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March 2, 2004
TALLAHASSEE, Fla.-Impending changes in the nature and financing of state and federal rural health initiatives were the focus of a day-long summit sponsored by the Blue Cross Blue Shield of Florida Center for Rural Health Research and Policy at the Florida State University College of Medicine.
National and statewide rural health leaders came together in Tallahassee for the Feb. 27 Rural Health Summit, which drew about 70 rural providers, hospital administrators, rural health network representatives and FSU medical students.
In spite of the constant financial struggle rural communities face in providing health care, Stephen Wilhide, executive director of the National Rural Health Association, said improvements can often result from simply bringing together all the players to identify existing resources, determine how they can be better coordinated and seek solutions for any gaps that are found.
"By maximizing and coordinating their resources, communities can achieve better outcomes," Wilhide said.
Rhonda Sherrod, administrator of Shands Hospital at Live Oak, Joel Montgomery, CEO of North Florida Medical Centers, and Kim Barnhill, director of the Jefferson and Madison County health departments, described many of the daily challenges they face in providing care to rural residents and the efforts they have made to find solutions for their communities.
Dr. Marcia Brand, director of the Office of Rural Health Policy in the Department of Health and Human Services, discussed new provisions in the recent Congressional overhaul of Medicare that steer more than $20 billion toward rural communities and help level the playing field between rural and urban providers of health care. However, Wilhide noted that proposed cuts to other federal programs that benefit rural providers, such as the Small Hospital Improvement Program and the Rural Hospital Flexibility Grant Program, could offset those gains. Many rural hospitals depend on such programs to support training and new equipment.
Patsy Justice, a registered nurse at the Washington County Health Department, was pleased to hear from Florida Health Secretary Dr. John Agwunobi about plans to improve patient safety by creating an electronic medical records system for Florida.
"We would love to see that happen," Justice said. "Right now (the electronic medical records system) doesn't exist, and yet the paper shuffle we all deal with is unreal. You're constantly getting requests for medical records in, and you're constantly mailing them out."
During the afternoon Dr. Robert Brooks, associate dean of health affairs at the FSU College of Medicine, and his colleague Nir Menachemi, director of the college's Center on Patient Safety, presented preliminary results of their recent research on rural providers and hospitals in Florida. The studies are expected to be published later this year.
Brooks described a 2003 survey of Florida's rural physicians showing the challenges physicians are facing in the midst of the medical professional liability insurance crisis which, if left uncorrected, will result in further loss of services to rural areas.
Menachemi's study identified trends in rural and urban hospital information technology use in Florida. The use of information technology in hospitals has been linked to enhanced patient safety, but the study indicated that due to limited resources, many rural hospitals have been unable to adopt new technologies.
Information about federal grants and other health care resources for rural communities is available at the Rural Assistance Center Web site, www.raconline.org and at www.ruralhealth.hrsa.gov .
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