2004 - 2005 Grantee Directory - Montana

Northcentral Montana Healthcare Alliance
Jack W. King
1126 26th St. So.
Great Falls, MT 59405
Ph: 406-455-4285 Fax: 406-455-4154
http://www.benefis.org
Email: kingjacw@benefis.org

Network Partners: The Northcentral Montana Healthcare Alliance (NMHA) and Realizing Education And Community Health (REACH) Telehealth Network consists of Benefis Healthcare (hub) and sites in Havre, White Sulphur Springs, Chester, Chinook, Chouteau, Ft. Benton, Big Sandy, Conrad, Cut Bank, and Shelby. Benefis Healthcare Foundation is an additional partner and the project hopes to partner with the University of Montana School of Pharmacy.

Project Purpose: To expand and enhance the connectivity and clinical capabilities of the existing REACH network. To improve access and reduce costs overall of providing medical specialty and mental health services to rural residents. To positively impact the financial, psychological, emotional, and spiritual well being of rural communities by improving retention of health care services and revenues. Outcomes Expected: Attain financial, strategic, and operational synergies (measure) - Financial data, retention and turnover rates, budget comparisons (tool). Expand clinical and Education Capabilities of Network (measure) - REACH Participant Satisfaction Survey (tool). Reduce costs of providing specialty and mental health services (measure) - Archival data comparison (tool). Positively impact well-being of communities (measure) - Comparative data for financial, participant satisfaction surveys for psychological, emotional, and spiritual (tool).

Service Area: Ten sites in nine counties, two rural and eight frontier, including seven MUA's, and serving eight full or partial HPSA's, 10 Mental Health HPSA's, and seven Dental Health HPSA's. Population in nine counties of 143,000, less than 2 people per square mile.

Services Provided: Services currently provided include CME for credit, professional development (non-credit), mental health consults, educational programming, and the clinical service of teleradiology (limited). Intend to expand teleradiology and include telepharmacy and other clinical services, such as pediatrics, orthopedics, and dermatology.

Equipment: Nine of the ten REACH sites use PictureTel Concord 4500 videoconferencing units. The tenth uses a Polycom Viewstation V.35 unit. All sites us Sony video monitors.

Transmission: The REACH network uses dedicated Full T1 lines connected to a Lucent MCU Bridge. The network currently uses a robbed-bit, switched video conferencing network at a speed of 336kbps. MONTANA Eastern Montana Telemedicine Network Deaconess Billings Clinic Foundation.

Project Purpose: To improve access to specialty medical and mental health services in rural and frontier communities of Montana and Wyoming. To decrease the overall cost of accessing specialty healthcare services by rural residents of Montana and Wyoming.

Outcomes Expected: Increased numbers and variety of telemedicine services provided to partner sites. Significant out of pocket savings for patient receiving services via telehealth. Improved access to specialty care. Data will be collect using EMTN developed data base. Service Area: 16 counties in eastern and central Montana and northern Wyoming serving 8 HPSA's/MUA's. Area served covers over 27,000 square miles and on an average has population density of 5 People per square mile.

Services Provided: Operational since 1994, EMTN provides the following services: Mental Health, Cardiology, CV surgery follow up, Shriners orthopedics, ENT, Diabetes, Nephrology Case Management, Emergency Medicine, consultation upon request, planned to be implemented in the early 04, teleoncology.

Equipment:12 VTEL and 10 PolyCom videoconferencing units, one VTEL MCU videoconferencing Bridge and Adtran CSU.

Transmission: Dedicated T1's running video at 384 kbps.

Deaconess Billings Clinic Center on Aging
Patricia J. Coon, MD
PO Box 37000
Billings, MT 59107-7000
Ph: 406-238-2287 Fax: 406-238-5193
http://www.billingsclinic.com
Email: pcoon@billingsclinic.org

Network Partners: Rural and critical access hospitals, tertiary care center, rural health clinics.

