Cerner and Nevada, Mo., Launch Healthy Nevada Project

Project to cut costs, improve quality and accessibility for rural health

Cerner has announced a partnership with the city of Nevada, Mo., to build a new model of health and care that will seamlessly integrate the two environments and create a Healthy Nevada. The project will aim to increase Vernon County and Nevada’s ranking in the Robert Wood Johnson Foundation annual report from the bottom third to the top third over the next five years. Currently the county ranks 88 out of 115 counties in Missouri for health outcomes and 77 for health factors.

The project will focus on creating a culture of health in the community through education, incentives, infrastructure and partnerships with stakeholders such as the Nevada school district, local employers and community organizations like the Nevada Housing Authority. It will also work to further digitize the health care community in Nevada, including the deployment of Cerner’s CommunityWorks(TM) model at Nevada Regional Medical Center.

“By digitizing our entire health care community, we are creating an environment that will allow for integrated communication among all providers, regardless of their EHR [electronic health record] system,” said Judy Feuquay, CEO of Nevada Regional Medical Center. “Eventually, all residents of Nevada will have access to their health information regardless of where they are or which provider they see.”

Creating an infrastructure that enables and encourages healthy choices will play a major role in contributing to the improvement of Nevada’s health status rankings by:

  • Improving the city layout through initiatives like increasing ADA accessible sidewalks and adding bike lanes.
  • Partnering with local restaurants and grocery stores to offer healthy choices.
  • Encouraging healthy eating and activity with walk to work/school programs, healthy snack carts, easily accessible Farmer’s Markets and community gardens.

“Nevada recognizes that health and wellness are fundamental quality of life issues essential to our economic prosperity,” said JD Kehrman, Nevada city manager. “The intent of this project is to make the healthy choice the easy choice, ultimately giving our residents more options, more choices and more control over their health and care.”

In addition, the Healthy Nevada project aims to decrease 10 percent of the current health care spend in Vernon County by decreasing the demand for services by placing an emphasis on health, wellness and prevention.

“A project of this scope and size has never been done before,” said Jeff Townsend, Cerner executive VP and chief of staff. “Cerner has a history of entrepreneurial advocacy and a passion for improving rural health with innovations that reduce cost and improve access and quality. Our goal is to see how quickly we can impact the cost, accessibility and quality of health and care to create a replicable and sustainable model for other communities across the U.S.”

[toggle title=”Article – Blueprint for wellness Nevada and Cerner Corporation announce Healthy Nevada project”]Friday, July 20, 2012 Nevada Daily Mail By Rusty Murry Nevada Daily Mail

The city of Nevada and the Cerner Corporation of North Kansas City, Mo., have announced a partnership to design and implement a first-of-its-kind research and development project aimed at creating a “culture of health” in Nevada.

The Healthy Nevada project has been in the works for about a year; and now that all the players and a basic framework for the project are in place, officials at Cerner and the city think now is the time to announce the project.

Healthy Nevada started when city manager J.D. Kehrman was approached by representatives of the Missouri Department of Economic Development and USDA Rural Development about being on a preliminary list of cities in which the project might be undertaken. Kehrman said the representatives were vague; and nothing more was heard until a month or two later when he received a letter asking a series of “fairly unusual” questions.

Kehrman said the questions “revolved around what’s this community’s vision for health and wellness.” They were “strange” questions, he said; and “We had no idea what was happening.”

The next step was a site visit. Kehrman said city employees Mark Mitchell and Julie Lewis pulled several people into the mix and managed to put together “the best site visit I’ve ever been involved in, because they got all of the players to the table.” Cerner was impressed with that; and, according to Executive Vice President and Chief of Staff Jeff Townsend, they chose Nevada over a variety of other cities across the state because the city “has the key components we were looking for.” Among those components were a strong medical community, employers willing to see a different future and a great parks system. The most impressive thing, Townsend said was, “The people and the leadership — from elected officials to corporate leaders and community leaders — all coming together around a common vision.”

The vision: Members of the Healthy Nevada Leadership Board — a group of area health professionals and community leaders involved in the coordination of the project so far — envision the community as becoming a model of coordinated and integrated medical facilities and professionals that are one aspect of a broad program. The web of healthy resources also will include wellness programs like exercise programs, fitness initiatives, diet challenges and efforts designed to make living a healthy lifestyle the easiest choice.

Cerner executive Erik Gallimore said, “We want to work with you to do all of these things.” According to board member Dr. Tricia Bridgewater, the board and Cerner envision a “working lab of health” where it’s easy to move through the city and in a way that’s healthy. Kehrman said it could create a “network of connectivity” where citizens could travel from residential areas to downtown or from downtown to the schools on a bicycle or on foot, “safely, and in a way that is friendly to people with mobility issues.”

