ViTALeconomy.com ©2006 ViTAL Economy, Inc. Southern Illinois Broadband Initiative Healthcare COI Leadership Milestone Meeting #1b Progress Meeting CONNECT SI Jim Haguewood - Frank Knott -

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Agenda – Healthcare COI Leadership Milestone #1B Progress Meeting Welcome & Introductions of Participants 0:10 – Objective of #1B Meeting, Strategy Review, Role of Research and GA 0:40 – Establishing Measurable Goals 1:15 – Work Plan Review, Assignments, Action Teams, Schedule 1:45 – Next Steps Agreement 2:00 – Adjourn

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Objectives of Milestone 1B Meeting Reinforce Connect SI Initiative and role of Healthcare COI Review role of GA and COIs relationship to value added research by Connect SI Establish measurable strategic goals Focus on preliminary short term wins; assess status and next steps Review and evaluate COI progress on Milestone #1 work plan Identify action plans with leadership assignments Begin to develop COI work plan document Establish COI, leadership and action team meeting schedules Get ready for Milestone #2 meeting the week of October 23

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Greater Egypt COI Strategy Southeastern COI Strategy Southern Five COI Strategy Greater Wabash COI Strategy Connect SI Regional CED COI Strategy Phase 1 Outcomes GIS Asset Maps Broadband Strategy Economic Benchmarks Regional Economic Strategy Healthcare Strategy Regional Economic Framework Five-Year Measurable Goals Implementation & Funding Plan Phase 2 Connect SI 20-County Phase 1 Roadmap Led By Connect SI Core Leadership Team GIS Mapping Team Supports COIs Healthcare Providers COI Strategy Network Providers COI Strategy

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Healthcare COI Implementation 1 - Organize COI, Issue ID, Priorities & Goal Setting Jul - Sep Map COI Value Chain, Conduct Gap Analysis, Oct - Dec 2006 Quantify Economic Impact 3 - ID & Quantify Connectivity Implications Jan - Feb 2007 for Healthcare Providers and Patients 4 - Prioritize & Define 3 Tele-Health Apps Mar - Apr 2007 & Value Propositions 5- Develop Economic/jobs strategy & Connect COI Strategy May 2007 to Region Strategy

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Connect SI Value Added Research Available to COI

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Interviews with community, business, government, finance and network provider leadership in each of four economic sub regions of Connect SI Interviews with federal, state, and local economic development officials Assess formal and informal leadership-understanding of the strategic role of connectivity in changing the way a community lives, works and governs Assess connectivity provider understanding of the role of connectivity assets for improving economic opportunity and performance Assess regions broadband connectivity versus best practice benchmarks Connect SI 20-County Readiness-Assessment - 1

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Assess role of community development assets in terms of the community vitality of the region in support of an integrated economic development strategy Assess the regions climate of innovation, risk-taking and entrepreneurship Assess collaborative leadership capacity and experience in the region Assess entrepreneurial mindset, and creative debt and equity capacity and capability to support and grow entrepreneurial knowledge based enterprises Review asset mapping to identify opportunities for emerging rural industry clusters Connect SI 20-County Readiness-Assessment - 2

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Develop a regional economic model which will allow users, without sophisticated economic expertise, to determine economic benchmarks for the region, four sub-regions and counties. This economic model will be able to be used to analyze existing economic performance and project future impacts based on key assumptions A standardized county level report template will be developed, so that standardized consistent reports can be quickly prepared for each of the 20 counties and four regions of Connect SI Develop a sub-assessment of Tourism and Knowledge-Based Enterprise (KBE) impacts within the four economic sub-regions of Connect SI. Integrate the results of this analysis into the economic model. Conduct industry specific interviews to assist in this sub-assessment Create a standard projections report, so that five-year projections of potential regional economic performance can be produced based on changes in employment and average wage assumptions Produce an Economic Model Training Manual which explains the model, how to use it and for what it can be used. Conduct a training session in the Connect SI region Regional Economic Model

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Develop a regional healthcare economic model which will allow users to prepare and print standard economic reports outlining key measures such as healthcares role in GDP, etc. Modify the regional economic model. Supplement it with healthcare data from other sources such as regional hospitals, previous studies, medical association statistics, to provide a more detailed analysis of healthcare in the region and within its four economic sub-regions Conduct a detailed analysis of the leakage of healthcare services from the region to neighboring states. Conduct interviews with healthcare professionals, assess available statistical data from multiple sources to establish a statistical basis for measuring leakage by type of service, location and demographic. Develop a micro-study of the economic activity related to a typical area hospital based on available data and interviews with regional industry leaders. Develop a standardized regional report on healthcare activity and its economic impact on the region. Create a standard projections report, so that five-year projections of potential regional economic performance can be produced based on changes in employment and average wage assumptions. Produce an Economic Model Training Manual which explains the model, how to use it and for what it can be used. Conduct a training session in the Connect SI region Regional Healthcare Economic Model

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Job Description Connect SI Graduate Assistant 1. Coordinate meetings for and work with members of Connect SI Leadership Team and the Community of Interest (COI) to be represented. 2.Record, distribute, and post meeting and COI documents 3.Assist in maintaining and archiving listservs, s, and other online communications pertinent to the respective COI. 4.Assist in relevant research related to the COI. 5.Provide regular contact, support, and encouragement for COI participants. 6.Coordinate closely with other COI and project graduate assistants. Attend meetings as needed, and collaboratively share ideas and thoughts for the betterment of the COIs and the project. 7.Assist in the promotion, development, and advancement of the Connect SI regional initiative. 8.Provide administrative support to the Connect SI Director. Complete other tasks as assigned by the Connect SI Director.

