2015 – 2016 Annual Report

As I reflect back on this past year, one particular thought comes to mind: what a remarkable year it was. I consider it an honor and privilege to serve UAMS Regional Programs and want to personally express my thanks and appreciation to the entire team.

External pressures will continue to influence the healthcare marketplace, and demands coming from virtually every segment of the system cause us to take a hard look at our model and ask, are we sustainable? UAMS, as the state’s only academic medical system, is making tremendous strides towards becoming a fully integrated health delivery system. With our statewide presence, and strong hospital and health system partnerships, Regional Programs is critically important to making this integration happen. For the first time in many years, our strategic planning process will have us focused on several key initiatives this next year:

1. The EMR Project: The launch of EPIC in our regional centers was delayed due to project cost increases. We are down to three EMR options with a decision expected in FY 2017. This new EMR and IT system will serve as the backbone for an integrated health delivery system that includes a robust Population Health tool that positions Regional Programs to be successful with new market reforms/payment initiatives.
2. Patient-Centered Medical Home (PCMH): We continue to improve our clinical processes to provide excellent patient-centered care, while moving toward a more pro-active and targeted population health model. This positions the regional centers well for taking on shared risk/savings arrangements (CPC+), and for preparing the next generation of clinical providers for advancing models of team-based care delivery.
3. Growing the qualified applicant pool for Arkansas’ medical schools: Research shows that students who come from Arkansas, attend medical school in Arkansas, and complete residency training in Arkansas are the most likely to remain and practice in Arkansas. Further, those who come from rural areas are far more likely to return to a rural area to practice. Consequently, our eight regional pre-health recruiters will continue their focus on growing the qualified applicant pool within our borders by helping more Arkansas students prepare successfully for medical school.
4. Regional Center Facilities: We continue to move toward building and/or modernizing our clinical facilities to gain efficiency that supports effective learning for residents, students, faculty, staff, and allows for expansion and growth of our programs. The new clinic facility at UAMS West should be ready in FY 2017, and commitments have been made on new spaces for UAMS South and UAMS North Central Regional Centers.
5. Residency Program Expansion: Family Medicine Residency expansion efforts will be focused in three regions: North Central, East, and Central. We are working with local hospital partners and our existing residency programs to develop and establish rural-focused community based residency programs that are best suited and, ultimately, most beneficial to those regional healthcare systems.
6. Partnerships & Collaborations: Wewillcontinueto nurture and expand our vital and strategic partnerships and collaborative relationships across the state and within UAMS bringing value to our partners and regions. Weexpect to deliver excellent and compassionate services thatprepare thenext generation ofproviders for every region ofthestate.

I am excited about the challenges of taking on the UAMS Northwest Campus and how that translates into more effective coordination and communication of all things UAMS. The possibilities and potential in both the short and long term for Northwest Arkansas are exciting. And with the likely growth of Family Medicine Residency sites, Regional Programs is positioned to be a significant influence in the way healthcare will be delivered to Arkansans for years to come. As we build an integrated health delivery system, strengthen our partnerships, and expand programs, we remain committed to our primary mission — preparing a competent and caring healthcare workforce for tomorrow. I have every confidence that Regional Programs will continue to be a significant part of the UAMS system of caring in ways that we all will be very proud.

Timothy E. Hill

Vice-Chancellor for UAMS Regional Programs

Regional Programs employ 745 people statewide (including residents), operating as important economic forces in their communities

2015 – 2016 Trainee Overview

This year, the regional centers provided training for:

• 524 health professions students
• 144 medical residents
• 4,815 high school and college students for structured programs, and another 32,442 in group presentations/events

2015 – 2016 Trainees

• Health Careers – 4815
• Allied Health – 63
• Nursing – 176
• Pharmacy – 44
• Residents – 144

Specific Program Goals

• Enhance the quality of health professions education by using the best academic resources available statewide
• Retain Arkansas graduates of health professions schools within the state
• Improve the supply and distribution of primary healthcare providers in Arkansas
• Increase the number of individuals from rural, minority, and other underserved populations entering health careers
• Supply professional support and continuing education for healthcare providers statewide
• Provide quality health care services and educational programs to the public
• Promote cooperation among providers, educational institutions, and health- related organizations

Jonell Hudson, PharmD, was honored with a Chancellor’s Teaching Award for Society and Health Education Excellence during commencement exercises on May 21. Nominees for the chancellor’s award show excellence in the areas of direct teaching, mentoring or educational scholarship.

Dr. Hudson is an associate professor of Pharmacy Practice in the College of Pharmacy at the Northwest Arkansas campus. She developed a comprehensive interprofessional course for medical and pharmacy students, which includes both class discussions and a work requirement at the student-led North Street Clinic on the Fayetteville campus. Dr. Hudson also serves a co-director for the clinic, which focuses on treating Type 2 diabetes and other chronic conditions that are prevalent in the region’s growing Marshallese population. Her efforts have been recognized at the regional and national level.

The Society and Health Education Excellence Award includes excellence in such areas as cultural awareness, health care economics, health equity, health literacy, health systems, patient- and family- centered care, and educational scholarship, among others.

Scott M. Dickson, MD, Director of the Family Medicine residency program at UAMS Northeast (NE) in Jonesboro, is recipient of the 2016 Regional Programs’ Excellence in Teaching award for his contributions to resident and medical student education. Dr. Dickson received his undergraduate degree from Arkansas State University (ASU) in Jonesboro, and his medical degree from the University of Arkansas for Medical Sciences (UAMS) in Little Rock. He returned to Jonesboro in 1998 to complete residency training at UAMS NE, serving as chief resident. In 2001, he was persuaded to remain as faculty and assistant director for the residency, and in 2009, Dr. Dickson was named Residency Director.

Colleague Tom Frank, PharmD, states: “Anyone who has tried knows how hard it is to maintain balance as an effective educator, clinician and administrator, while navigating the rapidly changing pressures of our current medical, political and legal environment. Dr. Dickson is not only able to gracefully negotiate this treacherous landscape, but he remains the ‘go-to’ person when a calm hand and a kind word are essential for the moment. Dr. Dickson finds the right tone and delivery to make a terrible situation less awful. He not only models and teaches that attitude; he expects it from his trainees as well. Dr. Dickson plays many active roles in local committees that have resulted in meaningful outcomes, always driven by a desire to reduce patient suffering and enhance appropriate use of healthcare resources.” As Center Director Ron Cole sums it up, “Dr. Dickson embodies the special character that knows when and how to balance exceptional teaching with genuine compassion.”

New Endowed Chair in Primary Care

Mark T. Jansen, M.D., Medical Director for UAMS Regional Programs, was invested April 4 as the inaugural recipient of the Arkansas Blue Cross & Blue Shield, George K. Mitchell, M.D., Endowed Chair in Primary Care. The endowment calls for innovations to meet

the Triple Aim of health system reform, which are 1) better patient experience, 2) improved health of the population, and 3) decreased costs, through the incorporation of team-based care, health promotion, health literacy and population health strategies into primary care settings. Dr. Jansen has pledged to address the shortage of primary care providers in rural areas of Arkansas, using telemedicine technology to deliver specialty care to underserved areas, and to serve as a platform for information sharing and medical education.

Dr. Jansen is a 1981 graduate of UAMS, who completed his family medicine residency at the University of Oklahoma, Tulsa Medical College in 1984. He and his wife, Cynthia, opened a solo practice in Arkadelphia that same year. He later became senior partner of Arkadelphia Medical

Clinic, a multi-provider group. Jansen practiced for 29 years in Arkadelphia before joining UAMS faculty in 2013. Since then, he has served as primary care medical director for the UAMS Center for Healthcare Enhancement and Development, as medical director for Physician Relations & Strategic Development, and in 2016 was named medical director for UAMS Regional Programs.

We gratefully acknowledge the faithful dedication of the following faculty and staff who mark this year with long-term service to UAMS Regional Programs.

40 Years: James Lindsey (SC)

35 Years: Michael Mackey (NE), Pamela Pyland (WE)

30 Years: Laura Doyle (SA), Herb Fendley, Renita Attwood (SC), Don Heard (WE)

25 Years: Sterling Moore, Adrienne Boone (LR), Robin Mouzy (NE), Virginia Breshears (NW), Terri Ashley (SW), Pamela Cannefax (WE)

20 Years: Tricia Edstrom, Kim Harris (LR), Alisa Lancaster (NC), Scott Lafoon (NE), E Adams, Jama Zulpo Vancleave (NW), Felicia Anderson (SA), Barbara McNeese, Kevin Green, Richard Justiss (SC), Deborah Birmingham-Lusk, Judy McDonald (SW), Kesha Woolsey (WE)

UAMS demonstrated it is leading the state in improving patient care while also saving money as Chancellor Dan Rahn, M.D., accepted $927,642 from Medicaid for its part in helping Arkansas avoid $34 million in Medicaid costs in 2014. At the state Capitol, Rahn praised UAMS Regional Centers in Fayetteville, Fort Smith, Jonesboro and Texarkana for achieving the savings.

The providers who received checks in October are enrolled in the state’s Patient-Centered Medical Home (PCMH) program, which is part of the Arkansas Health Care Payment Improvement Initiative. Of the 123 practices or groups enrolled in the first year, only 37 met the 5,000 Medicaid beneficiaries mark.

