2016 – 2017 Annual Report

Regional Programs employ 616 people statewide (including residents), operating as important economic forces in their communities

2016-2017 Trainees

• Pharmacy, 51
• Nursing, 88
• Residents, 144
• Allied Health, 69
• Medical Students, 247

2016-2017 Trainee Overview

This year, we provided regional training for:

• 455 health professions students
• 144 medical residents
• 3,903 high school and college students for structured programs, and another 32,057 in group presentations/events

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

Linda McGhee, MD, Residency Director at UAMS Northwest, received the Leonard Tow Award for Humanism in Medicine at the 2017 Dean’s Day Honors Ceremony in Little Rock. Dr. McGhee is the first recipient of this award not located on the main campus in Little Rock. This award is presented annually by the Arnold P. Gold Foundation to a UAMS faculty member who demonstrates outstanding compassion in the delivery of care; respect for patients, families, and healthcare colleagues; as well as demonstrated clinical excellence.

Dr. McGhee also received the Asklepion Award from the Arkansas Medical Society for her lifetime work providing quality patient care. This award, named for the Greek god of medicine, is given to a physician who promotes the art and science of medicine and the betterment of public health; embodies the values of the medical profession through leadership, service, excellence, integrity and ethical behavior; and serves the community through dedicated medical practice.

Dr. McGhee has served as full time faculty since 1978, and as Residency Director since August 2010. She has served on the Arkansas State Medical Board, the Minority Health Commission, and has received the Washington Regional Foundation’s Eagle Award for outstanding health care leadership and the AHEC Excellence in Teaching award. She serves on several boards related to HIV/AIDS, and since 1992 has been Medical Director of the Washington County HIV Clinic.

Michael Macechko, MD, UAMS Northwest faculty, was recognized on the Northwest Arkansas Business Journal’s 40 Under 40 list for 2017. Dr. Macechko graduated from UAMS and completed residency at UAMS Northwest. He has served at the state level as a Board Member of the Arkansas Academy of Family Physicians. This 40 Under 40 award honors individuals in six northwest counties who are making a positive difference in their professions and thriving in their communities. They were nominated as best in class by their peers in all industries.

Matthew Nix, MD, was recipient of the 2017 Regional Programs’ Excellence in Teaching award for his contributions to resident and medical student education. Dr. Nix is a Texarkana native who earned his MD from UAMS, completed residency at UAMS Southwest, and practiced in Ashdown before returning to serve as faculty at UAMS Southwest.

Dr. Nix shows leadership in both the academic and political aspects of family medicine, serving at the state level as current Vice-President of the Arkansas Academy of Family Physicians. He was also appointed by Governor Beebe as a Commissioner to the Arkansas Department of Health’s Early Childhood Development Commission.

Within Regional Programs he is Medical Director at UAMS Southwest, and has served as Co- chair of the Medical Directors Committee, helping to lead the clinical transformation process across all sites. His interest in advancing the quality of education through innovation and applied research demonstrates his constant and life-long pursuit of excellence.

A teacher holds an authoritative position, but their main purpose is to help shape the minds and skills of future leaders. Dr. Nix exemplifies the ability to teach, while relating to others so that no one ever feels inferior, which is a true gift. He has inspired me to be a passionate and knowledge-driven family physician. It is my hope and desire to have an impact on others as profoundly as he has influenced me.

Dr. Rita Alumanah, Chief Resident

UAMS West worked with architects, contractors, and members of the UAMS Design and Construction Department to plan and build a new 30,700 square foot state-of-the-art medical facility three blocks from Sparks Medical Center, their affiliated teaching hospital, and one block from their prior location. This new space will allow UAMS West to accommodate an increased number of trainees, while more efficiently and effectively expanding patient care services in all areas including: acute care, preventive services, chronic disease management, wellness, and mental/behavioral care. The new clinic was also designed to better facilitate the training and delivery of patient-centered and team-oriented care.

The previous Family Medical Center building will be extensively remodeled in the coming months to consolidate administrative operations into one place, providing new offices, a large conference room and computer training center. These new facilities will provide space for future growth at UAMS West.

Other Accolades!

• Scott Dickson, MD (NE) was named President-Elect of Arkansas Academy of Family Physicians.
• Richard Aclin, MD (WE) was again named to the “Best Doctors in Arkansas” by the Arkansas Times.
• Marcia Byers, PhD, RN (LR) successfully defended her dissertation in March to earn a PhD in Nursing.

Career Employees

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

• 35 Years: Gen Abdella (LR), Barbara Brown (SC), Linda Porter (WE), Joe Stallings (NE) 30 Years: Robin Howell (LR), Don Richter (SC), Carol Riggins (NW)
• 25 Years: Russell Mayo (SW), Lolita McGhee (WE), Diana Nash (NW)
• 20 Years: Elizabeth Beecher (NW), Ruby Hall, Deborah Pairsh (SC), Donna Petrus, Darrell Ragland (NE), Sharoslyn Smith, Jerry Stringfellow (SW)

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 and clinic operations, not only to keep up, but rather, to set the standard for excellence and efficiency in patient-centered primary care practice for Arkansas’ future health care professionals.

