What can you tell us about the health services program and technology in place at the Karuk Tribe?
We are a self-governing 638 tribe providing family medical services along with behavioral health and dental at three clinics stretching over 100 miles. The health division employs over 83 individuals and as the Clinical Applications Coordinator (CAC) I report to the IT Director of the tribe. We use the RPMS suite of programs in all our clinics and for billing we use Dentrix in our two dental clinics. My goal at the Karuk Tribe as the CAC is to make the systems work best for the providers. I don’t believe in making changes just because its new technology, it has to serve a better purpose for them and translate to better workflow or patient care. That motto has served me well in this role which I have been in since 2009.
What do you feel is a priority for your team this year and moving forward?
We recently received a grant from USDA/RUS for over $100,000. Funding that is providing us the opportunity to purchase video conferencing and telemedicine equipment to support the delivery of specialty, primary and behavioral heath care services from hub sites in Sacramento and Redding to our three end-user sites in Happy Camp, Orleans and Yreka. We’ve started this project to offer enhanced tele-health and will be continuing it into 2017. In July we had 50 tele-health patients. That may not seem like a lot (especially to larger tribes) but, in compariosn to 2015 where we maybe served 50 patients in an entire year, I’d say we are more than achieving our improvement goals! With our remote location and distance between sites, tele-med is a priority for us. I also think that MACRA/MIPS is a big topic on the minds of many healthcare professionals. There is such a big watershed in how care is reimbursed- it is a big ripple effect and I imagine that to be a hot topic at this year’s TribalNet conference.
What are some of the challenges that you face and solutions you implement to overcome them?
Location, as mentioned before, is a challenge. This is why the attention to our tele-med program is such a priority. Another challenge we face at times is having difficulty with recruiting and maintaining staff. As an interim solution to the issue, we utilize a temp agency to get licensed independent providers, but filling gaps in RNs and LPNs at some of our clinics remains a challenge. Our human resources department is also doing a great job marketing our area more. We have a lot of natural beauty in this region; I personally feel grateful to be here!
Do you collaborate with any other organizations that play a role in your success?
Yes, we do collaborate with and are members of several groups. Our IHS area office is a great resource and connection for us and we are also members of the California Rural Indian Health Board (CRIHB). We work closely with the Healthcare Alliance of Northern California which is made up of a dozen or so clinics in our region. Our relationship with them has been very important as we work on quality care programs. We are members of the California Telehealth Network, which has been an amazing partner to us in our tele-health project. I was asked this year to serve on TribalNet’s Health IT Committee and have welcomed the opportunity to collaborate with my peers in that role. In 21 years of being in Tribal healthcare, the changes in the industry and environment speak for themselves. Aligning ourselves with several agencies and entities keeps our perspective broad.