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State Innovation Model of Iowa's (SIM) monthly SIMplify newsletter header image including a desktop computer.
Volume 33   ▪   November 21, 2018
Leadership is the capacity to translate vision into reality."
Warren Bennis
Spotlight   ▪   Save the Date  ▪   Tools, Links and Resources   ▪   Statewide Strategies   ▪   Data Corner   ▪   Pharmacy Corner ▪   Information Sharing
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Iowans Leading Healthcare Transformation

Socio-economic challenges in providing access to high-quality healthcare in Iowa’s communities threaten the sustainability of the healthcare system and the health of Iowans. To address these challenges, Governor Reynolds established the Iowa Healthcare Innovation and Visioning Roundtable; an engaging and diverse group of business leaders, payers, providers and public agency leaders from rural and urban communities across the state to recommend strategies to improve the health and well-being of all Iowans. The Roundtable (link) is a two-year commitment for invited leaders to develop a post-State Innovation Model (SIM) sustainability work plan. It launched in December 2017, convened through August 2018 and completed a recommendation document.

Roundtable recommendations to Governor Reynolds (PDF) included a three-year transformation vision, guiding principles and innovation through a robust public-private partnership and multi-stakeholder engagement process. The guiding principles for Iowa’s transformation is the path to improving health and well-being are:
  • Promote accountability, sustainability, high quality care, coordinated efforts, equitable participation, affordability, patient-centeredness and transparency.
  • Consider the impact of all strategies on rural communities because Iowa is a predominantly rural state.
  • Maximize opportunity to secure federal funds in support of new services and infrastructure development.
  • Minimize administrative and reporting requirements for providers, payers and patients.
Roundtable participants are leaders from around the state appointed by the Department of Human Services (DHS). The DHS director serves as Chair of the Roundtable. Membership consist of a Visioning and Innovation Leadership workgroup, the Data Sharing and Use workgroup and Healthy Communities workgroup.   

SIMplify is a system designed to make interacting with others of the same cloth, well, simpler. From sharing documents to sharing stories to organizing meetings, this system is intended to handle the communication needs of the group. Members of SIMplify are focused on respect, consideration for other’s ideas, collaboration, and fairness. 
Join SIMplify (link) today or sign up (link) for our monthly SIMplify newsletter. 
Save the Date
Midwest Rural Agricultural Safety
and Health Conference

November 27 – 29
Council Bluffs
Event Registration (Link)

Network for Public Health Law: The Potential Impacts of the Midterm Elections
on Public Health

November 29 – 12-1 PM
Event Registration (Link)

Iowa Public Health Legislative Forum
December 6
Ankeny (DMACC Campus)
Event Registration (Link)
State Innovation Model of Iowa's (SIM) logo.

The Iowa State Innovation Model (SIM) is aimed at improving healthcare quality, effectiveness, and efficiency through population-based, community-applied solutions. In pursuit of these aims, a portion of SIM funding and technical assistance is deployed at the local level to facilitate community health management initiatives. 

More information (link) about SIM is located on our website.
Tools, Links and Resources
Rural Health Leaders
Rural Health Leadership Radio TM (link) is the very first radio show of its kind. Weekly podcasts feature leaders working in rural health; leaders of hospitals, clinics, networks, companies and communities.

Public Health Leadership Forum
Health professionals working to protect and improve health in communities and across the nation realize that none of our distinct systems – not health care, public health nor social services – is fully equipped to accomplish its mission alone. National healthcare transformation task force leaders released a “Framework for Collaboration” (PDF).

Physician Business Leadership Certificate Program
February 27, 2019, 9:00 AM – February 28, 2019, 4:00 PM (CST)
Providers today are facing an era of change unlike any before. Reform policies shifting requirements and fiscal uncertainty create a chaotic atmosphere for professionals as well as providers. During times like these, strong leaders who demonstrate innovation and focused decision-making abilities are required. Participants in this program (link) will gain the tools to become successful leaders in today’s complex health care environment.
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Statewide Strategies

The topic of healthcare transformation has not only been recurrent throughout our SIMplify newsletter, but, is truly the crux of all our monthly themes. No matter what lens we use to talk about transformation, one thing is consistent – the need for leadership. There are two facets that define leadership in healthcare transformation – the need for buy-in and investment from existing healthcare leaders and the capacity for local champions and organizations to step forward to be leaders of change. Both facets are acknowledged and integrated within the span of our statewide strategies.

Whether in the Care Coordination, Falls Prevention or Medication Management strategies, the call for diverse partnerships is evident. Strategies intentionally use language that applies across disciplines and settings to support stakeholders across the continuum to see themselves reflected and their involvement expected. The use of meaningful language can sometimes be as simple as recognizing the difference between the use of the word “patient” versus “resident” or “consumer,” or the nuances between “patient-centered” and “person-centered” care design. Language also includes explicit inclusions within objectives and tactics detailing the need for cross-sector participation, transparency and outlining opportunities for such.

Knowing that our strategies have these expressed roles across the healthcare community is not new, as we’ve discussed this in detail over the months. But what is different when we consider leadership in healthcare transformation is the application of these roles and the execution of such strategic guidance. The delineation of roles throughout the statewide strategies serve a two-fold purpose: 1) to recognize the role of all healthcare professionals at all levels – from direct care to administration, community planners to payers and beyond; and 2) to offer direction of what these roles could/should entail as a means to support shared understanding and offering directive support to healthcare leaders who are wading into the healthcare transformation and looking for answers in how this work may/will be done.