Electronic Health Records (EHR)

After an exhaustive evaluation process, the decision was made to remain on the current EHR platform (GE Centricity) but to consolidate all regional sites onto one central platform hosted in Little Rock. Currently we are mid-project for Phase 1, building a new environment for the six sites, moving them to the datacenter, and transitioning the centers to them by the end of this calendar year. Phase 2 will be the consolidation of these six databases into a single unified platform, to align business and patient care needs for standardization, to decrease administrative overhead, and to improve data quality and reporting. We are also working to provide the centers with secondary circuits to create backup capability in the event of a primary circuit break. These circuits will increase the available bandwidth, enabling our regional sites to establish quick access to the EHR hosted at the UAMS datacenter, while also positioning them to take on future telemedicine initiatives.

CPCI to CPC+

The Family Medicine Centers (FMCs) in Fayetteville, Springdale, Fort Smith, Texarkana and Jonesboro completed the four-year Comprehensive Primary Care Initiative (CPCI). Medicare, along with

commercial and State health insurance plans, offered enhanced payments to primary care doctors who coordinated care for their patients more effectively. Arkansas and Oklahoma were the only two states to earn shared savings through the CPCI program. The same FMCs were selected to participate in the new five-year CPC+ program that began January 2017. CPC+ includes two primary care practice tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices in the United States. All our regional FMCs are participating in Track 2, the more comprehensive track. “CPC+ seeks to improve quality, access, and efficiency of primary care. Practices in both tracks will make changes in the way they deliver care, centered on the key Comprehensive Primary Care Functions of (1) Access and Continuity; (2) Care Management; (3) Comprehensiveness and Coordination; (4) Patient and Caregiver Engagement; and (5) Planned Care and Population Health.” (Source: Center for Medicare & Medicaid Services)

Medicare Access and Chip Reauthorization Act (MACRA) / (Merit-based Incentive Payment System (MIPS)

MACRA, bipartisan legislation to update how physicians are paid for Medicare services, went into effect January 1, 2017. Under MACRA, the MIPS system was created to combine existing quality initiatives, i.e., Meaningful Use (MU), Physician Quality Reporting System (PQRS), and the Value-based Payment Modifier (VBPM), in order to provide reimbursement levels based on quality and patient outcomes, as opposed to fee-for-service. UAMS Regional Programs will participate in MIPS at the group level with all of the UAMS System. While CPC+ clinics are exempt from attestation, due to group level reporting, all quality data will count toward the overall UAMS score. Also, the practices that participate in the Medicaid MU program will continue with that, along with MIPS.

Nursing Summary

Holly Jenkins, MSN, RN was hired in January 2017 as Director of Clinical Practice, to lead non- physician clinical staff and assist in closing quality metric gaps. The first phase is standardizing policies and standing orders to allow nursing staff to assist providers in meeting quality metrics.

Enli Care Manager/Central Worklist

CareManager remains the population health tool used in our regional FMCs. An additional tool, Central Worklist, was implemented this year to allow tracking of transitions of care for patients discharged from the ED and inpatient hospitalizations. Other programs for outreach to patients with care gaps, referrals and missed opportunities will be developed.

UAMS Regional Programs were awarded $1.8 million in Shared Savings this year under the Medicaid PCMH program for the 2015 performance period!

Medicaid Patient Centered Medical Home (PCMH)

Since the inception of the Arkansas Health Care Payment Improvement Initiative in 2014, our regional FMC sites have participated in the Medicaid PCMH program, along with the UAMS Primary Care Service Line. Our Regional Programs achieved over $3 million in shared savings for the 2014 and 2015 performance periods.

Behavioral Health Integration

UAMS Regional Programs recognize the impact of Behavioral Health on the overall health and wellness of their patients. Increasing focus is being placed on the role of Behavioral Health as part of the team-based system of integrated care within our clinics. Kathy Emans, MSW, has been hired as our statewide Director of Behavioral Health to promote and expand care within our Patient Centered Medical Homes.

Behavioral Health Faculty at our centers are working closely with medical staff to provide education on signs and symptoms of behavioral health disorders, in order to promote early identification, treatment and appropriate referrals. In the upcoming year, these faculty will play a key role in promoting and expanding inter-professional education (IPE) activities to improve patient and population health outcomes. New education will also be targeted toward provider well being and satisfaction, looking to build resiliency and satisfaction among our own medical staff and residents.

In addition to education, Behavioral Health Faculty provide consultation, short-term treatment and referral for clinic patients; thus bridging an often seen treatment gap within primary care practice. We will also be partnering with the University of Arkansas School Of Social Work in efforts to expand clinical training sites for MSW students in more rural and underserved communities throughout Arkansas.

Telemedicine

Regional Programs continue to explore new ways to serve our patients across the state. With revisions to telemedicine laws during the last legislative session, this vehicle for care delivery is opening up new opportunities. In partnership with Dr. Stephen Canon at the Department of Urology at Arkansas Children’s Hospital (ACH), Texarkana and Fort Smith can now provide pediatric urology services via telemedicine. Children in these regions that need to be seen by an ACH Urologist no longer need to make four-hour roundtrips to Little Rock. Now they come to the UAMS Regional Center and see their ACH physician via telemedicine technology.

During this visit, a telemedicine nurse becomes the hands of the distant physician by using special cameras, stethoscopes and other technology to provide assessment information in real time. Parental satisfaction has been excellent.

Several locations are now also beaming retina images of diabetic patients from their location to Jones Eye Institute in Little Rock. Several staff have been trained in obtaining retinal images for a tele-retinal pilot with Blue Cross/ Blue Shield.

This provides high quality screening for eye disease utilizing the state’s top experts, while avoiding long distance travel and inconvenience for rural patients.

