UNE Students share their Experiences on the third and final day of the 2018 DownEast Rural Health Immersion

June 6th, 2018 by healthinnovation
VhzC6MHxglct8nUPr_9LDCPfe-bUUgD_BmXkcTXGzDaF1BgRVOn3xq5F4f3jW-IWtZh4ylxlFjsRNAyVCdqq0lwSNvIDTYqV7PkM7Bo80Fzh1Zxzpm-2PVj-bAWy2Z8ArLDGyZDd4G4_jmJL6FA8g5L

Before returning to Portland the students spend the morning at Schoodic Point of Acadia National Park. Off in the distance is Cadillac Mountain.

Ten UNE health professions students recently participated in a weeklong rural health immersion to Washington County in Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the sixth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to the DownEast area.  In March a group of 10 students traveled to Piscataquis County; last Fall a group of 10 students traveled to Oxford County and Carroll County in New Hampshire for a long weekend immersion; in May of 2017 a group of 13 medical, pharmacy, dental, and nursing students traveled to Maine’s midcoast region of Knox and Waldo Counties for a weeklong immersion; in March of 2017 medical and nursing students participated in a weeklong immersion in Franklin County; and in May of 2016 a group of 15 medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County.  Throughout the immersion the students are purposefully split into interprofessional teams so that they can learn the roles and how to communicate effectively with other disciplines in order to learn the skills necessary to provide high quality team-based care and improve patient outcomes.  The students experienced a variety of clinical, community, and population health activities in rural and underserved communities in Washington County, including Calais, Eastport, Lubec, Campobello, and Machias.   Below are reflections from one team after the third day of the trip on Friday, May 25, 2018.

BjsQHVf0WZXUlslmw7114LE8GKAwgwO8KE0BKjXAKFJ11mQEBW0oRzFgwDxy6gM9xLJ7IWZ4IOcNsVIvoNmD7d58nTyY0QpSJb5bAiRhdOqrfSL3-64YqmWPUxGc_bA1ZZDnGqTQWbED39pIRuFe2Fm

The students pose with the staff at Eastport Health Care, who warmly embraced the group of students.

Sammuel Stratton, second year osteopathic medicine student

Could I do what Ben Okafor, PharmD, has done? It takes a special kind of person to move halfway around the world and risk everything to start a business in a place seemingly opposite from everything you know and against current industry trends. Ben is originally from Nigeria, Africa’s most populous country. He came to Washington County, one of Maine’s least populous counties, to establish Eastport Family Pharmacy in Eastport, a community of approximately 1,300 year-round residents. At a time when most pharmacies are owned by one of a few mega-corporations, Eastport Family Pharmacy is independently owned and operated by Ben. Despite the superficial differences with the commiunity, Ben found a deeper connection. In Eastport, as in Ben’s Nigerian culture, family and community are everything. Ben saw a need and an opportunity in Eastport. He left the security of a salaried pharmacist’s position and cashed out his 401K retirement funds to take a risk on establishing Eastport Family Pharmacy and he never looked back. Because of his steadfast commitment to his community, Ben and his pharmacy have been embraced by the people of Eastport and have found success. Would I be able to find the courage to risk everything like Ben has in order to follow a dream? Reflecting on Ben’s inspiring story I am more likely to say “yes” when the opportunity is right. I am more likely to risk it all for an opportunity to follow a dream.

An hour-long meeting with the staff at the Eastport community health center was not the place I was expecting to be rethinking my life’s plans. Coming in and out of an engaging and deep discussion at Eastport Health Care I found my mind racing: how could I convince my wife to consider moving down east to Eastport? what am I thinking—I still have at least six more years between school and training? when would be a good time to at least have my wife and son visit Eastport? Hadn’t I already convinced myself that I wanted to live someplace warm in the future? It is the sign of a special kind of place that gets you consider turning your life upside down to be part of the magic that is happening there. Following the community circle at Eastport Health Care, my one word is: “inspired.”

R_xOccv1ni5oyMjAZkc_WZBIvKANi421bgVtQcujPJnc23999fqeQHESsd32ui6pO6nCDEKaFBrLEhh7LVHMLWrfl2Rf6ZEIsjGT1dyXgzLX7znCWNdX6zfkO9UmLHfzPRZFbJ2mbUCXeRjjIKt5TTj

The students met with Ben Okafor, PharmD, independent owner of Eastport Family Pharmacy.

During the DownEast rural health immersion, the days were long and packed with meetings but the energy levels and spirits were high. From one day to the next the meetings and the discussions were continually deeper and richer. People were genuine and generous. The connections made us feel like they were with people you have known since forever and the friendships feel lifelong. After only four days how is it that one can feel like it has been always and will be forever? The answer is in the openness of the communities to embrace us during our rural health immersion and in the openness of the students who let themselves be changed by the experience. A four-day period is short; it is approximately one three-hundred-sixty-fifth of a four-year medical education, or in other words it is almost no time at all. But this relatively insignificant amount of time will hold tremendous significance for me throughout the remainder of my medical education, training, and into my practice. There is real value in connecting with people on an individual level. Listening to understand not only demonstrates respect for the other individual but also makes it more likely that you learn something from the interaction.

L5zvI1fNZSazgIcdfhvF37gFpaVxIkBHuI3tuOv_3ZqTwiU6udWCF88yvVR__5tO1n3Ma2vPGslbEHe3bE0_T2XK1AYrIFu7Yp8H0IOZ8ySdMAoW3rbw4iGzjbwuoLkJ3SpOy7WIqsgsUU7Q55HED-e

Before having lobster rolls for lunch the students toured Quoddy Bay Lobster in Eastport.

 

Grace Kim, third year pharmacy student

Each experience during the DownEast rural health immersion was filled with a tremendous amount of indescribable emotions that I have never felt before in my life. It was a mixture of joy, grief, regrets, enlightenment, and courage all together. But these words alone cannot truly describe several heartaches, and excitement through this trip. It was heartwarming to be so welcomed everywhere we visited, and I’m leaving feeling full of knowledge with empowerment over just a few days spent in Washington County. Then I started having few lingering thoughts in my mind. What would I have done if I were in their situation? Will I be able to provide the same health care with equal amount of passion and unlimited love towards the community? How would I be able to return my services and knowledge to the community? And would I even be adequate enough of a pharmacist in the end to even their community?

The answers were found in several different visits of health care sites in Eastport Community. We first visited Eastport Family Pharmacy owned by Dr. Benjamin Okafor, who showed how grateful and privileged he was to give back something for the Eastport community. It was shocking to listen to him speak about the services that he provides for his patients, regardless of some burdens that he might go through to provide those services to them. He was a true passion and dedication to his profession, and portrayed a love to his “own home.” All the community needed was a single heart of dedication to create innovation in the form of an independent family pharmacy. It was a true courage that we all saw through the visit to his pharmacy, and it re-inspired so much neglected insightfulness that health care professional students often forget through our busy schedules. It was a moment of enlightenment and recognition at the same time to reframe why we decided to pursue health care careers.

 

VRFUkOu3RfYo7ryfEUUj0LybFR1BXegMz-ygGIFsBHQzkmIxOtIIDZCAPJLCuZDBD0jjUe4hggKdbuO6a8wwcggwyVhmb2w6sX7U9iPp0mc8emBxm4z9hD3GD0Z0-C122eO8pmNqyUTkiRkXCBDbUDA

Students tour Raye’s Mustard in Eastport with Kevin and Karen Raye.

Then, after a short walk from the pharmacy, we visited Eastport Health Care Center. With warm welcome, the visit to Eastport Health Care Center started with a brief introduction, and taking a moment of silence. The shift in dynamics and the mood in that very moment in the room brought core reason, and empowerment. It implanted a meaning of what true health care needs to be. Everyone was able to engage and to form immediate bond to as of who we are, and what we are responsible as of future health professionals. Then, after listening to a poem written by John O-Donohue, “What Dreams Did I Create Last Night?”, it consolidated every little piece of the trip together.  As health care professional students, we get trained to be precise, accurate, and knowledgeable at all times, and to provide the optimal health care to the patient, this is true. We do receive education on science, and information that will be necessary in practice. But there is so much more to providing quality healthcare than just the basic sciences. And those simple things often slip or get pushed aside as we move from one block to the next. The love and adequate attention to each patient that was portrayed by EHC will not only create special bonds with patients, but also accelerate the rate of changes in health care society in better way. The approach may be different in each health professions, but holistically, we all share the same goal-  true patient centered care with collaborative teamwork. With constant exposure and awareness, which was emphasized throughout our rural health immersion, then better future and health care services will be provided to every single patient.

Answers were always there. Lingering thoughts that I had been having the first two years of my education were suddenly cleared out once I realize that it only needed one little change in mindset: That it is my passion, and everywhere I go will be my community regardless of geographical areas. That small change of thought brought courage, and passion, and I am sure it did for all other students that participated in this trip as well.

ginxpNNV1bQgLo3OMYYrMx0HaHzSSaG7XE5alMVIuBSyrfUqS3gqQF1in7hij2X6ls8pMoMS1pcV_R__vuhps7HVeSqmKMpKyh60-ZmJcZqrZOCebLN-SJljwyuVHZ1mzlNdbjZ8KTJr5gAvUpzf7Vw

The students met with a panel of community guests in Eastport to get a better sense of what its like to live in a rural community.

Christina Renodin, second year osteopathic medicine student

As a future health care provider, cultural competency and patient sensitivity is a necessity. Throughout our exploration of Washington County, our group of interprofessional students discussed this topic often. I appreciated the continued conversation we engaged in as developing cultural competency is a dynamic process that occurs along a continuum. Having been exposed to many aspects of rural health care including a local critical access hospital, multiple federally qualified health centers, dental offices, and a privately-owned pharmacy within rural areas, these experiences allows us to broaden our own understanding of the needs of diverse populations encountered in rural areas. This rural health immersion helped us to develop how we, as future health care professionals, may respect and appropriately respond to diverse populations. This theme continued in our visit to the Eastpoint Health Care where we spoke with staff about how they strive to meet the needs of their patients with creative solutions. This was a commonality we met through our trip, how rural health care providers wear many hats both in their health care field and as an engaged community member.