We are encouraged by results like better outcomes and experiences for the patient, fewer readmissions and emergency room visits, better chronic disease management, and lower cost. We appreciate Medicaid investing in payment redesign to facilitate this transformation.

UAMS Chancellor Dan Rahn, MD

• UAMS honored 32 Phenomenal Women during Women’s History Month in March for their contributions to UAMS and its health care mission, including Regional Programs’ Jessica Ellis (LR) and Virginia King (West).
• Vicky Montague (LR) was recognized in February for earning a Certified Research Specialist (CRS) certificate, which is administered by the UAMS Office of Research Compliance to ensure research integrity.
• Linda McGhee, MD (NW) continues to serve as Vice Chair of the Arkansas Minority Health Commission.
• Richard Aclin, MD (West) was named one of the “Best Doctors in Arkansas” in 2016, by the Arkansas Times.
• Matthew Nix, MD (SW) continues to serve as an appointee by Governor Mike Beebe to the Arkansas Early Childhood Commission for the period 2015-2017.

In January, UAMS Southwest celebrated the move of its Family Medical Center (FMC) to a new, more accessible location at 3417 U of A Way in Texarkana, Arkansas. The UAMS All for Kids Pediatric Clinic and Neighborhood Clinic continue to operate at the 300 E. Sixth St location.

While floor space for the FMC operations is about the same, all services are now on the ground floor, making it easier for patients to enter and exit. The new space is designed so that providers, faculty and nursing staff are in a central hub, surrounded by patient exam rooms, creating a collaborative space for providers and staff to communicate more effectively as a team to improve patient care. These new modern facilities will help accomplish Regional Programs’ patient- centered goals, and increase and enhance all our medical education programs.

In March, shovels marked the start of work on a new

30,000-sq ft UAMS West FMC at the corner of South 12th and South E streets in Fort Smith. The new facility will provide space for growth of patient care and medical education programs.

One block from the current facility at 612 S. 12th St., the new FMC will include a state-of-the-art outpatient clinic with 48 exam rooms, x-ray facilities, lab, procedure areas, patient counseling rooms and a children’s immunization area.

Once the new facility is completed, UAMS West will remodel sections of its building at 612 S. 12th St. to accommodate administrative, financial, and education needs. The remodeling project is expected to be completed in Summer 2017. Together, these two projects will more than double the interior space available for UAMS West, providing growing room for the next 15-20 years.

UAMS Regional Programs and these Family Medical Centers are showing that their commitment to patients, enhancing the patient experience and improving health outcomes will continue long into the future. From our Little Rock campus to Fort Smith and Texarkana, UAMS is working to improve patient care for all Arkansans for a better state of health.

UAMS Chancellor Dan Rahn, M.D.

Pre-Health Professions Recruiters continue to travel their regions to encourage students across the state to become Arkansas’ health professionals of tomorrow, this year reaching 37,257 students statewide.

Medical Applications of Science for Health (M*A*S*H)

In Summer 2015, 420 high school students participated in one of 30 M*A*S*H camps across the state, with 71% from rural or minority backgrounds. During this two-week program for students entering grades 11 and 12, participants are certified in First Aid and CPR, learn healthy lifestyles, and apply science concepts to “real life” healthcare situations. A total of 17 medical students served as M*A*S*H program assistants.

Community Health Applied in Medical Public Service (CHAMPS)

Last spring and summer, 149 students participated in CHAMPS. This week- long program offers hands-on experiences in health careers and community service for students entering grades 8, 9 and 10, with 80% coming from either rural communities or minority backgrounds.

Advancement Into Medicine (AIM)

During 2015-16, 450 high school students participated in AIM, which continues to engage former M*A*S*H students through college advising, mentoring, interviewing and writing skills, clubs and community service.

Hands-On Health Care and Health Explorers

In 2015-16, 129 students glimpsed health careers through Hands-On Health Care activities such as giving injections, drawing blood, and physical therapy, as well as 1,911 Health Explorers engaged in other age-appropriate offerings.

A Day in the Life

These one-day events give an in-depth look into a specific health career, such as nursing or radiology, and include both lecture and hands-on activities. In 2015-16, 575 students participated.

Club Scrub & Med Pro-Ed

School-based clubs encourage exploration of health careers through meetings and activities, with 712 students participating this year.

Medical Interpreting

Our UAMS Northwest recruiter, who is Hispanic, teaches a Medical Interpreting class for bilingual high school seniors interested in a health career. This spring, 24 students completed the course.

College Pre-Professional Training and Support

College students can arrange mentoring and volunteer service opportunities through any of the Regional Centers. Pre-Med students receive help applying for medical school through advising, mock interviews, and MCAT preparation. This year 445 college students participated in some aspect of these programs.

Group Presentations and Events

In addition to the structured programs described above, our recruiters reached 32,442 other students across the state through school presentations, career fair booths, facility tours, and other groups and venues to increase awareness about health careers, workforce needs, salary potential, training opportunities, and academic pre- requisites. Statewide, general networking also reached 3,000 parents and faculty to explore future initiatives.

Research consistently shows that those who come from Arkansas, attend medical school in Arkansas, and complete residency training in Arkansas are the most likely to remain and practice in Arkansas, and those who come from rural areas are far more likely to return to rural areas to practice.

Producing enough doctors to care for Arkansans in future years will depend on how effectively we recruit and train promising young students from within Arkansas… NOW!

• The number of NON-Arkansan applicants to the UAMS College of Medicine (COM) continues to increase.
• HOWEVER, since 1999, the College of Medicine has received fewer than 350 applications from Arkansas students for its 174 first-year slots.
• By 2017, two new osteopathic medical schools will add 265 new slots for incoming first-year medical students, totaling 439.
• If the pool of qualified Arkansas applicants does not increase, many of these new medical school slots will be filled by out-of-state applicants.
• Arkansas has only 192 first-year residency slots, including just 52 in Family Medicine, so many of these new medical school graduates will have to go back out of state for residency.
• Research shows that 55% of physicians practice within 100 miles of where they completed residency training, so if these doctors are not from Arkansas, they will not likely return to practice in Arkansas.

Recruitment efforts targeting Arkansas students, especially from rural areas, combined with rural practice scholarships and incentives are our best long-term investments!

What We’re Doing is Working!

This year UAMS COM saw the highest number of Arkansas applicants since 1997!

Our recruiters are making a difference by connecting with these students and then providing ongoing support through their high school and college years with academic advising, MCAT prep, help with interview and writing skills, arranging mentoring and volunteer opportunities, and other referrals as needed.

This year, the highest number of UAMS medical school graduates in over a decade matched to a residency program in Family Medicine! We also saw an increase of overall graduates matching to a residency in a primary care specialty (56%), including FM, IM, Peds, and Ob/Gyn. Of the 33 who matched in Family Medicine, 10 matched to a program at one of our regional centers.

Regional Programs provided training for 144 residents in 2015-16, including 45 who completed their 3-year residency to become board eligible in Family Medicine.

Of these total graduates, 64% (29/45) remained in Arkansas to practice, with 62% (18/29) remaining in their training region to practice, and 41% (12/29) going to small towns of <15,000 population.

The UAMS South Arkansas Rural Training Track (RTT) in Magnolia continues with Martha Garrett- Shaver, MD, serving as director.

UAMS Regional Centers’ Residency programs have trained nearly HALF of all the Family Physicians practicing in Arkansas’ small towns.

Several HRSA grants that allowed an increase in our residency program slots ended last year, which reduced the number of total of first-year residency slots available this year to 52, including 46 for Regional Programs and 6 at the Dept. of Family and Preventive Medicine in Little Rock.

UAMS Regional Centers’ Family Medicine Residency Graduates Ten-Year Totals (2006-2016)

• 64% (280/438) remained in Arkansas
• 35% (98/280) are in small towns <15,000

The state’s first sports medicine fellowship for family physicians, offering advanced training on diagnosis and treatment of sports-related illness and injury, started in July 2015 at the UAMS Northwest campus with cooperation from the University of Arkansas Athletics Department and other clinical partners.

Sports medicine fellows will gain clinical experience seeing patients at UAMS-affiliated clinics as well as working with University of Arkansas student-athletes while under supervision of UAMS faculty and clinical partners, including Advanced Orthopaedic Specialists, the official sports medicine provider for the Arkansas Razorbacks. Completing the fellowship will enable a physician to sit for the sports medicine subspecialty board exam conducted by the American Board of Family Medicine. Kyle Arthur, MD, was selected as the first fellow.

761 UAMS Regional Center-trained physicians now practice in 130 Arkansas communities*, including 69 of the state’s 75 counties.

