1. Building a Healthier Hawaii Island-- Together Hawaii Community College Community Economic Development Strategies, April 27 2012 Sharon Vitousek MD, North Hawaii Outcomes Project, www.nhop.org www.nhop.org Hawaii Island Healthcare Alliance www.hawaiihealthcarealliance.org

2. How can HCC support economic growth of the Health sector? What health careers are expected to grow? [What additional training is needed for existing health professions?] [What partnerships/ resources can help answer these questions?]

3. Why should we collaborate to grow the health sector on Hawaii Island ?

4. Inadequate Access on Hawaii Island Source IHI John Wasson MD

5. Impact of Primary Care Shortage Delayed Care & Increased suffering Higher ER utilization Higher hospital utilization Increased costs Less focus on Prevention- Life style Less screening- Cancer & Depression Poorer outcomes

6. Health Disparities in Hawaii Count y Higher Death rates from: –All causes –Heart disease –Stroke –Overall cancer –Infant Mortality –Suicide –Traffic-related accidents Lower Life Expectancy Higher Teen Birth Rates

11. Institute of Medicine Framework for Population Health Social and Physical Environment Social, Economic & Physical Environment (Socioeconomic Determinants) Health-Related Behaviors Health Systems (Access to Care) Population Health Outcomes

18. Health Disparities - Hawaii County Health Related Behaviors- 2010 BehaviorStateHawaii County Smoking 15%20% Obesity 26.323.1 Binge Drinking 17.917.7 Adults no leisure physical activity 19.220.2

19. Health Disparities - Hawaii County Health Systems Access to care: Higher uninsured  Lower ratio of physicians per 1,000 population Higher percent of population without a personal doctor Lower percent mothers receiving prenatal care Utilization & Cost: Higher acute care hospitalizations per 1,000 population Quality:

21. Increasing Hawaii Island Increasing Provider Shortages 331 Source : JABSOM Workforce Study, Kelly Withy

22. What Healthcare Providers Are Doing Collaboration to improve: –Hawaii Island Healthcare Alliance- –Hawaii Island Beacon Community Health information exchange Clinical transformation, care coordination –Hawaii Island Trauma Committee –Hawaii Island Perinatal Collaborative –Long Term Care Hui / Aging Resource Center,

24. Island wide, voluntary, collaborative group of stakeholders Goal: Improve health & healthcare in Hawaii County by increasing healthcare workforce Friends of the Future is 501(c )(3) Fiscal Agent

25. Supports  Growing Our Primary Care Workforce  Family Practice Residency Program in Hilo  Growing effective use of mid-level providers  Improving recruitment & retention of providers  Increase effective use of technology - Beacon  Collaboration and leveraging resources  Regional planning  Aligning high leverage policy change.

27. HAWAII ISLAND FAMILY HEALTH CENTER Current Health Training site

28. Health Workforce Shortages are in a Larger Economic Context Negative Impact Health Disparities are Partly a Result of poorer rural economy AND Health Workforce shortages are a Barrier to productivity & economic growth Opportunity Growing the health workforce is an OPPORTUNITY to stimulate economy Job multiplier effect of Physicians is ~1 to 5

29. Healthcare is 3 rd Largest Employer in Hawaii County (DBED Nov 2011) Growing Healthcare sector is part of economic development for Hawaii Island Employment sector# of Employees 1. Government12,000 2. Retail trade8,000 3. Healthcare/social assistance6,900 4. Accommodations5,500 5. Food and beverage services5,200

30. What Hawaii County Can Do Approach policy decisions through a health lens: “How will this policy impact the health of our community-- now & in future ?” Support Hawaii County economic development of the science, energy, education & healthcare sectors Add community health improvement to Criteria for Community Development Conditions Advocate for State health data to be analyzed by County and Sub- county to better track needs & progress

31. How can HCC support economic growth of the Health sector? What health careers are expected to grow? What additional training is needed for existing health professions? What partnerships/ resources can help answer these questions?