One of the most rewarding experiences of our rural health immersion was engaging in conversation with local community members of Eastport, ME. Here we spoke with a legislature, a business owner, a police officer and port authority director, as well as individuals who moved to Eastport later in life. Much of our conversation was about the needs of the community and how providers who decide to work in a small community, such as Eastport, may address those needs. This meeting was enlightening as we had spent a majority of our immersion meeting with health care providers. Our students connected with the community during this meeting because we were able to hear real life adversity faced within the community. We discussed how the port authority was working to increase business through the port, the community’s limited access to health care, as well as the high cost of health care and health insurance. The most compelling element conveyed to our students was the true sense of community within Eastport and how hardworking the coastal town was.

Our rural health immersion in Washington County concluded with a reflection on our immersion and with a visit to Schoodic Point. It was breathtaking to see hightide and watch the changing of the tides. This capstone moment gave us one last chance to connect as a group and appreciate all the beauty and wonder rural Maine has to offer.

Cody Hutchins, third year pharmacy student

Being raised in a rural area during a time where my family and I had to jump from town to town every year was all the experience I needed to know exactly what a move to Washington County would consist of, or so I thought. Moving to this place where there are more lobster traps than people, I thought would mean moving to another sprawling community that provides no chance of making connection. Here my Bostonian shoes stand before a creaking dock in Eastport, the most eastern corner of the United States, as a cool ocean breeze runs down my spine; it gives me the sense that nine months of cold weather and winter driving in this foreign place will only add to the time I will have to myself and myself alone.

It’s Day 3 of the DownEast rural health immersion. It has only been a couple hours since the sun crept over the blue edge of the Earth and chased off the morning mist over the harbor, and I am having an experience that is shifting my perception of what it means to live in a rural community. Our interprofessional team of students hop out of the UNE commercial van and walk through the front door of Eastport’s only pharmacy. My first impression is that the single aisle of medication really fails at masking the identity of the tiny laundromat that the pharmacy was repurposed from, but the trusting smile behind the counter quickly and successfully completes the illusion. The smile belongs to the pharmacist Ben Okafor, PharmD. Ben is from Africa and seemingly as out of place as my shiny shoes on that work dock or this aisle of medication in this used-to-be laundromat. Ben welcomes us with his charisma and shares with us his core values. He explains to us that if your business works hard for the community the community will work hard for your business. Ben drives a great distance to hand deliver prescriptions to people in their homes and in return people from great distance come to Ben entrusting him with their health.

UGmds2OgoqjLEPDyfNB1Wg6I7nephGQD1UZYMSVXLt154M-AnExqV4BuVnkxu1lZQBb50LB29pGZGA8nnLPWxMA49tDRolVFRS1kaCWMSL_0_wMUmeltnG6vqlbBoOSCphGxZWQHKJ4k8SGcUcvYnLe

The students enjoyed having breakfast at Karen’s Diner in Calais each morning.

Witnessing how the small community of Eastport has sought out and taken to Ben makes me believe that finding friends and belonging is just part of Washington County’s allure. It seems that the cold does not isolate people here, it huddles people together. Ben’s story changes my fear of being lost to Washington County to a sense of hope in finding a true tight knit community. I leave this experience and Washington County with a new appreciation for rural communities and their capacity of giving oneself belonging. Maybe my feet will look less out of place in front of that creaky dock when I return with my Bean boots.

UNE Students share their Experiences on the second day of the 2018 DownEast Rural Health Immersion

June 1st, 2018 by healthinnovation

Ten UNE health professions students recently participated in a weeklong rural health immersion to Washington County in Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the sixth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to the DownEast area.  In March a group of 10 students traveled to Piscataquis County; last Fall a group of 10 students traveled to Oxford County and Carroll County in New Hampshire for a long weekend immersion; in May of 2017 a group of 13 medical, pharmacy, dental, and nursing students traveled to Maine’s midcoast region of Knox and Waldo Counties for a weeklong immersion; in March of 2017 medical and nursing students participated in a weeklong immersion in Franklin County; and in May of 2016 a group of 15 medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County.  Throughout the immersion the students are purposefully split into interprofessional teams so that they can learn the roles and how to communicate effectively with other disciplines in order to learn the skills necessary to provide high quality team-based care and improve patient outcomes.  The students experienced a variety of clinical, community, and population health activities in rural and underserved communities in Washington County, including Calais, Eastport, Lubec, Campobello, and Machias.   Below are reflections from one team after the second day of the trip on Thursday, May 24, 2018.

 

Amanda Follensbee, first year social work student

Spending the morning at the Calais High School and visiting the onsite health center and school nurse I instantly felt the sense of hardship and adversities that the community faces with the minimal organizations that they have. Yet, this did not seem to stop the small-town community from persevering and strengthening the resources they have by “double dipping”. Utilizing the school nurse as also a place for the health center it became evident how resourceful and strategic the people of Calais were.

Similarly, speaking with the students about higher education at the high school I felt the same sense of hardship coming from them in the sense that a few of them felt stuck in the small town they grew up in. These students expressed a responsibility to the community to stay where they are and help where help is needed. I related to this feeling of responsibility for the community when I was in high school; nearly every teacher told me to “Come back to Vermont and work”. I didn’t venture far for my undergraduate education and I did feel the need of the community in Vermont for social workers. But when I returned to school to pursue my Masters of Social Work, I wanted to broaden my horizons and therefore attended school at UNE in Maine. Through that, as well as through the DownEast rural health immersion, I learned that the need for social workers and health professions as a whole are needed in almost every community.

During our time at the Lubec Regional Medical Center I felt a strong message of support and community; the term “People place” came up often during our discussion with the staff and faculty at the facility. The rural health immersion taught me the importance of a strong community and pulling resources together in order to provide for the need of the community. Our visit to Lubec and Campobello strengthened the idea that we’re all in this together.  I learned that it’s much better to utilize what the community already has and strengthen those resources, rather than wishing for more or better, or for things that are unattainable.

 

Joelene Nguyen, third year pharmacy student

The third day of our Maine Adventure continued to surprise me with more motivational and inspiring works from the healthcare providers in Washington County.

We visited Calais Highschool and actually had a chance to tell our story and inspire other students. Talking to the current high school students really allowed me to reflect on my experience and journey as a future healthcare provider. The students were shy and appeared unresponsive in the beginning; however, some of the head nodding at the end showed that they were listening. After the presentation, I thought about how I acted when I was in their seats back then as a high school student.  I could see myself being shy about asking questions, and sometimes distracted whenever there was an opportunity to listen to any speaker. However, I think as I continue my education, I have become more focused and listened to everything being presented to me, which is one thing I tried to emphasize to the high school students. I think it is important to not shut down any idea the first moment that I am being presented to. I’ve used this thinking during the DownEast rural health immersion, where I have tried to take all the information in and slowly process it, especially as I ponder the decision to practice pharmacy in a rural area.

The visit to the health center in Campobello was a very interesting experience. Seeing the advantages of having universal healthcare in Canada, I did question if the healthcare system in the U.S. is the cause of much of the poor health outcomes that we learn about in class.  These poor health outcomes aren’t limited to rural areas but as a nation as a whole. A common theme that might explain these poor health outcomes in the U.S. that we’ve seen so far in the DownEast rural health immersion is that there is not enough healthcare providers in the communities that we’ve visited (Calais and Lubec so far).  Due to the healthcare professional shortages, we saw certain health professionals wearing many hats and juggling between different responsibilities to deliver the best patient care possible. Another theme that we talked about at length in Campobello, was that a large portion of patients in the rural US are uninsured and that can have an effect on payment to for services and the day to day operations of healthcare systems in rural communities. Thus, I think this issue in particular plays a major role in de-motivating health professional students from practicing medicine rurally because they might struggle financially due to their student loan burden. So, I reflect now and question what if we had universal healthcare in the U.S.? I definitely believe that it would increase accessibility and also allow an easier path for students to fully immerse in practicing their career wherever they want.

This trip has given me a chance to be exposed to rural medicine. So far, I have heard from so many inspirational community members, and their stories about what brought them to rural Maine. The conversations that we’ve had so far and the places that we’ve visisted have made me realize that there is such a need for healthcare services in the rural areas in the state of Maine and I may be able to make a difference as a future provider.

UNE Students share their Experiences on the first day of the 2018 DownEast Rural Health Immersion

May 31st, 2018 by healthinnovation

 

FDIgHjoga4qwLZmBIr7l1IaZZpJN2yB-Bg7WzsbUlzef4FlmfxmAvRYaYSR5zgh8bASczkkvzCVteCliddoDZKSsEVC0FVC24lu0c_hY8byq1QCx6DW7wp8ZvhU_LvS8ywZpiTJoa5vSJM0z22SiBAHS9m95H_HWg8WKwMzKTjnxUaxtBPmdwePMyRU71t

Ten graduate healthcare students recently participated in a weeklong rural health immersion to Washington County, Maine. Here, the students pose in from of Calais Regional Hospital before spending the day meeting with a number of the hospital staff.

 

Ten UNE health professions students recently participated in a weeklong rural health immersion to Washington County in Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the sixth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to the DownEast area.  In March a group of 10 students traveled to Piscataquis County; last Fall a group of 10 students traveled to Oxford County and Carroll County in New Hampshire for a long weekend immersion; in May of 2017 a group of 13 medical, pharmacy, dental, and nursing students traveled to Maine’s midcoast region of Knox and Waldo Counties for a weeklong immersion; in March of 2017 medical and nursing students participated in a weeklong immersion in Franklin County; and in May of 2016 a group of 15 medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County.  Throughout the immersion the students are purposefully split into interprofessional teams so that they can learn the roles and how to communicate effectively with other disciplines in order to learn the skills necessary to provide high quality team-based care and improve patient outcomes.  The students experienced a variety of clinical, community, and population health activities in rural and underserved communities in Washington County, including Calais, Eastport, Lubec, Campobello, and Machias.   Below are reflections from one team after the first day of the trip on Wednesday, May 23, 2018.

opUr0eVUehsUuBkFN-0OCmX90cr_TazYWm9H3Srr2GIC3DOCLF0wuBxDQSSuJ6yUEfWC3XAueTx2KrEoNUq2A5_8iiQihUvy80H5qYlESkSBLlQDhJnJcVU3x69MN8ZbZIhuemsOrFN2aJosx6a8tVCJnmo_cspYDCazuYLnof_-7EMxZnQoPzh_TSHak5

The students stayed at the Washington County Community College for three nights during the trip. During the first night they got to use the rock wall at the community college.