Of these, 53% remained in their training region, with 37% practicing in small towns and rural counties

Arkansas*

• De Witt (3,292)
• Stuttgart (9,326)

Ashley*

• Crossett (5,507)

Baxter*

• Mountain Home (12,448)

Benton

• Bentonville (35,301)
• Centerton (9,515)
• Decatur (1,699)
• Gentry (3,158)
• Gravette (2,325)
• Lowell (7,327)
• Pea Ridge (4,794)
• Rogers (55,964)
• Siloam Springs (15,039)

Boone*

• Harrison (12,943)

Bradley*

• Warren (6,003)

Calhoun*

• Hampton (1,324)

Carroll*

• Berryville (5,356)
• Eureka Springs (2,073)

Chicot*

• Lake Village (2,575)

Clark*

• Arkadelphia (10,714)

Clay*

• Corning (3,377)
• Piggott (3,849)

Cleburne*

• Greers Ferry (891)
• Heber Springs (7,165)

Columbia*

• Magnolia (11,577)

Conway*

• Morrilton (6,767)

Craighead

• Brookland (1,642)
• Jonesboro (67,263)
• Lake City (2,082)
• Monette (1,501)

Crawford

• Van Buren (22,791)

Crittenden

• Marion (12,345)
• West Memphis (26,240)

Cross*

• Wynne (8,367)

Dallas*

• Fordyce (4,300)

Desha*

• Arkansas City (366)
• Dumas (4,706)
• Mcgehee (4,219)

Drew*

• Monticello (9,467)

Faulkner

• Conway (58,908)
• Greenbrier (4,706)
• Mayflower (2,234)
• Vilonia (3815)

Franklin*

• Charleston (2,494)
• Ozark (3,684)

Fulton*

• Moko (1,635)
• Salem (1,635)

Garland

• Hot Springs (35,193)
• Hot Springs Village (12,807)

Grant

• Sheridan (4,603)

Greene*

• Paragould (26,113)

Hempstead*

• Hope (10,095)

Hot Spring*

• Malvern (10,318

Howard*

• Nashville (4,627)

Independence*

• Batesville (10,248)

Izard*

• Melbourne (1,848)

Jackson*

• Newport (7,879)

Jefferson

• Altheimer (984)
• Pine Bluff (49,083)
• White Hall (5,526)

Johnson*

• Clarksville (9,178)

Lafayette*

• Lewisville (1,280)

Lawrence*

• Walnut Ridge (4,890)

Lee*

• Marianna (4,115)

Little River*

• Ashdown (4,723)

Logan*

• Paris (3,532)
• Ratcliff (202)

Lonoke

• Cabot (23,776)
• Carlisle (2,214)
• Scott (72)

Madison

• Huntsville (2,346)

Miller

• Texarkana (29,919)

Mississippi*

• Blytheville (15,620)
• Manila (3,342)

Monroe*

• Clarendon (1,664)

Montgomery*

• Mount Ida (1,076)

Ouachita*

• Camden (12,183)

Perry

• Perryville (1,460)

Phillips*

• Helena/West Helena (12,282)

Pike*

• Glenwood (2,228)
• Murfreesboro (1,641)

Poinsett

• Harrisburg (2,288)
• Trumann (7,243)

Polk*

• Mena (5,737)

Pope*

• Dover (1,378)
• Pottsville (2,838)
• Russellville (27,920)

Pulaski

• Hensley (139)
• Jacksonville (28,364)
• Little Rock (193,524)
• Maumelle (17,163)
• North Little Rock (62,304)
• Roland (746)
• Sherwood (29,523)

Randolph*

• Pocahontas (6,608)

Saline

• Alexander (2,901)
• Benton (30,681)
• Bryant (16,688)

Scott*

• Waldron (3,618)

Sebastian

• Barling (4,649)
• Fort Smith (86,209)
• Greenwood (8,952)
• Hackett (812)

Sevier*

• De Queen (6,594)

Sharp*

• Ash Flat (1,082)
• Cherokee Village (4,671)

St. Francis*

• Forrest City (15,371)
• Hughes (1,441)

Stone*

• Mountain View (2,748)

Union*

• El Dorado (18,884)
• Junction City (581)
• Smackover (1,865)

Van Buren*

• Clinton (2,602)

Washington

• Farmington (5,974)
• Fayetteville (73,580)
• Lincoln (2,249)
• Prairie Grove (4,380)
• Springdale (69,797)

White*

• Bald Knob (2,897)
• Bradford (759)
• Kensett (1,648)
• Searcy (22,858)

Woodruff*

• Augusta (2,199)

Yell*

• Danville (2,409)
• Dardanelle (4,745)

All Regional Centers offer rotations at multiple clinical sites to prepare students and residents for practicing in a variety of community-based primary care settings, especially in rural and underserved areas.

Regional Programs sponsored training took place in 31 counties in 39 different communities

Ashley

Crossett (5,507)

Baxter

Mountain Home (12,448)

Benton

Rogers (55,964)

Chicot

Lake Village (2,575)

Columbia

Magnolia (11,577)

Craighead

Brookland (1,642)
Jonesboro (67,263)

Crawford

Cedarville (1,394)
Van Buren (22,791)

Dallas

Fordyce (4,300)

Desha

Dumas (4,706)

Desha

Mcgehee (4,219)

Drew

Monticello (9,467)

Faulkner

Conway (58,908)

Franklin

Charleston (2,494)
Ozark (3,684)

Greene

Paragould (26,113)

Independence

Batesville (10,248)

Jefferson

Pine Bluff (49,083)

Little River

Ashdown (4,723)

Logan

Booneville (3,990)

Madison

Huntsville (2,346)

Miller

Texarkana (29,919)

Ouachita

Camden (12,183)

Pike

Murfreesboro (1,641)

Poinsett

Harrisburg (2,288)

Pope

Dover (1,378)

Pulaski

Little Rock (193,524)

Saline

Benton (30,681)

Scott

Waldron (3,618)

Sebastian

Fort Smith (86,209)
Mansfield (1,139)

Stone

Mountain View (2,748)

Union

El Dorado (18,884)

Washington

Fayetteville (73,580)
Johnson (3,354)
Lincoln (2,249)
Springdale (69,797)

Bowie

Texarkana, Tx (36,411)

The Rural Medicine Student Leadership Association (RMSLA) is sponsored by Regional Programs and Arkansas Farm Bureau to provide peer support for Rural Practice students, to inform state policy, to create links between students and communities, and to provide regular meetings and speakers to discuss issues of importance to future rural physicians. This year, 152 students were involved in RMSLA.

In August, Kristin Mitchell of North Little Rock was awarded the 2015 Arkansas Mutual Medical Student Award, a $10,000 scholarship for third-year UAMS medical students who plan to practice primary care in rural Arkansas. Mitchell, who is the junior class representative for UAMS’ Family Medicine Interest Group, and her husband, a first-year medical student from a small town in Oklahoma, both want to practice and live in a smaller Arkansas community.

This scholarship is funded by Arkansas Mutual Insurance, the only medical liability insurance provider headquartered in Arkansas, in partnership with the UAMS College of Medicine to encourage more medical students to enter primary care fields and to practice in rural Arkansas. With the average medical school debt of UAMS graduates soaring to $179,673, that financial burden can be a significant factor for graduates when choosing their specialty and place of practice.

One of the reasons I am interested in family medicine is the ability to build long-term relationships with patients. Often in rural communities the family physician is the internist, dermatologist, gastroenterologist and OB/GYN, and it is humbling to think of the trusted role they have in their patients’ lives. I love the thought of my family planting in a community and truly investing in it for years.

Kristin Mitchell

Other Rural Practice Incentive Programs

UAMS Medical Students who participate in the Rural Practice Program are required to perform a Family Medicine Preceptorship through a Regional Center, and complete a portion of their Junior Clerkship in a rural community. They also complete at least one senior rotation (Acting Internship or Primary Care Selective) at a Regional Center. In 2015-16, 40 medical students and 22 residents in training had a Rural Practice commitment, with another 28 physicians actually practicing in a qualifying community.

Family Medicine Interest Group

This year, the Family Medicine Interest Group (FMIG) reached 300 students, with attendance at monthly meetings averaging 40-50. Guest speakers offer diverse perspectives to increase student awareness of all aspects of medicine, practice models, financial management, health care policies, and personal stories.

Family Medicine Week was held October 5-9, 2015 with presenters highlighting different facets of their personal and professional experiences as a family physician. Twenty-one medical students attended the 2015 AAFP National Student and Resident Conference August 7-8, 2015, in Kansas City, KS, which is a record number of UAMS students active in this organization.

Family Medicine Preceptorships

During Summer 2015, 59 medical students participated in the Family Medicine Preceptorship program, involving 4-week extra-curricular clinical shadowing opportunities for entering M2 medical students to work with family physicians in towns across Arkansas.

Service Learning Preceptorships

Additional 4-week Service Learning Preceptorships were completed by 5 students in Summer 2015. Projects included: Living with Diabetes –a resource for chronic disease management, Health Literacy Research/Plain Language Editing, and developing report cards for Quality Improvement milestones.

Junior Clerkships in Family Medicine

In 2015-16, 70% (113/162) of the junior class performed family medicine clerkships in UAMS Regional Centers. This mandatory experience, at a time when students are beginning to make decisions regarding specialty and practice location, is the most effective recruitment tool to date for our residency programs. There were an additional 18 Longitudinal Clerkships (6 month) that took place at UAMS Northwest.

I very much enjoyed my experience! The residents and physicians were great and imparted much knowledge about medicine. This experience opened my eyes and I am now highly considering a residency in Family Medicine. 

Clerkship Participant

Senior Electives/Selectives

In 2015-16, 28% (49/173) of the senior class completed rotations in the UAMS Regional Centers. The senior year of medical school allows students to design a program of study to meet personal career goals. Acting Internships are 4-week required rotations that focus on clinical skills and instill confidence in preparation for the first year of residency. The Senior Selective in Primary Care is a 4-week rotation required of senior students, with an outpatient, or clinical, focus. Electives in most specialties can also be taken in the UAMS Regional Centers.

