About Beacon
Two years ago, the Beacon Community of the Inland Northwest (BCIN) was named one of 17 communities across the country by the U. S. Department of Health and Human Services for a federally-funded project to highlight the value of health information technology in improving health outcomes. Originally funded by the American Recovery and Reinvestment Act, BCIN has worked closely with community hospitals and clinics to increase care coordination and disease management for patients with diabetes in rural and urban communities across eastern Washington and northern Idaho.

We are beginning to see the fruits of our labors – practices having tools to help them transform the care they deliver to their patients, with an emphasis on population health and prevention; providers having additional information at their fingertips to support better clinical decision-making; and patients better able to control their diabetes through active care coordination.

While new hospitals and clinics are continually joining, to date BCIN has connected 14 hospitals, one skilled nursing facility and 12 ambulatory care groups at 22 clinic sites in 20 communities across eastern Washington and northern Idaho. An average of 1.3 million distinct patient identifiers and nearly 2 million distinct patient records are now housed in the BCIN data repository.

Participating health care organizations are seeing benefit as well, with real-time sharing of patient information between BCIN participants, access to extensive technical support and training and help in preparing to meet meaningful use and being prepared for medical home or other pay-for-performance reimbursement models that are currently under development by both public and private sector payers.

What are we working on next? Expansion.
Initially focused on type 2 diabetes for the federally funded phase, BCIN is now expanding to support care for all patients across a wider variety of health issues and health organizations. The robust technology infrastructure supports coordination of care between multiple disparate information systems in different health care organizations across our large geographic area.

The possibilities are endless in how this infrastructure can benefit providers and patients, regardless of the technology the practice has implemented. By working together as a health care community serving a common population, we can make a difference in health status and health outcomes for our family, our neighbors and our patients. To learn more, visit www.beaconcommunity.org.

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New Names, Same Great Service

Over the years, our community has come to rely on the Health Training Network and CHER for the very best in training and health education. Inland Northwest Health Services (INHS) is pleased to announce a change in name and logo to match our larger mission. Health Training Network will now go by INHS Health Training and CHER will now be known as INHS Community Wellness. Both will adopt the logo of parent organization INHS. Nothing else is changing as we continue working together to provide health training and wellness services to our communities in the region. For more information, visit healthtraining.inhs.org.

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Shriners Hospitals for Children - Spokane Expert Care Continues to Grow

Shriners Hospitals for Children – Spokane was recently deemed the most efficient in their system of 22 hospitals by its corporate leadership. What a difference a few short years can make. In 2009 the Spokane Shriners Hospital was in jeopardy of closure, today the hospital is considered a “flagship” hospital within the system.

The Spokane Shriners Hospital specializes in pediatric orthopaedics; treating kids with orthopaedic conditions ranging from serious issues requiring multiple surgeries to simple fractures easily corrected with a single surgery. In addition, the hospital staff performs thousands of radiology, physical therapy and casting appointments each year. Kids from Washington, Idaho, Montana, Alaska and Canada receive care and services at the Spokane Hospital regardless of the patient’s ability to pay.

Shriners Hospitals for Children — Spokane is proud to announce the addition of a fourth full time pediatric orthopaedic surgeon. Dr. William Bronson has been a consulting surgeon at the hospital since 1992 and has recently joined the staff as a full time surgeon; his interests include general pediatric orthopaedics and spinal surgery. Shriners Hospitals for Children ? Spokane is where you will find the only fellowship trained pediatric orthopaedic surgeons in Spokane and surrounding region.

The future is looking bright for the Spokane Shriners Hospital, 2013 will bring new services, changes and updates to the hospital. Adding a fourth surgeon will create the opportunity to see more patients in the outpatient clinic and perform more surgeries. With volumes up and the hospital running efficiently, the hospital still has availability to see more kids and is accepting new patients.

Access to care has never been easier. Contracts are now in place with most major insurance networks; Premera Blue Cross/Blue Shield, Group Health, Molina Healthcare, Cigna, Aetna and many others. But, whether or not a family has insurance has never been a factor, acceptance for care is based only on medical need.

As volumes continue to grow, the hospital may be growing as well. The Spokane Hospital has received preliminary approval from the local Board of Governors and is waiting on final approval from the national Joint Boards in Tampa, Fla. to expand the hospital. The architectural firm NAC Architecture of Spokane, Washington has been selected to perform the design plan. The proposed expansion includes re-configuring operating rooms, adding an outpatient surgery center, moving the administration offices, expanding the parking structure and reconstructing the Family Center. The hospital will know in April if the expansion is approved.