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Establishing Measurable Goals

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Step #1 - Relate Goals to Priority Issues How Other Health COIs Have Done This Unhealthy increase in percent of revenues from Medicaid/Medicare Critical skills shortages lowers service and increases costs 3rd Party Paid health service dollars accessing services outside region Appearance & remoteness of region hinders attraction of professionals Inadequate access to healthcare services and poor health outcomes Lack of coordination of and connection between services within region A vision for the future is dependent on defining a regions issues of challenge and opportunity

ViTALeconomy.com ©2006 ViTAL Economy, Inc. VEs Essential Guiding Principle If You Cannot Measure It, You Cannot Manage It! Vision and/or Mission Must Be Achievable, Believable and Transforming Benchmarks For Where We Are Today Must Be Established Measurement of Accomplishments Between Benchmark and Vision Is Critical Goals Must Enable The Realization of the Mission and Be Measurable Strategies Enable Measurable Accomplishment of a Specific Goal Action Plans Are Measurable Implementations of a Strategy All Actions Are Measured and Related Back to the Intended Goal, Strategy and Vision

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Step #2 - Establish Benchmark of Where You are Now and Establish a Measurable Goal for Where You Want to be in 5 Years Decrease Medicaid/Medicare percent of revenues by ___% Establish skills shortage deficit by profession and quantify the measurable benefit that will result from addressing this gap We will recapture $________ of 3rd Party Revenue within 5 years Define a specific improvement in access to health services Define measurable improvement in specific areas of health outcomes Define what services coordination will be improved and how connecting services will change the cost or revenue equation for what sectors

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Healthcare Issues of Opportunity From Milestone #1 Mtg Your ideas… Improved health status for children; mental health, medical m Benefit; reduced healthcare costs, better performance in school, parenting, less gaps in care, cost avoidance, system of care Access to applications for other resources IHN involvement in access, audit, authenticity Regional health information system; birth to death m Benefits; coordination of care, efficiency of system, better outcomes, transportation costs One stop/page for prescription programs, list of all prescription programs PCCM model of care, pick a medical home/provider and stay with it Connectivity is a relationship issue, identification of need in the other areas and share HR costs VA has access to specific specialties, unified approach to recruiting skills Provide high speed to 900 VA employees; secure network ability to work at home Delivery of education programs Sharing the HR in the area; physical therapist, supervisory relationships No pediatric neurologist in the Southern IL region, bring in to area with networks Billing/payment issues across state-lines Sustainable funding mechanism for small business health insurance ERs drug seekers moving throughout the region, network the locations together

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Healthcare Issues of Challenge From Milestone #1 Meeting Your ideas… Fearful of movement to digital medical records Workforce that is capable of working in a e-health network system Good communication and education plan to deeply engrain SI into the region. Lack of an easily updated resource list, regional healthcare talents What is available? Hospital placement for mental health clients, beds Leap between e-health network and keeping people in region and a climate of working together, capture of out-migration of revenues 3 rd party payers going outside of SI region for services Specialist that come from Springfield, St. Louis and other areas see patient and then take them outside area for surgery Involvement of physicians (federal, clinic, independents, hospital) in the Connect SI Healthcare COI Identifying a patients that should be seen with tele-health E-health having a negative impact on local service delivery, bring resource into the community (local control), getting more from the healthcare system Using already scarce resource to highest patient and system benefit

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Measurable Goals Ideas From Milestone #1 Meeting What Healthcare COI goals are important to you and why… Reduce the prevalence of chronic illness, improve the outcomes of chronic illness status in the region Change in the payer mix, higher 3 rd party % Increase connectivity of healthcare providers at home % of prescriptions filled through e-health system Eliminate the nursing shortage in the region, different levels and determine degree of shortage Healthcare training slots in the region Clinical placements Identification of fiscal resources for implementation of chartless system, national standards

ViTALeconomy.com ©2006 ViTAL Economy, Inc. What Are Meaningful/Measurable Goals for the Healthcare COI Is it Improvement in healthcare access, outcomes, revenue or jobs, etc? Your ideas…

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Work Plan Review and Action Team Task Assignments

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Healthcare COI Work Plan Prior To October Assign Task Completion to Leaders or Action Teams 1. Establish a leadership team to manage the work of the healthcare COI (Leaders) 2.Develop a champion and investor recruitment plan to sustain Connect SI (Team) 3. Identify healthcare industry research reports for Connect SI team 4. Clarify how Connect SI could help accelerate/benefit existing initiatives (Leaders) 5. Define what will enable and sustain regional collaboration versus competition Establish Marketing Committee to address 5 and 7 6. Clarify how the sub-regional input & involvement can be maximized by COI Sub-Region Engagement team complete this task

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Healthcare COI Work Plan Prior To October Establish strategies that will address challenges to regional collaboration (Marketing) 8.Complete, and prioritize issues of challenge and opportunity (Team) 9.Prioritize definition of measurable goals for COI (Team) 10.Select the issue that creates the greatest sense of urgency for the COI (Leaders) 11.Focus on collaborations that can result in short term wins linked to process (Leaders) 12.Define what makes your investment of time, talent and treasure worthwhile (Leaders)

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Confirm Leadership Team - Task 1 Who…

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Champion and Investor Recruitment Team - Task 2 Who… When?

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Marketing Committee - Tasks 5 & 7 Who… When…

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Sub-Regional Engagement Plan - Task 6 Who… How it links back to the region… When…

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Issues of Challenge & Opportunity Team - Task 8 Who… When…

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Measurable Goals Team - Task 9 Who… When…

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Leadership Team -Tasks 1,4,10,11,12 Who… When…

ViTALeconomy.com ©2006 ViTAL Economy, Inc. Agree on Next Steps Action Team Meeting Time Frames Milestone #2 Meeting in October or November