Longitudinal Senior Elective

This year, 6 medical and 8 pharmacy students completed a new inter- professional pharmacotherapeutics course at UAMS Northwest. This 12-week elective course is approved through both the Colleges of Medicine and Pharmacy curriculum committees. Students complete a didactic portion and then team up in groups where medical and pharmacy students and faculty conduct case studies, discuss, share, and see patients as a team in a student-run clinic.

This year, 42 traditional pharmacy students and 2 pharmacy residents completed training at one of our regional centers.

UAMS Regional Programs’ clinical pharmacists have been pursuing the Triple Aim since before the Triple Aim had a name, with most enjoying an integral role in the complex care committees in their respective family medicine clinics as part of the Comprehensive Primary Care Initiative (CPCI).

This year revealed significant growth and development in population health and quality improvement. Intensive review of high utilization patients often reveals drug therapy opportunities to improve quality metrics and reduce costs. A particular point of emphasis has been review and quality improvement with prescription of controlled substances, with these efforts paying dividends in improving consistency in proper provision and documentation of this type of clinical care.

The rapidly changing content of pharmacy practice provides both challenge and opportunity. Drug costs have increased 12% in the past year, with our pharmacists actively involved in trying to manage this issue. One of the most timely moments to intervene is at transitions of care. A valuable strategy that has worked with complex care patients is alignment of refills for chronic use medications to reduce the frequency of trips to the pharmacy.

Education has been the strong suit of clinical pharmacy in Regional Programs for over 30 years. We congratulate our colleague Jonell Hudson, PharmD, for receiving the Chancellor’s Teaching Award for Society and Health Education Excellence at UAMS. Her work in diabetes education with the Marshallese community in Northwest Arkansas is a credit to the highest standards of the university.

The diversity of our educational effort is an abiding presence in Regional Programs.

Our pharmacists are consistent leaders, from didactic therapeutics lectures in the College of Pharmacy to post-graduate continuing education presentations sponsored by UAMS.

Elective pharmacology rotations taught by our pharmacists to family medicine residents promote confidence and competence in drug therapy. Interdisciplinary education has been a cornerstone in Regional Programs for over a generation, with our pharmacists often in leadership positions for these group learning activities. Our learning group commonly involves family medicine residents and faculty, pharmacy residents, pharmacy faculty and pharmacy students, medical students and physician assistant students.

Scholarly activity and academic leadership are well represented among pharmacy faculty. This year, numerous invited platform presentations were delivered at national and state meetings, and a wide range of articles have been published, many involving family medicine residents as an author. Two of our pharmacists serve on the Internal Review Board (IRB) of their host hospital to ensure the safety of research project subjects. One pharmacy faculty serves as a member of the Dean’s Senior Advisory Council in the UAMS College of Medicine, which deals with issues of professionalism through Illumine.

Our pharmacists will also be involved in the design and delivery of educational content in support of a new regulation from the Arkansas State Board of Medicine regarding continuing education on pain medications.

In 2015-16, 176 nursing students from various educational institutions, ranging from nursing assistants to masters level practitioners, participated in educational courses and practicum experiences at our regional centers.

UAMS College of Nursing

UAMS College of Nursing faculty members at the Regional Centers teach courses and serve as faculty preceptors, while also assisting rural students with academic advising, registration, online and interactive video offerings, medical library access, and clinical preceptor assignments.

In 2015-16, 42 students were enrolled in UAMS College of Nursing programs and received services through our Regional Centers. Nurses throughout the state can remain in their home communities while earning credits toward a Masters of Nursing Science (MNSc) degree in a variety of Advanced Practice Registered Nurse (APRN) specialties, including pediatric primary and acute care, adult- gerontology primary and acute care, family nurse practitioner, psychiatric-mental health, or nursing administration. The online RN-BSN, RN-MNSc and Doctor of Nursing (DNP) practice programs are also available to students throughout the state.

Nursing Assistants & Home Aides

In response to community needs, Certified Nursing Assistant (CNA) and Home Care Aide training is offered through UAMS North Central and Northwest, with 94 trained this year.

Other Nursing Programs

Students from other institutions performing clinical rotations through our centers included:

• 6   APRN/ NPs
• 18   RNs
• 16   LPNs

UAMS Regional Centers offer programs or clinical practicum in several allied health professions. Center faculty also teach CPR, ACLS, PALS, and HeartSaver training. Some programs are being phased out due to loss of funding or market saturation. This year, 63 students were trained.

Health Information Management

The UAMS Health Information Management (HIM) Department offers an online AS degree in Health Information Technology and an online BS degree in Health Information Administration. The AS qualifies the graduate to take the RHIT certification exam; the BS qualifies them to take the RHIA exam. Texarkana is a clinical affiliate and exam location.

Medical Laboratory Science

Graduates of the Medical Laboratory Sciences Program at Texarkana are prepared to sit for entry-level national certification exams. The full-time track requires 17 months, and the part-time track allows a maximum of 5 semesters. Upon completion, a BS degree in Medical Laboratory Sciences is awarded. An MLT-to-MLS advanced placement track is also offered for working medical laboratory technicians.

Medical Assistants

UAMS West in Fort Smith provides training for medical assistant students from the local Petra Allied Health. The students learn proper technique for assessing vital signs, setting for procedures, assisting with minor office procedures, and gathering information for the doctor prior to patient visit. Students also gain working understanding of HIPPA, workplace safety, Universal Precautions, and professionalism.

Phlebotomy

A Phlebotomy course is available in Texarkana, including both classroom and clinical portions where students must complete 100 clinical hours as well as 100 successful venipunctures. Completers receive a certificate making them eligible to take the American Society for Clinical Pathology (ASCP) exam.

Radiologic Imaging Sciences

The AS in Medical Radiography is offered in Fayetteville at the UAMS NW Campus. Graduates are eligible to take the national certifying exam given by the American Registry of Radiologic Technologists.

Physician Assistant Program

The second cohort of 25 students from the new UAMS Physician Assistant program began their clinical rotations through our regional centers in July 2015. These experiences in the regional centers focus on the clinical aspects of family medicine and primary care in both outpatient and inpatient settings. Students participate in history taking, performing physical exams, developing differential diagnoses, formulating diagnoses, designing prevention and management plans, and documenting common medical conditions observed in family medicine outpatient and inpatient settings. Students have exposure to a variety of procedures, with emphasis on caring for patients across the life-span. We are pleased to welcome these students to our centers as the most recent addition to our teams.

UAMS Regional Centers’ Librarians saw many staff changes for the 2015-2016 year. The sudden passing of Pine Bluff Librarian, Julie Dobbins, has left a void. Julie was with the Melville Library for 38 years. Julie’s wisdom and humor will be missed. UAMS South Librarian, Jana Terry, resigned in August 2015, to return to her true calling as school librarian and UAMS West gained a new librarian, Elizabeth Burden.

Librarians Donna Petrus and Destiny Carter worked with UAMS Librarian, Louise Montgomery, to implement a short training on Reach Out and Read with residents in two clinics, UAMS Northeast and UAMS Southwest. The video reduced the training time for residents who wished to participate in the Reach Out and Read program. They are currently working together on a paper to present at the South Central Chapter of the Medical Library Association meeting in October 2016.

UAMS Regional Centers’ Librarians continue to serve patrons in their areas, providing research and information to residents, local physicians, students, and other organizations, and assisting with health fairs and other outreach projects. Several librarians attended the 2015 SCC/MLA meeting in Little Rock, where the theme was Bridging the Rivers of Change and gained info on health literacy, assisting in research, and among other topics, facing changes in library sciences.

AHEC Library Patrons 2015 – 2016

13,712	Health Professionals
22,194	Students and Residents
13,436	Consumers
49,342	Total Patrons

Reference/Resources/Services

8,331	Information/Manual Requests
3,098	Electronic Searches
2,807	Books Circulated
2,408	Journals Circulated
2,654	Audiovisuals Circulated
2,039	Interlibrary Loans Filled
12,179	Articles Photocopied

Julie Lenore Dobbins

February 15, 1954 – June 24, 2016

All UAMS Regional Programs faculty and staff were deeply saddened by the passing of long-time employee Julie Lenore Dobbins, age 62, of Pine Bluff. Julie began her career at UAMS in 1978 and will forever be part of us. Julie was one of the original employees of UAMS South Central in Pine Bluff (formerly AHEC Pine Bluff), where she had been employed for 38 years as longtime Director of Library Services for the Melville Library.

A lifelong resident of Pine Bluff, Julie was a daughter of the late Roy Heaton Dobbins and Margaret Lou Hugon Dobbins. Julie graduated from

Pine Bluff High School in the class of 1972 and earned a Bachelor of Science degree from the University of Arkansas at Monticello. Julie was a member of Lakeside United Methodist Church, the John McAlmont Chapter of the Daughters of the American Revolution, a member of Alpha Sigma Alpha sorority, and former board member of the Pine Bluff-Jefferson County Historical Museum Auxiliary.

Her faithful service to the people in the South Central region and across the state was an inspiration to all. Through the years, Julie’s expertise was invaluable to hundreds of resident and area physicians, nurses, student learners and scores of others, and she touched many lives with her tremendous compassion, caring heart, and wonderful wit. She will be greatly missed.

The Center for Distance Health (CDH) provides most continuing education programming for UAMS Regional Centers. CDH Programs are available in a variety of formats, including webinar, face-to-face, and interactive video.