“Shriners Hospitals for Children – Spokane has been treating kids with orthopaedic conditions for nearly ninety years and we are definitely poised for the next ninety,” said J. Craig Patchin, Shriners Hospital Spokane Interim Administrator. “We are proud to be a part of this community and to continue to care for the families in our region.”

About Shriners Hospitals for Children
Shriners Hospitals for Children is a health care system of 22 hospitals dedicated to improving the lives of children by providing pediatric specialty care, innovative research and outstanding teaching programs to medical professionals. Children up to age 18 with orthopaedic conditions, burns, spinal cord injuries, and cleft lip and palate are eligible for care and receive all services in a family-centered environment, regardless of the patients’ ability to pay. Shriners Hospitals for Children relies on the generosity of donors to deliver this mission every day. For more information, please visit www.shrinershospitalsforchildren.org.

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Medical Student Field Trip to Grays Harbor County

submitted by: Peter House

On Friday, March 1, 2013 sixteen University of Washington medical students visited facilities and providers in Grays Harbor County. The students are part of the UW’s Targeted Rural Underserved Track (TRUST) and each was admitted to the School of Medicine based on their demonstrated interest in living and working in a rural setting. The students are enrolled in Family Medicine 540 (“Rural Health 201”), a class coordinated by Peter House, Lauren Henricksen, and Toby Keys. Ki Shin, MD, planned the field trip. Dr. Shin is an internist practicing in Montesano and he also serves as the UW Assistant Dean for Western Washington, WWAMI. The purpose of the trip was to give the students an in-depth view of a rural health system.

The students started with a visit to the family practice residency in Olympia. Other stops included the new Critical Access Hospital in Elma (Summit Pacific Medical Center), Grays Harbor Community Hospital, and Dr. Shin’s practice in Montesano. They heard from providers in the county, including representatives of the Grays Harbor County Health Department, Joan Brewster (Director) and John Bausher, MD, County Public Health Officer. Other professionals participating included Maggie Miller (Olympia), Kelly Copp (Western Washington Area Health Education Center), Renee Jensen (Administrator Summit Pacific Medical Center), Tristan Knutson, MD (Elma), Juris Macs, MD (Aberdeen), Tom Jensen (CEO Grays Harbor County Hospital), Juliet Erickson, MD (Montesano), Lynette Kiser (Montesano Food Bank), and Clara Shin, MD (Montesano).

With the decline of the forest products and fishing industries, Grays Harbor County faces some large challenges in keeping the public healthy. Despite the challenges, the local providers showed remarkable energy and commitment to their work and their communities, and they are strong role models for our up-and-coming rural physicians. After the field trip, several students remarked that Grays Harbor County is “just the sort practice setting I am looking for.”

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Life Flight Network's Response to Two Northwest Mass Casualty Incidents

Life Flight Network (LFN) bases in Washington and Oregon responded recently to two mass casualty incidents (MCI) where first reports pointed to the likelihood of multiple trauma victims. A MCI is defined by the World Health Organization as an event which generates more patients at one time than locally available resources can manage using routine procedures. Utilizing air medical response during MCI events provides additional resources and supports timely transportation of victims from scenes and hospital facilities to regional trauma centers for tertiary care.

The first incident occurred on December 11th at Clackamas Town Center in Happy Valley, Oregon. There were approximately 10,000 holiday shoppers at the mall as the first 911 call came in at 15:28 with reports of an active shooter near Macy’s. As the Clackamas County Communication Center became inundated with numerous reports confirming shots being fired, police, fire, and EMS were dispatched to the scene. Clackamas County Fire District #1 established two command points and notified trauma centers of the incident.

While waiting for law enforcement to report back with an assessment of the number of victims, Incident Commander Brian Rooney activated Life Flight Network directly to the scene in anticipation of multiple trauma patients. Life Flight 2, only 14 miles away in Aurora, responded immediately and landed in a secure area in the mall parking lot ready to accept a patient for rapid transport. LFN Communication Specialists mobilized additional LFN aircraft from Longview and Dallesport, Washington and Eugene, Oregon to reposition close to the location and remain on standby should additional air resources be needed.

In addition to air resources en route, American Medical Response made 15 ground transport units available and Clackamas County Fire District #1 pulled additional ground units to respond to the shooting. Effective coordination ensured their service areas were covered by other county agencies. The potential for multiple gunshot casualties was substantial, but was ultimately limited to three victims – one transported by ground and two who did not survive their injuries. Though no patients were transported by LFN, rapid activation of air ambulance resources by the incident commander ensured patients would have had access to rapid critical care air transport to a trauma center within minutes.

The second MCI occurred on the morning of December 31st, when a Canadian-based charter bus traveling on icy Interstate 84 near Pendleton, Oregon left the roadway and rolled down a 200-foot embankment. Of the 40 passengers aboard, 26 were injured and 9 were killed. LFN received the request for activation directly to the scene from the Pendleton base (Life Flight 12), but inclement weather delayed the ability to fly.