Project Purpose: Deaconess Billings Clinic (DBC) Northwest Area Center for Studies on Aging is conducting a study to: 1) determine systems irregularities at Deaconess Hospital that lead to increased medication administration errors among Medicare beneficiaries during their hospitalization and upon discharge home; and 2) determine the effect of a computerized inpatient pharmacy system at Deaconess Hospital on these errors.

Outcomes Expected: The primary focus will be factors that increase risk for medication errors particularly in the elderly, since they may be at greatest risk for adverse drug events. The hypothesis is that elderly patients are at greatest risk for medication errors during times of transmission through the health system, that is, when admitted or discharged from a health institution. In addition, medication errors that occur at these points are, in part, due to irregularities in hospital process that can be modified using a computerized pharmacy system.

Service Area: Serving 11 counties in eastern and central Montana.

Services Provided: Chronic disease management, medication errors research.

Equipment:Utilizes Eastern Montana Telemedicine Network's videoconferencing using V-Tel TC 1000, Polycom View Station and VICON Vigo.

Transmission: Dedicated T1 running at 384kbps for videoconferencing, PRI ISDN for off-network videoconferencing, DSL for desktop videoconferencing.

Rocky Mountain Technology Foundation (RMTF)
Luke Kobold
1045 N 30th
Street Billings, MT 59102
Ph: 406-255-8478 Fax: 406-247-6492
http://www.rmtf.org
Email: lkobold@billingsclinic.org

Network Partners: Deaconess Billings Clinic, Daniels Memorial Hospital (Scobey, Montana), Livingston HealthCare (Livingston, Montana), Rosebud Healthcare Center (Forsyth, Montana), Beartooth Hospital and Health Center (Red Lodge, Montana), Sheridan Memorial Hospital (Plentywood, Montana), Rocky Mountain College, Fort Peck Community College, Big Horn Community College, and Chief Dull Knife Community College.

Project Purpose: Offer business solutions and telehealth alternatives to rural clinics and hospitals in order to improve patient care. Also, efforts are underway to expand distance learning opportunities for Montanans based in rural settings and tribal communities across the state. This project includes technological upgrades to five rural hospitals to improve clinical efficiency and allow those clinics an opportunity to participate in telehealth programs with Deaconess Billings Clinic. Additional benefits include offering online CME/CEU certification programs and baccalaureate degrees from Rocky Mountain College for students enrolled in the two year Tribal College institutions.

Outcomes Expected: Deaconess Billings Clinic affiliate hospitals gained Accounts Receivable efficiency measure of 15% - 20% on average. Rocky Mountain College has realized a 25% increase in Native American Students enrollment to date and an approximate overall student enrollment increase of 15% for the Fall Semester of 2003.

Service Area: Rural hospitals and clinics in six Eastern Montana counties and three Tribal Colleges in Eastern Montana.

Services Provided: Business Information system upgrades for rural clinics and the development and implementation of online course material.

Equipment:WebCT for online learning modules, teleconferencing via VisionNet.

Transmission: T1 Lines.

Rocky Mountain Technology Foundation (RMTF)
Luke Kobold
1045 N 30th Street
Billings, MT 59102
Ph: 406-255-8478 Fax: 406-247-6492
http://www.rmtf.org
Email: lkobold@billingsclinic.org

Network Partners: Deaconess Billings Clinic, Beartooth Hospital and Healthcare (Red Lodge, MT), Stillwater Community Hospital (Columbus, MT), and North Bighorn Hospital (Lovell, WY).

Project Purpose: RMTF will address the critical issue of medication errors in rural hospitals and clinics by funding a state-of-the-art telepharmacy project, helping to provide pharmaceutical care through the use of telecommunication and information technologies to patients and care providers in remote areas. Deaconess Billings Clinic, through funding from RMTF, will assist in the implementation of decentralized and clinical pharmacy concepts, providing a host of services and support to rural clinics and hospitals.

Outcomes Expected: Objective 1: Implementation of an integrated Clinical Information System will significantly decrease medication errors and Adverse Drug Events (ADEs) in the acute hospital setting. Objective 2: Implementation of an integrated Clinical Information System will significantly decrease medication errors and ADEs during times of care transition, i.e. admission to and discharge from an acute hospital setting. Objective 3: Implementation of an integrated Clinical Information System will significantly decrease medication errors that occur in local community pharmacies. (We could do this by working with a few local pharmacies that track the number of calls for clarification or random questionnaires to high risk patients).

