Greater Minnesota Strategy New Models in Education and Care

1. Greater Minnesota StrategyNew Models in Education and Care Barbara F. Brandt, PhD University of Minnesota Academic Health Center

2. Topics • Disparities between urban and rural Minnesota health and workforce statistics • Greater Minnesota Strategy: • University of Minnesota response • New Models of Education and Care

3. Health and Wellbeing of Rural Minnesotans 2001 MDH

4. Health Professional Workforce Shortages: A Major Problem in Minnesota • The number one state with a need for pharmacists (JAPhA, 2002) • Minnesota: Leading State Experiencing Negative Percentage Change in Dentist to Population Ratio (ADA, 2003) • Rightsizing the nursing workforce remains a challenge • Large percentage of public health retirees in next five years (MDH, 2005) • Need 150 – 200 additional clinical laboratory scientist graduates in Minnesota (MDH, 2005)

5. MN Health Professions Trainee 2001-2003 Exit Survey

6. Minnesota Area Health Education Center (AHEC):An important resource in linking theUniversity of Minnesota with greater Minnesota Our vision for our rural education programs in Minnesota is to: *promote health outcomes by developing future health professionals who value community engagement; *assure a vital health professions workforce through community-campus partnerships with the University of Minnesota; and *contribute to a vibrant rural economy by eliminating health professions shortage areas.

7. Minnesota AHEC Goals • Nurture an interest un health careers among youth; • Support disciplinary, interprofessional, and community-based education for health professions students; • Support continuing education for community-based faculty and other health professionals in greater Minnesota; and • Share information and resources that enrich vitality of health care sectors in medically underserved areas.

8. Vision: Position the Minnesota AHEC in the Senior Leadership of the Academic Health Center • Creating sustainable community partnership models for education/training • Maximizing resources: • Learning platform • University of Minnesota Extension • Outcomes tracking • Rural Health Modules • University strategic repositioning • Leadership to the health community through interprofessional community health

11. Minnesota AHEC:A Snapshot of Outcomes Since its inception in 2002, Minnesota AHEC has: • Established AHECs in the Northeast, Northwest, Central and Southern Minnesota regions. • Supported 250 health professions students in Greater Minnesota with partial reimbursements to offset expenses for food, mileage and housing during rotations. • Provided health career educational activities for 2,497 K-12 students. • Facilitated clinical training, internships, and other activities for 1,051 health professions students. • Provided continuing education activities for 2,834 health care professionals and community members. • Provided CPR manikins to support training in Basic Life Support and/or Infant/Child CPR for more than 534 people since January 2006. • Trained 55 medical interpreters. • Supported two dental clinics in Greater Minnesota that currently provide access to dental care for over 4,800 underserved residents per year. • Facilitated 11 community health projects.

12. Minnesota AHEC:Health Careers Exploration • Promoting health careers for rural youth • Promoting youth organizations: • Health Occupations Students of America (HOSA) • Health Occupations Today (HOT) Camps • University on the Prairie • UMN Health Career Center’s Rural Health Days • Bringing health careers to the classroom: • Health Careers Exploration Program (HCEP) kit • Classroom presentations

13. Minnesota AHEC:Creating Partnerships • Regional AHECs are 501 (c) non-profit organizations with community-based boards of directors. • 33 community board members are serving AHEC’s mission across Minnesota. • 4 regional AHEC directors serve as community-based resources for faculty and students across 64 greater Minnesota counties. • Comprehensive recruitment and tracking system to support continuum of experiences. • Hosted Leading Change: Strategies for a Vital Health Professions Workforce in 2005. • Jointly support position with University of Minnesota Extension Service.

14. Minnesota AHEC: Providing Academic Support Services • Support AHC faculty and staff in identifying and providing rural training opportunities. • Convene and support Faculty Leadership Council. • Provide financial assistance for students to offset additional expenses for food, mileage and housing during rural rotations. • Developed Affiliation Agreement Database in partnership with AHC schools to create, track, and monitor affiliate relationships. • Coordinate educational resources developed by faculty that enhance rural knowledge and understanding. • Coordinate seminars and updates that inform students of additional resources (rural library access, loan repayment programs, etc). • Provide added value for students in rural communities (arrange community activities, linkages with other students in communities, service opportunities, etc).