Continuing Education 2015 – 2016
Number of Live Conferences	129
Number of Teleconferences Total	387
Attendees	3,318
New Learn On Demand Activities	210
Total New Users This Year	2571

The CDH has a strong infrastructure in continuing education, particularly with learnondemand.org, which has grown to nearly 6,500 users. Health care professionals are able to obtain continuing education credit online. The online programs are accredited by the Accreditation Council for Continuing Medical Education (ACCME), American Nurses Credentialing Center’s Commission of Accreditation, and Certified Health Education Specialists/Master Certified Health Education Specialists (CHES/MCHES) and certificates of attendance for allied health.

Live and online program topics this year included obesity, diabetes, cardiovascular disease, and other chronic diseases. Additionally, health care trends, geriatrics, women’s health, pharmacology, safety, and pediatrics were frequent topics of discussion. CDH provides Obstetrical Emergency Drills, Neonatal Resuscitation Program (NRP), and fetal monitoring at the Regional Centers on request and offers Sugar & Safe Care, Temperature, Airway, Blood Pressure, Lab work, Emotional Support (STABLE) as a live interactive video program quarterly. The patient education site (patientslearn.org) has added content related to adoption, birth control, brain and spinal injuries, cardiovascular disease, safe sleep, car seat safety, depression, and sickle cell disease, along with existing information on breastfeeding and childbirth, and diabetes modules for women with gestational diabetes.

UAMS Regional Centers’ faculty, residents, and staff are very active in their communities, serving on many national, state, and local advisory boards and committees. They also provide a vast array of health care services, screenings, support groups, and other resources, some of which are listed below:

Physical exams and health services

• Boy and Girl Scouts
• Church Health Clinics
• Medical Mission Trips
• Nursing Homes
• Immunizations
• School Athletics
• Special Olympics
• Veterans CBOC

Specialty clinics

• Asthma/COPD
• Pediatric Cardiology
• Diabetes
• GI/Colonoscopy/EGD
• HIV/AIDS
• High Risk Obstetrics
• Infectious Diseases
• Minor Surgery

Other clinics & counseling

• Anticoagulation
• Colposcopy
• Developmentally Delayed
• Hyperlipidemia
• Prescription Assistance
• Prenatal Care
• Tobacco Cessation
• Weight Control

Community Education & Service

• Aging Successfully
• Baby Safety Showers
• CPR Instruction
• Diabetes Management
• Drug/Alcohol Abuse
• Hypertension/Stroke
• Nutrition & Fitness
• Reach Out & Read

Clinic Patient Services 2015 – 2016

• Outpatient Visits 172,807
• Babies Delivered 860
• Uninsured Care $1.01M
• Hospital Visits 75,147
• ER Visits 1,901
• Nursina Home Visits 3.416

In response to many changes at the national level in health care practice, policy, and reimbursement, our Regional Centers continue with comprehensive transformation in our residency clinical operations, not only to keep up, but rather, to set the standard for excellence and efficiency in primary care practice for Arkansas’ future health care professionals.

Comprehensive Primary Care Initiative (CPCI): The five Family Medicine Centers (FMCs) in Fayetteville, Springdale, Fort Smith, Texarkana and Jonesboro continue to participate in the CPCI, a multi-payer initiative to strengthen primary care. Medicare, along with commercial and State health insurance plans, offer enhanced payments to primary care doctors who coordinate care for their patients more effectively. We are currently completing the final year, and all clinics, with the exception of Magnolia and Texarkana All For Kids, have applied for the newly announced CPC+ program.

Medicaid PCMH: All FMCs participated in the Medicaid PCMH initiative, which is part of the Arkansas Health Care Payment Improvement Initiative. Clinics are separated into two groups – CPCI (Fayetteville and Springdale, Fort Smith, Texarkana and Jonesboro) and non-CPCI (Texarkana AFK, Pine Bluff, Magnolia and UAMS FMC). CPCI clinics benefit through shared savings, while the non-CPCI clinics receive monthly care coordination payments plus shared savings. For 2014, the CPC clinics earned approximately $1.5 million in Shared Savings.

Enli CareManager (CM): CareManager continues to be the population health tool used to address patient care gaps. Current modules include Cardiovascular Risk Reduction, Cancer Screening, Diabetes and Prevention, with Heart Failure and Peds modules expected soon.

MACRA/MIPS: Our clinics are now preparing to meet new Medicare Access & CHIP Reauthorization Act (MACRA) and Merit-Based Incentive Payment System (MIPS) requirements which go into effect in 2017.

Behavioral Health and Health Education

UAMS Regional Programs believes that educating and empowering Arkansans to make healthy lifestyle choices, equipping individuals for better self-management of their chronic diseases, and dealing strategically with patients who have mental health and/or substance abuse issues are some of the most cost effective investments to be made. Such efforts can improve patient outcomes, reduce complications, and decrease hospital admissions and readmissions.

Behavioral health faculty have been integrated into our clinical teams and are improving the efficiency and effectiveness of the primary care system by helping patients with behavioral issues. They also function as core faculty members to educate residents and students, demonstrating a patient-centered team-based care model within the Family Medicine Residency context. Regional Programs is currently expanding inter-professional education (IPE) opportunities to strengthen the integration of Behavioral faculty into care teams. Campus experts in IPE and research are exploring opportunities to use electronic de-identified data to conduct a generalized assessment of behavioral care issues within our network.

That analysis would allow researchers and educators to target future efforts for maximum impact.

In addition, our Health Educators have taken a more clinical approach as members of the PCMH team, to provide education and coaching for preventative and follow up efforts to help patients meet health goals such as weight loss, smoking cessation, and diabetes self-management. They also connect patients and residents with community services and resources to address other barriers and determinates of health, be they biological, socioeconomic, psychosocial, behavioral, or social in nature.

Our Regional Programs’ faculty and staff have become active collaborators with strategic initiatives on campus to develop and expand inter-professional education and research initiatives. Moving forward, our priorities will be focused on clinical innovations that respond to the goals of the Triple Aim, which include 1) organizational change to improve patient care, patient outcomes, and/or reduce costs; 2) testing components of the PCMH model across centers; and 3) researching Regional Programs patient data on outcomes, quality and cost.

The second annual Statewide Teaching Innovations Symposium was held in Fayetteville in June 2016, with 10 faculty and 5 residents presenting or leading discussions on new and innovative teaching, administration, and QI research projects to share findings, ideas, and best practices.

Publications & Presentations

UAMS Regional Programs’ faculty and staff are respected nationally in many areas of expertise. A sampling of publications and presentations from this year is listed below.

Publications

Nwude E, Hudson J, Coulter L. Are overweight children more likely to be overweight adults? Journal of Family Practice 2015; 64(10): 663-4.

McElfish PA, Kohler PO, Smith C, Warmack S, Buron B, Hudson J, Bridges M, Purvis R, Rubon-Chutaro J. Community-driven research agenda to reduce health disparities. Journal of Clinical and Translational Science OnlineFirst, published Nov 2015.

McElfish PA, Bridges M, Hudson J, Purvis R, Bursac Z, Kohler P, Goulden P. Family Model of Diabetes Education With a Pacific Islander Community. The Diabetes Educator . OnlineFirst, published Sept 11, 2015 as doi:10.1177/0145721715606806

Campion M, Campion R, Campion V. Eye Whitening Using Subconjunctival Injections. The American Journal of Cosmetic Surgery; 32(4): 254-7.

National Presentations

Brimberry R. Practice Transformation with CareManager 4.5, invited speaker at Enlighten 2015: Better Outcomes for Everyone, a CareManager customer forum hosted by Kryptiq. Portland, OR (Sept 2015)

Frank T. New Drugs in Primary Care 2016; Annual Meeting; American Society of Health Systems Pharmacists; Baltimore, MD (June 2016)

Frank T. New Drugs 2016; Annual Meeting; American Drug Utilization Review Society; Scottsdale, AZ (Feb 2016)

Gray D. Breathing New Life into a Geriatric Rotation; a poster, at PDW/RPS Residency Education Symposium in Kansas City, MO (April 2016)

Hudson J, Brimberry R. The Development of an InterProfessional Complex Care Team. Paper presented at Society of Teachers of Family Medicine, Conference on Practice Improvement. Dallas, TX (Dec 2015)

Macechko M. Educating Millennials: Improving Core Measures and Achieving Payment Initiatives Using Repetition & Creative Visual Aids, a poster, at the PDW/RPS Residency Education Symposium in Kansas City, MO (April 2016)

Sparks K, Hudson J, Wiley G, Kohler P, McElfish P. Family Model of Diabetes Self-Management Education (DSME) in the Marshallese Community: Preliminary Findings. 31^st ADA Annual Clinical Conference on Diabetes, Jacksonville, FL (May 2016)

1. The EMR Project: The launch of EPIC in our centers was delayed due to project cost increases. We are down to three EMR options with a decision expected in FY 2017. The EMR selected will determine our implementation schedule for 2017, and the new EMR and IT system will serve as the backbone for an integrated health delivery system that includes a robust Population Health tool that will position Regional Programs to be successful with new market reforms/payment initiatives.
2. Patient-Centered Medical Home (PCMH): We continue to improve our clinical processes to provide excellent patient-centered care, while moving toward a more pro-active and targeted population health model. This positions our regional centers well for taking on shared risk/savings arrangements (CPC+), and for preparing the next generation of clinical providers for advancing models of team-based care delivery.
3. Growing the qualified applicant pool for Arkansas’ medical schools: Research shows that those students who 1) come from Arkansas, 2) attend medical school in Arkansas, and 3) complete residency training in Arkansas are most likely to remain and practice in Arkansas. Further, those who come from rural areas are far more likely to return to a rural area to practice. Consequently, our eight regional pre-health recruiters will continue their focus on growing the qualified applicant pool within our borders by helping more Arkansas students prepare successfully for medical school.
4. Regional Center Facilities: We continue to move toward building and/or modernizing our clinical facilities to gain efficiency that supports effective learning environments for residents, students, faculty and staff, and which allows for expansion and growth of our programs. The new clinic facility at UAMS West should be ready in FY 2017, and commitments have been made on new spaces for UAMS South and UAMS North Central Regional Centers.
5. Residency Program expansion: Family Medicine Residency expansion efforts will be focused in three regions: North Central, East and Central. We’re working with local hospital partners and our existing residency programs to develop and establish rural-focused community based residency programs that are best suited and, ultimately, most beneficial to those regional healthcare systems.
6. Partnerships & Collaborations: We will continue to nurture and expand our vital and strategic partnerships and collaborative relationships across the state and within UAMS bringing value to our partners and the region. We expect to deliver excellent and compassionate services that prepare the next generation of providers for every region of the state.