Kelsey Hickey, second year osteopathic medicine student

A common theme from spending just two days in the quintessential Maine town of Calais is pride. I grew up in rural Maine and I remember laughing about this fact at lunch with all the various faculty and staff at UNE – namely those in the group who are “from away”; thinking it was a fun quirk us Mainers have. However, as we toured Calais and its hospital and mental health facilities, I have begun to recognize this pride in myself and in other Maine people who are living in this rural area. I never really realized before, but whenever someone asks me where I’m from, I get a rush of pride to say that I am from Maine. As I reflect on our experiences so far, I think the thing that stands out to me the most is really the people that we have met in Washington County.

This sense of state pride is well earned; I have had the pleasure of traveling to many different places around the world and nothing compares to a the life of a being true Mainer. Hard-working, proud, stubborn for sure, and certainly compassionate. Living in rural Maine is no easy task – you have to work for everything that you get. The rural areas tend to be poor and less educated (a drastic generalization, but I think it can be applied to Calais). Talking with our hospital tour guides and the Calais hospital staff, you would never be able to pick up on these factors that make Calais an underserved population. What I mean by that is again, I just felt an immense pride in all that the greater Calais community has accomplished. Keeping the hospital running in a harsh economic environment is no easy task; but I really liked that everyone seemed able to recognize each other’s strengths (and weaknesses). My impression is that everyone makes sacrifices in living in rural, poor communities, but this is more than made up for by the fact that you are all family, in a sense. I love that everyone looks out for one another and takes care of each other. While I was working in Boston, for example, this was most definitely not the case.

I think this is my rather clumsily-worded way of saying that despite growing up in rural Maine and having my own personal experiences in rural healthcare, just being surrounded by community members and healthcare workers who take such pride in their work just strengthens my resolve and pride in being a Mainer myself. I consider myself lucky to be part of such a strong community, and as our tour guide at the hospital put it, “no matter how poor you are, you always provide for your community.” These are the values I really want to take with me as a physician, because to be able to give back to your community in meaningful ways is truly a privilege, in my opinion. I think everyone found meaning in Dr. McHugh’s sentiment that it is our responsibility to give back and contribute to other’s lives in a meaningful way. These are words I hope will guide me throughout my training.

 

However, despite these wonderful experiences I look forward to talking to more providers about their careers as rural healthcare providers, to see how they overcame the challenges of practicing rural medicine. It’s very true that you make personal and career sacrifices by dedicating your time and effort to a small hospital that has limited resources. I know that my personal and professional goals are somewhat contradictory – I really want to experience a diverse and enriching training after I graduate, and realistically this is best accomplished in a somewhat urban environment. After all, more people = more money. But I found hope in Dr. Lee’s career path: get the most out of your training and do all that you can to enrich your own experiences. Then you can take this training back with you to the rural areas that need it the most. These past couple days have given me clarity in that I know I want to stay in Maine and practice. After all, that stubborn Maine pride usually wins out over everything else.

 

Aliza Hanif, second year dental student

X_-2g47ahTaNSqs6ZmWOSZBb5EJ28Yq-6yDAMw0B1_kh-fLkEN6YDSK1604phT-xUQEXzB1oY5O5T4mk2doSJ0kb3hzE_G1JUtNJ_7X0AzXmH-wIdiA9a_wj_akq4RPuGBn1VWFU2BGLk3q0gMo5sbuPH2Jw3cHADlFZyev_rfpj2DyjynTf48gq3UIWGW

Aliza Hanif, second year dental student, participates in a conversation on the importance of interprofessional education and practice at UNE with international thought leader, George Thibault, MD.

During my rural health immersion experience with the University of New England, I found myself fully appreciating the sense of community and collaboration that various areas in rural Maine offer. The experience of this trip reminded me of the time when I mentored girls at The First Tee of Miami program on translating the life skills learned from golf into academic and leadership pursuits. Within this program, we learned how each of the nine core values can be applied to their daily lives as students. While on my trip to the health centers in Calais, I too found myself applying those same core values to the experiences that we gained at each site visit.

We ended our first day of the immersion trip with a bit of rock climbing in which we exercised The First Tee core value “courtesy.” It was amazing to see the respect for one another regardless of what profession we were in. It was apparent that all of us had each other’s best interests at heart. This core value is particularly important in healthcare because there should no longer be competition, but rather collaboration.

ZAWV1rTuhKOTa5bB2y7ae27LxcsNxOSW5VUCPDFgcg_XGa4vueEXhrW4K3kFxMH7mJT1E64pfrE8F2v-IMgvxuszviFujTecdB7K3vI3-s5xrvE6ZgqcgfEpQiylJrWW5r-ZL483gUKQkWbrbFPnF1MjUpJf7UpC8a8_t5fXuoMDhj98kgReNhKxP21eu5

While at Calais Regional Hospital, the students met with Dr. Tom McHugh, MD, to talk about substance use disorder.

Bright and early the next morning, we began our journey to different healthcare centers in Calais. One of our site visits included interacting with Dr. Karen Delaney, a family dentist who also performs endodontics and oral surgery. While most general dentists in the field may not feel comfortable performing extractions and root canals, Dr. Delaney was very much the dentist to go to when it came to those particular procedures. I admired her go-getter attitude and the notion that she is truly a champion of evidence-based dentistry. Seeing the state-of-the-art technology in her office taught me that you can truly be innovative even in a rural area in Maine. The experience reminded me of The First Tee core value “judgement” because though Dr. Delaney had the latest technology, she made sure to tailor her procedures to each patient’s needs.

 

The next day of our rural immersion experience began with engaging high school sophomores and juniors at Calais High School. I think the one core value that all of us stressed to the students was “perseverance.” All of us have our own story to tell and it is what makes each of us unique. As a collective group of students, we are from areas that range from extremely rural areas in upstate New York all the way to metropolitan cities like Los Angeles. Whichever pathway we took to get here, we all persevered through our own struggles to solidify a position within our respective professions. We never let anyone’s opinions of us define who we were.

I think one of the biggest takeaways so far from this experience is one of The First Tee’s core values, which is “respect.” While at the Aroostook Mental Health Center in Calais, I witnessed each of our osteopathic, pharmacy, and social work students actively listen to the services provided by this center. We were all awestruck by how much of a powerful role these women play in the lives of the youth. As we discussed various ways to improve communication in healthcare, the hierarchy of medicine disappeared and we all acted as one unit within that room.

pPYz95vtk94lNG5zQOKhIsUmWBj5ZQNFpknjjjqMWCFpA2Js1Xn-2fhyrEoTHPXoLQTZCx6nEup_-epk2l7qYvqf99EZVNQtgt6dJixYDuVAeZRrsjdNvmQa4KmGQpGhuq31A9HYaL_hzTsTdDgKn44-j_zcwAIa8x4-cwGTTe26UYxIXQnyXR1FKY3b1C

Later in the day the students visited the Aroostook Mental Health Center in Calais.

The best part of this trip was creating a new network of professionals and making life-long friends that I would not have otherwise had the opportunity to meet during dental school. From meeting social workers who deal with cases such as those suffering from bulimia nervosa, to hearing a triple-board certified pulmonary specialist express the importance of mentorship, and finally to being treated like family at a federally qualified healthcare center reminded me of the core value “responsibility.” It is our responsibility as future healthcare professionals to put our own values aside for the sake of our patient. It is our duty to be informed with the latest research of the type of medicine that we will provide to our patients. It is our responsibility to create that beautiful sense of community that all rural areas offer within our own medical practices. I challenge you as my fellow student colleagues to think about your own core values and how you can translate those into your own profession, whether it be an osteopathic physician, a pharmacist, a social worker, or even a dentist.

HW9sM23Gp-OS8h-J4l3NP92jEPDv6HS8a2TQZhyLR-pcBgOc-TZQSBVNE1KPqiFg-3o7QcpRVlBTOIUyMaTA-AtgyNLzl7R8OLq-i9excvV4F4YbT790AxLlKkC9od_nYcr9Zxmy8ihCN-JKEy8kCPzxcW0KZE0bbOdXFW0v5jOc8AoWubVHbt5kENmYSV

Sara McConnell, Maine SNAP-Ed nutrition educator, welcomed the group of students into her Nutrition Education class at the Methodist Church in Calais.

Anna Dempsey, third  year pharmacy student

If you have never been to a hospital in a rural area, Calais Regional Hospital is the place that carries a motto of strong dedication of healthcare professionals committed to serving the community. Dr. Thomas McHugh and Anne Perry (also a state representative that has initiated passing the legislation for PMP in Maine) were some of the professionals who emphasized that if we eventually decided to move to Calais or its surrounding areas then we would need to have solid professional expertise and we would need to be willing to seek resources and opportunities to provide the best possible patient care with limited staff and funds. What impressed me during the visit to the hospital is the inspirational mindset of the providers- having to practice in community-based healthcare and knowing your patients really well and what they are dealing with. This style of healthcare practice actually allows for better patient care outcomes or even patient adherence to medication or appointments; such provider-client relationships brings the patient closer to proposed clinical goal.

The fact that Anne Perry started nursing school at the age of 50 also inspired me as a healthcare professional and someone who can take on a challenge and be able to be innovative and creative in structuring new ideas, especially since most patients are to be perceived as a whole with their mental, physical and psychosocial concerns. And that’s never easy to do, partly because it means you have to be prepared to answer questions and contemplate over things you’d never think of while working in retail pharmaceuticals.

f5ojCx8ZjQ625ESBLeC9aSlPiUP070ZVdBUkQ6yHK0yT4yAoOn_yrsp6AeoVpNA4A429nw2Fa7w_thwisAhWv06M6ujJeTlF61GbOQqB3EAUUaOH-Rin3HKqwlG6vroXZ90_kiFZ3KlUIFdNPH3mp0T-l_bRZTXI_Meo38mql5fmtaJgMHQjDKj0Hw-9TD

Anne Perry, F-NP, State Representative, talked to the students about her experience living and working in a rural community.

