Progress Health 2018

GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018 •

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Special to the Great Bend Tribune Sunday, February 4, 2018

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• GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018

Barton County faces the opioid crisis

BY SUSAN THACKER sthacker@gbtribune.com

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pioids are powerful painkillers but they are also addictive, which is why there is growing concern about overuse and abuse. Last October, President Donald Trump directed the Department of Health and Human Services to declare the opioid crisis a public health emergency.

The word “opioid” comes from the narcotic opium. The name includes other drugs with similar properties: morphine, heroin and prescription painkillers like OxyContin, Percocet and Vicodin. The synthetic painkiller fentanyl, which is used for anesthesia, is many times more potent than morphine or heroin, according to the Centers for Disease Control and Prevention.

The New York Times reports the first governmental account of nationwide drug deaths shows roughly 64,000 people died from drug overdoses in 2016. “Drug overdoses are now the leading cause of death among Americans under 50.”

Who is abusing opioids?

According to the National Center for Health Statistics, Centers for Disease Control, 2015 drug overdose deaths per 100,000 people in Kansas were highest is Osborne County, and not unknown to central Kansas: • 17 deaths per 100,000 reported in Osborne County • 15 in Sedgwick, Reno, Osage and Shawnee counties • 9 in Ellsworth, Rice and Russell counties • 8 in Pawnee and Barton counties • 7 in Rush County • 6 in Stafford County Health-care officials as well as law-enforcement officials in Barton County say they have seen an increase in opioid abuse.

“I don’t believe there is any doubt opioid use has increased our criminal caseload,” Barton County Attorney Amy Mellor said recently.

See OPIOIDS, 3

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OPIOIDS, from page 2 Sheriff Brian Bellendir said methamphetamine, which is not an opioid, is still the most serious controlled substance problem for Kansas officers, but there is an opioid problem. “I was recently at the Kansas Sheriffs Association convention in Topeka and most Kansas sheriffs report this to be the case,� he said. “I must emphasize that the most dangerous element of the opioid crisis is not prescription medications. It is the illicit use of heroin and fentanyl, an extremely potent synthetic opioid. “Fentanyl is used to cut heroin as well as methamphetamine,� he said. “The overdose cases that we have seen here in Barton County are from fentanyl. While prescription pain medication is an issue, it is not causing the grief that heroin and fentanyl are. Many addictions start with prescription pain drugs, but when these become no longer available the addict will move to heroin or fentanyl.�

Bellendir said drug abuse is not limited to one age or socioeconomic group. “We have people arrested on a regular basis ranging from their teens all the way into their 60s,� he said. “We face the exact same issues with opioids that we do with any other controlled substance,� Bellendir said. “As long as there is demand for it, there will always be a market. From a law enforcement perspective, we believe enforcement and curtailing the flow of the drug is our most effective tool. We work with our partners in the public health sector and I do believe education is an important part of the eradication of opioids, but the bottom line is we deal with it on the street and our only tool is criminal charges,� Bellendir said. “Many opioid addicts go undetected because it started as a legitimate prescription from your doctor and has progressed to illicit use for nonmedical reasons,� he said.

Amy Boxberger at Central Kansas Community Corrections said people on parole were tested for opioids often in 2017, but there were relatively few positives. “Oxycodone was tested for 1,604 times and there were 76 positives,� she said. Some of those positive results were not actually violations of probation, because they may have included valid prescriptions. “It is more interesting when we are conducting risk assessments to discuss the history of use with our participants,� she said. “‘Pills’ are many times categorized as drugs that have been tried or ingested to get high. I would say that most addicts who are assessed by our agency admit to having tried ‘pills.’ They may deny that it is a drug of choice, but in my experience, addiction can cross over to drugs other than what is their first choice. I’ve seen relapse on their drug of choice after a prescription for an opioid, even for legitimate prescriptions,� she said.

Other threats Marissa Woodmansee, director of Juvenile Services, said benzodiazephienes (tranquilizers) such as Xanax are posing the greatest problem among juvenile offenders here. “We do have youth testing positive to prescriptions not prescribed to them, but this is not something we have tracked,�

Woodmansee said. “The trend we have seen and heard from our juvenile population is the consumption of the Xanax bars.� That is a slang term for the highest dosage of Xanax pill. “Kids will take a couple pills and chill at someone’s house. They are possibly mixing with alcohol and other drugs,� she said. “It’s bizarre; the kids state it is easy to get Xanax.�

What can be done Barton County Health Department Director Shelly Schneider agrees there is an opioid problem in Barton County. “But it is more ‘hidden’ than the usual drug addictions that we are used to seeing,� she said. Abusers include “drug seekers, teenagers who are purchasing these illegally and then re-selling them, and chronic pain sufferers,� she said. “We are researching grant opportunities to see if it would be a possibility to collaborate with our local agencies to gain awareness and develop an action plan to start identifying and remediating these situations,� Schneider said. “Last year, I attended the Opioid Conference, sponsored by DCCCA. I was shocked to learn that prescription drug overdose deaths have quadrupled among (Kansans 12-25 year old) over the past 12 years,� she said. She also learned that, according to the 2005-2016 Kansas Vital statistics, Bureau of Epidemiology and Public Health Informatics, pharmaceutical opioids lead the drug poisoning deaths over benzodiazepines and methamphetamine/amphetamines in the age categories 15-34 and 35-54 years old.

K-TRACS A more holistic approach to pain treatment would lessen the need for opioids.

In 2017, Kansas received a $178,000 federal grant for it prescription drug monitoring programs. According to kcur.org, the Kansas Board of Pharmacy oversee K-TRACS, a system for monitoring prescriptions for controlled substances. Board Executive Secretary Alexandra Blasi said doctors, dentists and pharmacists who participate in the program report their prescription activity to the state to verify a patient’s history. “The goal of the program is really to prevent misuse, abuse and diversion of controlled substances while still encouraging and maintaining legitimate medical use in the communities,� Blasi said.

TRIBUNE FILE PHOTO

In this October 2017 file photo, the Barton County Sheriff’s Office and the Barton County Health Department together manned the drug take-back booth at the southeast corner of the courthouse square.

Drug take-back day Twice a year the U.S. Drug Enforcement Agency gives local law enforcement the authority to handle and receive controlled substances on the schedule of dangerous drugs.

The Barton County Health Department assists the Barton County Sheriff ’s Office in collecting these items. “The BCSO takes the lead in this effort and the BCHD collaborates on the planning (and execution) of the event,� Barton County Health Department Director Shelly Schneider said. “We have done this for at least the past two years, and plan to continue the drug take-back days in the future,� Sheriff Brian Bellendir said. “In 2017 we did two drugtake back days. Both of those were extremely successful. Both events recovered in excess of 150 pounds of controlled substances to be returned to law enforcement for destruction.�

At the events, people drop off items such as unused medication. Officers from the BCSO take possession of the items, which are sealed and shipped to a DEA facility where they are incinerated.

A variety of drugs have been recovered, including fentanyl patches, morphine and other prescription opioid medication, Bellendir said. “I consider these events to be very successful and intend to continue them with the health department.�

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• GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018

BCC Nursing graduate driven to impact lives

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arbie Deschner, a Barton Community College Nursing graduate of the class of 2009, embodies what it means to celebrate today and own tomorrow.