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 35,960 students statewide.

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

In Summer 2016, 460 high school students participated in one of 32 M*A*S*H camps across the state, with 74% 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 7 medical students served as M*A*S*H program assistants.

Community Health Applied in Medical Public Service (CHAMPS)

In Summer 2016 and Spring 2017, 183 students participated in CHAMPS. This 3-5 day program offers hands-on experiences in health careers and community service for students entering grades 8, 9 and 10, with 76% coming from either rural communities or minority backgrounds.

Advancement Into Medicine (AIM)

During 2016-17, 89 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 2016-17, 116 students glimpsed health careers through Hands-On Health Care activities such as giving injections, drawing blood, and physical therapy, as well as 1,448 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 2016-17, 447 students participated.

Club Scrub & Med Pro-Ed

School-based clubs encourage exploration of health careers through meetings and activities, with 646 students participating this year.

Medical Interpreting

Our UAMS Northwest recruiter, who is Hispanic, teaches a Medical Interpreting class for bilingual HS seniors interested in a health career. This spring, 16 students completed.   

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 prep. This year 453 college students participated in such programs.

Group Presentations and Events

In addition to the structured programs described above, our recruiters reached 32,057 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 3,960 parents and faculty.

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 facilitated training in 47 different communities (36 counties)

Arkansas

• Stuttgart (9,326)

Baxter

• Mountain Home (12,448)

Benton

• Gravette (2,325)

Chicot

• Lake Village (2,575)

Columbia

• Magnolia (11,577)

Craighead

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

Crawford

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

Desha

• Dumas (4,706)

Drew

• Monticello (9,467)

Faulkner

• Conway (58,908)
• Greenbrier (4,706)

Franklin

• Charleston (2,494)
• Ozark (3,684)

Garland

• Hot Springs (35,193)

Greene

• Paragould (26,113)

Hempstead

• Hope (10,095)

Hot Spring

• Malvern (10,318)

Howard

• Nashville (4,627)

Independence

• Batesville (10,248)

Izard

• Calico Rock (1,545)

Jefferson

• Pine Bluff (49,083)

Johnson

• Clarksville (9,178)

Little River

• Ashdown (4,723)

Logan

• Booneville (3,990)

Lonoke

• Cabot (23,776)

Madison

• Huntsville (2,346)

Miller

• Texarkana (29,919)

Phillips

• Helena-West Helena (12,282)

Pike

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

Pope

• Atkins (3,016)

Pulaski

• Little Rock (193,524)

Saline

• Benton (30,681)
• Bryant (16,688)

Sebastian

• Fort Smith (86,209)
• Greenwood (8,952)

Union

• El Dorado (18,884)

Washington

• Fayetteville (73,580)
• Johnson (3,354)
• Lincoln (2,249)
• Prairie Grove (4,380)
• Springdale (69,797)

White

• Beebe (7,315)

Yell

• Danville (2,409)

Bowie

• Texarkana (36,411)

In 2016, the Winthrop Rockefeller Institute began engaging Dr. Mark Jansen about rural health care needs in Arkansas. That conversation expanded to include other health care leaders, culminating in a Rural Health Summit in March 2017. These leaders support creating a network of cross-collaboration among the many efforts currently operating in rural Arkansas and looking at manageable short-term goals to address over the next two years. Establishing this network is an important first step toward creating a rural health care environment across the state that will be more attractive to new providers and will foster quality care, patient and provider satisfaction, and provider retention.

This year, we saw an increase of UAMS College of Medicine (COM) graduates matching to a residency in a primary care specialty (61%), including Family Medicine, Internal Medicine, Pediatrics, and Ob/Gyn. Of the 26 who matched in Family Medicine, 13 of them (50%) matched to a residency program at one of our regional centers. Overall, 40% of all COM graduates matched to a residency in Arkansas.

Regional Programs provided training for 144 residents in 2016-17, including 48 who completed their 3-year residency to become board eligible in Family Medicine. Of these, 54% (26/48) remained in Arkansas to practice, 35% (17/48) remained in their training region, and 27% (7/26) of those in Arkansas chose a rural practice location.

UAMS Regional Programs’ Family Medicine Residency Graduates

Of all former graduates, 64% (786/1,237) remained in Arkansas,33% (410/1,237) remained in their training region.

Of those staying in Arkansas, 37% (290/786) practice in small towns and rural counties.  

There are currently a total of 52 first-year Family Medicine residency slots available in Arkansas, including 46 for Regional Programs and 6 at the Department of Family and Preventive Medicine in Little Rock.

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.

786 UAMS Regional Programs ’-trained physicians now practice in 129 Arkansas communities*, including 69 of the state’s 75 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)

Counties with * are designated as “RURAL” (non-SMSA). Underlined cities indicate UAMS Regional Center locations.

21 former UAMS Regional Center trained physicians also practice in Texarkana, Texas

Arkansas Blue Cross & Blue Shield Primary Care Scholarship

Evan Branscum and Julie Sherrill were each awarded a $20,000 scholarship in 2016. Branscum, a senior from Marshall, and Sherrill, a junior from Dumas, both plan to return to practice near their hometowns. Both have been active in the Family Medicine Interest Group (FMIG) and the Rural Medicine Student Leadership Association (RMSLA), Branscum serving as FMIG president and Sherrill as RMSLA president.