Our statewide strategies can serve as tools for education, and empowerment guidance from these statewide strategies can enable stakeholders to make greater sense of what “healthcare transformation” means and can even see applications to specific areas such as diabetes, healthcare associated infections, or even advance care planning and palliative care (IPOST). Leaders can then make decisions and commitments to change, starting from small process changes to larger investments in cultures of health – all of which are exemplified in various capacities throughout the strategies.

As the strategies empower leaders for change within their own auspices, the strategies can and should also be used as catalysts to develop healthcare leaders within communities. With illustrated roles for involvement of players throughout the healthcare spectrum, there is opportunity for stakeholders from any and all avenues to take on the charge to be leaders within their own communities. The statewide strategies can serve as blueprints for those stepping into leadership roles to know who else to bring to the table and what actions can be undertaken to progress population health at the community level. With thoughtful application and execution, the statewide strategies are tools to equip leaders and laymen alike to be champions and drivers of healthcare transformation.
Learn more about Iowa Healthcare Collaborative (Link)
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Data Corner

Healthcare transformation can’t happen without the support of hospital leaders. Institute for Healthcare Improvement has a short article (link) and a 1.5-minute video (video link) on how to speak to leaders. Some key points include: starting with praises, talking about impacts on people and connecting to the leader’s passion and emotions.

Davis Balestracci, a past Chair of American Society for Quality’s statistics division, has a blog on Quality Digest (link) where he writes about quality improvement management and data presentation.

American Hospital Association/Health Research & Educational Trust developed a series of guidelines on various quality improvement areas, which can be used to educate hospital leaders and get them on board. Some of the guidelines were listed below:
  • Early Learnings from the Bundled Payment Acute Care Episode Demonstration Project (Link)
  • Health Care Leader Action Guide on Implementation of Electronic Health Records (Link)
  • Improving Health Equity Through Data Collection AND Use: A Guide for Hospital Leaders (Link)
  • The Quest for Equity in Health Care (Link)
  • Health Care Leader Action Guide to Effectively Using HCAHPS (PDF)
  • A Guide to Strategic Cost Transformation in Hospitals and Health Systems (Link)
  • Hospital Readiness for Population-based Accountable Care (Link)
  • Metrics for the Second Curve of Health Care (Link)
  • Value-Based Contracting (Link)
  • Integrating behavioral health across the continuum of care (Link)
  • Leadership Toolkit for Redefining the H: Engaging Trustees and Communities (PDF)
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Pharmacy Corner

Patients come into the pharmacy on average two or more times a month making pharmacists the most accessible healthcare providers. Given the accessibility and the known gaps in patients receiving immunizations for a variety of reasons, the Iowa Legislature passed legislation to allow pharmacists to administer vaccinations to those eleven years and older and the influenza vaccination down to the age of six months. Rules are still in the making with the Board of Pharmacy on age ranges and how this care will be provided.

Previously, pharmacists could only immunize eighteen and older for most vaccinations other than the influenza in which pharmacists could administer the influenza vaccine down to the age of six. With this transformation in healthcare, pharmacists can administer vaccinations to those who may not otherwise have access to vaccinations. Specifically, pharmacists can impact the immunization rate of underserved populations or those who do not have regular access to healthcare services. Additionally, when a patient picks up their medication from the pharmacy, the pharmacist can check the Iowa Immunization Registry Information System to encourage patients to get their immunizations if they are not up to date. Ask your pharmacist how they are advancing care with immunizations in their current practice.
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Information Sharing

November is National Diabetes Awareness Month 
November is National Diabetes Awareness Month. There are several themes focusing awareness on this national epidemic. In Iowa public health, health systems, organizations and communities are hosting conferences, public gatherings and mounting social media awareness campaigns. Learn more about the
Iowa Diabetes Prevention Action Plan 2018-2020 (PDF) and the Iowa Diabetes Statewide Strategy (PDF).

Building Healthcare Leaders in Iowa 
University of Iowa College of Public Health supports students to foster personal and career development relating to health leadership by joining the Iowa Student
Association of Healthcare Leaders (PDF). Students are engaged in three pillars: professional development, civic responsibility and social engagement and have opportunity to network with university and community leaders, and be mentored in volunteerism and leadership skills.

FY 19 Rural Communities Opioid Response Program – Planning
HRSA/FORHP is pleased to announce a second round of the Rural Communities Opioid Response Program (Planning). The purpose of this program is to support treatment for and prevention of substance use disorder, including opioid use disorder, in rural communities. In FY 18 HRSA made 95 awards and in FY 19 HRSA anticipates making approximately 120 awards. The current Planning awardees can be found on the 
HRSA website (link). Any domestic organization forming a consortium of four or more members in a rural community may be eligible to apply for funding. More information on eligibility and requirements can be found in the Notice of Funding Opportunity (link).
100 East Grand Avenue, Suite 360  |  Des Moines, IA 50309  |  (515) 283-9330

The Iowa State Innovation Model (SIM-IA) is supported by grant # 1G1CMS331400-01-00 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the views of the U.S. Department of Health and Human Services or any of its agencies.

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