Dr. Thomas McHugh, who has been practicing in the Regional Medical Center in Lubec as well as in Calais Regional Hospital over the course of his career, also has extensive experience working with patients with substance use disorder. He mentioned that what drove most patients to become addicted was hopelessness. During his career, he has seen patients struggling with addiction and coming back to their providers claiming they aren’t on the right path to recovery. Yet Dr. McHugh always tried to work with patients to overcome resistance and focus on patient’s willingness to suppress or overcome addiction. Dr. McHugh urged us not to be discouraged by the “placebo effect” of the treatment and, for example, that it’s okay to tell a patient, “I can provide the resources but you have to do the work.”

y7PAlPxj1CVNT6qmeiecZMBC_KbRQ0ddc9bvBJek9pFb2yI5U74AeMQXY4mWE5ND51Boq9nURMqDcB4cm26Az2ZoeJ9nQBJ3iJrVM9X3-2xbEAVu5cOTRG6IryQKpxbIBlv3mcpGnnmciDl07tmvq9LpzoN8PvijVLqhosL9Tb8Xg2PkmzxtowbdvznMqu

The students debrief about their experiences in Washington County after the first day of the weeklong trip.

In order to improve healthcare outcomes, both Dr. McHugh and Anne Perry have been working on a project for substance abuse disorder, to collaborate with police, social workers, etc. to get involved with the community and better observe the results of the patient’s path to recovery. The project, they said, will take about two years and is a promising example of the innovative culture in Washington county and an idea that could possibly serve as a sample project to target neighboring counties if positive outcomes are discovered.

SAvPvp7s7h9iMz7jSOEoBB_LnJ86TAY2C9tWNzl3E4EQv1euwclrkHXPvuO4mf56o16pnZxdlIY29g5mdnWZS8rItFmzcjTqzWvJ_oSOgyWhp2dDfURvgDhVYGa9oZOi67WQTUVTXHWAvvxZNygcJrM9xGRoY2oPmf2PcJ03L1HggZ3dNpV4MHb2hDw6Cv

On the way down to Washington County the group stopped in at Renys for “A Maine Adventure”.

UNE Students Share Experiences on their Last Day of the 2018 Piscataquis County Rural Health Immersion

March 21st, 2018 by healthinnovation
The students and faculty pose for a photo after teaching their lessons to students at Greenville School.

The students and faculty pose for a photo after teaching their lessons to students at Greenville School.

Ten UNE health professions students recently participated in a weeklong rural health immersion to Piscataquis County in Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the fifth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to the Penquis area.  Last Fall a group of 10 students traveled to Oxford County and Carroll County in New Hampshire for a long weekend immersion; in May of 2017 a group of 13 medical, pharmacy, dental, and nursing students traveled to Maine’s midcoast region of Knox and Waldo Counties for a weeklong immersion; in March of 2017 medical and nursing students participated in a weeklong immersion in Franklin County; and in May of 2016 a group of 15 medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County.  Throughout the immersion the students are purposefully split into interprofessional teams so that they can learn the roles and how to communicate effectively with other disciplines in order to learn the skills necessary to provide high quality team-based care and improve patient outcomes.  The students experienced a variety of clinical, community, and population health activities in rural and underserved communities in central Maine communities, including Newport, Dover-Foxcroft, and Greenville.  The group was also supposed to visit Eastern Maine Medical Center and Penobscot Community Health Care but due to a Nor’easter the first two days of the trip in Penobscot County were canceled.  Below are reflections from one team after the last day of the trip on Friday, March 16th, 2018.

Mooshead Lake as seen from the Kineo View Lodge

Mooshead Lake as seen from the Kineo View Lodge

Taxia Arabatzis, First year Osteopathic Medicine Student

Dynamic and innovative are some of the words that come to mind when I think about the health care providers we have come across over the past few days in the UNE Maine Rural Health Immersion trip to Piscatquis county. The providers ranged from school nurses to hospital doctors to administrative staff in the clinics and hospitals, and all were very dynamic and innovative. Being in rural areas these providers are limited in almost every way, yet, through strong dedication they are able to make it work.

In rural communities everyone knows everyone, so the local providers are ingrained in the community and they know the needs of the people. Therefore, rural providers are able to directly meet the needs of the people by doing things like delivering extra educational classes at their hospitals, or starting programs to combat substance abuse, or any number of other initiatives to help their community. One thing in particular that I noticed at every facility that we went to was that the staff always mentioned that Fridays were Jeans days for the employees and the money they raised from this was ALWAYS put right back into the direct needs of their community. At one hospital in particular they said the money went towards a food pantry that they could send their patients to if they screened positive for food insecurity (unfortunately a common occurrence in parts of rural Maine). The providers started the food pantry because they felt terrible asking patients about their access to food before the food bank was started since, at that time, they didn’t have a solution to the problem. This is a simple example, but it shows how the providers in rural Maine are truly dynamic and problem solvers. It was clear that the providers we met with understand the needs of their patients in an intimate way that is often hard to find in an urban setting, and that they do everything they can to address their patients needs.

After visiting at the Greenville School the students spent time at Dean Memorial Hospital.

After visiting at the Greenville School the students spent time at Dean Memorial Hospital talking about rural health with the local providers.

Despite the tremendous needs of the rural communities that we visited, they are ahead of the game and innovative in their approach to determining the needs of their community and directly addressing them.  It can be very daunting to look at the health needs of a patient, including physical, social, emotional, and socio-economical health factors and try to address them all. However, in the rural communities health providers are used to this, and they are used to fighting for their patients, who are their neighbors and community members, and that is a lesson that all of modern medicine can learn from.

The last stop of the trip was in Shirley at Lone Wolf Guiding Services where the students learned about dog sledding.

The last stop of the trip was in Shirley at Lone Wolf Guiding Services where the students learned about dog sledding.

Matthew Senno, First year Osteopathic Medicine Student

Meeting with the kids at the Greenville School this morning was such a great experience. I loved interacting with a group of students that is still learning, and it is a great opportunity to improve all of our teaching abilities. It’s always great to spread awareness about brain injuries, and how the brain works in general, especially to children in the 4th grade, who are riding their bikes and playing outside, so have a lot to learn of the proper safety equipment. I was surprised at how much some of the kids knew about the brain already and I was blown away by some of their questions (many of which I didn’t have an answer to). The school nurse was amazing as well. She seemed so dedicated to her job, and to helping all of the kids in the school.

After we left the school, I really enjoyed meeting with Dr. Galen Durose at Dean Memorial Hospital in Greenville. It was interesting to hear how he alone had to run the ED, and how he could be one of the only physicians in the entire hospital. This was eye opening because previously I didn’t fully understand the extent of the lack of providers in such a rural area, and all of the extra work that these health care providers have to do for great patient care, and how willing they are to do it. That seemed to be the overall theme of this trip- that there is a lack of providers, but all of the practicing providers in these areas are willing and happy to work so hard in order to better the health of their patients. This is an encouraging thought for myself as a future physician, knowing that there are currently providers like this that I can look up to, and contact for any advice in my coming years.

One last group photo before heading back to Portland.

One last group photo before heading back to Portland.

UNE Students Share Experiences on their Second Day of the 2018 Piscataquis County Rural Health Immersion

March 20th, 2018 by healthinnovation
Students talk about health policy with Maine State Senator Paul Davis, who represents communities in Piscataquis county

Over breakfast students talk health policy with Maine State Senator Paul Davis, who represents communities in Piscataquis county

Ten UNE health professions students recently participated in a weeklong rural health immersion to Piscataquis County in Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the fifth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to the Penquis area.  Last Fall a group of 10 students traveled to Oxford County and Carroll County in New Hampshire for a long weekend immersion; in May of 2017 a group of 13 medical, pharmacy, dental, and nursing students traveled to Maine’s midcoast region of Knox and Waldo Counties for a weeklong immersion; in March of 2017 medical and nursing students participated in a weeklong immersion in Franklin County; and in May of 2016 a group of 15 medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County.  Throughout the immersion the students are purposefully split into interprofessional teams so that they can learn the roles and how to communicate effectively with other disciplines in order to learn the skills necessary to provide high quality team-based care and improve patient outcomes.  The students experienced a variety of clinical, community, and population health activities in rural and underserved communities in central Maine communities, including Newport, Dover-Foxcroft, and Greenville.  The group was also supposed to visit Eastern Maine Medical Center and Penobscot Community Health Care but due to a Nor’easter the first two days of the trip in Penobscot County were canceled.  Below are reflections from one team after the second day of the trip on Thursday, March 15th, 2018.

DSC_1205

The students meet with Mayo Regional Hopsital CEO, Marie Vienneau to talk about working for a Critical Access Hospital in rural Maine.

Emily Krusec, junior ABSN student

It takes a village. What a cliché – especially when referencing small, rural towns – but in Maine, survival in these types of communities is centered around this overused expression. Being from “away”, as Mainers might say to someone like me who was not born in Maine, I noticed the strong sense of community when moving to the state – this profound characteristic is even more exaggerated in rural Maine. This led me to question why rural areas have such a strong sense of community. During this immersive experience, I learned that it is for survival. Access to healthcare and related resources is not ubiquitous; this is especially a reality in rural areas. To help combat this, many healthcare professionals have adopted the “whatever it takes” mentality in addition to tailoring healthcare programs to the community in order to efficiently utilize the few resources they do have. Rural community healthcare providers must heavily rely on collaboration with others in order to meet the basic quality healthcare needs.

