Delta Health Alliance: Dr. Karen Fox, CEO

by HCE Exchange on August 19, 2010

When a program is the first of its kind, there are inherent challenges. There’s no one to follow, no examples to discover and no practices to emulate. Add to that situation some of the poorest living conditions in the country and you have the scenario for the work being done by Delta Health Alliance (DHA), a collaborative partnership of organizations that have come together to coordinate and provide oversight for community-based programs that address critical healthcare issues in the 18-county area of the Mississippi Delta.

According to president and CEO Karen Fox, PhD, the Stoneville, Miss.-based DHA is a collaborative partnership founded in 2001 by Delta State University, Mississippi State University, Mississippi Valley State University, University of Mississippi Medical Center and Delta Council. The group maintains a cooperative agreement with the federal government and does not receive grant funding. In addition, due to the collaborative nature of the alliance, partners also do not receive grants.

“The challenge is that nothing like Delta Health Alliance has ever been done, so therefore, it’s not like we have a cookbook to go by,” she said. “That’s difficult, but the nice thing about it is that we can build something new. We can look at what’s been done in the past and try to build something very successful.”

Mississippi is the fourth most rural state in the country, with the Mississippi Delta region ranking among the poorest areas nationwide. In response to the problems in this economically troubled region, DHA created a comprehensive plan that addresses needs in a coordinated, systematic manner.

Services

Delta Health Alliance started with about four projects and two staff members and has grown to an organization that handles nearly 30 projects and employs about 50 diverse people. Fox said the organization’s range of services stretch from access to care and education about healthcare issues to the research associated with those areas.

“The research we do is specifically designed not just for the sake of research but to measure whether or not our projects are working,” she said.

Access to Care

With the 21st Century Chronic Disease project, headed by DHA’s chief medical officer Keith Mansel, MD, the focus is on prevention and early health care. This project involves the issue of access to care for the working uninsured who suffer from chronic diseases.

“These people don’t see a doctor until they are seriously ill and by then they are going to emergency rooms rather than family physicians,” Fox said. “A lot of people are forced to choose whether to spend a day at a physician’s office or spend a day getting paid working. This is why it is important to teach people that it is better to take care of a medical situation early, than to wait until they become very sick.”

This project also provides patient navigation services to help them work through what can be a complicated healthcare system. With insufficient funds and oftentimes limited access to education, it’s important to help these patients gain access to healthcare so that they can receive the treatment they need, she said.

Another barrier to medical care is a dwindling number of healthcare providers. With that, DHA instituted a project designed to increase the workforce. For example, the organization works with partner Delta State on a program to increase not only the number of students who attend the university’s nursing school, but that keeps them working in the Delta once they graduate.

“We have a dearth of access to nurse practitioners and other types of health care providers,” Fox said. “Because of that, we focus on programs that increase that level of workforce.”

Recruitment efforts begin as early as high school, where DHA steps in and advises students on what classes they should take to provide them with the proper prerequisites for the university-level nursing program.

Children and Early Childhood Healthcare

Changing the next generation’s viewpoint on healthcare is the focus of another DHA project that focuses on early childhood and children’s issues. In that vain, the alliance instituted a Promise Community in the Delta, a program that mimics the Harlem Children’s Zone. The Harlem project is a community-based organization that has offered education, social service and community-building programs to children and families in this New York community since 1970.

“We will use the same techniques that they use in the Harlem program and measure our success against that,” Fox said. “With our early childhood and children’s programs we can build a new, healthy, educated generation that won’t have the problems that we currently see in the older generation.”

Technology Infrastructure

Tying together the health records of residents within the Mississippi Delta is a daunting task, but one Fox believes is vital to DHA meeting its goals of access to care and healthcare education. To create the technology infrastructure to make that happen, the alliance built a large electronic health record network. Currently, about 200 physicians within the Delta and Jackson areas are operating on this system, and Fox hopes to see more join every day.

“When the project is complete we hope to have every submission in the Delta on an electronic health record,” she said.

As a follow up to the electronic health records implementation, DHA plans to install a telemedicine network that would electronically link physicians from outside the Delta to patients within the region to assist with their medical care. The University of Mississippi Medical Center is assisting with this project, and DHA has engaged Allscripts as a vendor.

Change Will Come

Fox and her DHA partners understand that change at this level takes a long time. The plan is to continue to exert the effort, measure successes and make adjustments along the way.

“We hope to be successful but we know that it will take a couple of decades before we’re actually changing nationally ranked figures about the Delta,” she said. “We know this is not a quick fix. “

-by Kathy Knaub-Hardy

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