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My research question: To what extent do health disparities of rural geographic locations differ from larger metropolitan areas?

• What interventions of population health should exist to improve patient outcomes and decrease the cost of care in rural settings?

• How can rural health settings develop a patient centered approach to improve access and convenience to high quality affordable care?

THEME Article 1 Article 2 Article 3 Article 4 Article 5 Article 6

Purpose of Study:

The online delivery of healthcare is a new concept. Health Partners of Minnesota has had incredible success with this affordable, easy and convenient method of health care.

Framework changes in population health management in rural settings.

Nine strategies organizations should adopt to improve population health, enhance patient experience, and reduce cost.

Use of peer health coaches for improvements in blood sugar levels of low income patients.

Alternatives to colonoscopies for colorectal cancer screening.

The addition of interorganizational health care has potential to improve economic and demographical challenges in rural settings.

Type and Population:

General low risk patient population seeking low cost and affordable healthcare.

Rural general population. Health care management application for general population.

Low income primary care patients in San Francisco, California.

Discussion targeted for low risk patients who seek preventative care.

Rural general population.

Other:

Excellent resource for best practice of patient satisfaction.

Ideas based strategies. Lacks implementation plan.

First main idea:

Success HealthPartners had with targeting a low risk patient population with a convenient and affordable alternative of care.

Population health and disparities. Traditional concerns about primary care continue to challenge rural health policy.

Use of predictive analytics for risk stratification.

Health coaches are effective because of real time feedback and inexpensive costs.

Challenges associated with colonoscopies and benefits of using kit testing.

Interorganizational collaboration is defined by combining efforts of cooperation, need of expertise, financial resources, sharing of risk, and need for adaptive efficiency.

Second main idea:

Claims analysis of online care delivery versus a traditional care route.

Population health and transitions of culture. To what extent are rural health settings challenged by education and income.

Combine predictive modeling with algorithms for financial risk assessment.

The use of health coaches in diabetes care has improved A1c levels of low income uncontrolled diabetic patients.

Sensitivities and specificities for alternative methods for screening.

Conceptual framework includes relationships of technologies, structures, and operational process.

Others main ideas:

Customer satisfaction scores of online healthcare delivery.

Water quality, agricultural methods, forestry, and mining can complicate rural residents’ perceived isolation.

Use of population registries to identify care gaps.

While the gold standard for colorectal cancer care is a colonoscopy, fit testing is the next best alternative.

Interorganizational collaboration will mimic a spider web design. Everyone communicates with everyone.

Why does rural residence (culture, community, and environment) reinforce negative health behaviors?

Build models of care to work care team members to the top of their licensure. Transition work from providers to other care staff.

The targeted audience for alternative methods are a different demographic of patients who may not feel comfortable with a colonoscopy.

Learning to work together will not come without stress and re- programming.

References

1. Courbeya, Patrick (2013). HealthPartners’ Online Clinic for Simple Conditions Delivers Savings Of $88 per Episode And High Patient Approval.

Health Affairs, 32, no.2 (2013) 385-392. Doi: 10.1377/hlhaff.2012.1157.

2. Hartley, David (2004, October). Rural Health Disparities, Population Health, and Rural Culture. Rural Health and Health Care Disparities, 94(10),

1675-1678. Doi 10.2105/AJPH.94.10.1675

3. Handmaker, K., & Hart, J. (2015, April). 9 Steps to Effective Population Health Management. Healthcare Finance Manager, 69(4)70-6.

4 Thom, David. (2012, April 1). Impact of Peer Health Coaching on Glycemic Control in Low- Income Patients with Diabetes. Annals of Family

Medicine, 11(2), 137-144. Doi:10.1370/afm.1443

5. Imperiale, T. (2014.). Multitarget Stool DNA Testing for Colorectal-Cancer Screening. The New England Journal of Medicine, 370:1287-1297.

DOI: 10.1056/NEJMOA1311194.

6. Schumaker, Alice (2002, September 1). Interorganizational Networks: Using a Theoretical Model to Predict Effectiveness of Rural Health Care

Delivery Networks. Journal of Health and Human Services Administration, 25(3), 371.