1. St. Louis Regional Healthcare Workforce Intelligence System Presented to: Kevin Kast President CEO of SSM St. Joseph’s Hospital, Medical Park & Health Center September 22, 2003

2. The Founders

3. Objectives to forecast the regional demand for skilled healthcare workers to inform decision-makers about the impact of legislative, economic, other changes to help employers anticipate conditions affecting worker supply

4. Objectives (cont.) to connect transportation, childcare, other supporting systems to guide education and training providers to foster communication and collaboration among public / private sector interests, joined in a…

5. … Regional Healthcare Workforce Information Network. Public Policy Organizations St. Louis Regional Workforce Policy Group Local/State/Federal Governments Elected Officials Depts. of Health and Social Services Metropolitan Planning Organization Labor Unions Workforce Training Agencies Medicare/Medicaid Agencies Healthcare Industry Hospital Systems Offices of Physicians & Dentists Long-term Care Providers Residential Care Providers Medical and Dental Labs Public Sector Insurers Private Sector Insurers Healthcare Educators/Trainers University MO-St. Louis University MO-Columbia Medical Colleges Med Tech Schools Community Colleges Vocational Educators Career Guidance Counselors K-12 Educators Regional Healthcare Workforce Intelligence System

6. How is this unique? regional multi-dimensional dynamic ongoing a network of sensors embedded within the healthcare workforce system

7. Today … We have started to lay the foundation for a comprehensive system, using employment forecast and policy simulation. We think in terms of three components, although inextricable: supply, demand, connectors

8. Supply side issues: example

9. The problem has many facets.

10. DOL Community Audit Grant supported our initial research National literature review Analysis of existing data Census Bureau, BLS, Nat’l Center for Health Workforce Information and Analysis, state data centers, professional associations

11. Methods (continued) Linking and completing fragmented info systems

12. East-West Gateway: Geographic Information Systems (GIS) To display spatial associations and emphasize regional dimensions Methods (Continued)

13. Methods (continued) Focus groups and interviews “Many patients have unique needs and feel more comfortable being cared for by someone who looks like them, acts like them, and can speak their language. Immigrants and refugees can be an important asset.”

14. Focus Groups & Interviews - Continued “[Consider] RNs who have been out of nursing for years and want to come back. They are intimidated by new advances in technology and medicine, and decide to look somewhere else to work….” “If we don’t address hospital working conditions, we will never be able to address the [nursing] shortage.”

15. Demand Side Issues Medicare/Medicaid Private Payers, HMOs, PPOs, etc. Physician Induced Demand/Defensive Medicine Certificate of Need HIPAA of 1996 Demographic Trends

16. Where We Are Initial Steps to Building a Healthcare Workforce Modeling System: Current Progress

17. Health Services: SIC 80

18. Offices & Clinics Of Doctors: SIC 801

19. Nursing and Personal Care: SIC 805

20. Hospitals: SIC 806

21. Medical & Dental Labs: SIC 807

22. Where We’re Going Next Step: From Baselines to Policy Simulations

23. Impact of Government Health Insurance on Health Employment: A First Run Annual Increase of Medicaid Coverage by 1%

24. Where We’re Going Next Step: Build Regional Representative Hospital

25. FAPRI:The Representative Farm Approach Panel of Farmers Benefits of ‘Representative’ as opposed to ‘Average’ Ability to talk about micro or local concerns as opposed to macro Kinds of questions one can answer Communication opportunities

26. Representative Hospitals First and Foremost Up to local health care to determine what questions need answering Use models to communicate to policy makers Does require some openness to build operations Multiple types of operations

27. Future Course of Action Labor supply & wage models Occupational demand models Policy simulations Supply side / connectors research Working groups in place Positioned within Regional process Sustainable resources