Service Area: Three counties in Eastern Montana and one site in Northern Wyoming.

Services Provided: Implementation of a computerized Pharmacy system that supports Pharmacy operation and patient safety initiatives through the use of alerts for drug/allergy, drug/drug, drug/laboratory and dose range checking. Equipment:Cerner PharmNet Software.

Transmission: Dedicated T1 Lines.

St. Vincent Healthcare Foundation
Doris T. Barta
1106 North 30th Street
Billings, MT 59101
Ph: 406-237-3602 Fax: 406-237-3619
http://www.svhhc.org
Email: doris.barta@svh-mt.org

Network Partners: The Mansfield Health Education Center (MHEC) was developed through Congressionally mandated funds; a state of the art - high tech conference center available for telehealth or educational telecommunications use statewide, nationally and internationally.

Project Purpose: To provide the cornerstone for health education and conferencing programs regionally, possibly expanding to national and international health education programs. Equipped with the most current technological services, the MHEC deploys video telecommunications to extended community areas, providing access to high speed internet services, store and forward technology, satellite education and two way videoconferencing. The Health Sciences Library in the MHEC provides access to health information via the internet, publications, periodicals, and videotapes.

Outcomes Expected: Outcomes include increased educational programs improving public information about health topics and increased educational opportunities. Health Library consumers have access to a library that is centrally located in the medical corridor. Increased space in the Library provides better services to consumers. The new Library space provides a private area for family consultation, as well as educational access to HIPPA compliant computer terminals and training materials. Evaluation consists of Customer Service Surveys requested of all constituents who use the center. Service Area: 28 counties in south, central, eastern and central Montana; 2 counties in Wyoming. All or part of the 28 counties served by PHTN (including rural areas of Yellowstone County - HUB location) are designated as HPSAs, MUA's Mental Health shortage areas and Dental Shortage Areas, with the exception of Fergus County (Lewistown).

Services Provided: Orthopedics, mental health, dermatology, radiology, pediatrics, Perinatology, congestive heart failure, administrative and education services. The PHTN network began operations in 1998. A secondary HUB is St. James Healthcare, a wireless network in Southwest Montana.

Equipment:PolyCom Video Codec's from IP based Via Video to FX and Custom VS4000 room systems, V-Tel custom and room systems, VCONN Executive IP systems, Accord Polycom MGC 100 MCU that performs audio, ISDN and IP video bridging and data collaboration services, Panasonic 3 CCD Cameras, AMD General Exam cameras, Olympus video microscope, Vidar digital Imagers and various other traditional computer based peripherals.

Transmission: Standardized telemedicine delivery at a minimum of 12 channels, @ 64 Kpbs over leased T1 lines, microwave wireless, cellular and IP based transmission services. Segmentation of circuits for voice/video or data provided for more cost effective utilization of leased circuits and is used as appropriate. MONTANA Partners in Health Telemedicine Network (PHTN) St. Vincent Healthcare Foundation.

Doris T. Barta
1106 North 30th Street
Billings, MT 59101
Ph: 406-237-3602 Fax: 406-237-3619
http://www.svhhc.org
Email: doris.barta@svh-mt.org

Network Partners: (4) Frontier/rural hospitals in Montana: Lewistown, Butte, Miles City, Harlowton; (1) in Cody Wyoming. (6) Rural Clinics in Montana: Absarokee, Ashland, Bridger, Hardin, Stanford, Lewistown (Mental Health Clinic); (5) Physician offices in Billings - Montana Orthopedics, Orthopedic Surgeons, Mental Health Center, Yellowstone Dermatology and the Fetal Diagnostic Center; (1) Montana Hospital Association in Helena, MT.