The Arkansas Blue Cross and Blue Shield Primary Care Scholarship encourages aspiring physicians to pursue primary care in rural Arkansas. Arkansas Blue Cross and Blue Shield, the state’s largest insurer,

established the endowed scholarship in 2010 with a $1 million gift to the UAMS Foundation Fund. With the average medical school debt of UAMS graduates soaring to $180,000, that financial burden can be a significant factor for graduates when choosing their specialty and place of practice.

I realize I can’t save the world, but I can use my training to serve a community that truly needs help.

Julie Sherrill

Family Medicine Interest Group

This year, the Family Medicine Interest Group (FMIG) reached 340 students, with attendance at monthly meetings averaging 30-40. Guest speakers offer diverse perspectives to increase student awareness of all aspects of medicine, practice models, financial management, health care policies, and personal stories.

Nineteen medical students attended the 2016 AAFP National Student and Resident Conference July 28-30, in Kansas City, KS. Family Medicine Student Interest Night was held on September 8, 2016, with representatives from Arkansas’ Family Medicine residency programs and hospitals, as well as financial incentives available through the Rural Practice Program and National Health Service Corps.

Rural Medicine Student Leadership Association

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, 150 students were involved in RMSLA.

Other Rural Practice Incentive Programs

Medical students who participate in the UAMS Rural Practice Program are required to complete a Family Medicine Preceptorship and part of their Junior Family Medicine Clerkship in a non-urban community, which often is one of our regional centers. Students must also complete a senior rotation (Primary Care Selective or Acting Internship) at a regional site.

In 2016-17, 42 medical students and 24 residents had a Rural Practice commitment, with another 32 physicians actually practicing in a qualifying community. See Rural Practice Programs.

Family Medicine Preceptorships

During Summer 2016, 56 medical students participated in the Family Medicine Preceptorship program, involving 4-week extra-curricular clinical shadowing opportunities for entering second-year medical students to work with family physicians in towns across Arkansas.

Service Learning Preceptorships

Additional 4-week Service Learning Preceptorships were completed by 10 students in Summer 2016. Projects included Nutrition for Rural Oncology patients, Bystander CPR, Summer Health Education for Adolescents, MCAT Prep Assistant, TAR Wars, and a variety of clinical Quality Improvement projects.

Junior Clerkships in Family Medicine

In 2016-17, 71% (115/162) of the junior class performed family medicine clerkships in 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 15 Longitudinal Clerkships (6 month) that took place at UAMS Northwest.

Senior Electives/Selectives

In 2016-17, 35% (60/173) 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, 15 medical and 6 pharmacy students completed the 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.

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

This year, 50 pharmacy students and 1 pharmacy resident completed training at one of our centers.

UAMS Regional Programs clinical pharmacists have long been pursuing the Triple Aim, 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 and CPC+.

This year revealed 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 care.

The rapidly changing content of pharmacy practice provides both challenge and opportunity. Drug costs have increased, 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 frequency of trips to the pharmacy.

Education has been the strong suit of clinical pharmacy in Regional Programs for over 30 years. Our pharmacists are consistent leaders, from didactic therapeutics lectures in the UAMS College of Pharmacy to post-graduate continuing education presentations.

Elective pharmacology rotations taught by our pharmacists to family medicine residents promote confidence and competence in drug therapy. Interprofessional education has been a cornerstone for over a generation, with our pharmacists often in leadership positions for team 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. Presentations are delivered at national and state meetings, and a wide range of articles published. Two of our pharmacists serve on the Institutional 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 have also been 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 2016-17, 88 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 2016-17, 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

In response to community needs, Certified Nursing Assistant (CNA) training is offered through UAMS North Central, with 23 trained this year.

Other Nursing Programs

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

LPN/LVN – 14
RN (BSN) – 6
APRN/NP Track – 2
Masters (MSN/MCSe) – 1

UAMS Regional Centers offer programs or clinical practicum in several allied health professions. Center faculty also teach CPR, ACLS, PALS, and HeartSaver training. 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 and Fort Smith are clinical affiliates/exam locations. ent/

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 Jonesboro, 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

Students from the UAMS Physician Assistant program conduct clinical rotations at our regional centers. These experiences focus on 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 are exposed to various procedures, with emphasis on caring for patients across the life-span.

• Number of Live Conferences – 129
• Number of Teleconferences – 382
• Total Attendees – 3,318
• New Learn On Demand Activities – 210
• Total New Users This Year – 2,571

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. The CDH has a strong infrastructure in continuing education, particularly with learnondemand.org, which has grown to more than 9,500 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.

Learning Resource Centers

UAMS Regional Centers’ Librarians continue to serve patrons in their areas, providing research and information to residents, physicians, students, and other organizations. Due to the expansion and ease of availability to online resources in recent years, our library facilities have scaled back as appropriate. We are pleased to welcome Debbie Hinkle to Pine Bluff.

In Memoriam: Ms. Grace Anderson, 81, passed away on May 26, 2017 in Fort Smith. Grace had been a long-term, faithful UAMS employee, serving as Director of the UAMS (AHEC) West Medical Library for 37 years until her retirement in 2012; she also served on the Fort Smith Public Library Board. Grace was instrumental in implementing electronic medical search systems in the UAMS/Sparks Regional Medical Center Library. She touched the lives of many faculty, residents, students and providers over her nearly four decades of employment with us.