Deschner was born and raised in Great Bend where she was inspired by her father’s career as a paramedic to enter the nursing field.

“Seeing people come up to my dad saying, ‘thank you’ for saving their life or being there for them drove what I wanted to do,” she said.

“You could go to work all day and not feel like you make a difference because it is just your job, but with nursing, you go to work every day and you get to impact people’s lives.”

Upon her graduation from Barton, she started working in pediatrics in Great Bend before moving to Wichita and working at Via Christi St. Francis, then pursued a career as a travel nurse.

“After two years at Via Christi, I was itching to learn more,” Deschner said. “I ended up talking to a travel agency and within two weeks had my first assignment in Washington state.

Two weeks later I moved across the country.”

She described the experience as both liberating and challenging. As a traveling nurse, Deschner did not know all the new hospital protocols and policies. She was left on her own and was expected to start working with only her knowledge from school to fall back on.

During this time, she learned to trust herself, capitalize on her skills and acquire knowledge from her coworkers.

“I feel like those experiences made me a better nurse,” she said.

A career change After her experience as a traveling nurse, Deschner signed on with Stanford University Hospital as full-time staff. She started in the medical surgery telemetry unit and hospice care. Two years ago, she became a Crisis Response Nurse, who responds to all crisis and trauma situations. If a patient is not doing very well, she assesses and applies different medical lines such as feeding tubes, which floor nurses cannot.

“It is pretty intense but it is really awesome,” she said.

Working in a hospital, Deschner realized the need to live each day to its fullest.

“I feel like every day you wake up is a beautiful day, and you should be so thankful for your life. In our profession, we see a lot of people who don’t have tomorrow,” she said. “I think you should take in every ounce of beauty around you and be fortunate for it, and that will make you a better and more motivated

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Barton Career Fair Career Technical Education Month at Barton Community College will culminate with a Career Technical Education Fair open to the public from noon to 2:30 p.m. on Feb. 28 in the Case New Holland Shop in the northeast side of the Technical Building on the BCC campus.

Registration opens at noon. The fair will feature demonstrations, hands-on-activities, refreshments, prizes and photo ops with the Barton mascot.

To sign up, contact Denise Schreiber at 620-792-9324 or schreiberd@bartonccc. edu.

Students in eighth grade through seniors in high school are invited to attend a keynote address and tours beginning at 9:30 a.m. in the auditorium lobby in the Fine Arts Building.

person for tomorrow.”

Deschner said she feels Barton prepared her well for the rigors of her profession.

“Having worked directly with new grads from other nursing schools as a seasoned nurse, I remember feeling like I was way more prepared to go into the nursing world than some people are,” she said. “I had a good foundation on which to learn and further my practice; at Barton, everything was hands-on and I am grateful for that.”

Deschner said her Barton experience was top notch, thanks to the well-educated staff and the valuable clinical and hands-on experiences.

“Deciding on where to go to school is hard, but if nursing is something you want to do, Barton is a great place to start. I never figured I would leave nursing school to work in pediatrics, then move to a bigger city, then across the country, then travel and live my life in such a fulfilling way,” she said. “I was then able to go back to school and get my bachelor’s degree and now I am in grad school working on my nurse practitioner degree. It all started here (Barton Community College) and I have Barton to thank. I have my dream job and I am part of a team where I can help someone in dire need.”

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Crisis Response Nurse Barbie Deschner, a graduate of Barton’s nursing program, poses for a photo on Barton’s campus.

CTE Month 2018 This feature is the first of four stories to be released by Barton Community College in February in celebration of Career Technical Education (CTE) Month.

CTE Month® is an annual celebration of CTE community members’ achievements and accomplishments nationwide. CTE Month 2018, with its tagline of “Celebrate Today, Own Tomorrow!” gives colleges the chance to inform others of the innovation and excellence that exists within our local CTE programs and raise awareness of the crucial role that CTE plays in readying our students for careers and our nation for economic success.

GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018 •

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Help for Barton County Veterans VA providing services for returning veterans • • • • •

BY RUSSELL EDEM

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eterans Affairs welcomes home war veterans with honor by providing quality readjustment service in a caring manner, assisting veterans and their family members toward a successful postwar adjustment in or near their communities.

“It is very important that these veterans that are coming back from war receives the proper care and training they need,” Readjustment Counseling Services Representative John Henshall said.

The Wichita Vet Center will provide clinical and outreach service to veterans at the Great Bend National Guard Armory, 9571 B 29 Hwy Great Bend, Ks. 67530. These services are currently available every other Thursday of the month from 10:30 am to 3 p.m. This is an effort to assist local Veterans and their families with Vet Center Services.

“Vet Centers offers unique services such as individual readjustment counseling, group readjustment counseling, and marital and family counseling,” Henshall said. “The Vet Center can offer a wide range of group counseling services to include: PTSD Veteran Groups, PTSD Aftercare Groups, PTSD Psycho-Education Groups, Marriage Enrichment Groups, and Coping Skills Groups.”

According to Henshall, the Vet Center is also open to new group development based on the needs of the veterans and the community.

“This includes direct client services, community education, consultation, conjoint treatment in concert with VA medical centers and outpatient clinics, the provision of guidance regarding obtaining needed services, networking and referrals, and training of VA counselors and mental health professionals within the Vet Center staff.

Currently,” Henshall said. “There are 300 Vet Centers nationwide providing the services that our veterans need.”

Counseling Services are free of charge to any Veteran and active duty service member, to include members of the National Guard and Reserve components who: • Have served on active military duty

Global War on Terrorism Operation Enduring Freedom Operation Freedom Sentinel Operation Iraqi Freedom Operation New Dawn PTSD and symptoms

in any combat theater or area of hostility.

• Provided direct emergent medical care or mortuary services, while on active duty, to casualties of war.

• Served as a member of an unmanned aerial vehicle crew that provided operational support in combat area.

Services also provided to family members of Veterans and service members for military related issues regarding readjustment of those that have served. These include: • Family counseling for military related issues • Bereavement counseling for families who experience an active duty death • Military sexual trauma counseling and referral • Substance abuse assessment and referral To be eligible for these service,

veterans must have Served in a combat theater or area of hostility to include but not limited to: • World War II • Korean War • Vietnam War • Lebanon • Grenada • Desert Storm/Desert Shield • Bosnia • Kosovo • Operations in Yugoslavia area

Posttraumatic stress disorder is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.

According to www.ptsd.va.gov, PTSD can happen to anyone. It is not a sign of weakness. A number of factors can increase the chance that someone will have PTSD, many of which are not under that person’s control.

There are four types of symptoms of PTSD, but they may not be exactly the same for everyone. Each person experiences symptoms in their own way.

• Reliving the event (also called reexperiencing symptoms). You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.

• Avoiding situations that remind you of the event. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.

• Having more negative beliefs and feelings. The way you think about yourself and others may change because of the trauma. You may feel guilt or shame. Or, you may not be interested in activities you used to enjoy. You may feel that the world is dangerous and you can’t trust anyone. You might be numb, or find it hard to feel happy.

• Feeling keyed up (also called hyperarousal). You may be jittery, or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. You might suddenly get angry or irritable, startle easily, or act in unhealthy ways like smoking, using drugs and alcohol, or driving recklessly.

For questions, concerns or if you need additional information, please contact John Henshall at 316-265-0889.

