss local food, big ag at Science on Tap
- Youth groups encourage farmer safety
- MRASH conference meets Nov. 14-15 in Pella
- Thorne: Rural areas face environmental challenges
- Active Ottumwa helps residents get more physically active
- Mueller discusses rural health care at Georgia task force meeting