Each interaction, during this immersive experience, touched on community participation in its own way – starting with Piscataquis County Senator Paul Davis who told stories about personal involvement with community members and the impact it had on those individuals. He shared his experience with one woman in his community who lost her driver’s license because of poor vision. For bureaucratic reasons, the DMV was not allowed to give her a license after she had her vision corrected. Senator Davis was able to make a few phone calls and work some magic so this woman was able to get her driver’s license back. In this woman’s case, it solved the most common obstacle of healthcare access in rural Maine: transportation.

The students meet with Gail Bergeron, owner and operator of Foxcroft Pharmacy

The students meet with Gail Bergeron, owner and operator of Foxcroft Pharmacy

Transportation was another common motif that was later emphasized in our meeting with elder town residents who were in the process of establishing a community center in Dover-Foxcroft. Among the seniors was Leslie Fernow, a retired local physician who had a strong passion for her community. In response to the transportation obstacles many of her patients faced, she adopted the “whatever it takes” work ethic by providing home health visits to her patients. Doing so offered many other benefits, including seeing her patient’s in their environment to paint a better picture of their health, along with truly interacting and spending more time with her patients on a personal level. Dr. Fernow also emphasized the importance of community involvement and contributions by healthcare professionals – through fully giving back to patients, neighbors and the community in many ways, this completes the integrated healthcare circle.

This theme continued on in our meeting with the staff at Mayo Regional Hospital. Mayo Hospital is an essential part of the community in Dover; it facilitates community town halls to collect feedback, organizes free classes directed toward health promotion and disease prevention, and they tailor many of their programs to fit the needs of the community – thereby efficiently allocating the limited resources. Mayo providers also discussed the staffing shortage crisis and how rural areas are hit particularly hard. The provider shortage has led to increased collaboration among healthcare professionals and one person having to fill many – sometimes as many as 6 – various roles, just to provide basic quality healthcare. This again reiterates the theme of “whatever it takes”.

Before this trip I believed living in rural areas and having a sense of community were mutually exclusive, but I learned that it was quite the antithesis: the limited resources in a rural community actually brings the community together, making it stronger. So what does it take to provide basic quality healthcare services in rural, underserved areas? It takes health professionals who adopt the “whatever it takes” mentality along with healthcare providers who reach out, collaborate and support one another because that’s all they have. Most importantly, to provide basic quality healthcare in rural communities, it takes the contribution of all members; it takes a village.

DSC_1220

First year osteopathic medicine student, Gigi Green, and junior nursing student, Lauren Yelinek, practice intubating a pediatric patient in Mayo Regional Hospitals Sim Lab with Kathryn Brandt, Director of Primary Care in UNE’s College of Osteopathic Medicine.

 

Evangeline (GiGi) Green, First year Osteopathic Medicine Student

When I woke up this morning I had no idea what to expect from the day. As someone who likes to have control of all aspects of my life this left me feeling extremely apprehensive, but in the end it was a blessing. To give up control and have no expectations allowed me to be fully present with the community and the experiences that we were given during the rural health immersion. I wasn’t taking each experience and comparing it to another one or to some made up benchmark that I had set in my head; to some extent I think this parallels the practice of health in a rural community. The lack of resources that we heard about from the providers that we met with requires creativity and support for one another. At Mayo Regional Hospital in Dover-Foxcroft we were informed of the high turnover rate in rural medical practices due to provider burnout. Part of me couldn’t help but wonder if this burnout stemmed from the expectations that we have as practitioners for a certain level of facility or support that can’tnecessarily be reached in a rural setting.

Nikki Chadwick, VP of Quality and Education at Mayo Regional Hospital, talks to the students about how the staff is striving for superior healthcare quality

Nikki Chadwick, VP of Quality and Education at Mayo Regional Hospital, talks to the students about how the hospital staff is striving for superior healthcare quality

In talking with the providers in Dover-Foxcroft I couldn’t help but be amazed with the level of creativity that they used in their delivery of care as well as their dedication to serving as many roles as they felt the community had a need for them to be in. These people were thriving in their roles, they did not hold on to expectations of the way healthcare needed to be delivered, but rather they ditched those expectations and focused on the needs of their community and how they could best provide the services to meet those needs in an effective manner. This idea of working together with the community is something that continued throughout the rest of the day.

After leaving the hospital we went to the Maine Highlands Senior Center in Dover to meet with elders in the community and to hear their take on health needs. This experience dove back into the concept of community and fostering a stronger community in order to address its needs. The building that we stood in was once the center of the town, it was a place that could be used by all and served many roles and fulfilled many needs. For many years it had been neglected and had not been used for some time, but members of the community came together to restore the building and bring it back to what it once was- a community gathering spot- but with additional services to address the emerging needs of the community. What stuck with me is that community means different things in different places. When in a town that has challenges a strong sense of community becomes even more meaningful. Dr. Leslie Fernow talked to us about the unfortunate societal trend of decentralizing a community and moving away from the traditional community-oriented lifestyle. In her opinion, which I agree with, this is not what we should be striving to achieve. Instead, we should be fostering stronger community and bringing people together, which will be achieved through the Maine Highlands Senior Center. Giving people a place to go and a sense of belonging allows you to pool your resources and work together to achieve greater health.

DSC_1236

Students meet with community elders at the Maine Highlands Senior Center in Dover-Foxcroft. They later broke out into small groups to talk to the elder guests about what its like to live and work in a rural community like Dover.

 

Alicia Bergquist, Junior ABSN Student

“We’re both seventy-five, and neither of us are on any medications.” Over the next thirty minutes Joe and Beth, locals to Piscataquis and Penobscot Counties, became my idols for what it could mean to age healthily in a small rural community. Having moved to Dexter, Maine twenty-five years ago with their daughter to, “escape the rat race” of New Jersey, the couple almost immediately were made integral members of the community. With a population of less than 4,000 the citizens of Dexter were eager to take advantage of Joe’s background in middle and high school education and Beth’s speech pathology practice. Since retiring, Beth has started the first chapter in the Penquis Region for the National Alliance of Mental Illness (NAMI), and is forming one of the first geriatric mental health support groups in the area. Once Joe retired from teaching, he got right to building a small house for the two of them on their eighty-six acre plot of land. “How do you two stay so healthy?” I asked, suspecting I may have a good idea already. “Staying active in our community, and a whole food, plant-based diet!” Beth affirmed. They are lucky enough to have had the same family physician since they came to Dexter – in contrast to another community member who had expressed great anxiety over the announcement that her primary care physician was leaving her practice – and emphasized their appreciation for their provider always taking as much time as necessary with their every appointment. Hearing about how involved they were in the towns of Dexter and Dover-Foxcroft, and seeing the positive results reflected in their springy steps, easy laughter, and kind words for each other, their town, and their experiences reinforced the growing sense I was getting for just how supportive and fulfilling a small rural community can really be.

I had been introduced to Joe and Beth at the soon-to-be gorgeous Town Commons in downtown Dover-Foxcroft. The historic building is nearly finished after extensive renovations, and the lively couple were two out of the seven elder community members we had the privilege to spend some time with in what will soon be established as a senior center for the community. As we received a tour of the building, the beautiful stage and event space, and the senior center, my mind was flooded with possibilities of what could soon be happening there. The thought of residents of all ages coming together to celebrate, learn, and just get to know one another appealed to my romantic notions of old-fashioned small town rural America. As we become more isolated behind our phone and computer screens, we become more and more detached from our neighbors and local opportunities for leadership. As populations concentrate in urban centers, resources begin to disappear from rural communities on the margins, and even the simplest things like access to fresh fruits and vegetables can become insurmountable. We hear complaints about America changing for the worst, and it can feel like our environments are becoming more dangerous, hostile, and prohibitive to success. After spending the first part of the day at Mayo Regional Hospital in Dover-Foxcroft, where we learned how the scope of practice for rural providers can be expansive, often with a much heavier focus on community health, meeting with community members made me realize the pathway to community involvement and collaboration is still accessible.

DSC_1201

The stairwell at Mayo Regional is painted with a wonderful mural in order to encourage people to take the stairs instead of the elevator.

Of course there are many challenges to rural health, which we also discussed throughout the course of the trip. Maine’s aging population is one of the largest obstacles; Piscataquis County has the oldest population in the oldest state in the country. “We used to see kids running all over the grocery store…we almost never see any children any more”, mused Beth and Joe. Poverty and food insecurity are very real problems in these communities, and people really depend on each other to make ends meet. When I asked Beth and Joe if it was easy to maintain an organic vegetarian diet in their town, Beth just laughed, and sang her praises for the online food delivery service they use. While small farms are reemerging as providers of tons of produce, meat, and dairy in these areas, cost is still a preventing factor for many families. Lack of transportation can make access to health care, employment, and other needs nearly impossible making the, “under one roof” model of Mayo Hospital and the Maine Highlands Senior Center invaluable. Burnout for health care providers leads to high turnover and a recruitment deficit, and as large numbers of staff members reach retirement there are fewer candidates to replace them. Most of us may react to challenges like these by skipping town to seek more opportunity; the residents of these small towns, however, are committed to their community. The pride, loyalty, and optimism in the face of the facts demonstrated by all the people we met with today is overwhelming. When I left Mayo Regional Hospital and the Maine Highlands Senior Center, I felt motivated by everyone’s tireless devotion to their towns and stalwart faith in their missions to improve the lives around them. We heard several times: the people here are what makes this community work worthwhile. I left Dover-Foxcroft thinking, I may just find myself getting to know these very people much better.

 

The group of ten UNE healthcare students meet with Mayo Regional Hospital CEO, Marie Vienneau

The view from the Kineo View Lodge in Greenville where the group stayed on Thursday night. Just to the right was a beautiful view of Moosehead Lake.

UNE Students Share Experiences on their First Day of the 2018 Piscataquis County Rural Health Immersion

March 19th, 2018 by healthinnovation
DSC_1271

Ten healthcare students from the University of New England recently participated in a rural health immersion to Piscataquis County.