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• GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018

A MUCH NEEDED HAND Sens. Roberts, Heitkamp introduce bill to improve rural healthcare

BY DALE HOGG dhogg@gbtribune.com

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National and state issues have a direct impact on local hospitals, such as Great Bend Regional Hospital.

The Medicare “disproportionate share� funding to Kansas Hospitals, which is designed to provide Medicare’s “pro-rata� share of the “indigent care� cost burden to rural hospitals, is continually being reduced as the primary mechanism by which the federal government intends to pay for the cost of expanding Medicaid enrollment, he explained. “As result, Kansas rural hospitals ‘medicare’ reimbursements are declining yet not being offset by the increased enrollment in the Medicaid population it serves.�

TRIBUNE FILE PHOTO

Health care facilities like Ellinwood District Hospital are important economic drivers in rural communities.

care,� Heitkamp said. “Our bill gives State Offices of Rural Health the support they need to help strengthen our health care system and ensure those who need care the most aren’t left behind.

Every day I come to work in the U.S. Senate fighting for rural America, and this is a bipartisan plan to develop long-term solutions to rural health problems that would impact North Dakotans across our state.�

The National Rural Health Association offered their support for the legislation saying, “State Offices of Rural Health help provide rural communities with critical resources to improve rural health care and expand access to quality, affordable care for individuals in rural communities. This legislation, the State Offices of Rural Health Reauthorization Act of 2017, will allow these crucial offices to continue operating through 2022.� The National Organization of State Offices of Rural Health has also endorsed the legislation.

Members of the Rural Health Caucus have introduced similar legislation in the previous Congresses. The bill was cosponsored by Sens.

Baldwin (D-Wis.), Barrasso (R-Wyo.), Casey (D-Pa.), and Grassley (R-Iowa).

By the numbers Rural health care is a big deal, the Kansas Hospital Association noted. It provided the following statistics: • Approximately 62 mil-

lion people – nearly one in five Americans – live in rural and frontier areas.

Rural Americans reside in 80 percent of the total U.S. land area but only comprise 20 percent of the U.S. population. • There are 4,118 primary care Health Professional Shortage Areas (HPSAs) in rural and frontier areas of all U.S. states and territories compared to 1,960 in metropolitan areas. • The average median income for rural U.S. residents is $40,615 compared to $51,831 for urban residents.

Approximately 15.4 percent of rural U.S. residents live in poverty compared to 11.9 percent of urban residents.

Closer to home in Barton County, there are 2,017.3 residents per doctor. This is higher than the state average of 1,895, but lower than the national average of 2,667.7.

Of the county’s nearly 28,000 residents, 14.4 percent live in poverty, compared to the state average of 12.1 percent. • There is a more holistic, patient-centered approach to health care in rural communities – providers have the opportunity to provide more comprehensive care to their patients.

Despite this opportunity, only nine percent of all physicians and 12 percent of all pharmacists practice in those settings. • There were 55 primary care physicians per 100,000 residents in rural areas in

2005, compared with 72 per 100,000 in urban areas – a figure which decreases to 36 per 100,000 in isolated, small rural areas. • There are only half as many specialists per 100,000 residents in rural areas compared to urban areas.

Rural areas average about 30 dentists per 100,000 residents; urban areas average approximately twice that number.

Only 10 percent of psychologists/psychiatrists and 20 percent of masters-level social workers work in rural areas. • While nearly 85 percent of U.S. residents can reach a Level I or Level II trauma center within an hour, only 24 percent of residents living in rural areas can do so within that time frame – this despite the fact that 60 percent of all trauma deaths in the United States occur in rural areas.

In Kansas, The only state Level I and Level II trauma centers are as follows: Level I -The University of Kansas Health System, Kansas City; Level I - Wesley Medical Center, Wichita; Level I Via Christi Wichita; Level II - Overland Park Medical Center, Overland Park; and Level II - Stormont Vail Medical Center, Topeka. • Approximately 21.9 percent of residents in remote rural counties are uninsured, compared to 17.5 percent in rural counties adjacent to urban counties and 14.3 percent in urban counties.

The uninsured rate in Barton County is 12.8 percent. Statewide, the number is 10.1.

Therefore, rural residents spend more on health care out of pocket than their urban counterparts; on average, rural residents pay or 40 percent of their health care costs out of their own pocket compared with the urban share of one-third.

One in five rural residents spends more than $1,000 out of pocket in a year. • Rural hospitals are sources of innovation and resourcefulness that reach beyond geographical boundaries to deliver quality care. They are also typically the economic foundation of their communities – every dollar spent on rural hospitals generates about $2.20 for the local economy.

Twelve percent of rural hospitals indicate they are not considering HIT investments because of cost concerns compared to 3 percent of urban hospitals.

Critical Access Hospitals care for a higher percentage of Medicare patients than other hospitals because rural populations are typically older than urban populations.

Please call me direct should you have any additional questions. I may reached by calling 573-724-3287.

Kerry Noble Chief Executive Officer Great Bend Regional

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Background The State Offices of Rural Health Reauthorization Act of 2018 introduced

by Roberts “helps provide rural communities with the resources they need to strengthen the rural health delivery system and improve access to quality care for citizens in these areas,� he said.

All 50 states have state offices of rural health (SORHs) that serve an essential role in assisting and providing resources for rural health care providers.

SORHs serve as a clearinghouse of information and innovative approaches to rural health services delivery; coordinate state activities related to rural health in order to avoid duplication of efforts and resources; and identify Federal, State and nongovernmental programs that can provide technical assistance to public/private nonprofit entities serving rural populations.

Collectively, SORHs provided technical assistance to 22,349 clients, totaling 71,868 transactions. “Our rural communities face unique needs and often immense hurdles in regards to continuing to provide top-notch care,� said Roberts. “The State Offices of Rural Health Reauthorization Act recognizes that rural health care providers have very different needs than their urban counterparts.� “Rural communities like North Dakota’s face unique challenges in accessing quality, affordable health

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n January, U.S. Sens.

Pat Roberts (R-Kan.), chairman of the Senate Rural Health Caucus, and Heidi Heitkamp (D-N.D.) introduced bipartisan legislation to reauthorize the State Offices of Rural Health grant program, which will help equip rural communities with the resources they need to strengthen rural health care delivery systems and improve access to high quality services for individuals living in rural and underserved areas.

This was welcome news for local healthcare providers. “Rural hospitals are not only the safety net that keeps its citizens from slipping through very large cracks in the healthcare system,� said Kile Magner, Ellinwood District Hospital chief executive officer. “They often find themselves in the position of primary employer for their communities. This places them in a very precarious position.�

These facilities must be all things healthcare for their populous while staying afloat with an ever shrinking reimbursement pool for those services provided, he said. “This and many other reasons make rural healthcare more of a calling and less of a career.�

In the United States, healthcare accounted for $3.2 trillion in spending (about $9,900 per person) and 17.8 percent of GDP. A local hospital was once a way to merely lure new employers, but that role has expanded as the facilities themselves have become major job providers.

The United States relies on a two-track system to pay for medical care: private and employer-subsidized health insurance, and federal and state health-insurance programs like Medicaid (the federal health-insurance program for low-income people) and Medicare (which covers Americans over 65).

(Military veterans have the additional option of the Veterans Health Administration system.) As of 2015, Medicaid and Medicare accounted for 40 percent of personal health-care purchases, private insurance 35 percent.

