A lack of healthcare professionals

The Great Plains Institutional Development Award (IDeA) Clinical & Translational Research (CTR) Network headquartered at the University of Nebraska Medical Center has received a $180,000 grant to participate in a national effort to collect and share data on COVID-19-related patient outcomes for use in research.

“The exciting thing is that we now have a robust framework to gain new knowledge to face down future health challenges beyond COVID.”

The funding from the National Institutes of General Medical Sciences will support data transfer to the National COVID Cohort Collaborative (N3C) Data Enclave; a registry of COVID-19-related information from patients across the country. The enclave will enable researchers with data to use agreements from UNMC and seven other IDeA-CTR networks – with support totaling more than $1.4 million – to track the disease in patients across the country.

N3C will help scientists develop insight into potential risk factors, protective factors, and long-term health consequences. Fifty-seven sites across the country will share data from the electronic health records of individuals (identity of individuals will not be included) tested for COVID-19, including demographics, symptoms, laboratory test results, procedures, medications, medical conditions, physical measurements, and more.

Matthew Rizzo, MD, Frances & Edgar Reynolds Chair and professor in the UNMC Department of Neurological Sciences, in collaboration with James McClay, MD, said he and his team rapidly responded to the challenge recently by being the first in the region to contribute to the enclave.

Dr. McClay is principal investigator of UNMC’s research data warehouse and director of the Biomedical Informatics Core of the Great Plains IDeA-CTR.

“Being nimble, pivoting quickly, and marshalling resources to face down COVID helped create this gold mine for all kinds of answers for all kinds of questions,” Dr. Rizzo said. “Some of the questions we want to answer are what treatments work, what are the long-term side effects, is there a greater rate of cognitive problems, who’s at greater risk, will the virus have consequences down the road?

“It’s unprecedented to get so many networks together quickly so we can pool data to help figure out what is going on with this disease and the pandemic.”

By aggregated counts of anticipated positive COVID-19 patients, the N3C Data Enclave is anticipated to be one of the world’s largest collections of data on COVID-19 patients.

Dr. Rizzo said the registry also ensures the data represents the diversity of the country so researchers can understand and address geographic and population disparities during the pandemic.

“There are many opportunities in the future,” Dr Rizzo said. “We could apply this national strategy for gathering information on COVID to gain comprehensive information on critical areas such as mind and brain health and many medical disorders. The exciting thing is that we now have a robust framework to gain new knowledge to face down future health challenges beyond COVID.” (UNMC provided this information.)

Alzheimer’s Association offers free webinars

The Alzheimer’s Association is offering a variety of free educational webinars.

Topics include the warning signs of Alzheimer’s, dementia research, healthy living, legal and financial planning, early stage care partners, late stage caregivers, and understanding and responding to dementia-related behavior.

To register or for more information, please call 800272-3900 or go to alz.org/crf.

Totals broken down county by county UNMC report: Rural areas of Nebraska need additional healthcare professionals

A2020 healthcare workforce report by the University of Nebraska Medical Center reveals the number of physicians and nurse practitioners increased slightly in Nebraska since the last survey in 2018. Despite these positive developments, rural areas of the state still lag in the number of needed healthcare professionals.

The report examined 21 healthcare professions ranging from physicians and physician assistants to nursing, dental, and allied health professionals.

It also looked at the sex, age, race, and ethnicity of each healthcare professional, as well as measured the number and rate of healthcare professionals per 100,000 people in Nebraska by county.

“The delivery of comprehensive, highquality, team-based care is getting more difficult in rural communities that have limited or no access to the key healthcare specialists and nursing professionals needed to case-manage and care for increasingly complex patients,” said Nicole Carritt, director of the UNMC Office of Rural Health Initiatives.

“Healthcare professions are high demand, high skill, and high wage occupations,” said Jeffrey P. Gold, MD, the chancellor of UNMC and the University of Nebraska at Omaha.

“These professions are critical to the overarching healthcare system as they facilitate access to quality healthcare and have a significant impact on Nebraska’s health, economy, and the sustainability and vibrancy of the state’s rural communities.”

The study, commissioned and funded by the Office of Rural Health Initiatives and the Nebraska Area Health Education Center Program, used the most recent data from the UNMC Health Professions Tracking Service and the state of Nebraska.

“This report helps to measure the progress we have made in the state in dealing with some of the workforce issues in rural Nebraska and in planning for the future,” said Nizar Wehbi, MD, assistant professor and deputy director for the UNMC Center for Health Policy.

Several programs have helped increase the number of rural health professionals in Nebraska.

“Grow Your Own programs encourage, incentivize, and support students from rural and disadvantaged backgrounds who enroll in pre-health and health profession training programs and are committed to returning to rural areas to practice,” Carritt said. “More than 71% of graduates from the UNMC’s Rural Health Opportunities Program and the Kearney Health Opportunities Program are practicing in rural Nebraska.”

Still, challenges remain including the reality that nearly one-fourth of the physicians in Nebraska are more than 60 years old, and thus likely to retire in the near future; 17 of 93 Nebraska counties have no pharmacist; and 14 of 93 Nebraska counties have no practicing primary care physician.

Demographics in many Nebraska counties are becoming more diverse, but the current health workforce doesn’t necessarily reflect the populations being served.

“In partnership with stakeholders across UNMC’s 500-mile campus, we’ve made progress over the years. But the landscape of healthcare is rapidly changing, and we must remain diligent to sustain the progress we’ve made and close the gaps,” Carritt said.

“The time is right for new and innovative community-based ideas and policy solutions that incentivize healthcare providers to practice in high-need areas and attract private investment to strengthen the healthcare infrastructure in rural Nebraska.”

Other key findings of the report include: • Out of 93 Nebraska counties, only 39 have active OB/GYN physicians in 2019 compared to 49 in 2017. • There are 1,335 nurse practitioners in Nebraska. That’s a 16.3% increase since 2017 when there were 1,148. • The number of registered nurses increased by 1,137 between 2017 and 2019. • The number of practicing pharmacists decreased slightly between 2017 and 2019 while the number of pharmacy technicians increased by 83. • There are substantial gaps in the distribution of allied health professionals across the state, particularly in north central Nebraska.

Based on the findings, the report issued the following recommendations: • Enhance existing pipeline programs and educational initiatives that incentivize healthcare professionals to practice in rural communities. • Enhance the availability of scholarships and student loan repayment programs for health profession students and practitioners at all levels, especially those interested in working in rural and underserved urban areas to assist students with unmet financial needs and encourage students to remain in the state after completion of their training programs. • Increase the number of medical residency training positions in Nebraska to include significant training in rural and underserved areas. • Expand the capacity of the telecommunication infrastructure to support the adoption and utilization of telehealth for expanding access to healthcare. • Develop innovative healthcare delivery solutions and related policy interventions to mitigate gaps in healthcare access due to health profession shortages as well as support rural training programs. • Perform targeted, ongoing data collection to monitor the healthcare workforce and forecast future needs and requirements. • Establish and streamline existing public-private partnerships aimed at health professions education, workforce development, and healthcare delivery. (UNMC provided this information.)