 

Ten UNE health professions students recently participated in a weeklong rural health immersion to Piscataquis County in Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the fifth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to the Penquis area.  Last Fall a group of 10 students traveled to Oxford County and Carroll County in New Hampshire for a long weekend immersion; in May of 2017 a group of 13 medical, pharmacy, dental, and nursing students traveled to Maine’s midcoast region of Knox and Waldo Counties for a weeklong immersion; in March of 2017 medical and nursing students participated in a weeklong immersion in Franklin County; and in May of 2016 a group of 15 medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County.  Throughout the immersion the students are purposefully split into interprofessional teams so that they can learn the roles and how to communicate effectively with other disciplines in order to learn the skills necessary to provide high quality team-based care and improve patient outcomes.  The students experienced a variety of clinical, community, and population health activities in rural and underserved communities in central Maine communities, including Newport, Dover-Foxcroft, and Greenville.  The group was also supposed to visit Eastern Maine Medical Center and Penobscot Community Health Care but due to a Nor’easter the first two days of the trip in Penobscot County were canceled.  Below are reflections from one team after the first day of the trip on Wednesday, March 14th, 2018.

 

Colleen Moore, Junior ABSN student

For the typical student of health care, an immersive experience in a rural setting is unimaginable, if attainable to any extent. On a cloudy, slightly snowy day in Newport, Maine, however improbable the circumstance, ten students were granted the opportunity to begin a tour of rural healthcare across the Penobscot and Piscataquis counties of Maine. The trip already having been truncated due to a massive snow storm, the plans for visiting Eastern Maine Medical Center and Penobscot Community Health Care were regretfully cancelled, leaving the fresh osteopathic, pharmacy, and nursing students with little rural exposure after the first day. With some quick thinking by the trip leader, we were graciously received by Robin Winslow, the CEO, of Hometown Health Center, a Federally Qualified Health Center (FQHC) devoted to serving rural Maine in different locations across five counties.

In a well-lit, comfortable, clean clinic, with the walls adorned with stickers from the movies Cars and Frozen, Robin educated our group about the role of Federally Qualified Health Centers in rural settings, and how her clinics operated within those strict parameters. We learned about the lack of providers coming to rural health clinics due to competing incentives from hospitals, and the struggle for the future of quality rural healthcare due to the aging population of Maine’s healthcare professionals and the impact of opioid addiction.

The most striking aspect of rural healthcare for me that Robin presented was the complex role that each health care professional played in her clinic. In a rural setting, a patient faces many challenges in receiving quality, individualized health care. In an urban setting, quality care usually entails referring a patient to a specialist. In a rural setting, certain barriers, such as transportation, lack of providers, lack of funding, limited resources, and distance between health care facilities present challenges. To address these challenges, Robin talked about the benefits of providing integrated medical, dental, and mental health care all in one facility. In order to provide the best care possible for Hometown Health Care, Robin told us about the nurses, the doctors, and the one pharmacist, and how each contributes to the clinic in by playing many roles that go beyond merely examining their 7,300 patients.

Throughout our discussion, the staff members of Hometown Health Center awed me with their level of interdisciplinary cohesion, and how each healthcare professional worked with compassion to deliver excellent health care in a setting with limited resources. I was left with an impression of Robin’s emphatic resilience, and her dedication to providing affordable, quality care for a community she genuinely cared for, by expanding the roles each of the healthcare providers played.

The success of Robin’s clinic seemed not to come from being financially well-supported, well-staffed, or having especially attracted top-ranked professionals, but from the uniquely dedicated and compassion that each professional brings to the clinic. Each member of the clinic was personally invested in meeting whatever role was needed by the patients, and indeed each staff member wore many hats regardless of the role expectations of that professional’s background. Any clinic can grow and learn from the dedicated interdisciplinary efforts of Hometown Health Center.

 

Alivia Spicer, First Year Osteopathic Medical Student

Finally, after having our trip delayed by 1.5 days due to a Nor’easter, myself and nine other pharmacy, nursing, and medical students were on our way north for the March 2018 Rural Health Immersion Program. Our first stop in the journey north was at the Hometown Health Center (HHC) in Newport, ME. HHC is a federally qualified health center (FQHC) and is a non-profit organization, serving roughly 7300 patients in four locations.

We dropped off boxes of medical supplies at HHC that we had picked up in Portland before departing for the rural health immersion and we were able to get a tour of the facility and meet with Robin, the CEO. Within minutes of listening to Robin discuss the history of the four practices she operated located in Pittsfield, Dover-Foxcroft, Dexter, and Newport; it became very apparent to me of the need for more healthcare providers in rural areas. She stated that out of four locations, they had only four nurses and seven providers (one being a medical doctor and the rest being mid-level providers). She stated that as a non-profit organization, they struggle with recruiting and keeping physicians due to the hard to compete with nearby hospitals that offer better pay and better benefits.

Throughout the entire talk, I could see how driven and compassionate Robin was in providing healthcare to patients in rural Maine with limited resources to the best of her ability. Whether that meant rallying staff together to contribute money to pay for a cab ride for a patient to the hospital or if it meant guaranteeing to see that patient the same day they called for an appointment, you could tell that the providers working there do it out of the goodness of their heart with their patient’s health and well-being as their number one priority.

Having grown up in rural Maine myself, I have seen the need for more healthcare providers and the lack of access to healthcare first-hand. However, todays visit at HHC made me realize that we as future nurses, pharmacists, and physicians will be playing a significant role in the direction and future of medicine. It starts now.

IMG_3265

Jen Van Deusen, Director of Curriculum in UNE’s College of Osteopathic Medicine, discusses the goals of the trip after dinner on the first night.

Jenny Lau, Second Year Pharmacy Student

March 14, 2018 marks Day 1 of the 2018 Central Maine Rural Health Immersion. Our first stop was at Hometown Health Center (HHC) in Newport, one of their four offices in Maine. Upon delivering several boxes of medical supplies, the CEO (Robin Winslow) graciously welcomed us and introduced HHC to us. As I reflect back on what she said, what I found most memorable is when she mentioned there is only a total of 7 providers in all 4 locations and they get about 23,000 patient visits annually. The majority of these providers are mid-level providers and there is only one physician. As she expressed her concern of physician shortages and provider shortages in general due to the aging healthcare workforce and inevitable retirements, I can’t help but to question why there aren’t any promising solutions to this crisis. How is it possible to have such disparities in healthcare? As students, what can we do now to help with the reform?

On a brighter note, this brief experience showed me a different side of a conventional workplace environment. I was surprise to see how well the staffs worked together as a team towards the same goal. I didn’t sense there was a chain of command in place; the nurse practitioner spoke freely in the presence of the CEO. I believe these particular healthcare members face additional stress and challenges as they account for their patient’s transportation and the financial burden of medical expenses for their patients. Despite these unique challenges, the staff were seemed very happy at work. Unlike in urban communities with adequate healthcare access, it was apparent here that the staffs here are valued and not easily replaced.

I look forward to the rest of this immersion and continue to learn with an open heart.

 

Lauren Yelinek, Junior ABSN Student

We left for Dover-Foxcroft at 3:00pm on Wednesday March 14th 2018, a day and a half later than we had planned. It is March in Maine, and it is clear that Mother Nature does not care about our Rural Health Immersion itinerary. As I watched the piles of snow on the side of the road climb higher as we rolled north, it occurred to me that we might not be the only ones whose plans may have been changed due to the third Nor’easter in three weeks. As we would come to find out at an impromptu visit to Hometown Health Center in Newport, transportation is one of the most considerable challenges to accessing quality healthcare for communities in central Maine.

Hometown Health Center (HHC) is a Federally Qualified Health Center (FQHC), a non-profit organization funded by and beholden to federal grants. While this means tight regulations and careful documentation by administration, it also means that rural communities in central Maine have access to quality healthcare providers and programs that they might not otherwise have, such as the Prescription Assistance Program that allocated over $1 million worth of prescription drugs to the 7300-person patient pool at HHC. Robin, the CEO, repeatedly referred to the efforts of the HHC as “the mission”, which underscored that the work done here is more than a note on a chart or a tally mark for a grant application. She mentioned that the staff participated in dress-down Fridays to contribute to a petty cash fund for patient needs, and that some of these funds recently went toward a patient’s medical procedure. The sadness in Robin’s voice when she described the difficulty of finding a cab to transport this patient to their procedure made me feel ashamed for being frustrated with our delay hours earlier.

Robin was clearly more than a CEO; she cared deeply about consistently and effectively being able to reach those in the community who needed care the most. This was evident in her explanation of current providers within the HHC system, and her concern for the future. The need for more providers at HHC – particularly, physicians – is met with economic and geographic constraints. As a FQHC, HHC cannot match the provider pay and benefits offered by traditional, for-profit healthcare organizations.

As we exited HHC, we walked past brightly-colored Sliding Scale signage and community resource pamphlets, and I sat down in the UNE van that had delivered me here, with accessibility on my mind. We had still arrived at HHC, despite the storm. But how many patients had missed an appointment? How many community members don’t see providers because they can’t get there in the first place? How many young professionals think that Newport, ME, is just too far, “too rural”? How many can’t afford to work at an FQHC, for a “mission”? Accessibility is not just a patient issue, it is a systemic healthcare issue that impacts those receiving and providing care, particularly in rural communities. I told myself not to forget this as we drove north toward Dover-Foxcroft, passing several homes that had snow piles nearly blocking their front doors.

UNE Forms a Pipeline to Western Maine to Address Healthcare Shortages

November 10th, 2017 by healthinnovation
A group of ten UNE healthcare students recently participated in a rural health immersion to western Maine, in Oxford County, as part of a pipeline program to alleviate healthcare workforce shortages in rural communities.

A group of ten UNE healthcare students recently participated in a rural health immersion to western Maine, in Oxford County, as part of a pipeline program to alleviate healthcare workforce shortages in rural communities.

Ten healthcare students from UNE’s College of Osteopathic Medicine, College of Pharmacy, College of Dental Medicine, and Westbrook College of Health Professions Physican Assistant and Bachelor of Science in Nursing (BSN) programs recently attended a long weekend rural health immersion in Oxford County of Western Maine and Carroll County of Northern New Hampshire. The experience, which is coordinated and funded by UNE’s Center for Excellence in Health Innovation and the Maine Area Health Education Center (AHEC), is a pipeline activity created to reduce healthcare provider shortages in rural Maine and to strengthen UNE’s relationships with healthcare centers around Maine. The October immersion experience was the fourth time that a rural health immersion has been offered to UNE students but the first time that a group had gone to Oxford County; last May a weeklong immersion was held in Maine’s midcoast region of Knox and Waldo Counties; last March a weeklong immersion was held in Franklin County; and in May of 2016 the first weeklong immersion was held in Maine’s northern most county, Aroostook County.