There are also threats imposed by the recently passed tax overhaul bill and efforts to repeals and/or replace the Affordable Care Act. “This is a very vital resource to assist rural hospitals throughout the State of Kansas,� said Kerry Nobel, chief executive officer with Great Bend Regional Hospital of the State Rural Health Grant Program. Unfortunately, as a “physician-owned for profit� hospital, GBRH is ineligible to participate in such grant programs.

But, “overall, the continuance of this program should be of vital importance to the eligible rural hospitals across the state.�

Still, national and state issues, such issues as the upheaval over Obamacare and efforts to repeal/replace it and the inaction of the Kansas lawmakers on Medicaid hit home in rural communities, Nobel said. “In general, the inability of our U.S. Congress to repeal/ replace Obamacare is very beneficial to rural hospitals across the country. However, due to the failure of the Kansas State Legislature to expand Medicaid as provided via the Affordable Health Care Act, rural hospitals throughout Kansas have not benefited from the shift of status for the ‘uninsured’ population to one of insured coverage under the Kansas State Medicaid Program.�

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GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018 •

7

Some gains, some losses in 2017 Barton County health rankings

BY VERONICA COONS vcoons@gbtribune.com

B

arton County experienced a big jump in the ranking for Length of Life, from 77 in 2016 to 35. According to Barton County Health Department Administrator Shelly Schneider, based off the average lifespan of 75, the difference between that age and a person’s actual age at the time of death is considered a year of life lost. That loss of life isn’t’ just a number, Schneider said. It’s a loss of what that person could have done in their life, and what we as a community will now miss out on.

Even with a significant jump, we can’t get too excited, she warned. The county has trended toward a steady decline in ranking in this area since 2011, after all. It’s unclear if this will become a new trend, or only a fluke.

Bright spot is fewer low birth weight babies The Quality of Life ranking for the county is lower this year, dropping from 71 to 76. The number of residents that have poor or fair health, experienced poor physical health or poor mental health days compared to elsewhere in the state was a little higher. But, the ranking also includes the number of babies born with low birth weight, and there Barton County is on par with the rest of the country and better than the state average.

This is the second year in a row that Barton has bested the state average, “It’s an area we’ve been working on for a long time now,” Schneider said.

She credits programs her department has in place that are state funded pregnancy maintenance initiatives that are resulting in these improved pregnancy outcomes.

There has been steady

TRIBUNE FILE PHOTO

In this picture, a doctor is checking a mammography machine scan with a female patient.

improvement there since in 2011, the county ranked significantly higher than the state average.

Obesity and alcohol deaths up, but also activity picking up Barton County also took a dip in its Health Factors ranking, dropping from 75 last year to 80. Health Behaviors took the same five-point dip, from 81 to 86.

“Barton County is a little fatter than average,” Schneider said. Adult smoking and adult obesity stayed steady, as it did with Kansas and the country as a whole.

But, residents of the county did become more

physically active in 2017.

That makes sense, with new playgrounds, signage like sharrows and bike path indicators, in Great Bend, a new walking path around Clara Barton Hospital in Hoisington, and the opening of splash pads in Ellinwood and Great Bend in the last two years. These additions are also behind a positive change in access to exercise opportunities ranking in the county.

“We like booze,” Schneider said. “Driving deaths from alcohol impairment unfortunately went up in the last year.”

Barton County’s percentage of driving deaths resulting from alcohol increased from

16 percent in 2016 to 21 percent in 2017. This, in a year where percentages decreased throughout the rest of the country and the state.

Clinical care improving, but fewer accessing mammograms While the county’s Clinical Care rating decreased this year, all subfactors saw increases.

This indicates many

counties in the state are working to improve in this area too. There were fewer people without insurance, and more primary care physicians, dentists and mental health providers available, so access to care improved. There were also fewer preventable hospital stays, and improvements in diabetes monitoring screening too.

The percentage of women ages 67-69 that receive

mammography screenings was down from 68 percent in 2016 to 65% last year. In response, Schneider said, the Health Department has a program to help lowor no-income women to access mammograms.

They need to come to the health department where we will check their eligibility and enroll them,” Schneider said. “In many ways, we are resource investigators.”

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• GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018

Health Department looks to ‘unique relationships’ to address poverty Poor Social and Economic ranking at heart of county’s 2017 health rankings

BY VERONICA COONS vcoons@gbtribune.com

B

arton County Health Outcomes may be up, but don’t let that fool you into thinking it’s okay to engage cruise control.

While the overall Health Outcomes ranking for Barton County in 2017 went up significantly, the county dipped in almost every other ranking. As the county’s top public health official, Barton County Health Department Administrator Shelly Schneider has been hard at work pinpointing how the county can foster the changes needed to turn this around.

Probably the biggest area of concern, and the one Schneider is focusing hardest on is Social and Economic Factors, which dropped from a ranking of 75 to 84 over the past year. “Two positive actions we’re taking to turn this around are the introduction of Trauma Informed Care and the Circles program,� she said.

In recent years, public health practitioners have focused attention on a new health prediction tool, the Adverse Childhood Experience survey. Adverse experiences include direct abuse or abuse of a family member witnessed including physical, mental, or sexual abuse, neglect, availability of food, exposure to drugs and alcohol, and depression.

The survey consists of 10 “yes or no� questions about

The Barton County Health Department offers a number of services.

events from a person’s childhood. For every yes, the ACE score increases.

The higher the ACE score, the more likely that person will experience poor health outcomes in life unless an equal amount of positive early childhood experiences that can build resiliency occur.

Schneider and Community Corrections Director Amy Boxberger have been working closely with other groups in the county, including school districts, early childhood education programs, juvenile services and pediatric offices spreading awareness so they can collaborate on ways to

build resilience in the county.

Finding the answers is going to require community collaboration.

What’s behind the number of single-parent households, for example.

Is it because parents simply aren’t married, or are they divorced, widowed, incarcerated, or has one parent moved out of the area for employment? Finding the answers is what traumainformed care is about, Schneider said.

Ultimately, poverty is at the heart of the county’s health problems, Schneider said, and at the center of much of

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the trauma experienced by the very young. It is apparent when looking at the breakdown of the Social and Economic Factors ranking. Last year, the unemployment rate went up in this county.

There are more children living in poverty here than on average around the state, and more children in single-parent households. And while the number of violent crime incidents went down, they were more than average compared to the rest of the state. For Schneider, the number one question this raises is simply, “Why?�

February will mark

The program is designed to foster relationships between people seeking to break out of the cycle of poverty with people who can support them in various ways in that journey. On Jan. 25, the first Circles graduates were recognized in a ceremony at First United Methodist Church, and on Saturday, Jan. 27, community members went through training prior to the beginning of the second Circles class. “We’re making unusual partnerships, and that’s driving change,� Schneider said. The Barton County Health Department is collaborating with Marissa Woodmansee, director of Juvenile Services, as well as FUMC Pastor Lennie Maxwell, for example, to implement the Circles TRIBUNE FILE PHOTO program. “It’s hard to be poor. No one wants to live that way, and people one year since the first experiencing poverty informational meeting in don’t want less for their the county about Circles. children,� Schneider said.

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GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018 •

9

Medically Supervised Weight Management yields results

BY SUSAN THACKER sthacker@gbtribune.com

O

besity in America is epidemic, but help is available for those who are willing to make lifestyle changes, said Greg Lindholm, PA, MPH. He offers the Medically Supervised Weight Management program at Advanced Therapy & Sports Medicine in Great Bend and at Progressive Therapy & Sports Medicine in Larned.

A program directed by a physician and supervised by a medical doctor can help people get on track with weight loss and end yo-yo dieting, Lindholm said.

“Two out of three of us are struggling with our weight,” he said. “Myself and a couple of medical doctors started the Weight Management model about 14 years ago out of a hospital in McPherson.”

Now offered through the Family Health Care Clinic, a department of Lindsborg Community Hospital, Medically Supervised Weight Management is starting its fourth year in the outreach in Great Bend.

Family practitioners routinely see the negative impact of poor lifestyle choices as patients develop medical issues, he said. These can include diabetes, high blood pressure, high cholesterol, heart disease, cancer, sleep apnea, obesity, and arthritis in the hips and knees.

Other issues may range from fatigue and decreased motivation to depression and social withdrawal.

“The first step is to begin lifestyle change,” he said.

“But most doctors skip that and go straight to prescription medicine.”

Lindholm sees himself as an adjunct to the family doctor, not a replacement.

“We work with them and make sure they are aware of changes we recommend,” he said.

“There’s good science behind what we recommend,” Lindholm said. “We don’t have one diet, one way of doing things.” Typically, the

customized weight management plan starts with a comprehensive lab panel before developing a plan for treatment.

There are three tiers of treatment. Those who take the most aggressive approach may lose 3-4 pounds a week at first.

“Research shows losing weight faster in the beginning has a better long-term outcome,” Lindholm said.

“You see the changes pretty quick and it keeps you motivated.”

Clients will start the program with two weeks of meal replacements that supply the core nutrients the body needs.

“During that time we’re making it simple for them to make food decisions, basically wiping the slate clean,” he said. “We gradually reintroduce regular food in a controlled way.”

While most of the weight comes off in 3-6 months, this is a two-year program.

The maintenance that fol-

lows the weight loss is just as important.

Success stories The success stories Lindholm has seen do not surprise him.

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“Predictably, we see people who need less medicine,” he said. They may get off blood pressure medication altogether. The need for insulin and oral medications for diabetes may decrease.

“It’s exciting as a healthcare provider to start taking medication away from people,” he said.

Lindholm recalled a 49-year-old woman who came to see him in Great

Bend. “Her lab panel looked awful,” he said. “She was at very high risk of heart disease. We got her in for a stress test; she failed.”

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â&#x20AC;˘ GREAT BEND (KAN.) TRIBUNE â&#x20AC;˘ SUNDAY, FEBRUARY 4, 2018

GBRH welcomes new doctor Great Bend Regional Hospital is excited to welcome Dr. V. Annapurna to the health-care team at Heartland Regional Health Clinic OB/Gyn. â&#x20AC;&#x153;Dr. Annaâ&#x20AC;? joins Dr. Jodi Henrikson and Sheila Hein, Advanced Practice Registered Nurse (APRN) in providing obstetrical and gynecological care to women in central Kansas. She will begin seeing patients on Monday, Feb. 5. To schedule an appointment, patients may call the office at 620-7922151.

Dr. Anna brings with her a wealth of experience that she has gained throughout more than 20 years of practice, not only in her home country of India, but also in Jamaica where she managed a high risk pregnancy clinic. During her time in Jamaica, she was also responsible for the supervision of midwives and medical residents and assisted in the deliveries

Dr. Annapurna

Dr. Henrikson

Sheila Hein APRN

of 1,500 babies each year.

Dr. Annaâ&#x20AC;&#x2122;s most recent experience comes from Flint, Mich. where she not only practiced medicine, but also served also as a professor at Michigan State University College of Osteopathic medicine and Des Moines School of Osteopathic Medical Center.

With over 20 years in practice, she brings experience in caring for

women in all areas of their life beginning as a young adult and moving through their childbearing years and into menopause. She provides care for both low and high risk pregnancies, and consults Maternal Fetal Medicine Specialists when needed to assist in caring for challenging or uncommon cases.

Dr. Anna is committed to providing compassionate

care to her patients. When caring for an OB patient throughout her pregnancy, she provides ongoing education to her patients in preparation for the birth of the baby. She admits that one of her greatest joys is â&#x20AC;&#x153;seeing the patient with a happy baby when they come for their six week postpartum appointment.â&#x20AC;?

Tracey Post, MSN, RN and OB supervisor at GBRH

WEIGHT, from page 9 The tests showed she needed cardiac catheterization, a procedure to examine how well the heart is working. What they found was potentially fatal. â&#x20AC;&#x153;There was 99 percent blockage in the main artery,â&#x20AC;? he said. â&#x20AC;&#x153;We did this full analysis and put the pieces together.â&#x20AC;?

For that woman, the program may have been life-saving. â&#x20AC;&#x153;She gives me a big hug every time we meet.â&#x20AC;?

Reasons people seek this program include feeling better, wanting to have more energy, and desiring to be involved in the lives of their children and grandchildren, he said. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s like a transformation from hope-

less to turning around â&#x20AC;&#x201D; and they start living again.â&#x20AC;?

Advanced Therapy & Sports Medicine An optional, individualized fitness program can be developed through Advanced Therapy & Sports Medicine, Lindholm said. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;ve learned that to maintain weight the exercise is crucial,â&#x20AC;? he said.

As clients achieve weight loss through diet, they can meet with a physical therapist for further assessment and develop a more structured program.

Benefits beyond maintaining weight include more strength, endurance and flexibility.

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states â&#x20AC;&#x153;We are very excited to welcome Dr. Anna to GBRH and to have a female OB/Gyn back in our community, something that we know is very important for many women when seeking maternity care. We are proud to again be able to offer women the choice to receive their care locally, close to home and avoid leaving the area.â&#x20AC;?

Dr. Anna will perform surgeries as needed for her patients at GBRH. These surgeries range from very minor procedures such as tubal ligation for sterilization to more invasive surgeries such as a hysterectomy.

Dr. Anna will be joining Dr. Jodi Henrikson as the second OB/Gyn provider in the HRHC clinic where Dr. Henrikson has been the sole physician in the practice since mid-June.

The two will be collaborating together and assisting one another to provide

high quality, patient centered care, and will share call to ensure 24/7 availability to their patients.

Each will be available to area providers for consult if a patient is in need of a specialist.

When asked about relocating to Great Bend, she stated â&#x20AC;&#x153;My husband is working in Haysâ&#x20AC;? and she desired to be closer to him. She chose Great Bend because she wanted a â&#x20AC;&#x153;smaller hospital and more family like atmosphereâ&#x20AC;?. Her vast experience has shown her that smaller hospitals provide staff where people work as a team and â&#x20AC;&#x153;help in case of trouble.â&#x20AC;?

Welcome to Great Bend Regional Hospital and Central Kansas Dr. Anna!

Meet Greg Lindholm Born in Great Bend, Greg Lindholm graduated from Wichita State University in 1989 with a Bachelor of Health Sciences, Physician Assistant Program at Wichita State and completed his Masters of Public Health in 2013 at the University of Kansas School of Medicine.