AHEC Library Patrons 2016 – 2017

1,746	Health Professionals
7,194	Students and Residents
15,651	Consumers
24, 591	Total Patrons

Our faculty, residents, and staff are very active in their communities, serving on many national, state, and local advisory boards and committees. They 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

Clinic Patient Services 2016-2017
Patients Served	48,165
Outpatient Visits	159,431
Uninsured Care	$726,100
Hospital Visits	61,908
Nursing Home Visits	4,058
Babies Delivered	464

Community Education & Service:

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

Regional Programs continues to demonstrate exceptional financial performance in the management of its resources. The following information highlights key accomplishments for the period ended June 30, 2017:

• Regional Programs exceeded its overall operating margin goal by 2% for FY 2017.
• Four of our Family Medicine Clinics met certain quality and cost control measures of the Patient Centered Medical Home (PCMH), which allowed them to achieve $1.8 million dollars in shared savings with the Arkansas Medicaid Program. The shared savings payment received in FY 2017 was for the 2015 reporting period.
• We continue to expand the Patient Centered Medical Home (PCMH) model at our Family Medicine Clinics by implementing advance care processes and protocols as required under the PCMH delivery model.
• Our management and staff continue to seek ways to reduce overall cost of operations by standardizing certain business processes, procuring of supplies and services under group purchasing agreements, and by ensuring that our human capital resources are optimally employed to meet program requirements.
• A key strategic initiative in FY 2017 was centered-around planning the implementation of a statewide Electronic Health Record (EHR) system for Regional Programs. UAMS Leadership has endorsed efforts to move forward with assessing and selecting the EHR product for future use, which included system configuration and design, cost of implementation, and when and how this initiative should be implemented.

This singular initiative is the cornerstone for building the future infrastructure that will enable Regional Programs to support the training of healthcare professionals in accordance with the new payment model of population health consistent with improved patient outcomes.

Funding Sources 2016 – 2017
Grants / Other	3%
Contracts	17%
Professional Fees	54%
State Funds	23%
Tobacco Funds	3%

Expenditures 2016 – 2017
Residency Programs	36%
Clinical Services	34%
Public Education & Outreach	4%
Student Education	2%
Library & Continuing Education	1%
Administration	23%

This has been a very productive year for Regional Programs’ research, grants, and clinical innovation, as demonstrated by the number of active projects within our sites. As we prepare for continued growth, we plan to transition away from mostly externally-driven to predominantly internally-driven activities.

To ensure future success in supporting projects that are defined, developed, implemented, and completed by our faculty, we are standardizing procedures and processes to streamline grant submissions. These activities include:

1) Developing a website to continuously inform internal and external customers of active projects; 2) Transforming the current request process from paper to electronic; 3) Creating a subcommittee to review requests, particularly external requests, for relevance and benefit to our centers, faculty, and patients; 4) Developing resources for internally-driven requests, including boilerplate information for grant submissions, by individual sites and for the network; and 5) Increasing central support/resources to encourage and assist in projects developed by our regional sites. Through these activities, we hope to create the necessary infrastructure to successfully expand Regional Programs’ projects that address our real-world challenges and meaningfully impact the quality of care we deliver to our patients.

Project Title	Principal Investigator	Funding Source	Project Period	Participating Sites
AHEC Point of Service Maintenance and Enhancement Program	Mark Jansen	HRSA	9/1/2017-8/31/2022	All sites
Clinical Services	Mark Jansen	None	2016+	All sites
UAMS Regional Programs Tele-Retinopathy	Mark Jansen	None	5/1/2017 – 4/30/2018	Northeast, Southwest South
Measuring and Talking to Patients About the Accuracy of Data Used in Patient Outcome Research	Meredith Zozus	PCORI	7/1/2015 – 2/30/2019	Northwest, Southwest, South
Health Literacy Intervention to Improve Diabetes Outcomes among Rural Primary Care Patients	Kristie Hadden	NIH/NIDDK	5/1/2016 – 02/29/2020	Northwest, Northeast, West, South Central, Southwest, South
Patient Health Literacy Screening. An Informatics Approach	Kristie Hadden	TRI	2017 – 2018	Northwest
How To Find Out About Your Health	Kristie Hadden	NNLM	5/1/2017-4/30/2018	All
Preop Pediatric Urology Telemedicine	Steven Cannon	None	2016+	Southwest, West, South, East, North Central
Tackling Type 2 Diabetes at the Community Level	Mark Jansen	Novo Nordisk	7/04/2016 – 7/03/2018	Northwest, Northeast, West, South Central, Southwest, South
Health Education for Local Providers (HELP) Project	Becky Hall	HRSA	8/1/2016 – 7/31/2019	East
Affordable Care Act Teaching Health Center (THC) Graduate Medical Education (GME) Payment Program (AHEC West Teaching Health Center) – Continuation	Katherine Irish-Clardy	HRSA	7/1/2016 – 6/30/201/	West
ARCOP PSE Change Project	Becky Hall	ACOP	6/1/2017 – 11/30/2017	East
Developing and pilot testing multilevel evidence-based strategies to increase HPV vaccinations among young adults in Arkansas: A public health informations and implementation science approach	Brooke Montgomery	NIH – pending approval	7/1/2018 – 6/30/2022	South, East, North Central
Quality of Care for Nurse-Led Wellness Visits	Marcia Byers	None	1/1/2016 – 6/30/2017	Northwest, Norhteast, West, South Central, Southwest, South
Phase II Clinical Trial of Human Papillomavirus Therapeutic Vaccine, PepCan for Treatment of Cervical Dysplasia	Mayumi Nakagawa	NIH	2017 – 2020	Northwest, Norhteast, West, South Central, Southwest, South

The third Annual Statewide Research Colloquium &Teaching Innovations Symposium was held in Little Rock in April 2017, with 14 faculty and residents presenting or leading discussions on new and innovative teaching, quality improvement, and other research projects to share findings, ideas, and best practices.

