Review of HealthCare Initiatives in Travis County, Texas: Recommendations and suggestions regarding the proposed University of Texas Medical School at Austin, improvements to the University Medical Center at Brackenridge (UMCB) and related proposed community healthcare improvements.
Our recommendations on the best way to complement Senator Watson's "10 By 10 Plan."
As our policy-makers are crafting an Integrated Delivery System (IDS) which is a critical component of the 1115 Waiver Program and as a plethora of related policy and service delivery improvements toward the goal of bringing a world class medical school and teaching hospital to the Austin area it has become necessary to examine our current delivery systems. In doing so, the Latino HealthCare Forum (LHCF) prepared and published Paper No.1 “Review of Health Care Initiatives in Travis County, Texas” on May 5, 2012. As promised, this is the second Policy Paper we share to stimulate discussion and recommend what we believe is an obvious complement to Senator Watson’s “10 By 10 Plan”.
Within the context of “Paper No.1” we identified current gaps and omissions that negatively impact Latino’s opportunity to access medical/health care and our ability to communicate with our service providers at all levels of service delivery. We also expressed the objective that health disparities be eliminated at every opportunity as the new IDS model is built and implemented. The difficulties created by this fragmented, siloed delivery system is expensive and contribute to inappropriate use of medical, hospital and ED visits, which result in unhealthy medical outcomes. The genesis of these difficulties was fostered over decades because in the US as in Texas and in Austin, our payment/reimbursement for health care was built on the volume of services rather than for the value of the services toward the patients’ overall health. These facts are well documented and an entirely new health delivery model has been developed nationally (ACA).
One of the lynch pins of the new health delivery model is the precept that a patient-centered medical home, supported by a vibrant, real-time health information exchange which include certified community health workers/navigators to facilitate two-way communication between consumer and provider, will ameliorate many of the difficulties that exist. These are new concepts that have not been applied in a meaningful, effective manner, yet.
We have been fortunate over the previous months with the opportunity to train many of our neighbors to be Community Health Workers (CHW). To date, most the graduates of our PromoSalud program are low-income Latinos who are, in fact, long time subsidized consumers of our local health delivery system. During their training, we learned that nearly all our students owned and used wireless cell phones—a statistical fact that is just now being touted nationally. When we recognized this fact we also realized the need to develop a curriculum for the use of this new and constantly evolving technology, related software and smart phone applications. We also learned that there was a steep learning curve between our student’s ability to operate the wireless technology to its maximum capability-to the benefit of the health/medical consumers, their families our providers and payers. When we asked our students why they were not equally proficient with their smart phones and how they learned about its capabilities and use, the response was simple and emphatic- “our kids show us”. As has been the case for generations before, the children will show us the way.
It is with this observation in mind as we witness and contribute to the development and deployment of our new health delivery system (IDS) that we ask who better than the kids to help insure the success of the new IDS and its many new parts, rules, benefits and the outcomes desired by all?
With the help, direction and support of our Board of Advisors, the Latino HealthCare Forum recommends that a magnet health/medical high school be incorporated as a core component of the medical school’s campus and curriculum. We further recommend:
· The magnet school be contiguous to the new medical school campus to maximize teaching/learning opportunities
· AISD become the primary contributor toward the planning and operation of the magnet high school
· Where practical, economies of scale be realized in the capital and operational funding requirements for both campuses
· That a comprehensive curriculum for related allied health programs be incorporated, including nursing, social and behavioral health programs
· Because Senator Watson’s objective is for a 10-year program, recruitment of students begins as soon as possible starting with the excellent health programs AISD already has in place at Akins and Lanier High Schools
· Operation and maintenance of the magnet school should be considered for funding within the context of available 1115 Waiver opportunities and the associated Intergovernmental Fund Transfer (IGT)
· All identified partners and stakeholders of the 10-By-10 Plan including the University of Texas System, Seton Family of Hospitals, Central Health, Community Care, Lone Star Circle of Care, ICC, St David’s Foundation, private providers and all others be consulted for their input and collaboration at all levels of planning, development and funding for the magnet high school
· As development of the magnet high school curriculum evolves, a meaningful focus should be placed on the use of new communication products and devices and the importance these products (telemedicine, health, eHealth, EHR, etc.) will play in the new integrated health delivery model to facilitate and improve all forms of communications between the health/medical consumers and their providers. These initiatives and applications have the potential to build a bridge to better health care for all our communities. Innovative wireless technologies provide new and more substantive opportunities for better health and better health education than ever before
El Paso has an excellent health magnet program (http://silva.episd.org). Their partners and collaborators have been with the El Paso ISD since the magnet school’s inception. Texas Tech University Medical Center, Paul Foster School of Medicine and Texas Tech University Health Sciences Center have contributed to make the Maxine Silva Health Magnet High School a success.
We believe that Austin’s youth will play a critical role in the success of Senator Watson’s plan of our world class medical school and teaching hospital and the LHCF strongly recommends that the health magnet high school be included with this ambitious opportunity.
“In the middle of difficulty lies opportunity.” Einstein