32. Future Health Care? Address “silver tsunami” & shortages More team care More allied personnel More “care coordination” More integration with behavioral health –Lifestyle coaching More use of population health data More use of info systems

33. What health careers are expected to grow? Health Workforce Information Center http://www.hwic.org/topics/professions.php Virtual Career Network - health care- a project of the American Association of Community Colleges http://www.vcn.org/healthcare/careergrid/wo rktypecode/mdn/score/high On line courses

34. Health Careers Expected to Grow Audiologists Dietitians and Nutritionists Health Aides, Assistants and Guides Community Health Workers Health Educators Home Health Aides Medical Assistants Nursing Aides Patient Navigators Personal and Home Care Aides Health Information and Informatics Occupations Chief Information Officers Chief Medical Information Officers Health Informaticians Health Information Administrators Health Information Technicians

35. Health Careers Expected to Grow Health Technologists and Technicians Cardiovascular Technologists and Technicians Diagnostic Medical Sonographers Medical Appliance Technicians Nuclear Medicine Technologists Radiologic Technologists and Technicians Surgical Technologists Laboratory Professionals Phlebotomists Medical Interpreters Pharmacy Occupations Pharmacy Technicians and Aides Speech-Language Pathologists Vision Care Occupations Optometric Assistants and Technicians

36. 10 Hot Careers in the Health Industry 1. Dental Assisting 2. Information Management 3. Health Care Administrator 4. Medical Assistants and Nurses 5. Massage Therapy 6. Medical Transcriptionists 7. Billing and Coding 8. Medical Imaging 9. Pharmacy Techs 10. Occupational Therapists http://www.healthdegrees.com/10-hot-careers-in-the-health-industry

37. Top Ten (10) Fastest Growing Allied Health Careers 1. Medical Assistants: 2.Cardiovascular Technologists 3.Diagnostic Medical Sonographers: 4.Physician Assistants: 5.Respiratory Therapists and Technicians: 6.Athletic Trainers: 7.Surgical Technologists: 8.Clinical Laboratory Technologists: 9.Medical and Health Services Managers: 10. Dietitians and Nutritionists: Source: Bureau of labor statistics 8/2011

38. What additional training for existing professionals? Leadership & Change Management –Mentoring Healthcare Finances Performance monitoring/ Program evaluation Effective use of data Mediation/Negotiations Communications Billing & coding

39. What partnerships/ resources can help answer these questions? Hawaii Workforce Development Council To support and facilitate the development of a skilled workforce that meets the needs of business and industry, enhances workplace productivity, and increases opportunities for employment and entrepreneurship. Hawaii Workforce Development Council Contact: dlir.workforce.council@hawaii.gov 808.586.8670 dlir.workforce.council@hawaii.gov

40. Benefits of Developing Hawaii Island Health Workforce- Health lens Improved Access –Timely care & decreased suffering –More recommended screenings More prevention & better lifestyles Better outcomes & quality of life Improved productivity of workforce Improved economy - job creation Decreased healthcare costs Lower hospital/ER utilization

41. Benefits of Developing Hawaii Island Health Workforce- Education lens Increased educational attainment Increased economic potential of individuals Can afford better living conditions, lifestyle Increased health literacy Better outcomes & quality of life Improved productivity of workforce Improved economy - job creation Decreased healthcare costs

42. Improving Health & Healthcare for our community Is Our Kuleana

43. Contact info vitousek@nhop.org www.nhop.org www.hawaiihealthcarealliance.org Tools for policy makers

44. Hawaii Island Medical Specialties Gaps 7 4 10 2

45. Hawaii Island Shortages-2011

46. Hawaii Island Surgical Specialties Gaps 13 6 7 10

47. Hawaii Island Beacon Objectives Improve access to primary care, specialty care and behavioral health care Avert the onset and advancement of diabetes, hypertension and hyperlipidemia Reduce health disparities for Native Hawaiians and other populations at risk Achieve EHR adoption & meaningful use among > 60% of primary care providers

48. Beacon Progress Meaningful use of Electronic medical records Clinical Transformation Mini-grants www.hibeacon.org web site www.hibeacon.org Wellogic HIE Amalga HIE

49. Family Medicine Residency - Hilo Why: – Rural residencies grow the local provider work force – Growing Primary Care reduces death rates – Growing Primary Care reduces costs – Growing Primary Care grows the economy Recent progress: Timeline: What's different now: – Critical Success Factors are in place: