Rural Health Network Development Program: Big Sandy Healthcare
The Georgia Health Policy Center recently spoke to Pamela Spradling, director of strategic planning and development at Big Sandy Healthcare (Kentucky), to discuss how the network is addressing chronic health conditions in a five-county region of eastern Kentucky, in the heart of Appalachia.
To date, what has been the biggest accomplishment or win for your network development?
One of our biggest accomplishments is the intrinsic synergy that our network has been able to create. While that is the intention of the Network Development Program, it is really easy to get distracted by what you want your network to do rather than focusing on developing the network. But, we have been bringing the right partners to the table and developing these deliverables that the Health Resources and Services Administration has asked for because they really help us create the capacity to do the work that we want to do.
Because we did the hard work early on and developed our network as fully as we did, that helped us to create the capacity to respond to the global pandemic in a way that brought all network partners on board, gave everybody something important to do, and let everybody work to their fullest potential.
What is a tip or early learning that you would share with an organization launching a similar network?
Do not let your project, or the work that you want your network to do, distract you from the development of your network. Focus on your network and find the right partners. Sometimes they may or may not be traditional health care partners.
We instantly think of the health providers in the community, and the hospitals make wonderful partners — they bring a lot to the table. But it is also important to look for those nontraditional partners because sometimes they have avenues to folks that we don’t necessarily have as a health care organization and their missions and goals are aligned very well with the network. Our nontraditional partners include cooperative extension partners, local school systems, churches, and food pantries. They fill gaps that traditional health care partners are not able to do. It is important to plug those folks in and keep them engaged. Part of that is making sure that you share success with your network partners instead of taking all the credit yourself.
How do you see participation in the Federal Office of Rural Health Policy’s Office for the Network Planning Program impacting your broader health improvement efforts?
Our project is focused on our patients with chronic conditions, and we have used community health workers to work with those patients — providing health education, navigation services, and linkages to other community resources that many of our network partners provide. We developed a reciprocal referral system for these patients to meet social determinants of health.
We have data that our program is successful because the patients with diabetes who are enrolled in our project have lowered their A1C by an average of 2.5 points. We have seen improvements in blood pressure among patients with hypertension, and they have lost weight. We have also experienced a 93% reduction in emergency department visits and an 82% reduction in hospital visits for those patients with chronic conditions. We know that this effort is having an impact on our patients, and we believe that as time goes on, and in a broader sense, it can have a significant impact on population health in our region.
What will your organization be doing more of or differently to emerge stronger from the pandemic?
I think the pandemic has made us think more in terms of providing services outside the walls of our health center. Instead of patients coming to us, we have had to take our services to them and that is really reflected in the expansion of telehealth services during the pandemic. But, we live in a region again that my husband calls the “roadkill on the information superhighway” and many of our patients don’t have access to broadband internet and they do not have a smart device in their home. Sometimes, even if they have those things, they do not have the skills to use them to access telehealth services.
By putting a community health worker or a nurse in their home, which is part of our project, we can help them have that health care access without leaving their home. That solves a multitude of issues for some of our patients who also have transportation issues. They may also have social support needs and might not have someone to go to the doctor with them to help them understand what the provider wants them to do and how to take their medicines.
This is what new health care looks like. I do not see us moving away from that model after the pandemic. It is working and it is better than what we had done before. This is a permanent fixture both for Big Sandy Healthcare and in a broader sense as well.