“So far, we’ve had over 50 students participate in the immersion experience, and the data that we’ve collected from them suggests that these students are more interested in practicing in a rural or medically underserved area after participating in the immersion” says Karen O’Rourke, Director of the Maine AHEC, located within UNE’s Center for Excellence in Health Innovation. “This corresponds to the literature which shows that early and often exposure to rural health is the most effective strategy to increasing rural provider retention. This is is precisely why we’ve created the rural health immersion, to provide opportunities for our students to get exposed to Maine’s more rural communities, so that they are more likely to become a rural healthcare provider after graduating.”

The students discuss population health initiatives with Sue Ruka, RN, PhD, at Memorial Hopsital, a Critical Access Hospital in Conway, NH.

The students discuss population health initiatives with Sue Ruka, RN, PhD, at Memorial Hopsital, a Critical Access Hospital in Conway, NH.

Attracting healthcare professionals to rural and underserved communities has been a national priority for several years and a particular issue for Maine partly due to the fact that, according to the 2010 Census Data, Maine was the most rural state in the United States. Rural terrain can lead to long commutes for patients seeking basic healthcare services and can exacerbate provider shortages, leading to poorer health outcomes. This is a particular problem in Maine where nearly 1/3 of all of Maine’s providers work in Cumberland County, leaving many of Maine’s larger and more rural communities underserved. In order to help alleviate healthcare workforce shortages in Maine’s more rural counties, the Maine AHEC has strategically located three AHEC centers around Maine in Aroostook, Franklin, and Penobscot counties. “Oxford County is one of the Maine’s counties with the fewest healthcare providers in the State, with only about 2% of the providers living in that area. We were able to utilize our western Maine AHEC center, which covers Oxford County, to help connect with area hospitals for this immersion.”, says O’Rourke.

Sue leads the students through one of the Gemba boards at Memorial Hospital.

Sue leads the students through one of the Gemba boards at Memorial Hospital.

Maine and New Hampshire provide a contrasting picture of health and well being, despite neighboring one another. According to the United Health Foundation, New Hampshire ranked 6th in overall health rankings, whereas Maine did not fair as well, ranking 22nd. “These health disparities became apparent to the students rather quickly” said Ian Imbert, MPH, the project coordinator of a prestigious four year Josiah Macy Jr. Foundation grant in UNE’s Center for Excellence in Health Innovation, which aims to enhance team-based care and improve patient outcomes. “The immersion experience provided them an opportunity to see first-hand the effects of healthcare access and funding for prevention programs. In Maine, the decision not to expand Medicaid has created access barriers that have effected the health of our communities, whereas the expansion of Medicaid in New Hampshire has created additional funding to provide much needed services to its underserved populations.” Indeed, the Robert Wood Johnson Foundation’s 2016 county health rankings, for example, show that Carroll County in New Hampshire ranked 4 out of 10 in health outcomes, while Oxford County in Maine did not fair as well, finishing close to the bottom, 14th out of 16.

The first stop of the day was at Saccopee Valley Health Center in Porter, ME, where the students met with Dr. Jeff Ray, DO, Medical Director, and Dr. Israel Adeloye, DMD.

The first stop of the day was at Saccopee Valley Health Center in Porter, ME, where the students met with Dr. Jeff Ray, DO, Medical Director, and Dr. Israel Adeloye, DMD.

It’s predicted that some of the health challenges that Maine’s more disparate Counties face would be improved if there were more providers who lived and worked in those areas. According to the Robert Graham Center and the Nursing Workforce Forecast, Maine will need an additional 120 primary care physicians and 3,200 nurses in the next decade in order to maintain current rates of healthcare utilization. Moreover, the Maine Department of Labor projects a shortage of 170 dentists. Research shows that students are more likely to practice rural medicine if they have a personal connection to a rural area, so, the rural health immersions aim to provide opportunities for students to connect to rural Maine and hopefully alleviate healthcare provider shortages.

The students who participated in the Western Maine rural health immersion came from a broad array of backgrounds, some growing up throughout the country in areas like Maryland and Pennsylvania while about a third of the students had grown up in New England or had spent time previously in rural Maine, either through extended family or while vacationing. Most students had some experience working with underserved populations in the past but for a few it was their first opportunity to experience rural underserved healthcare. One student from UNE’s College of Dental Medicine, Nicole Caron, from Massachusetts, reflected after the final day of the immersion, “This trip introduced me to a bunch of different rural communities that all had one thing in common, extraordinary healthcare providers who work every day to improve the health of their patients and their communities, despite the obstacles they may face in rural areas. I have been inspired and I hope that I am able to practice dentistry just like the professionals that we interacted with this weekend.”

The students pose for a photo outside of Conway Oral Health with Dr. Eric Heirschfield, DMD.

The students pose for a photo outside of Conway Oral Health with Dr. Eric Heirschfield, DMD.

During the immersion, the students experienced a variety of activities in underserved areas in Oxford and Carroll Counties, such as meeting with providers of Memorial Hospital in Conway, NH, and Bridgton Hospital in Bridgton, ME, for a tour of the hospital facilities; a tour and discussion with providers at Sacopee Valley Health Center, a Federally Qualified Health Center in Porter, ME and at White Mountain Community Health Center, a rural community health center in Conway, NH; a trip to Conway Oral Health in Conway, NH to talk about dentition in rural communities; and a tour of Hannafords pharmacy in Bridgton, ME. “This was the first time that an immersion cradled two states”, said Imbert “which allowed the students to think about health policy, and the effect it can have on populations..”

A pharmacy and an osteopathic medicine student work together to collect a blood pressure from a community member at the Fryeburg Fair.

A pharmacy and an osteopathic medicine student work together to collect a blood pressure from a community member at the Fryeburg Fair.

The students attended the Fryeburg Fair, Maine’s largest agricultural festival, where they helped staff the first aid centers. The students created care kits, consisiting of basic, yet essential health care products, like toothpaste, toothbrush, soap, band aids, and more, to hand out to people at the fair. They also worked along paramedics to take blood pressures and provide basic health education on oral health, exercise, and nutrition. “This event gave me the opportunity to meet and talk with people who live in rural communities in Maine”, said Minh Tam Hua, a second year pharmacy student. “I feel that we as health professional students should create more health screenings in rural areas to educate the community about many of the diseases that we saw. If we all stand together and contribute our part, we will be able to help reduce the number of chronic diseases that are taking place in these rural areas.”

Students conducted a Worksite Health ScoreCard at the fair to assess it's performance in several categories like Animal areas, Nutrition, Tobacco, and more.

Students conducted a Worksite Health ScoreCard at the fair to assess it’s performance in several categories like Animal areas, Nutrition, Tobacco, and more.

Jen Van Deusen, MEd, Director of Curriculum in UNE’s College of Osteopathic Medicine, has participated in all four immersions and once again helped to lead the western Maine immersion. “It’s amazing to see the students perceptions of rural health change throughout the trip. And when they return to the classroom I see how excited they are to share what they’ve learned with their peers, creating a ripple effect.”

The full team of students who attended the Midcoast Maine immersion included two medical students from UNE’s College of Ostepathic Medicine Taylor Ouellette and Rodger Carter; two pharmacy students from UNE’s College of Pharmacy Kelly Banks and Minh Tam Hua; two students from UNE’s Nursing Department Katherine Clark and Lesley Lafland; three students from UNE’s College of Dental Medicine Nicole Caron, Brittany Malia, and Kimberlee Sell; and one student from UNE’s Physician Assistant Department Rachel Moore. You can read more on each students experience here.

The group roasts marshmallows on their last night together in Oxford County.

The group roasts marshmallows on their last night together in Oxford County.

The trip was graciously supported by Maine’s Area Health Education Center (AHEC), the Josiah Macy Jr. Foundation, and UNE’s Center for Excellence in Health Innovation. The Maine AHEC has continued to prioritize experiential learning in rural communities for graduate healthcare students and their commitment to the rural health immersion proved to be invaluable for the success of the trip. The Josiah Macy Jr. Foundation grant that also helped fund the experience is a four-year grant awarded to UNE in 2015 from the Josiah Macy Jr. Foundation and aims to improve health care and education in rural areas. Dora Anne Mills, MD, MPH, FAAP, Director of UNE’s Center for Excellence in Health Innovation, helped create the immersion experience.

 

FMI: Contact Ian Imbert, MPH, (207-221-4625 or iimbert@une.edu)

 

University of New England Works with State and Community Partners for Public Health Emergency Preparedness Exercises

November 8th, 2017 by healthinnovation
UNE osteopathic medicine student adminsters a flu vaccine at the October 20th Alternate Care Site emergency preparedness exercise located at UNE's Biddeford campus center gymnasium.

UNE osteopathic medicine student Justin Doroshenko adminsters a flu vaccine at the October 20th Alternate Care Site (ACS) emergency preparedness exercise located at UNE’s Biddeford campus center gymnasium.  This was the first time that an ACS exercise had been conducted in Maine.

The University of New England recently hosted two public health emergency preparedness training exercises in collaboration with state and community partners, offering free influenza vaccinations to the UNE community and public as part of the events. This is the second year in a row that UNE has partnered with local and state public health agencies to conduct a public health emergency preparedness exercise in order to be better prepared in the event of a real public health emergency. “For several years UNE has registered to be part of a volunteer network of Points of Distribution, or PODs, that will serve as centers for administering medicines, vaccines, and/or necessary supplies for the public in the event of a large-scale emergency”, explained Dora Anne Mills, M.D., M.P.H., FAAP, vice president for Clinical Affairs and director of UNE’s Center for Health Innovation. “To fully prepare for such an event, UNE faculty, staff, and students work in collaboration with state and community partners to simulate such an event, and offer free influenza vaccines to the public as part of the exercise.”