UAMS Regional Programs’ faculty and staff are respected and celebrated in many areas of expertise. Residents and faculty present regularly at local and statewide venues, and publish scholarly articles extensively in Evidence-Based Practice, a national peer-reviewed journal published by the Family Practice Inquiries Network (FPIN). Due to limited space, only a sampling of publications and national presentations from this year are listed below.

Publications

Luhring KE, Butts CL, Smith CR, Bonacci JA, Ylanan RC, Ganio MS, McDermott BP. Cooling Effectiveness of a Modified Cold- Water Immersion Method After Exercise-Induced Hyperthermia. J Athl Train. 2016 Nov;51(11):946-951. doi: 10.4085/1062-6050 – 51.12.07. Epub 2016 Nov 22. PMID:27874299

Mayo R, Downs M, Fu C, Horner D. Do annual preventive examinations lead to better mortality outcomes? Evidence- Based Practice. 2016; 19(8); 9.

McElfish PA, Rowland B, Long CR, Hudson J, Piel M, Buron B, Riklon S, Bing WI, Warmack TS. Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings. J Racial Ethn Health Disparities. 2016 Nov 11. PMID: 27837454.

Over DR, Guthmann R. What treatments are safe and effective for chronic sinusitis? J. Fam Pract. 2016 (Nov); 65(11):829- 831 [PMID 28087873]

Pandey T, Over DR, Campbell JC. Acute Renal Infraction. J Arkansas Medical Society. 2017 (Jan); 113(8):196-198;200.

Thys S, Coulter L, Hudson J. Is Cognitive Behavioral Therapy (CBT) an effective treatment of Fibromyalgia? Evidence-Based Practice, July 2016: 19(7):9.

National Presentations

Marshall A. Medical Applications of Science for Health (M*A*S*H): Effectiveness of Early Pipeline Efforts to Rural Medical Student Recruitment. Poster presented at: Working Together for Health: Aligning the Health Workforce with Population Needs. AAMC Workforce Research Conference; 2017 May 4-5; Arlington, VA.

Mikesell B. Comprehensive Primary Care Plus (CPC+) Panel. Centricity Live, Boston, Massachusetts, April 2017.

Yeary K, Aitaoto N, Sparks K, Ritok M, Hudson J, Goulden P, Bing W, Riklon S, Rubon J, McElfish P. Cultural Adaptation of Diabetes Self-Management Education for U.S. residing Marshallese. Society of Behavior Medicine 38th Annual Meeting, San Diego, California, March 2017.

Becky G. Hall, EdD, Director

UAMS East continues to provide services in 7 Delta counties that suffer some of the harshest health outcomes in the state. With centers in Helena, Lake Village and West Memphis, UAMS East provides chronic illness prevention, wellness, education, and recruitment of health professionals to meet the needs of Delta residents. UAMS East encounters totaled nearly 130,000 last year.

UAMS East will open a Family Medicine Clinic in the fall of 2017, with Dr. Thomas Bailey, a local physician, as primary provider. The clinic will function on the patient centered medical home (PCMH) model, with services to include diabetes education, health coaching, dietary counseling, and behavioral health services. The clinic will also be a telemedicine site for specialty consultations. This clinic will serve as a foundation for a proposed rural residency training program, in collaboration with UAMS South Central in Pine Bluff.

UAMS East offers ongoing services to health professions students and interns. Mentoring and assistance in arranging clinical opportunities was provided to 4 students in the RN/BSN program. Dr. Josephine Jackson, MSN, RN, APRN, FNP is an Adjunct Instructor in the UAMS College of Nursing and was preceptor for 5 MSN students. UAMS East provided a preceptorship for a UAMS College of Medicine M1 Student from Phillips County. The pre- professions recruitment program offered M*A*S*H, CHAMPS, A Day in the Life, Destined to be Doctors, and a Funology Science Camp, with 405 youth participating. The UAMS East Library served 11,179 patrons.

UAMS East continued work with the Arkansas Hunger Relief Alliance, holding 4 “Cooking Matters” courses in new locations, including Brinkley, Marianna, McGehee and Lake Village, and hosting 3 “Cooking Matters at the Store” events for 550 participants.

This free, guided tour teaches participants how to get the most nutrition for their food dollars.

UAMS East was selected to host an Arkansas Coalition for Obesity Prevention (ArCOP) Regional Summit. ArCOP awarded grants to fund a community garden in Helena, and to support worksite wellness programs. Kids for Health reached 19,145 youth, and Baby Safety Showers served 382 expectant mothers, with staff correctly installing 93 car seats. UAMS East established a Breast Cancer Support Group and hosted 2 mobile mammography screening events. UAMS East partnered with Alzheimer’s Arkansas to host the 2^nd annual “Hope for the Future” conference for both healthcare professionals and caregivers.

UAMS East promotes healthy lifestyles through various exercise and weight loss classes offered through the Fitness Center and in locations throughout the service area, including spinning, yoga, silver sneakers, ZUMBA, and Boot Camp for Kids. Two UAMS East employees attended the 10^th Annual Southern Obesity Summit in Houston, TX.