Greg has a 27-year work history as Primary Care Provider, most recently in McPhersonâ&#x20AC;&#x2122;s Associates in Family Care and the Canton Community Clinic. He has experience in Occupational Health, Internal Medicine and Cardiology. He is now with the Family Health Care Clinic, a department of Lindsborg Community Hospital.

A self-described outdoorsman, he and his family enjoy nature and outdoor activities, including camping and golf. Greg and his wife Keri (who is originally from Hoisington) live in McPherson and have a son and a daughter in college.

Gregâ&#x20AC;&#x2122;s clinical interests are preventative medicine and advocating for lifestyle and behavior changes to improve the quality of health and life.

Three tiers of weight management The Medically Supervised Weight Management program offers three levels of supervision: â&#x20AC;˘ TIER ONE: This level is specifically designed for someone who already has diabetes, high blood pressure, heart disease or any other medical condition requiring close supervision. â&#x20AC;˘ TIER TWO: This level offers standard medical support for someone who has some conditions which require occasional

monitoring during treatment.

Those conditions include, but are not limited to elevated cholesterol, sleep apnea, arthritis, fatigue. â&#x20AC;˘ TIER THREE: This level is for someone who wants to focus on life-style changes with emphasis on weight loss AND who does not have a medical concern.

Clients will be asked for their insurance information at their first appointment of the Medically Supervised Weight Management

program. The information will be used to file an insurance claim on the patientâ&#x20AC;&#x2122;s behalf. Once payment is received from the insurance company, patients will receive a statement from the Family Health Care Clinic at Lindsborg Community Hospital indicating the amount that will be the patientâ&#x20AC;&#x2122;s responsibility. Financial assistance may be available.

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GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018 •

11

St. Rose supports local programs to help people in central Kansans

S

t. Rose Health Center has a legacy of reaching out to the community and it wants to do even more in the new year.

Three current and recent outreach projects demonstrate St. Rose’s commitment to central Kansans, Executive Director Zena Jacobs said.

The projects include providing speakers on health-related topics at the Great Bend Senior Center; providing a dropoff and pick-up site for the Kansas Food Bank; and a donation to the Hungry Heart soup kitchen.

“These examples illustrate the variety of ways St. Rose can help our neighbors,” Jacobs said. “We understand the challenges and hardships some people face and are dedicated to improving lives in any way we can.

“We are aligned with Hays Medical Center and The University of Kansas Health System to provide high-quality and compassionate care,” she continued. “Simultaneously, St. Rose supports the community and provides education.”

Senior Center speakers In the next few months, St. Rose providers will offer information on three topics.

Dr. James McReynolds will discuss end-of-life care at 1 p.m. Friday, March 2; Haley Gleason, advanced practice registered nurse (APRN), will offer information about female health at any age

boxes of useful food.”

For more information, contact Kreutzman by calling 316-265-3663.

There are still openings for the program.

DALE HOGG Great Bend Tribune

St. Rose Health Center, 3515 Broadway Ave., has a long-stranding tradition of providing service to the residents of central Kansas.

at 1 p.m. Friday, April 13; and Kristin Babcock and Jeanne Habash, both physician assistants (PAs), will share their knowledge about women’s health.

“St. Rose providers know it is important to be out in the community, sharing their expertise,” Jacobs said. “Their presentations help the community understand the importance of early detection, screenings and prevention. They will encourage questions and we hope folks take advantage of these great educational opportunities.”

Previously, two other

St. Rose providers spoke at the Senior Center.

Alisha Stinemetz, APRN, discussed diabetes in January and Ed Habash, PA, talked about prostate cancer this month.

Kansas Food Bank St. Rose stepped up to provide a site for the Senior Food Box Program in Barton County. This is a U.S. Department of Agriculture project that provides monthly food boxes to low-income seniors; its formal name is Commodity Supplemental Food Program (CSFP).

The first pick-up for

those who applied and qualified for the program will be from 9 to 11:30 a.m. Friday, Feb. 9 at the St. Rose Maintenance Building.

Janel Rose, Central Kansas Partnership public health educator, was “instrumental in starting this program here. It wouldn’t have happened without her,” Jacobs said.

“We also commend the Kansas Food Bank in Wichita for all its efforts.

Debi Kreutzman has been extremely helpful.”

Kreutzman, Kansas Food Bank community relations manager, said

“we are so thankful that St. Rose offered a location to safely store the food boxes that are packed by volunteers in Wichita.

This is a safety net for seniors’ health and dovetails perfectly with St. Rose’s mission.”

She also noted this program doesn’t replace other services. “Seniors may still visit the local food pantry and participate in the commodity food program. This is an additional opportunity to put meals on the table. There are eligibility guidelines and a little bit of paperwork but it offers great

Hungry Heart In another effort to help people with nutritional needs, St. Rose sponsored a food drive for Hungry Heart Soup Kitchen.

“The soup kitchen is vital to so many of our neighbors,” Jacobs commented. “Even though we donated during the Christmas season, we want to keep them in mind all year round.”

Hungry Heart is part of the Central Kansas Dream Center, 2100 Broadway.

Kimberly Becker, Dream Center director, said the St. Rose donation of dry goods was appreciated. “We have already helped a number of families with the donated items,” Becker said. “May God bless St. Rose for its outreach. We thank St. Rose representatives for blessing the people we serve with their generosity.”

St. Rose Health Center specializes in primary care, prevention and wellness. Services include St. Rose Family Medicine, Convenient Care Walk-in Clinic, Great Bend Internists, Imaging, Cardiac Rehab, Physical Therapy, Golden Belt Home Health & Hospice and a comprehensive Specialty Clinic.

Hays Medical Center, which is part of The University of Kansas Health System, is the sole owner of St. Rose.

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12

• GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018

It’s about more than treating patients Kansas hospitals keep Kansas healthy and economically strong

BY DALE HOGG dhogg@gbtribune.com

H

ospitals and health care systems are a powerful economic force locally and across the state. Nowhere is that more evident than with Ellinwood District Hospital.

“Rural hospitals are usually main economic drivers in small communities,” said Lindsey Bogner, Ellinwood District Hospital foundation and marketing director. In most cases, hospitals and the school district are the top two employers in small towns.

“It’s a huge economic impact,” she said.

Looking around Kansas, the state’s health care sector generated $14.4 billion in income and $25.7 billion in sales last year, ranking it fifth among all economic sectors in the state.

Hospitals alone have a total impact on Kansas income of $9.4 billion, and they employ 86,324 people across the state.

New data confirm the health care sector is among the fastest growing in the economy.

National employment in health care services increased by 92 percent from 1990 to 2015, and by almost 400 percent since 1970.

These are just a few of the findings in the January 2018 report, The Importance of the Health Care Sector to the Kansas Economy, which details estimates of the “gross” impact of the health care sector on economic activity in the State of Kansas. In the report, K-State researchers identify three primary ways health care influences local economic development: health care attracts and retains business, attracts and retains retirees and creates local jobs.

Jobs are an essential part of the economic impact; however, funds also flow to businesses and throughout the economy as hospitals purchase goods and services. Hospitals generate nearly $3.2 billion in local retail sales in Kansas each year. Additionally, the hospital sector generates nearly $205 million in state sales tax. These are critical funds that the state uses for important programs such as education and transportation.

“Hospitals and health services truly are an economic anchor in our state,” said Tom Bell, president and CEO of the Kansas Hospital Association.

“This report documents the importance of the health care sector to the Kansas economy.