Discussing the need According to Kehrman, the population in Nevada and Vernon County ranks in the bottom one-third of the state for health issues like heart disease, juvenile diabetes, obesity and other health risks. Kehrman said that by implementing this program, he hopes to see that statistic change. “What I want this project to beis a vehicle for us to improve — move the meter, as they say — on these factors; we make a permanent, sustainable change in things like obesity and childhood diabetes and all those types of factors that characterize a rural — and to some degree, poverty-stricken — population.”

Townsend said many of Cerner’s top executives grew up in rural communities and “see both an opportunity and a need in rural America to have a health system that works for those citizens, for those individuals.” Townsend said Cerner spent more than “a year studying health care dynamics in rural populations in Missouri” and through their lengthy process “selected Nevada as our iconic community to go discover what might be possible.”

Cerner’s role According to Townsend, Cerner has 30 years’ experience in the health and healthcare delivery business and is on the cutting edge of medical software technology. Townsend says Cerner will come into Nevada and canvass the community to find out how they can make the project a success. He said public engagement will enable them to discover what would make living healthier and obtaining health care easier. Then Cerner will invest in the ideas.

“If we think the idea will produce a result and is viable, then we will make that investment,” Townsend said. Kehrman said the city has no “money on the table” in the project. Townsend said everyone has a healthcare story that they wish had transpired differently and that by being in the community during the first 60 to 90 days of the project “to hear the stories and the needs of the locals there, we can ideally come up with solutions to make that better.”

If the project is successful, then Cerner would have a viable model of community health and wellness that they can use in conjunction with their software to improve the health and wellness of almost any population and to sell their products and services.

Preparations made Nevada Regional Medical Center had already started working on changing over to a completely paperless system, according to CEO Judy Feuquay. The Cerner system will enable the hospital to implement that system in one year instead if three or four years. It will be much quicker because “Cerner does a whole lot of the work,” Feuquay said. “They do the groundwork for us,” which means the hospital gets “a product that is very close to being finished.”

The software is complex but it lets all the hospital staff operate with the same information in front of them and minimizes the time spent entering data. Feuquay said the new system will allow her staff “more time to do the thing they went to medical school for — spend more time with patients.”

The new system also will enable NRMC to communicate with other health care providers in the community. Feuquay said that implementing this system should reduce duplication of services and reduce the cost of health care to the patient as well as improve the health and wellness of the community. Nevada is going to be the first community in the country to be in this pilot research and development project. “It’s very cool, something that’s never been done before,” said Feuquay.

Moving forward The next step in the process is getting the community involved. Much of the next step is “creating awareness” according to Feuquay — awareness of the simple changes in their lives that can impact their health and wellness. Cerner is going to engage the civic groups in the community and try to get the schools involved. Then, ideas for creating a working, sustainable and repeatable model of community health should begin to unfold. According to Townsend, national statistics will be used to track success, but the programs and things that will be done in the community will be determined by the community.

Townsend said not all ideas will work for all people; so they plan to “find out why it didn’t for some and let them be targeted with something else.” Townsend said, “The partnership is working when city leadership goes to Cerner with an idea, needing help to implement it. That’s when sustainability kicks in and you’ve now taken over on your own; and you’re off and running. I think we’ll see that inside the first year,” Townsend said, “it will be exciting when that happens.” [/toggle]

[toggle title=”Article – Rural Mo. town serves as health care experiment”]AP News NEVADA, Mo.

(AP) — Polishing off his pork and beans at the local senior center, Gentry Malcom politely passes on the peas and broccoli still sitting on his plastic food tray. He’s finished eating, but not done talking about how a heart attack nearly killed him a decade ago. Malcom is still upset about a $1,600 co-payment — that took three years to pay off — for a life-saving helicopter ride from his rural hospital to a better-equipped facility in a bigger city.

He’s quit smoking. But his diet hasn’t changed dramatically. Exercise? “I have an excellent muscle on my clicker finger for the TV control,” quips Malcom, a 69-year-old diabetic who retired after a career at a state mental hospital. His self-assessment: “Basically, I’m pretty healthy.” His lifestyle may suggest otherwise.