UAMS East was a sub grantee of the Greater Delta Alliance for Health, a non-profit organization of ten hospitals in Southeast Arkansas, which funded diabetes and cooking classes and a Registered Dietician. UAMS East, Arkansas Family Health Center, and Phillips County Rotary received a Helena Health Foundation grant for “Healthy Smiles,” which provided K-6 students with free dental hygiene kits and education. A new initiative with Arkansas Autism Resource and Outreach Center is helping to identify children/families in need and provide early, in home interventions.

The success of UAMS East over the past 27 years has been the result of a dedicated staff and extensive community support, including over 100 state and local partners. We look forward to another year of opportunities to serve our communities.

Dennis F. Moore, PharmD, Director

This has been an exciting year in our evolving efforts to help meet the healthcare needs of North Central Arkansas communities. Both educational efforts and the provision of clinical services are being enhanced through local partnerships. As previously reported, the White River Medical Center (WRMC) has established an ACGME-accredited Internal Medicine Residency program with academic support coming from UAMS. Their first class of ten residents began training on July 1, 2017. Planning is proceeding for our new Family Medicine Residency program that will be sponsored by the UAMS North Central, through partnership with WRMC. Contracts have been signed to begin the clinic construction, with the grand opening of our new 23,000 square foot facility projected for May 2018. This new clinic will allow the development of a comprehensive patient- centered family medicine practice adequate to provide the necessary clinical experiences for the first cohort of residents that will begin in July 2019. The clinic is being modeled after the facility at UAMS West in Fort Smith; with 24 exam rooms to accommodate a 6-6-6 residency program, along with adequate educational rooms and administrative offices. We are in discussions with local providers to relocate their current patient populations into our new clinic, with one of those providers pursuing the specific experience required to ultimately become director of the new residency program.

Our pre-health professions recruiting efforts continue to expand, with a total of five M*A*S*H programs offered in our region this last summer. We offer the only accredited Diabetes Self-Management Education (DSME) program in the county, and have seen exponential growth in the program with referrals and completions having doubled as more emphasis is placed on the care of chronic illnesses among local practitioners.

Our Medication Assistance Program also continues to expand, this year obtaining over $2.3 Million in prescription medications for area residents—up $500,000 over last year. The increase is due to some outreach efforts as well as the increased cost of many prescription drugs.

We have educated 23 certified nursing assistants (CNAs) this year in a novel program that is financed almost exclusively by local nursing homes paying for the students’ tuition to ensure quality employees for their facilities. This group boasts a 98% pass rate for the CNA exam, and 30% of them have decided to advance on to nursing school. Consequently, this program is not only meeting the immediate workforce needs of our region, but also providing a new career pathway for area residents seeking to advance their education and job opportunities.

Additionally, our College of Nursing faculty representative has educated 11 nurse practitioner students for advanced health assessment and 19 for practicums, allowing them to advance their level of practice while continuing to work in their home communities.

The successful affiliation of UAMS and WRMC in the development of the Family Medicine Residency Program is a culmination of much planning and development. UAMS and White River Health Systems have also developed an affiliation agreement that will allow the opportunity to collaborate in clinical trials, research, telemedicine and e-consults between communities based clinicians and UAMS specialists. This should continue to strengthen our educational efforts as well as improve the future health professions workforce for the entire North Central region.

Ron Cole, MBA, Director

Academic year 2017 has been marked by retirement announcements, new faculty hires, changes in service delivery lines, strategic shifts for our statewide network, and continued refinement of quality and cost cutting initiatives.

This year Regional Programs reassessed its position strategically to ask how we might best be a change agent for healthcare in Arkansas. A team was sent to Chicago, Illinois and Providence, Rhode Island to look behind OZ’s healthcare curtain at possible futures. That peek set us on a path to significantly modify how this statewide network can or should function. Reconfigured IT, new governance structures, new workflows and more will be the focus for many of the 2018 Director Reports next year; for now, it is all about planning the work and working the plan.

How does a family medicine residency program attract new faculty when it is heavy with obstetric responsibilities and has a difficult night call schedule? Many of today’s family medicine graduates are simply no longer interested in providing OB delivery services, which is a lifestyle choice as much as a practice decision. UAMS Northeast’s answer was to turn OB deliveries over to the local hospital, thereby making our residency scope of practice a bit more appealing to potential faculty. As a result, we were able to hire Mark Brown, MD as our first dedicated Medical Director. Katie Ross, MD has also joined our faculty.

Two individuals that have served UAMS Northeast for many years announced their retirement plans this year. Tom Frank PharmD and Sandra Lusby retired from our program on June 30th.

Dr. Frank began his UAMS Northeast career in June 1985, serving as the program’s primary educator in pharmacology. He also served the program in many other capacities through the years, including program director. Sandra began her career in June 2004 as our Outreach Director, and she also served this program well and in many capacities. Sandra’s final role was as patient educator and she had become an integral part of the services we provide to our patients. I, along with the entire staff of UAMS Northeast, will miss their smiling faces and outstanding contributions to our educational efforts, and wish them all the best.

UAMS Northeast continues its participation in quality improvement (QI) and cost cutting programs like Arkansas Medicaid PCMH and CPC+. Regarding CPC+, UAMS Northeast was honored to be accepted to the CMS CPC+ program for another five-year term. CPC+ is a CMS demonstration program that endeavors to meet the “triple aim” of better patient health, at lower costs, with a better patient experience. These QI objectives present many challenges for a residency training program that private practices are able to avoid. For example, maintaining patient continuity of care in residency training due to the many specialty rotations required of residents is always a challenge, necessitating that our definition of “continuity” be expanded to include the entire team.

