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Tahoe Institute for Rural Health Research
November 1, 2011
The barriers to the delivery of optimal patient care in the rural setting are multiple including the scarcity of physicians, the limited availability of specialty physicians, geographic isolation, access to care, distance, resource limitations, technology, and financial challenges. In light of these challenges there is a need for a comprehensive, analytical approach to understanding and addressing the need for, and the problems of rural healthcare providers. To be effective, solutions to the multiple challenges facing rural healthcare providers should be based on sound research that is centered on the unique characteristics of rural healthcare delivery. Development of meaningful interventions is essential to maintain rural delivery systems and to enhance the health of rural residents. Responding to the need for rural focused research, the Tahoe Forest Health System located in Truckee, California, initiated and continues to support the creation of the Tahoe Institute for Rural Health Research (TIRHR).
The Tahoe Institute for Rural Health Research (TIRHR) was created in August 2009 as a 501(c)(3) nonprofit corporation of the Tahoe Forest Hospital District. The TIRHR mission is to create an environment in which practitioners, scientists, and industry leaders collaborate to address relevant healthcare questions through the application of rigorous research methodology to produce innovative solutions that can be integrated into rural health care delivery settings. The TIRHR includes the expertise of physicians, nurses, scientists, engineers, researchers, educators, and other related fields through its current collaborations with the Lawrence Livermore National Laboratory (LLNL) and the National Science Foundation (NSF) Center for Biophotonics at the University of California, Davis (UCD). Also contributing to the endeavors of the Research Institute are the UCD Schools of Medicine and Nursing, UCD Center for Healthcare Policy and Research, UCD Innovations Center, UCD Clinical and Translational Science Center (CTSC), and the UCD Graduate School of Management.
The President of the Institute is Thomas Hobday, an active community volunteer and retired Assistant Dean of UC Davis for Health Sciences Advancement. Prior to joining UC Davis, he had over 30 years in the industrial insurance industry, and since has had 16 years in health system administration. Mr. Hobday is a very competent administrator, team leader, and fund raiser. Tom also served for three years as the National Chairman of Fund Raising and the only lay member on the National Research Review Committee of the American Cancer Society.
The Chair of the Scientific Advisory Committee (SAC) is James Hood, PhD. Dr. Hood has over 38 years of experience in the development, manufacture and sales of high technology electronic equipment and systems with twenty years of general management responsibilities. The existence of this Scientific Advisory Committee, and its distinguished membership, allows the Institute to review projects from a broad and critical perspective, not usually found in organizations of its kind.
The TIRHR Board of Directors consists of 13 members that are affiliated with Tahoe Forest Health System (TFHS), UCD Clinical & Translational Science Center, the NSF Center for Biophotonics UC Davis, UCD Graduate School of Management, Truckee/Tahoe community business leaders, and the Senior Director Former Player Services of the National Football League Players Association.
The TIRHR is currently staffed by interested community volunteers with minimal financial support from TFHS. Although in its infancy, the TIRHR is well positioned to conduct high quality community-based research focusing on the unique barriers to optimal healthcare delivery in a geographically remote, mountainous region. This is based on the involvement of the community, the resources invested in TFHS in tele-education (currently>$400,000 per year for 5 years), the expertise of the leadership of TIRHR, and the track record of successful collaboration with UC Davis. The Scientific Advisory Committee (SAC) of the Institute has requested that interested community members and medical professionals provide innovative ideas to the TIRHR that can be translated into solutions for providing better rural healthcare delivery services. This effort resulted in numerous ideas from front line providers in the community. The institute is currently pursuing or developing five projects that were passed by the SAC.
The Institute projects that the funding for these efforts will come from a variety of sources including members and affiliates, federal, state, and private grant funding, private investors, and philanthropy. The TIRHR Board is actively reviewing and applying for grant monies as well as soliciting support from community members. August 1, 2011 the Institute received confirmation that it will receive initial funding of $99,999 over two years for one of its projects through the NSF Center for Biophotonics at UC Davis.
The projects the institute is currently pursuing promise to provide breakthroughs in solving rural health problems, but will be applicable to remote as well as major metropolitan areas. Two of these programs have been recommended for funding to the organization’s Founder’s Committee.
With the involvement of Nolan Harrison III, and his experience with traumatic brain injuries (TBI) on the playing field, and Rick Ganong, M.D., with his experience with skiing and sports injuries as a member of the medical staff for the US Ski Team, the Institute hosted a workshop on TBIs. The event included physicians, scientists, engineers, nurses, and athletes to brainstorm the development of diagnostic tools that can be used on the playing field, ski slope, ambulance, and other remote areas, to provide early objective diagnosis of TBIs and intervene appropriately. Two of the projects the Institute is pursuing evolved from the seminar. These projects will be implemented with the cooperation of the University of Nevada Sports Medicine program and the Tahoe Truckee Unified School District. They are directed by Drs. Keith Tatsukawa MD. PhD. and Janet Van Gelder RN, DNP, NEA-BC, and the TFHS Sports Medicine Department.
The Institute conducted another workshop in April 2009 in the field of psychiatry, which resulted in the opportunity to develop tools for use by psychiatrists in both the rural and urban setting. The Institute has had several promising medical needs presented to them by local physicians, and there are more yet to be provided by other front line providers. The Institute is uniquely positioned to fill a significant void in the identification and solution of problems found in rural and remote medical situations, as well as to analyze opportunities for the effective use of resources.
In addition to the programs described above, the Institute has recently opened a Division of Clinical Informatics under the direction of Lynn Barr Mph. This division provides a home for the California Rural Health Information Technology Network, which provides a rural-focused approach to gather exchange and use population health information to improve the quality, efficiency and patient-centeredness of care in rural communities. Resources are developed and shared among network members to facilitate the adoption and meaningful use of electronic health records, health information exchange and to promote accountable care. Examples of successful programs by the network include facilitating 18 hospitals through vendor selection, provision of low-cost deferred payment loans for EHR adoption, development of a Rural California HIE Strategic Plan, providing local workshops and programs and most recently the Rural Incumbent Worker Training program, which is currently teaching project management, change management, process and workflow redesign and fundamentals of HIE to 138 rural health workers in 20 facilities. The Division of Clinical Informatics is also developing a Health Information Exchange that would create discrete yet identical Community Clinical Data Repositories in each rural community, so that informatics resources and health improvement initiatives can be developed once and then shared among its members.
On August 1, 2011, the Institute received a $900,000 grant from HRSA to fund these programs for three years.
For more information, please contact Tom Hobday at thobday@suddenlink.net, Janet Van Gelder at jvangelder@tfhd.com, or Lynn Barr at lbarr@tfhd.com.
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