Though Malcom may not realize it, he and the nearly 8,400 other residents of the western Missouri city of Nevada are about to become part of an experiment testing whether a rural community that ranks near the bottom of many health indices can be transformed into a national example where the people are healthier, their doctors are more efficient and their health-care costs are lower. In short, it’s a private-sector attempt at health reform — coming as a highly-charged national debate continues to rage over the pros and cons of President Barack Obama’s health care law, which seeks to expand health coverage to millions of Americans through insurance mandates and enlarged government programs. “That’s great there’s a health care reform bill, but really this battle has got to be fought in a local ZIP code on the ground, and sponsored by leaders locally,” said Jeff Townsend, executive vice president and chief of staff at Cerner Corp., a Kansas City-based health technology firm that is spearheading the effort in Nevada.

The Healthy Nevada project will equip the local hospital with a new $10 million electronic health records system and allow patient information to be more easily shared among the town’s two dozen doctors and with medical experts in bigger cities. The city of Nevada, which recently enacted a special sales tax for parks and recreation, plans to chip in with new infrastructure such as bike lanes and improved sidewalks intended to make exercise more appealing. And an educational campaign will target residents with wellness screenings, nutrition tips and friendly competitions featuring prizes for such things as the top walkers or weight-losers. The project seeks to improve both the health of individuals and the quality of care they receive while reducing the overall amount spent on health care.

The goal is “to develop a program that’s never been done before,” said Carol Branham, the executive director of the Nevada Housing Authority and one of several residents on the project’s coordinating committee. “We want to be that model for the rest of the United States.” Other communities already have tried certain aspects of the plan. The federal government, for example, has awarded $250 million to 17 so-called Beacon Communities that already have made progress on developing electronic health systems that allow patient records to be shared among various medical providers. A 2009 initiative by Minneapolis-based Blue Zones LLC set out to improve health and longevity in Albert Lea, Minn., by making it easier for residents to make healthier choices. The project emphasized walking, developed community gardens, removed candy bowls from offices and labeled nutritious items at restaurants and grocery stores. Similar Blue Zone efforts now are under way in several California cities and in Iowa, where the insurer Wellmark Blue Cross and Blue Shield has pledged to spend $25 million toward the governor’s goal of making Iowans the healthiest residents in the nation by 2016.

What makes the Healthy Nevada project different is its simultaneous emphasis on healthy lifestyles and improved health care technology. Cerner, which hasn’t said how much it will spend on the project, hopes the model can be adopted elsewhere and eventually even generate a profit. In the years to come, “I think we’re going to see more of this, and I think it’s been encouraged,” said Karen Donelan, a senior scientist at the Mongan Institute for Health Policy in Boston. “It’s nice to know it’s trickling down for a small town.” The city of Nevada, located near the Kansas border about 85 miles south of Kansas City and 50 miles north of Joplin, was chosen after Cerner reached out to the Missouri Department of Economic Development seeking leads on rural towns. Burned to the ground by Union militia during the Civil War, Nevada was rebuilt in the late 1880s as a railroad town and gained renown for its state mental asylum. But the county’s population has fallen by a third since its peak in 1900, and the state has been closing its mental health facility.

The largest local employer is now a 3M manufacturing plant. The Robert Wood Johnson Foundation ranked Nevada’s home of Vernon County near the bottom of Missouri counties in a variety of health factors, including smoking rates, obesity, physical inactivity and premature deaths. The city manager estimates that more than half the residents are eligible for the Medicaid health-care program for the poor, an indicator of the area’s generational poverty. “We’re a typical rural Missouri town — not so healthy,” said Donna Redburn, 49, the city’s director of parks and recreation.

Yet the city is no slum. It has a new air conditioned community center where upward of125 kids play basketball and other games daily. Bright street signs point the way to “recreation districts,” featuring playgrounds, lakes, walking trails, a baseball field, exercise facilities and a modern aquatic center. The senior center hosts meals, blood-pressure screenings, dances and periodic nutrition programs. Although the town has a 72-bed hospital, including a maternity ward, many residents still travel to bigger cities for more serious health concerns.

When 80-year-old Jay Borders needed a knee replacement last year, he went to a Joplin hospital — then returned again and again and again for follow-up visits. Each trip consumed at least a half a day. Townsend, the Cerner executive, estimates that $120 million annually is spent on the health care of Vernon County residents by private insurers and government-run health care programs.

His objective is to decrease the demand for medical care by 10 percent by improving people’s health, and to keep an additional 10 percent of those health care costs in the local community through improved technology that reduces the need for patients to travel elsewhere. City manager J.D. Kehrman hopes Nevada can move from the bottom tier to the top third in health rankings. The intent is to “shift the focus here from sick care to prevention and one of health and wellness,” Kehrman said. He adds: “I really like the idea that we can redefine the way people engage health care.” [/toggle]