While the estimates of economic impact are substantial, they are only a partial accounting of the benefits that health care in general, and community hospitals in particular, provide to the state. Kansas community hospitals help stabilize the population base, invigorate their communities and contribute significantly to quality of life.”

Making an impact According to the 2018 economic report, Kansas hospitals employ 4.4 percent of all job holders in the state. The report calculated economic multipliers, or “ripple effects,” and estimated that hospitals account for 75,659 additional jobs throughout all other businesses and industries in the state. In other words, for each

new job in the hospital sector, another 0.88 jobs were created in other businesses and industries in Kansas. The hospital sector employment had a total impact on state employment of approximately 162,000 jobs.

Bogner pulled up EDH’s financials for this last year. The payroll totalled $5,339,750.

“That means it generates economic impact,” she said.

Two thirds of the facilities 79 employees live in Ellinwood and the immediate area.

This means their families are also there and utilize area businesses and services. This “roll-over” effect generates $1.9 million in retail sales.

Furthermore, the entire health sector in Kansas employs about 222,500 people, or 11.3 percent of all job holders in the state. This puts Kansas ahead of the national average, which is 10 percent of job holders in the United States working in health care services. The total employment impact of the health services sector in Kansas is approximately 369,210 jobs, making it the fourth largest aggregate employer in the state.

The study also found Kansas hospitals generate more than $6 billion in direct labor income to the Kansas economy each year. For every dollar of income generated in the hospital sector, another $0.56 was generated in other business and industry.

“A hospital is important to other businesses as well,” Bogner said.

There are additional intangibles, such as charity care, which added up to $282,000 last year, Bogner said. “It’s a huge benefit for the community.”

TRIBUNE FILE PHOTO

Offering outreach services, like the teddy bear clinic at Ellinwood District Hospital, are ways a facility can stay in touch with the community it serves.

Economic development Though the connections between health care services and local economic development are often overlooked, there are at least three important relationships to be recognized.

A strong health care system can help attract and maintain business and industry growth, attract and retain retirees, and also create jobs in the local area.

“Having a hospital important draw to community,” Bogner said. “Schools and medical care top two things looked for when people look at moving to a town.”

From hospital staff to the families that relocate, there is more than a financial benefit.

“They are involved in our communities. They are little league coaches, religion teachers and volunteers. It’s a huge thing for a small community, even for a huge community.” Studies have found that quality of life factors play a dramatic role in business and industry location decisions.

Health care services represent some of the most significant quality of life factors for at least three reasons. First, good health and education services are imperative to industrial and business leaders as they select a community for location.

Employees and participating management may offer strong resistance if they are asked to move into a community with substandard or inconvenient health services. Secondly, when a business or industry makes a location decision, it wants to ensure that the local labor force will be productive, and a key productivity factor is good

TRIBUNE FILE PHOTO

Health care facilities like Ellinwood District Hospital are important economic drivers in rural communities.

health. Thus, investments in health care services can be expected to yield dividends in the form of increased labor productivity.

The third factor that business and industry consider in location decisions is cost of health care services. A 1990 site selection survey concluded that corporations looked carefully at health care costs, and sites that provided health care services at a low cost sometimes received priority. In fact, 17 percent of the respondents indicated that their companies used health care costs as a tie-breaking factor between comparable sites.

A strong and convenient health care system is important to retirees, a special group of residents whose spending and purchasing can provide a significant source of income for the local economy.

Making jobs Job creation represents an important goal for most local economic development programs. National employment in health care services increased by 92 percent from 1990 to 2015, and by almost 400 per-

cent since 1970. In rural areas, in particular, employment in health-related services often accounts for 10 to 15 percent of total employment. This reflects the fact that the hospital is often the second largest employer in a rural community (local government including schools typically being the largest employer).

Another important factor is the growth of the health sector.

Health services, as a share of gross domestic product (GDP), have increased substantially over time. Americans spent $74.9 billion on health care in 1970, which accounted for 7.0 percent of the GDP. In 2015, health care costs increased to nearly $3.2 trillion, or 18.0 percent of the GDP. If current trends continue, projections indicate that Americans will spend nearly 20 percent of GDP on health care by 2025.

Sales generator In 2016, the Kansas economy generated about $344 billion in sales, the broadest measure of economic activity as shown in Table 2. Services (including health care) was the largest economic sector in terms of

total sales, accounting for 36.5 percent of total sales for the state. Manufacturing was the next largest single sector with about 28.1 percent of the total sales. The service sector is generally the fastest growing economic sector.

The services sector (including health care) employed the largest number of workers at about 958,200. This was over five times more than the number of workers employed by the manufacturing sector. One economic measure of efficiency is the output-per-worker ratio.

Dividing sales by the number of full- and part-time employees, the manufacturing sector had the largest output per worker ratio at nearly $575,000 per worker. The state average was about $174,300 per worker while the health sector had about $115,700 per worker. The relatively smaller ratio for health care suggests higher labor intensity needed to deliver these services.

And, by the nature of the business, a hospital is something just about everyone will need at one time or another, Bogneer said. “Everybody is our customer.”

GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018 •

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Digital health trends for 2018 future, artificial intelligence will be increasingly deployed to predict disease before someone is afflicted; understand what facilities or physicians produce the best outcomes for a specific condition; and engage patients so they receive care in a timely manner.

BY DR. SAM HO Chief Medical Officer, UnitedHealthcare

T

echnology continues to change how Americans work and live, especially when it comes to health care. New advances are changing how health care is paid for and delivered, putting access to information at our fingertips and creating a more seamless health care experience.

This revolution is on display this week in Las Vegas, home to the International Consumer Electronics Show (CES).

This annual showcase brings together the latest innovations from companies worldwide, including health and wellness organizations.

With that in mind, here are five digital health trends that consumers and business leaders should watch this year.

• Mobile Payments: The health care system is modernizing how care is paid for, including the addition of mobile payments.

More consumers are using mobile wallets such as Apple Pay®, to pay for qualified medical services from a health savings account (HSA) with their mobile devices. These new capabilities allow for more convenient transactions at health care providers’ offices and pharmacies, which can help save people time and facilitate faster payments for care providers.

• Wearable Sensors: The wearable-technology market

COURTESY PHOTO

This picture shows a remote medicine concept.

is booming, with revenues expected to reach nearly $52 billion by 2022, according to a recent research report from Markets and Markets. This is good news for consumers, as these wearable devices enable people to track their daily steps, monitor their heart rates and even analyze sleep patterns.

Employers and health plans are including fitness trackers as part of corporate wellness programs to help improve health outcomes and reduce health care costs.

• Remote Medical Monitoring and Treatment: In addition to wearable sensors, other consumer devices are being offered to help enable more widespread remote medical monitoring and treatment. More consumers now have access to telemedicine services through smartphone apps and online, to help provide more convenient and costeffective care. People with specific medical issues can also access resources such as wireless scales, which can notify health care professionals about sudden

weight fluctuations that could signal the need for immediate medical attention.

• Artificial Intelligence: Artificial intelligence and machine learning leverage troves of data to help improve the effectiveness and efficiency of health care services. The potential applications are wideranging, including closing gaps in care, eliminating unnecessary treatments and improving the speed and accuracy of customer service calls. In the

• Blockchain: The rise of cryptocurrencies, such as bitcoin, has garnered numerous headlines, but the underlying technology, known as blockchain, has significant potential for health care. A blockchain securely and cooperatively shares database transactions across multiple computers to provide a synchronized source of truth that can help automate processes and may improve the security and integrity of health care information, reducing data reconciliation costs and easing administrative burdens.