Becky G. Hall, EdD, Director

UAMS East serves 7 Delta counties with some of the worst health outcomes in the state. With centers in Helena, Lake Village and West Memphis, UAMS East provides chronic illness prevention and education, community wellness, and recruitment of health professionals to meet the current and future needs of Delta residents. UAMS East encounters totaled 173, 112 this year, the highest number ever recorded.

UAMS East offers education and training to health professions students, interns, and RN to BSN students. Internships were provided for Health Education students from Southern Illinois University, the University of Arkansas at Little Rock, and Washington Lee University through its Shepherd Poverty Alliance Internship. Mentoring and assistance in arranging clinical opportunities was provided to 15 students who completed the UAMS BSN to APN program and 2 who completed the APN program; all are staying in Phillips County to practice. UAMS East provided internship opportunities for two high school student members of Jobs for America’s Graduates (JAG). The UAMS East Library served 9,000 health practitioners, students, and consumers.

The pre-health professions recruitment program continues to grow, with offerings such as M*A*S*H and CHAMPS, A Day in the Life, Destined to be Doctors, and Funology Science Camp. This year, 493 youth participated in these programs, which encourage students to consider health careers and then remain in the Delta to practice.

UAMS East provides robust chronic illness prevention, education and wellness programs. With an $8,000 grant from the Arkansas Hunger Relief Alliance and in collaboration with the UA Division of Agriculture, a “Grocery Store Tour Event” was hosted in Helena and West Memphis for 600 participants, and “Cooking Matters” classes were held in all 3 Centers. Kids for Health reached 12,501 youth.

Baby Safety Showers served 251 expectant mothers, with staff correctly installing 75 car seats for parents.

West Memphis was awarded a $10,000 grant from the New York Life Foundation to fund CoEd Safety Baby Showers. Evidence-based curriculums “Making Proud Choices,” “Making a Difference,” and “Reducing the Risk” were implemented at numerous high schools.

UAMS East in Helena celebrated the 10^th anniversary of its Vasudevan Wellness Center, and Fitness Center encounters numbered 19,879. Exercise programs throughout the service area engaged 14,830 youth and adults, including spinning, yoga, Silver Sneakers, ZUMBA, and a Boot Camp for Kids.

UAMS East received a $23, 625 grant from the Helena Health Foundation to provide 15 Automated External Defibrillators, and training on their use, to schools and community organizations in Phillips County. A $25,000 grant was received from the UAMS Chancellor’s Circle for planning and implementing a walk in clinic. UAMS East in Lake Village received $1,591 from the SE Arkansas Community Foundation to supplement workout equipment at their Outreach Center. They also were awarded $1,861 from the Arkansas Minority Health Commission to implement its Healing Hearts Worksite Wellness Program.

Three staff collaborated with the College of Nursing on a poster presentation at the UAMS Nursing Research Conference, entitled, “A Snapshot of Cancer Incidence, Mortality, and Risk Factors in Phillips County Arkansas.”

The success of UAMS East, over the past 26 years, has been the result of a dedicated staff and vast local support. UAMS East partners with over 100 state and local groups, leading to new and successful programs that are improving the health of the Delta.

Dennis F. Moore, PharmD, Director

This year, UAMS North Central has continued to meet the needs of our region through community partnerships. Limited funding has precluded us from establishing a Family

Medicine Clinic as was previously planned. Rather, our efforts have shifted toward enhancing the strategic local relationship and collaboration with White River Medical Center (WRMC) to accomplish goals that will effectively address the specific health care and professional needs of our region through a mutually beneficial partnership. In cooperation with UAMS, WRMC is establishing a unique (to Arkansas) approach in launching a joint residency program that will train both Internal Medicine and Family Medicine residents in our community. WRMC elected to pursue ACGME accreditation for the Internal Medicine Residency using local funding, and they were successful in that effort. They recently initiated a Memorandum of Understanding (MOU) with UAMS to provide support for the program. Consequently, it appears that WRMC will be prepared to launch an Internal Medicine Residency program in July 2017, with ten residents in the inaugural class.

The current preliminary plan is to then launch and support, also through local funds, the Family Medicine Residency program in 2018. Historically, UAMS Regional Programs has established Family Medicine Residency programs as stand-alone programs/clinics in cooperation with sponsoring institutions. This emerging dual residency approach is a novel one in that it will encompass both Internal Medicine and Family Medicine residency programs, within which the academic support center will be combined and shared through Regional Programs. The template for financial and reporting specifics has yet to be determined, but it will be designed to serve as an effective mechanism to expand and enhance quality and comprehensive health care for our rural population.

Our Pre-Professional Recruitment program reached over 3,000 students this year, through various programs across the region to encourage students to consider health careers.

UAMS North Central continues to offer educational programs specifically geared to the needs of our region, such as the certified nursing assistant (CNA) program. These students continue to have a very high pass rate for certification, which sustains strong support by the local nursing homes for the program. In addition, the Diabetes Self-Management Education (DSME) program continues to work closely with and meet the needs of the local diabetic population. There is considerable excitement around the expectation that the Diabetes Prevention Program (DPP) will soon be reimbursed as a preventive service, as this will open up new opportunities for this program (and hopefully others) to focus more resources into actually preventing the onset of Diabetes.

The UAMS North Central Medication Assistance Program continues to expand its impact across our multi-county region. A program serving Van Buren and Searcy Counties was ended by the organizers. Seeing the tremendous need, our program elected to assume the responsibility for assisting with that additional caseload. This has resulted in obtaining the highest number of needed medications for area residents than ever before since the program’s inception in 2009. This fiscal year, the program expects to eclipse over $1.8 million in prescription medications for the people of our region.

We are honored to continue working with valued local partners to collaboratively address the health care and professional needs of the residents of North Central Arkansas.

Ron Cole, MBA, Director

Academic year 2015-2016 was a successful year for UAMS Northeast, marked by many positive milestones and new experiences. A few of the more significant events are highlighted below.

UAMS Northeast moved into its new location in February 2016. While still in acclimation mode, we resolved many building concerns (e.g., leaking roof, malfunctioning heat and air). The good news is that most issues have now been resolved and everyone is quite proud and comfortable in our new home.

There were two Friends of UAMS events in Jonesboro this year: a fall evening event at Sue’s Kitchen, October 8^th, and a spring noon event on March 7^th, held in conjunction with the Jonesboro Rotary Club. Both events were well attended and well received, with keynote speakers, Dr. Dan Rahn, UAMS Chancellor, and Dr. Peter Emanuel, UAMS Arkansas Cancer Research Center. The Friends of UAMS events provide communities the opportunity to stay abreast of the work UAMS does in leading the state to a higher state of healthcare.

UAMS Northeast, in partnership with ASU, conducted our sixth annual MCAT (Medical College Admissions Test) prep course in June. A total of 29 students enrolled (25 in Jonesboro and 4 in Magnolia). This year the course content was broadcast to our sister program in Magnolia, to allow participation by SAU students. The goal of this MCAT course is to provide pre-medical college students an opportunity to prepare for the MCAT exam in a cost effective manner, with professor-led learning sessions specific to the exam sections, such as chemistry, biology, and psych/social.

All participants are tested before and after the course sessions with a goal of increasing their total exam score. In addition to tracking student exam scoring gains, all students are surveyed in an effort to continuously improve the course. Once we complete the final evaluation and compile lessons learned from this pilot program offered via IVN, we hope to expand the MCAT course across the state through other regional centers via the interactive video network, providing opportunities for many more students living in rural areas across Arkansas to prepare for and pursue their medical school ambitions.

M*A*S*H is a product of UAMS Regional Programs that is producing its intended outcome, which is encouraging more Arkansas students to pursue medical professions. M*A*S*H succeeds by engaging high school students in two-week summer enrichment programs involving fun and educational hand-on activities and shadowing opportunities that demonstrate the many options that exist in health professions and what steps are required to pursue each of those careers. This year, UAMS Northeast conducted its 27^th annual M*A*S*H program in Jonesboro, while also supporting programs in Pocahontas and Blytheville. M*A*S*H, which stands for Medical Applications of Science for Health, is a very popular and competitive program, with many more applications received than our 20 available slots can accommodate, thus, additional satellite programs are being planned.

