Grantee Spotlight

Rural Health Network Development Program  

The Georgia Health Policy Center recently spoke to Jennifer Profitt, program director for the Indiana Transfer of Care network (InTOC), about how the initiative is using a network approach to improve care transitions and is serving as a model for statewide expansion. 

To date, what has been the biggest accomplishment in establishing your network?  
Our biggest accomplishment has been resisting the urge to operationalize too early, and instead, to build a disciplined, trusted network that deeply understands the problem of care transitions and is genuinely ready to test solutions. If real estate is all about location, location, location, building a network is all about listening, listening, listening. Early on, our partners were looking for quick fixes and when there is a big problem, who is not looking for a solution. The network learned, though, that workforce constraints and system fragmentation make that approach risky. Our biggest win has been aligning hospitals, emergency medical service (EMS) agencies, counties, and state partners around a shared understanding of the problem. This shared understanding allows us to move forward together, rather than all of us pulling in different directions. 

What is a tip you would share with an organization launching a similar network?  
Each partner has different skin in the game, so you have to find where there is common ground. Some of the partners are competitors in the business world, and there is nothing ignoble about being a competitor. But looking for that true commonality can help solve a very complicated problem. There is not a one-size-fits-all solution, which is why listening is so important. It takes honesty to look at what the problem is and not pass the buck or blame EMS or a hospital. We understand there are constraints at every level of providers. Listening honesty has been helpful to bring us together to not just solve a problem, but to resolve this problem. 

How do you see participation in the Federal Office of Rural Health Policy’s Office’s Network Development Program impacting your broader health improvement efforts? 
Indiana allocated $56.2 million from its Rural Health Transformation funds for mobile operational coordination for interfacility transfer. Our network, InTOC, hopes to serve as a pilot for that regionally. Our participating regional hospitals could learn from this pilot what works or does not work just as monies are coming down the pike. So, this grant has been a great gift for the state because it already has a program that is learning so much underway. This grant is not providing money to find out what the problem is, but to start creating the scaffolding for a sustainable and scalable solution.  

Do you have an example or story that illustrates the value of planning for a rural health network instead of a single organization at the helm? 
It became clear very early on that no single hospital or EMS agency could solve the transfer delays alone. A hospital may identify a need. EMS faces workforce shortages. Counties control governance and the state controls coordination tools. Planning as a network allows us to see those interdependencies more clearly. Solutions that would have helped one partner might have harmed other partners. Having those multiple perspectives at one table is what is protecting everyone in the network as we learn. It helps to make sure that one isn’t benefiting, while others are harmed in the process. That is what you get when you have a network. It is a more weighted response, and it really reduces the risk. 

What’s next on the horizon for your grant-funded program? 

This is an exciting point for InTOC because we are at that juncture where our scaffolding is about to mature to help build something for our state. Because of HRSA’s support, we are positioned in the right place at the right time. Additionally, more partners are becoming interested in the program. Our original partners received some of the monetary value of this grant, but now, other partners want to join just to learn more about it. To me, that shows the value of the network when you can get an administrator’s time when they are not receiving anything, except information. That is a real compliment to the network.