15. Minnesota AHEC:Interprofessional Education Incubator • Supporting 9 Interprofessional Practice and Education projects in greater Minnesota • Since 2004, supported by Minnesota Education and Research Costs funds • Partnerships with Minnesota communities supporting interprofessional practices and developing educational experiences that will have a positive impact on community health outcomes

16. Minnesota AHEC:Interprofessional Education Sites • Fergus Falls • The primary goal of this group is to increase public and health professional awareness of the impact of falls, particularly in the elderly, and to assess those at risk for falling. • Montevideo • the goals for this program include reduced pre-term labor incidence, improved birth outcomes, health promotion education, and increased access for at risk populations. • Hibbing • Because of the sizable geriatric population of the community, the low income levels of the population, high rates of obesity, and the increase in the incidence of Type 2 diabetes, Fairview Mesaba Clinics (FMC) /Range Regional Health Services (RRHS) identified diabetes as their community-based initiative. • Moose Lake • The primary goal of the Community Geriatric Project is to decrease hospitalization/re-hospitalization of the elderly, decrease ER and Urgent Care visits, and to strengthen ancillary services provided by the hospital. • Brainerd • Brainerd received funding in 2006 to focus on childhood obesity. They are targeting obese youth at the grade school-level.

17. Minnesota AHEC:Interprofessional Education Sites • Mountain Iron • Fairview Mesaba Clinic in Mountain Iron identified goal is to create environments that encourage and supports behaviors surrounding physical activity and healthy eating with the aim of reducing obesity. • New Ulm • New Ulm Medical Center’s (NUMC) Community Focus Committee developed an initiative focused on decreasing the incidence of childhood obesity. • Park Rapids • The Center for Weight Management, a service of St Joseph's Area Health Services based in Park Rapids, provides bariatric medicine services to patients from both Minnesota and North Dakota. • St. Cloud • The Mid-Minnesota Family Medicine Center (MMFMC) in St. Cloud has identified their Memory Disorders Clinic (MDC) as the focus of the interprofessional education project. The MDC provides early evaluation and treatment for individuals experiencing cognitive symptoms for patients with Alzheimer’s disease and other related dementias.

18. Minnesota AHEC IPE Projects:Short-term Outcomes • Enhanced interprofessional teamwork • Clear team membership • Roles and expectations clearly defined • Active system for ongoing communication • Functioning Project • Mission and goals clearly defined • Clear timelines and milestones established • Budget plan • Measurable project objectives • Improved interprofessional educational opportunities • Defined student roles • Identified appropriate HP disciplines to involve • Including more than two HP disciplines in project • Bringing students to community to participate in project • Improved care for patients/community • Community-campus partnership goals and outcomes established • Established system for ongoing communication with community members

19. Minnesota AHEC IPE Projects:Long-term Outcomes • Increased number of health professionals practicing in underserved areas of the state • Improved health behaviors • Improved long-term care services

20. Building Upon SuccessRural Physician Associate Program University of Minnesota Medical SchoolGwen W. Halaas, MD, MBA, Director, RPAP • A nine-month community-based experience for third year medical students • 1127 graduates since 1971 – 892 in practice • 78% primary care • 64% practice in Minnesota - 575 • Of those 63% are in rural practice – 361 physicians • 49% have stayed in the same rural community for 11 to 31 years

21. RPAP Grads in Communities Populations – 2,000 to 27,000

22. UMN College of Pharmacy • In 2003, increased class size by 50 in Duluth • Duluth: Specific mission: Rural pharmacy • May 2007: 22 graduates plan to practice in Greater Minnesota

23. UMN School of Dentistry • Increased class size • Students in rural dental clinics • Hibbing and Willmar • Serve hundreds dentally underserved patients weekly • 2005 – 2006 11 graduates – rural MN practice

24. Center for Allied Health Programs • Technology Enhanced Learning • The use of innovations in technology that increase access for learners, enhance learning quality, and increase learning productivity. • Multiple Performance Sites • Combines the virtual with the physical. • Physical places where faculty, student and lab resources are situated. • Some may be unique in the particular configuration of programs they serve.

25. Greater Minnesota StrategyNew Models in Education and Care Questions?