We are excited about the future of UAMS Northeast and the role we are playing on many levels, whether by training excellent physicians, nurses, pharmacists and other students, or by providing the best team- based healthcare available in our region. The future is bright and we are thrilled to be part of it.

Robert R. Gullett, Jr, MD, Director

This was a productive year for UAMS Northwest. We have much to report and of much to be proud. The entire Northwest team strives to make a positive difference in health care for the people in northwest Arkansas and this region.

Lois Coulter, PharmD, is the College of Pharmacy (COP) Residency Program Director for UAMS Northwest, which is a PGY-1 Pharmacy Residency that is ASHP accredited for 6 years. Pharmacy faculty teach and precept interprofessional activities. We have a volunteer pharmacist at Welcome Health, which is a free health clinic in Fayetteville, and also provided several volunteers at the annual American Diabetes Associates NWA Expo.

Congratulations to Jonell Hudson, PharmD, Associate Professor in the COP, who was recipient of the Chancellor’s Teaching Award for Society and Health Education Excellence. She became a Certified Diabetes Educator this year.

Derrick Gray, MD, and Michael Macechko, MD, continues to serve as co-Medical Directors at the Arkansas Veterans Home at Fayetteville. Dr. Gray received the Regional Programs Excellence in Teaching award. He treats patients at 7 Hills Homeless Center as a community service. Dr. Macechko serves as chair of the program’s Clinical Competency Committee.

With the highly anticipated ICD-10 conversion last fall, Linda McGhee, MD, led three seminars on implementation and created an ICD-10 Survival Guide, which is being used by Regional Programs throughout the state.

Eleven family medicine residents graduated in 2016, with all eleven passing their Board Exams. Six plan to practice in the state, including four in northwest Arkansas.

The UAMS Northwest Family Medicine Residency program hosted the 2^nd Annual Arkansas Family Medicine Scholarly Activity Colloquium in Fayetteville on June 3, 2016.

We welcome Kaye Yocham, RN, as nurse manager, who brings many years’ experience to the clinical team.

The Sports Medicine Fellowship (SMF) at UAMS Northwest is completing its first year. This program, directed by Ramon Ylanan, MD, is ACGME accredited and the state’s first SMF, giving family physicians the opportunity to receive advanced training on diagnosis and treatment of sports-related illness and injury. We value our partnership with the University of Arkansas Athletics Department. Our second fellow begins in July 2016.

The youth programs directed by Ana Sanchez, Recruiting Specialist, attract enthusiastic interest from both area students and community leaders. The MASH and CHAMPS camps allow junior high and high school students the opportunity to explore careers in health care. Ms. Sanchez also teaches a Medical Interpreter Program for high school seniors interested in a health career. This spring, she trained 24 bilingual students.

Eleanor Hughes, Health Educator, leads a biweekly Diabetes Support Group for diabetic patients and their family members. This group educates, offers guidance, and shares self-management ideas and recipes. Ms. Hughes, along with several other northwest campus co- workers, also provides interprofessional health screenings in the community.

The Outpatient Therapy Clinic provides rehab services, including physical, occupational and speech therapy. The clinic had significant increase in patient volume this year. UAMS Doctor of Physical Therapy students spend four hours in clinic each week as part of their Integrated Clinical Experience, working with licensed therapists and getting hands-on patient treatment experience. Two OTs have become Driver Rehab Specialists.

UAMS South has experienced a great year! The success of the clinic is a direct reflection of our outstanding personnel. Without our regional employees, residents, APRN’s, MD faculty, and UAMS central staff, the clinic would be just another clinic and not a UAMS regional center.

Patients continue to receive excellent care. With the addition of Shawntel Price, APRN, FNP, Adriana Delaney, APRN, WHNP, and Stephen Attebery, LPC, UAMS South has expanded its capacity to provide more patient care overall, as well as specialty care in women’s health and Behavioral Health. We are also pleased to welcome back Rebecka Wendling as our health educator. This year, our faculty, residents, and clinical staff provided over 15,000 outpatient encounters and more than 2,000 inpatient encounters.

In June 2016, the employees of UAMS South saw another class of Family Medicine physicians graduate, with all three having secured employment prior to graduation. We are very pleased to welcome one of those graduates, Dr. Michael Yambot, as a new member of our faculty.

UAMS South has received notification from CMS that our Rural Health Clinic status was renewed. A new ultrasound machine (GE Voluson E10 ultrasound) was purchased to better serve our patients, giving us the capabilities to perform vascular studies, OB/GYN exams, and ECHOs.

Our pre-health recruitment program continues to reach thousands of students from south Arkansas and encourage them to consider health careers. This year, an MCAT prep course was piloted via interactive video technology in Magnolia.

Faculty from ASU in Jonesboro have offered this MCAT program for many years, but this was the first time the reduced cost program was made available to students in another region via distance education. This pilot was a success, and lessons learned will be applied, with plans to offer the program to other regions via IVN technology in future years.

I could go on for many pages and still not provide the appropriate acknowledgments. Suffice it to say that UAMS Family Medical Center (FMC) – Magnolia has always been committed to providing the best possible care to all the families and communities we serve. It is hard to know exactly what the future landscape of healthcare will look like, given so many changes now taking place. However, the staff and faculty of UAMS South are committed to excellence, and have gone above and beyond to deliver quality care to patients who have chosen to call UAMS South their medical home.

Being part of the larger UAMS system, UAMS FMC – Magnolia will always be steadfast in pursuing the UAMS Mission of improving the health, health care, and well-being of Arkansans and of others across the region, nation and the world by:

• Education of current and future health professionals and the public;
• Providing high quality, innovative, patient- and family-centered health care, also providing specialty expertise not routinely available in community settings ; and
• Advancing knowledge in areas of human health and disease and translating and accelerating discoveries into health improvements.

Mark C. Deal, MBA, Director

Since its establishment in 1973 as the first AHEC in the state, UAMS South Central (formerly AHEC Pine Bluff), has served Jefferson, Saline, Lonoke, Arkansas, Cleveland, Drew, Garland, Prairie, Grant, Lincoln, and Hot Spring counties in Arkansas. Through the years, our program has been instrumental in providing training programs to improve the distribution, diversity, supply and quality of physicians, physician extenders and ancillary healthcare personnel, specifically targeting rural and underserved areas.

The team at UAMS South Central takes great pride in delivering the finest patient-centered clinical care for patients in our catchment area. Augmenting our team this year, we added the following staff: Channoah Williams, APRN; Autumn Swindol, PharmD; Tamika Rogers, LCSW; Dr. Steven Wright; and Dr. James Clyde Campbell. Through participation in the Medicaid Patient-Centered Medical Home (PCMH) Program, the NCQA PCMH program, and various quality initiatives, we have demonstrated improved patient outcomes and improvements in patient care quality metrics.

UAMS South Central staff, residents and faculty continue to participate on various Jefferson Regional Medical Center (JRMC) committees and are involved in activities such as health outreach, health fairs, screenings, community education, and serving on local, regional, and state boards and committees.

UAMS South Central and JRMC have reached an agreement to establish a new location for our programs on the JRMC campus in the Jefferson Professional Center II facility. This new facility, projected for completion in early 2018, will allow us to consolidate our family medicine program, three family medicine clinics and other ancillary operations, which are now spread out over multiple locations across Pine Bluff, into one location, affording more efficient operations and room for future growth.

The new facility will allow us to expand patient space and incorporate the latest models of patient-centered design to facilitate and maximize resident and student training in the PCMH model of team-based care.

We continue to explore the establishment of a Rural Family Medicine Training Track with our sister program, UAMS East in Helena, as well as the feasibility of potential programs in other areas of our region.

UAMS South Central continues to provide education to not only resident physicians, but also to advanced practice nurses, pharmacists, physician assistants, nursing students, and other allied health professions. In June 2016, our program graduated 12 Family Medicine residents and welcomed 9 new residents onboard.

We are proud to announce that Renisha Ward has joined our staff as Pre-Professional Recruiter, kicking off an exceptional MASH program for area high school students in June, with assistance from Angela Turner and Sara Theriot, and a special thanks to the volunteers who made the camp so successful. Plans are in development for expanding health careers programs to other counties throughout our region.

In closing, we remember our friend Julie Dobbins, longtime Director of The Melville Library who passed away June 24, 2016. Julie began her career at UAMS in 1978 and will forever be part of us. Her faithful service to the community and our region was an inspiration to all. Through the years, Julie’s expertise was invaluable to hundreds of resident and area physicians, nurses, student learners and scores of others, and she touched many lives with her compassion, caring, and wonderful wit. She will be greatly missed.

Patrick Evans, MEd, RRT, RN, Director

Construction of our beautiful new UAMS Southwest clinical facility was completed in December and opened on January 5^th. The new clinic configuration with faculty, residents, nurses, and support staff located in a central core area has achieved our goal of improved traffic flow and timely engagement among team members to enhance overall education and patient care. Both patients and staff are expressing a much higher level of satisfaction with the new facility.