On October 20th, 2017, the UNE Biddeford Campus Center gymnasium was converted into an Alternate Care Site (ACS), a temporary medical system that is established to provide low-acuity care during a public health emergency. UNE students from four of UNE’s six colleges participated in the exercise to learn some of the principles of emergency preparedness planning from State officials.  A large turnout of people looking to receive their flu vaccine allowed medical and pharmacy students to administer vaccines to more than 225 UNE students, faculty, and staff.  Jessica Rehrig, a second year osteopathic medical student in UNE’s College of Osteopathic Medicine said “It is reassuring, both as a student physician and a member of the community, to know that adequate policies and procedures are in place to accommodate patients in the event of a medical surge or state-wide emergency.”

ACS exercise overview smaller copy

The UNE campus center gymnasium was converted into a temporary medical system to provide flu vaccines to the public. Several local and state public health agencies participated in the exercise, including the Maine DOT who delivered the durable medical supplies shown here to Biddeford from a warehouse in Augusta.

The October 20th ACS exercise represents a milestone as the first deployment of a multi agency scenario for the newly established York County Medical Reserve Corps (MRC), a partnership between the greater York County community and UNE.  It was also the first time Maine had implemented a test of the ACS system. “Maine CDC Public Health Emergency Preparedness Program (PHEP) purchased these modules as a way to provide emergency medical assistance in the event of a real response situation. These modules are designed to assist in the immediate response effort, as in help until help arrives, when Federal Medical Systems cache can be deployed”, says Patrick Furey, Maine CDC Public Health Emergency Preparedness Exercise and Training Coordinator. “It was great working with UNE faculty, staff, and students, area Walgreens Pharmacy staff and management, as well as Maine’s Medical Reserve Corps (MRC) volunteers at this exercise.”

One week later, on October 27th, 2017, the newly renovated Innovation Hall at UNE’s Portland Campus was converted to a Point of Dispensing (POD) site where influenza vaccine was once again administered to community members.  Medical, pharmacy, nursing, and public health students helped staff the exercise.  Valerie Bedard, a senior nursing student in UNE’s Westbrook College of Health Professions said “As a student here, it is wonderful to see that UNE is proactively thinking about how it will take care of the community in the event of an emergency. I really enjoyed learning from, with, and about my medical and pharmacy student peers as well as from the local and state public health community.”

A Point of Dispensing (POD) exercise was conducted on October 27th in UNE's newly renovated Innovation Hall.

A Point of Dispensing (POD) exercise was conducted on October 27th 2017 in UNE’s newly renovated Innovation Hall.

Caity Hager, from Maine’s Cities Readiness Initiative based out of the City of Portland, helped coordinate last years POD exercise on the UNE Biddeford campus and was able to use some of the lessons learned from last year to improve upon this years exercise. “Partnering with UNE to conduct similar exercises two years in a row allows the Maine Cities Readiness Initiative to improve and strengthen our plans to respond to this type of emergency”, said Hager. “We have been improving and refining procedures based on feedback from last year’s exercise and it is important for our program to have the opportunity to exercise the changes and evaluate the improvements to our plans.”

Caity Hager from Maine's Cities Readiness Initiative provides a "Just-in-time" orienation training for the staff members who volunteered to operate the exercise.

Caity Hager from Maine’s Cities Readiness Initiative provides a “Just-in-time” orientation training for the staff members who volunteered to help operate the exercise.

In total, more than 350 people receive an influenza vaccine at these exercises. A partnership with Walgreens and UNE’s Health Services ensured that there was enough vaccine supply to dispense to the public at the exercises. Several employees from Walgreens, including seven licensed pharmacists, donated there time to help staff crucial clinical and non-clinical roles at both exercises.  Heather Stewart, an alumnus of UNE’s College of Pharmacy Class of 2014, and current Walgreens pharmacist, says that her time at UNE as a student helped instill the importance of influenza surveillance as a tool to keep the public healthy.  “Influenza is a vaccine preventable virus that has significant public health consequences including decreased productivity, and increased morbidity, mortality, and healthcare expenditures.  Events such as the ACS and POD exercises not only prepare our First Responders for a large scale emergency but they also increase ease of access by creating another public health environment for patients to obtain their influenza immunization.”, said Stewart.

Heather Stewart, PharmD, provides a workshop on proper flu vaccine administration techniques to UNE healthcare students.

Heather Stewart, PharmD, provides a workshop on proper flu vaccine administration techniques to UNE healthcare students.

These exercises are done in collaboration with a number of partners, including: Maine CDC, York and Cumberland District Public Health Councils, Emergency Management Agencys, the City of Portland’s Maine Cities Readiness Initiative, area Walgreens pharmacists and management, and Maine Responds (Maine’s emergency health volunteer system). “As part of this initiative, UNE’s Center for Health Innovation works collaboratively with our health professions programs as well as state and community partners to provide learning experiences for our students. A number of medical, public health, nursing, pharmacy, and other students attend sessions run by emergency preparedness experts and assist in administering vaccines,” said Mills. “As a result, southern Maine will be better prepared for an emergency today, and tomorrow’s health professionals will also be better prepared.”

To learn more about the Center for Excellence in Health Innovation, visit: www.une.edu/academics/centers-institutes/center-excellence-health-innovation

UNE Holds Workshop on Opioid Use Disorder and Medication Assisted Treatment

November 8th, 2017 by healthinnovation
Expert speakers discuss opioid use disorder and medication assisted treatment at the October 28th workshop located on UNE's Portland campus.

Expert speakers discuss opioid use disorder and medication assisted treatment at the October 28th workshop located on UNE’s Portland campus.

On Saturday, October 28, 2017, the University of New England Center for Excellence in Health Innovation hosted an opioid use disorder (OUD) and medication assisted treatment (MAT) Workshop at UNE’s newly renovated Innovation Hall.

More than 150 people registered, and attendees included UNE students from the College of Osteopathic Medicine, College of Pharmacy, Westbrook College of Health Professions and College of Dental Medicine, as well as UNE faculty and clinicians from the community. Experts led presentations and discussions on MAT; screening, brief intervention, and referral to treatment (SBIRT); prescribing laws; public health impact; and stigma.

“As we face a deadly epidemic of opioid addiction, workshops like this are critical to assuring the clinicians of tomorrow as well as today are able to work together with clinicians from other professions and patients to successfully screen people for addiction, help people get into treatment, and keep them in recovery,” said Dora Anne Mills, M.D., M.P.H., director of the Center for Excellence in Health Innovation.

In 2016, 313 Mainers died of an opioid-related overdose, which represents 83 percent of all drug-related deaths in the State. Currently, the demand for MAT in the state still outpaces the supply, especially among those who lack health insurance or live in health professional shortage areas. To address the critical need for health professions education around OUD and MAT, the Center for Excellence in Health Innovation received $80,000 in supplemental funding from its federal Health Resources Services Administration (HRSA) Primary Care Training and Enhancement (PCTE) grant to further increase education around MAT in primary care. The Center for Excellence in Health Innovation plans to hold lunch and learn programs and future events for faculty and students who are looking to learn more about OUD and specifically MAT.

FMI contact Melanie Caldwell, mcaldwell4@une.edu or visit http://www.une.edu/academics/centers-institutes/center-excellence-health-innovation/grants-initiatives/primary-care-training-and-enhancement-grant

UNE Faculty and Staff Present at Collaborating Across Borders VI Conference in Banff, Canada

November 8th, 2017 by healthinnovation
UNE faculty from the Westbrook College of Health Professions present in Banff Alberta at the Collaborating Across Border (CAB) conference (From L-R, Nancy Jo Ross, Sally McCormack Tutt, Kelli Fox, Elizabeth Crampsey, and Kris Hall)

UNE faculty from the Westbrook College of Health Professions present in Banff Alberta at the international Collaborating Across Border (CAB) conference (From L-R, Nancy Jo Ross, Sally McCormack Tutt, Kelli Fox, Elizabeth Crampsey, and Kris Hall)

The University of New England was well represented at the Collaborating Across Borders VI conference in Banff, Canada. Ruth Dufresne, S.M., research associate and evaluator in the Center for Excellence in Health Innovation, gave a presentation focused on evaluation of the Josiah Macy Jr. Foundation and the Health Resource Services Administration (HRSA) funded Primary Care Training an Enhancement (PCTE) Project. She presented on behalf of the PCTE Team which includes Dora Mills, M.D., M.P.H., F.A.A.P., Jennifer Gunderman, M.P.H., Melanie Caldwell, M.S., Ian Imbert, M.P.H., and Toho Soma, M.P.H., as well as clinical partners at Penobscot Community Health Care (PCHC).

Elizabeth Crampsey M.S., OTR/L, BCPR, Kelli S. Fox LCSW, CCS, LADC, Kris Hall M.F.A., Sally McCormack Tutt PT, D.P.T., M.P.H., and Nancy Jo Ross Ph.D., RN, gave an interactive presentation titled, “Parallel Processes in Interprofessional Education (IPE): From Campus to Community.” They described an interprofessional educational (IPE) experience the team has been teaching for the past three summers in collaboration with clinicians from Maine Medical Center. They led participants through activities that simulated student activities in the course. Other UNE faculty contributors include Jan Froehlich M.S., OTR/L, Valerie Jones LMSW, Kira Rodriguez, M.H.S., and Heather McNeil.

Faculty worked to parallel/align the on-campus curriculum with professionals in the field to illustrate the real-world challenges faced by interprofessional teams in clinical practice. The course consisted of two classroom sessions and an assignment for the student groups to work on during the week between the classroom sessions. Students were assigned to interprofessional groups and were guided through activities that provided them the opportunity to learn about two key interprofessional core competencies: teamwork and professional communication. The classroom sessions were evaluated by faculty student feedback. The student feedback was analyzed to determine changes in their comfort level with IPE upon completion of the entire series of activities. The results of this analysis were also presented at the conference.

FMI: Contact Kris Hall of UNE’s IPEC at ipec@une.edu or at (207) 221-4491