As information regarding the extent of the event was communicated, LFN elected to send critical care flight crews by ground from Pendleton to St. Anthony Hospital to offer assistance and help coordinate fixed-wing resources to the Pendleton airport. The flight crews reported to St. Anthony’s and staged throughout the hospital to assist with triage and care for the large number of patients starting to arrive.

Patients were transported from the scene to area hospitals, with a majority treated and stabilized at St. Anthony Hospital and later transferred to tertiary centers such as Kadlec Medical Center in Richland, Washington, and Oregon Health and Science University and Legacy Emanuel Medical Center in Portland, Oregon. The extent of injuries ranged from minor to life threatening. All told, LFN was able to provide medical support utilizing five critical care teams consisting of a Flight Registered Nurse and Flight Paramedic each, plus two helicopters and two fixed-wing aircraft.

According to Jennifer Peterson, St. Anthony Hospital’s Emergency Department Manager, a total of 26 patients were treated in their facility, of which LFN transported five to tertiary centers, along with one from another facility and one from the accident scene. Michael Weimer, Life Flight Network Regional Director notes, “LFN was able to provide immediate and extensive support for this mass casualty incident in the hospital and during air transport. The strategic locations of our community-based fixed and rotor-wing aircraft made it possible for multiple resources to respond within a short period of time.”

The scope and gravity of both incidents were communicated to LFN’s Communications Center in a timely fashion in order to organize an appropriate response. LFN regularly participates with urban and rural EMS, public agencies, and hospitals to collaboratively train and conduct drills in preparation for these low-frequency, high-risk events. Early notification and activation is encouraged in order to take advantage of air medical assets and provide fast critical care transport.

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EMS Live At Nite Celebrates Its 100th Episode

Tuesday, March 12 marked the 100th Episode for EMS Live at Nite. It started as monthly classes for a small group of EMS providers in north Spokane. This year it celebrates its 10 anniversary. EMS Live @ Nite has grown to bring a monthly live training program to EMS agencies in a six-state area at us to 60 sites and 200-300 attendees. EMS Live at Nite is broadcast over Northwest TeleHealth and other networks.

EMS Live at Nite is held on the 2nd Tues of each month at 6:45 – 8:15 p.m. (Pacific). Contact your local site coordinator to register for the regularly scheduled presentations. Site with video conferencing through NW TeleHealth can register online. Other sites contact Pam Currier, NW TeleHealth (509) 789-4960 to register at least one week prior. For topics and other information, visit healthtraining.inhs.org.

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WRHA Awards

The 26th NW Regional Rural Health conference awards ceremony honored true examples of authentic leadership, genuine dedication and commitment to the rural health community.

President's Award - Winner Mary Selecky

(image: Mary Selecky & Karen Jensen)

Mary Selecky Friend of Rural Health Award - Winner Dr. Roger Rosenblatt

(image: Dr. Roger Rosenblatt & Karen Jensen)

Leah Layne Memorial Health Leadership Award – Winner Renee Jensen

(image: Renee Jensen & Karen Jensen)

Dr. John Anderson Memorial Award for Outstanding Rural Health Practitioner – Winner Dr. Shawn Andrews

Outstanding Contribution to Rural Health - Winner Mike Bell

(image: Jeff Johnson, Gail Sarchet, & Karen Jensen)

Congratulations to all of this year's award winners!

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WRHA Welcomes New Board Members

The Washington Rural Health Association elected new Board members at the annual membership meeting on March 20, 2013.  Newly selected for three-year terms were Jeff Johnson, Wipfli LLP; Melissa Lovell, Office of Community Health Systems; Ron DeArth, administrator of Morton General Hospital; and Cass Bilodeau, from Kadlec Health System.

The complete list of Board members and officers follows:

Elected Officers

John Hanson, President – Washington State Department of Health, Olympia

Jon Smiley, President-Elect – Retired, Grandview

Konrad Capeller, Treasurer - CPA, Spokane

Bettie Rundlett, Secretary – Retired, Spokane

Vicky Brown - Immediate Past President – Retired, Moses Lake

Board Members

Nancy Alleman – Washington Dental, Steilacoom

Cass Bilodeau -Kadlec Medical Center, Richland

Ron DeArth - Morton General Hospital, Glenoma

Jeff Johnson - Wipfli CPA & Consultants, Spokane

Melissa Lovell - Office of Community Health Systems, DOH, Olympia

Fran Miller - Retired, Forks

Nancy Nash – WorkSource, Omak

Alex SnowMassara - UW School of Medicine, Bainbridge Island

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