Blockchain can help consumers store and share complex health data, which may help health professionals personalize care and make it easier for everyone to navigate the health system.

At UnitedHealthcare, we invest more than $3 billion annually in data, technology and innovation to help consumers take a more active role in their health. By using technology to help encourage people to pursue healthy behaviors, and to more easily navigate the health system, our goal is to advance better care management today and set the foundation for better health outcomes in the future.

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COURTESY PHOTO

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• GREAT BEND (KAN.) TRIBUNE • SUNDAY, FEBRUARY 4, 2018

Changes come to local healthcare

BY DALE HOGG dhogg@gbtribune.com

T

here was a lot of new partnerships and mergers that altered the Barton County healthcare landscape in 2017. Here is a rundown of those changes.

• Effective Jan. 1, 2017, the University of Kansas Hospital and Hays Medical Center (HaysMed) finalized their partnership agreement.

• As of July 1, Hays Medical Center, part of The University of Kansas Health System, was the sole owner of St. Rose Health Center.

The purchase includes the land adjacent to St. Rose to the east and west.

“HaysMed will look to expand services, while evaluating campus expansion in the very near future,” said HaysMed CEO Dr. John Jeter. “We continue to evaluate all options, including the addition of hospital beds in Great Bend, and the site does lend the possibility of future expansion of the current facility.”

Education will be a key component of St. Rose’s new relationship with HaysMed. “Our relationship with The University of Kansas Health System provides us access to the most current medical practices, which will enable St. Rose providers to stay up-to-date on the very latest advances in treatment,” Dr. Jeter said.

Another aspect of this new partnership is raising the level of recruitment efforts to attract new physicians and mid-level providers, Dr. Jeter noted.

St. Rose Executive Director Zena Jacobs said the most important aspects of St. Rose remain the same.

“We will continue to provide the appropriate level of care to patients, as close to home as possible in a timely fashion,” she explained. “Our health-care services are evidence-based to ensure patients receive highquality care and treatment.

“We will continue to work closely with HaysMed. We hope this relationship will bring the opportunity to bridge the gap in health care and bring even more specialists to St. Rose. This will only enhance the level of care for central Kansas residents. The possibilities are endless.”

Jacobs noted that HaysMed has responded to community needs since it became co-owners of St. Rose with Centura Health on Jan. 1, 2015.

For example, HaysMed learned patients wanted physical therapy at St. Rose and subsequently opened a clinic a year ago with one therapist. It now has two therapists, and recently added new equipment.

“HaysMed also has been committed to bringing in specialists to offer follow-up appointments close to home,” Jacobs commented. “They offer a seamless transfer process with hospitalists who respect our community’s needs. They are eager to care for our patients, as they work closely with St. Rose providers to ensure efficient transfers to HaysMed.” HaysMed Specialty Clinic at St. Rose offers providers who specialize in cardiology; urology; orthopedic and general surgery; obstetrics and

TRIBUNE FILE PHOTO

Patients in our area, like those shown in the Great Bend Regional Hospital lobby, have seen several changes in the local health care landscape over the past year.

gynecology; and pulmonology.

St. Rose Ambulatory & Surgery Center became part of Centura Health in 2012. HaysMed was the managing partner during its co-ownership of St. Rose Health Center with Centura.

St. Rose Health Center specializes in primary care, prevention and wellness. Services include St. Rose Family Medicine, Convenient Care Walk-in Clinic, Great Bend Internists, Imaging, Cardiac Rehab, Physical Therapy, Golden Belt Home Health & Hospice and a comprehensive Specialty Clinic.

• On Dec. 30, 2016, Bethesda, Md.-based Global Medical REIT Inc. announced that it entered into a purchase contract to acquire Great Bend Regional Hospital for a purchase price of $24,500,000, a deal that closed in the first quarter of 2017. However, local hospital officials stressed this includes the building and property only, and local control of the facility remain intact.

At that time, the current tenant, Great Bend Regional Hospital LLC., entered into a 15-year triple-net lease with GMR. GMR expect funded this acquisition using borrowings from the company’s credit facility or other available cash.

In other words, local hospital officials said the day-to-day operations will remain as they are.

“I am very happy to close out 2016 with strong acquisition momentum following the execution of this agreement to acquire the Great Bend Regional Hospital,” said David Young, GMR’s chief executive officer. “Moving into 2017, we expect to continue our policy of announcing material acquisitions when we enter into purchase contracts and announcing other smaller acquisitions through periodic acquisition updates.”

A triple-net lease is a lease agreement that designates the tenant, as being solely responsible for all the costs relating to the asset being leased, in addition to the rent fee applied under the lease. The structure of this type of lease re-

quires the tenant to pay the net amount for three types of costs, including net real estate taxes on the leased asset, net building insurance and net common area maintenance.

Global Medical is engaged primarily in the acquisition of licensed healthcare facilities and the leasing of these facilities to leading clinical operators with dominant market share.

GBRH is a 33-bed acute care hospital located in Great Bend serving 50,000-plus community residents.

The 58,000 square-foot facility is the sole community provider in its medical service area, where it provides services including women’s health, surgical, ancillary, hospital, and walkin treatment.

• Beginning in July, Great Bend Regional Hospital’s Urgent Care

moved. The Urgent Care clinic became an extension of Heartland Regional Health Clinic, located on the second floor of GBRH. The hours are 8 a.m. to 8 p.m., seven days a week.

According to Kelly Bachar, current ER/ Urgent Care/ICU nurse manager, the move came as a result of recognizing the need for a walk-in clinic where patients can be treated in a more cost efficient manner.

“Patients who come to the Urgent Care Walk In Clinic will continue to have their minor illnesses and injuries treated without the high cost of an Emergency Room visit.” The staff who have been working in Urgent Care will move upstairs as well, including the Advanced Practice Providers Ashley Vonada, PA, Hayley Zink, APRN, Maggie Myers, APRN

and Diane Haines, APRN. Nursing staff familiar with the needs of patients in the Urgent Care will also transition to the new location.

Patients will access the Urgent Care through the northeast door of the hospital, under the awning. The clinic will be located on the second floor. Patients will register with the Heartland Regional Health Clinic front desk staff and the Urgent Care staff will be available to care for those patients.

If patients require additional services such as lab or X-ray, they will be registered before they leave the clinic to go downstairs for testing to be completed. According to MaryAnn Keener, CNO at GBRH, “Staff will assist with transport of patients to receive any testing needed at the hospital level. These tests could include lab,

imaging studies, IV therapy, injections, or cardiorespiratory testing.”

Prompt test results will be available to the Urgent Care Clinic providers in the new location as well.

Keener and Bachar, along with Ann Hatesohl, Heartland Regional Health Clinic supervisor, emphasize that if a patient arrives in Urgent Care and it is determined that a higher level of care is needed, staff will immediately assist that patient to the Emergency Department for further evaluation and treatment.

In addition, if a patient arrives at the front desk of GBRH, triage personnel will be available to assess if the patient needs seen in the ER or can be given the option to proceed upstairs to the Heartland Regional Health Clinic.

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