Project Purpose: To develop telemedicine links between Billings based physicians and frontier/rural hospitals and clinics to improve access to specialist health care services for their rural healthcare facility, providing a cost-effective alternative to travel for both the patients and the healthcare providers, in addition to improving timely intervention when health care issues arise. The network is also used to provide surgical follow-up and case management reviews, continuing medical and laboratory education, community health education, business and administrative meetings.

Outcomes Expected: Evaluation focuses on determining if telemedicine applications are medically effective means of delivering health care. PHTN partners measure whether the costs involved in telemedicine applications are cost effective means of provision of care. The telemedicine technology has been evaluated to determine what process is associated with optimal health outcomes, and to the extent possible, appropriate use. Tools used include OAT GPRA Performance Measures, Patient and Provider satisfaction surveys, internal calculations of costs saved through travel savings. Service Area: 28 counties in south, central, eastern and central Montana; 2 counties in Wyoming. All or part of the 28 counties served by PHTN are designated as HPSAs, MUA's Mental Health shortage areas and Dental Shortage Areas, with the exception of Fergus County (Lewistown).

Services Provided: Orthopedics, mental health, dermatology, radiology, pediatrics, Perinatology, congestive heart failure, administrative meetings and education services. PHTN began operations in 1998. A secondary HUB is St. James Healthcare that operates a wireless network in Southwest Montana.

Equipment:PolyCom Video Codec's from IP based Via Video to FX and Custom VS4000 room systems, V-Tel custom and room systems, VCONN Executive IP systems, Accord Polycom MGC 100 MCU that performs audio, ISDN and IP video bridging and data collaboration services, Panasonic 3 CCD Cameras, AMD General Exam cameras, Olympus video microscope, Vidar digital Imagers and various other traditional computer based peripherals.

Transmission: Standardized telemedicine delivery at 12 channels, @ 64 Kpbs over leased T1 lines, microwave wireless, cellular and IP based transmission services. Segmentation of circuits for voice/video or data provided for more cost effective utilization of leased circuits and is used as appropriate. MONTANA ImProving Health Among Rural Montanans (IPHARM) The University of Montana - Missoula.

School of Pharmacy and Allied Health Sciences

Donna Beall, Pharm.D.
32 Campus Drive
Missoula, MT 59812-1522
Ph: 406-243-6710 Fax: 406-243-4353
http://www.spahs.umt.edu/IPHARM/
http://www.spahs.umt.edu/DIS/index.htm
Email: donna.beall@umontana.edu

Network Partners: NA

Project Purpose: For the pharmacy program at The University of Montana-Missoula (UM) to expand the capabilities of its existing campus-based Drug Information Service (DIS) and place an ambulatory care clinical pharmacy specialist in the seven rural and frontier counties of the Golden Triangle/Highline areas of north central Montana. The pharmacist conducts ultrasound tests for heel bone density, fingerstick blood tests for hemoglobin A1C and serum lipids, and spirometry for respiratory function.

Outcomes Expected: Increase the number of practitioner calls to the DIS by 10%, and increase the number of DIS newsletters mailed monthly to 1,000. Screen at least 250 rural residents for low bone density, diabetes, hyperlidipemia and respiratory dysfunction, provide one professional continuing education program to rural practitioners, participate in six rural community health fairs. In the first 9 months of the project, more than 1,600 screening tests have been conducted for more than 1,000 patients.

Service Area: For the DIS, the entire state of Montana. For the disease screening services, the seven-county Golden Triangle in north central Montana. This latter area has expanded, and eight additional counties (3 frontier, 3 rural, 2 non-rural) have also had IPHARM screening and educational programs conducted.

Services Provided: The DIS answers drug information questions and provides a monthly newsletter for Montana healthcare providers. The disease screening program tests bone density, hemoglobin A1C, lipid levels and respiratory function. Adult immunizations are planned.

Equipment:DIS uses an electronic database, web-based subscriptions, and a new website. Disease screening uses an ultrasound heel bone densitometer, Cholestech LDX for lipids, GDX for HbA1C, and an EasyONE spirometer. Wireless Internet uses a MotoSAT DataStorm.

Transmission: DIS utilizes a toll-free telephone landline. The screening clinic utilizes a MotoSAT Datastorm for wireless Internet communications.