UAMS Southwest invited local ‘Friends of UAMS’ to join our faculty at an after-hours event on January 14th to celebrate the opening of our new Family Medical Center (FMC). Along with Director Patrick Evans, attendees were invited to share testimonials about how UAMS and UAMS Southwest have impacted Texarkana’s medical communities. Other speakers included Lucille Cook, who contributed $35,000 toward the purchase of a new digital radiography system; John Goodson, UofA trustee; and Russell Mayo, M.D., UAMS Southwest Family Medical Residency Director.

UAMS Southwest is engaged in a unique partnership with Special Health Resources for Texas (SHRT). This is an opportunity to share resources between the UAMS Southwest All for Kids (AFK) Pediatric Clinic and SHRT, which is a Federally Qualified Health Center (FQHC) based in Longview, Texas, with a medical and dental clinic in Texarkana, Texas. This partnership is focused on improving care for pediatric patients from medically underserved areas. Medical care is delivered by AFK providers and staff under a services agreement, with the current focus on expanding services through the partnership to better meet needs of area families.

There is a mutual interest in exploring delivery of services now unavailable to Medicaid and Medicare patients in the area, with research opportunities also being considered.

A number of patients who live near the vacated downtown campus expressed interest in continuing to receive their medical care at that location. Consequently, the clinic is now staffed by a Family Physician and two Family Nurse Practitioners. This Neighborhood Clinic now occupies a portion of the space vacated when our FMC moved, and it serves adult Medicaid and Medicare patients primarily.

UAMS Southwest graduated 6 family medicine residents this year; also graduating 11 nurse practitioners and one RN to BSN graduate. Currently 19 students are enrolled in the MNSc program, 1 in the RN to BSN program, and 6 in the Doctorate of Nursing Practice program. The final 3 students completed the CardioRespiratory Care program, with a total of 117 graduates since the program started in 1990. Three students graduated from the Medical Laboratory Sciences program affiliated with CHRISTUS St. Michael.

A special story this year began when a special needs child caught the attention of Courtney Burnett, one of our All for Kids nurses. The family situation touched Courtney’s heart, which set in motion a plan to help. With the mother’s permission, an application was submitted to Kidd’s Kids. As a result, the family was surprised with the gift of a lifetime to enjoy a fully funded vacation to Disney World. AFK threw a party to celebrate with the family. It is stories like this that makes our work so very rewarding.

Don Heard, EdD, Director

This year was exciting and productive as UAMS West continued to address the challenges of a changing healthcare environment. Under the leadership of Dr. Katherine Irish-Clardy, Residency Director and Dr. Tabasum Imran, Medical Director, we continued to enhance our patient service systems and training programs, emphasizing team oriented / patient centered care. Success is evidenced by 1) recognition of our program as a Level III Patient Centered Medical Home by the National Committee for Quality Assurance (NCQA), under that program’s most current and demanding standards; 2) recognition by Arkansas Medicaid Services for high quality patient care, 3) all UAMS West eligible Faculty meeting Federal Meaningful Use requirements, and 4) 100% of our 2016 graduating residents taking and passing the American Board of Family Medicine Board Exam.

For several years, UAMS West has operated out of three different facilities; our significant growth has resulted in some overcrowding. In 2015, as part of long term planning, we began working with UAMS and architects to design a new clinical facility. The new clinic will be a state-of-the art building encompassing 30,000 square feet, including 48 exam rooms, with x-ray, lab, and procedures areas, patient counseling rooms, and a children’s immunization area. The clinic will be located within one block of our current facility and only three blocks from Sparks Hospital, our affiliated teaching hospital. The building design will allow for growth and be consistent with other UAMS building projects across the state. Construction commenced in May 2016, with completion expected in March 2017. Once the new clinic is complete, our current facility will be remodeled to accommodate education, IT, and administrative services.

UAMS West is pleased to welcome several new faculty and staff. Dr. Christopher Fortson, one of our graduates, joined our faculty in July 2015.

Dr. Fortson completed our Advanced Obstetrical training track and is credentialed to provide general and operative obstetrics. He also coordinates care for Ryan White patients, via the UAMS Telemedicine HIV clinic. Dr. Ed Gills joined our faculty in September 2015. He completed an Obstetrics fellowship in Jackson, MS, a Rural Family Medicine Fellowship in Takoma, WA, and taught Family Medicine in Tulsa, OK. Dr. Gills will also be our Junior Clerkship Director.

Jessica Binz, PharmD, BCACP, joined the faculty in August as Director of Clinical Pharmacy Education. In July 2015, Monique Bracken (Forehand), MS, became our Pre-Health Recruiting Specialist, and Ms. Elizabeth Burden assumed the role of Medical Library Manager.

In 2015-16 UAMS West, trained 28 residents, four of which were sponsored by a Federal Teaching Health Center Grant. A significant curricular change this year was the addition of a structured Sports Medicine component, as required by the new ACGME requirements for Family Medicine. UAMS West partnered with Darby Junior High School, through the Partners in Education of the Fort Smith Public Schools. Residents and faculty provided sports physicals and attended all JHS home football games, providing onsite medical care and support for district athletic trainers. The curriculum includes a series of self-directed modules to be covered over three years of residency. Darby JHS officials reported a 30% increase in athletic participation due to onsite physicals. UAMS West is looking forward to opportunities and challenges of the coming year.

Funding Sources 2015 – 2016

• Grants / Other, 3%
• Contracts, 20%
• Professional Fees, 50%
• State Funds, 24%
• Tobacco Funds, 3%

Expenditures 2015 – 2016

• Administration, 22%
• Residency Programs, 36%
• Library & Cont. Ed., 1%
• Student Education, 2%
• Public Ed. & Outreach,/ 4%
• Clinical Services, 35%

Regional Programs, like other Divisions of UAMS, is adjusting to the new Expense-Based Budget system that was implemented campus- wide in FY 2016.

Under this new system, Regional Programs was given an operating allocation based on prior years’ operating expenses, with adjustments for certain cost increases and program changes.

Based on this allocation, State Funds comprised approximately 24% of the operating allocation in FY 2016, compared to 26% in FY 2015.

In spite of the challenges faced when adapting to a new budgeting system, we continue to expand the Patient-Centered Medical Home (PCMH) model at all our Family Medicine Clinics by pressing forward to adopt and implement advance care processes and protocols as required under the new PCMH delivery model.

The efforts of our centers have indeed improved access and enhanced quality of patient care, as recognized by the Shared Savings that were achieved this year by our UAMS clinics that participated in the Medicaid PMCH program.

We are extremely grateful for the leadership of the Regional Programs Advisory Council, our Center directors, faculty, and hardworking employees, the dedication of our volunteer faculty, the support of affiliated hospitals and other community partners, and the commitment to educational outreach of the various UAMS Colleges.

Advisory Council

Internal and external advisory groups consult on various aspects of Regional Programs planning and implementation from a statewide perspective (page 36).

UAMS

Educational programs at UAMS Regional Centers are approved by the appropriate colleges at UAMS and coordinated through a central office on the UAMS campus. Regional faculty are involved in the medical school admissions process, teach classes on campus, and participate in medical student interviews.

Regional Center Faculty

Center Directors serve as regional health care leaders and are responsible for administering programs in their respective areas. Multi- disciplinary teams of physician, nursing, pharmacy, and allied health professionals oversee and participate in clinical training, including 200 paid and volunteer faculty.

Regional Partners

Regional Centers work closely with Community Health Centers, public health clinics, mental health, and other providers and facilities to promote cooperative solutions to local health problems. We are indebted to the Arkansas Farm Bureau, Blue Cross/Blue Shield, Baptist Health Systems, and the Office of Oral Health of the

Regional Center Faculty

Center Directors serve as regional health care leaders and are responsible for administering programs in their respective areas. Multi- disciplinary teams of physician, nursing, pharmacy, and allied health professionals oversee and participate in clinical training, including 200 paid and volunteer faculty. Arkansas Department of Health for their ongoing support of our M*A*S*H programs, in collaboration with Regional Programs. Other important partnerships with the UAMS Donald W. Reynolds Center on Aging and the Veterans Administration are meeting regional needs of the State’s elderly and our veterans.

Other Schools and Universities

UAMS Regional Programs collaborate with many schools, vo-tech and community colleges, and universities across Arkansas to provide health professions education specific to regional needs.

The Regional Centers hold formal agreements with the community hospitals listed below as host institutions and training facilities. We extend our deep appreciation to our teaching hospital affiliates, which contribute facilities, funds, and staff in support of our programs.

UAMS East

• Crittenden Memorial Hospital
• Helena Regional Medical Center
• Chicot Memorial Hospital

UAMS North Central

• White River Medical Center
• Baxter Regional Medical Center

UAMS Northeast

• St. Bernards Regional Medical Center
• NEA Baptist Memorial Hospital

UAMS Northwest

• Washington Regional Medical Center
• Northwest Medical Center –Springdale
• Veterans Health Care System of the Ozarks
• Willow Creek Women’s Hospital

UAMS South

• Magnolia Regional Medical Center

UAMS South Central

• Jefferson Regional Medical Center

UAMS Southwest

• CHRISTUS St. Michael Health System
• CHRISTUS St. Michael Rehab Hospital
• Wadley Regional Medical Center

UAMS West

• Sparks Regional Medical Center

One of my daughter’s friends asked her why she would go to CHAMPS on her spring break, that it was like being at school. Olivia told her it was so much fun and it was helping her learn what she needed to become a doctor one day. This was an experience she will never forget. You have made a difference in my child’s life, and for that, you have no idea how very much you’re appreciated!”

Jennifer White, parent