About ASQ

Opening Statement of

John Heer
President & CEO
North Mississippi Health Services, Tupelo, Mississippi

 ASQ Health Care Panel
For the 21 st Century Health Care Caucus
Washington, D.C.
April 26, 2006

There was a time when being last, or close to it, stopped surprising or even disappointing residents of Mississippi. For too long, Mississippi had placed last or near last among the nation in education, income, and health status. Recent surveys indicate that Mississippi is:

• 50th in overall health status
• 50th motor vehicle death rate (2.7 deaths per million miles traveled)
• 50th heart disease death (354 deaths per 100,000)
• 50th infant mortality (10.4 deaths per 1000 live births)
• 50th in preventable deaths (premature deaths) and
• the only state not improved in 11 years of reporting.

North Mississippi Health Services is a health care organization prepared to continuously improve the health of the people of our region. Beginning in the early ‘90s, NMHS began a journey to create an integrated, seamless health care system to serve our 22 counties in Northeast Mississippi and 4 counties in Northwest Alabama . Our success is based on a planned regional healthcare approach leveraged by strategic facility locations, a world-class information system, and a commitment to attracting and developing an engaged, motivated work force. The socio-economic standing and poor health status of our region were and are contributing factors to the challenges we faced and will be forced to contend with in the future.

One of our major challenges has been and is creating delivery processes that address inequities in the health status of our region which result from less-than-desirable education, income and lifestyle habits of those we serve. In order to address these shortcomings, NMHS has created a system which consists of the following:

• 7 hospitals including a 650-bed tertiary medical center located in Tupelo, MS, 5 owned community hospitals and a contractual relationship to manage another community hospital
• 4 nursing homes
• A physician company which includes over 100 physician and nurse-practitioner providers in 32 locations in 19 communities throughout our region. Many of these communities would not have readily available access to health care providers were it not for NMHS
• an internally-funded Family Medicine Residency Training Program created to “grow our own” physicians who would be more likely to remain in our region upon completion of their residencies
• Internally funded School Health Clinics staffed by 16 RNs which provide primary care to many who otherwise wouldn’t have access to care

All of these physical locations are tied together through an innovative, role-model information system which includes:

• Electronic Medical Record which can be accessed by any provider at any location who has access to our system. This is based on a system that includes a unique patient identifier for all patients that enables the aggregation of all care provided to a particular patient regardless of the location at which that care was rendered
• a PACS medical imaging system which allows providers access to radiology images, not just the report
• V-TEL or video teleconferencing system for distance learning and communication.

NMHS also partners with a local “free clinic” which provides primary care to the working poor and performs numerous health screenings throughout our service area.

In addition NMHS:

• Has 219 separate agreements with colleges/universities for allied health professional education and we provide over $400,000 in direct financial support
• Conducts multiple health screening fairs with a heavy emphasis on health education – there were 266,000 participants in 2003
• Provides 7 athletic trainers in 13 schools
• Facilitates a church nurse program with 63 volunteer nurses who perform health screening and education programs in area churches.

Many of these programs or services are not directly funded by external sources, but as part of our Mission , we believe we must provide them. However, as reimbursement from all sources fails to keep up with the rate of inflation in our industry, maintaining these programs becomes more challenging. One major current concern is CMS’s proposal to revamp the DRG reimbursement system, shifting dollars away from high tech, high resource utilization diagnoses to less costly procedures. While this bodes well for our rural facilities, our concern is that the shift of dollars away from our flagship hospital will far outweigh any increase in reimbursement we experience at our smaller facilities.

In the mid 90s, NMMC took our quality initiative to the next level by first entering the Mississippi Quality Award Program and subsequently the Malcolm Baldrige National Quality Award Program. Our Baldrige journey has created a quality focus unparalleled by any other initiative we’ve undertaken. Its non-prescriptive, adaptable criteria has forced the organization to remain focused on our Mission, Vision, Values and Critical Success Factors of People, Service, Quality, Financial, and Growth which ensures that we don’t forget why we were established in the first place: to help people. It has also resulted in a leadership system that

• respects and values staff at all levels and involves them in decision making activities
• is relentlessly focused on our patients and other customers
• is focused on achieving progressively higher levels of clinical quality
• believes that higher quality results in lower costs and
• is systems oriented in its approach.

By being relentlessly focused on our Mission, Vision, Values, and Critical Success Factors we have maintained a balanced approach to health care leadership and remain committed to providing assistance to those who have instilled their trust in us.

In closing, thank you for the opportunity to speak with you today. All of us in the healthcare industry value and respect the leadership you are providing for our country and welcome the opportunity to discuss current healthcare issues with you, both now and in the future.

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