These are exciting and challenging times for healthcare, and for residency training programs in particular. Our staff at UAMS Northeast embrace these challenges as opportunities to better serve our patients and improve healthcare. If there is something we have learned in recent years it is that change is inevitable. What matters is how well we learn to manage change and recognize opportunities to make change work for us.

Robert R. Gullett, Jr, MD, Director

This was another productive year for UAMS Northwest, with much to report and of much to be proud. The entire Northwest team strives to make a positive difference in for the people in northwest Arkansas and throughout the region.

Dr. Hunter Judkins was named chair of the Medicine Department at Northwest Medical Center-Springdale.

Dr. Derrick Gray and Dr. Michael Macechko continue to serve as co-Medical Directors at the Arkansas Veterans Home in Fayetteville. Dr. Macechko also serves as chair of the residency’s Clinical Competency Committee.

Ten family medicine residents graduated from our 10-10- 10 program as part of the Class of 2017.

The UAMS Northwest Primary Care Sports Medicine Fellowship graduated its second fellow, Dr. Ryan Rhodes, on June 30. He plans to practice at family medicine and orthopedic clinics in Hammond, LA. The Sports Medicine Fellowship continues to grow, with interviews for a third fellow to take place in Fall 2017.

UAMS Northwest has an excellent social work intern program, hosting MS level and BS level students year- round. They are supervised by Leigh Wade, LCSW, our behavioral health faculty. These interns are incredibly helpful for both our clinics.

UAMS Northwest has many successful youth programs, directed by our recruitment specialist, Ana Sanchez. A total of 29 students in 8th – 10th grade from seven school districts participated in the Spring CHAMPS program.

An Introduction to Medical Interpreter Training Program also took place during the spring semester, with 30 graduating High School Seniors earning a certificate of completion. Each student was required to attend a total of 20 hours of training.

Four CHAMPS programs took place during the summer, with 50 participates, and three M*A*S*H programs took place in July, with 48 participants.

Our Health Educator saw patients for health coaching on nutrition, smoking cessation, and for a health literate diabetes intervention funded by a RO1 grant through the National Institutes for Health. She also led a biweekly Diabetes Support Group for diabetic patients and their family members, as well as biometric screenings to market the clinic and increase patient recruitment.

UAMS Northwest has partnered with the Butterfield Trail Village retirement community to provide resident health care services. Dr. Allan Martin will serve as Butterfield Trail Village’s Geriatric Family Physician and UAMS Northwest will offer an outpatient clinic at the Village, five half-days per week, starting in November 2017.

Beginning January 2018, SmartCare will be available to employees at UAMS Northwest.

James L. Gooch, MHS, RRT-NPS, Director

As UAMS South’s fourth year in Magnolia comes to a close, our center’s spirit of teamwork continues to help us move forward on a path of patient centered care that is rooted in connections to the communities that we serve. As one of the smallest, most rural UAMS Family Medical Centers in Arkansas, our staff and health care providers truly get to know our patients as we provide for their care. As change continues to be constant in the world of healthcare, our team remains focused on helping local families achieve their best health.

We continue to appreciate community support for our program, and were grateful this year to receive a grant from the local Albemarle Foundation for our Reach Out and Read Program. These funds will enable us to continue providing books to children, ages birth through 5 years old, when they come to the clinic for a regularly scheduled visit with their provider. We typically serve an average of 330 local children each year with this program. Many of the families served are low-income, and books provided through the Reach Out and Read program are the first (and sometimes only) books for these children.

Several of our staff members have volunteered their time during evenings and weekends to help at various community health screenings, checking blood sugar, blood pressure, and providing basic health education. This year, you could find us at the local county fair, at various town festivals, and at local senior centers. UAMS South faculty and staff enjoy being an active part of our southern Arkansas community.

Efforts to encourage students to pursue health careers included several M*A*S*H programs, interactive presentations at local schools, and opportunities for pre- med students to shadow physicians in our clinic. We truly enjoy making lasting connections with these students, and share in their excitement when they earn a coveted spot in a UAMS degree program.

Lauren Glaze, PharmD, has represented UAMS South well as she presented at multiple professional conferences. During her “Pharmacist’s Involvement in Transitions of Care” talk at the Arkansas Association of Health System Pharmacists Conference in Hot Springs, she detailed her medication management service for local patients who transition from the inpatient hospital setting back to their homes. She later gave this same presentation during a national webinar for TMF Quality Innovations Network. During the Arkansas Society for Respiratory Care Conference, also in Hot Springs, she presented a “Respiratory Medication Update”.

We have all worked toward improvement in our clinical processes, revising work flows, policies and standing orders. Behavioral Health options have been integrated into our clinic’s chronic pain management strategy, and we have increased our focus on Medicare Wellness visits. These efforts reflect our commitment to continuously strive for improvement, and to give our patients the very best care possible.

As UAMS South continues to grow and evolve in Magnolia, we intend to remain true to the unique needs of our rural region. The diversity of our talented team of local professionals makes us unique, and our ability to provide quality care to our patients, without the need to travel far from home, is one of our greatest strengths.

Mark C. Deal, MBA, Director

UAMS South Central has, since 1973, served 11 counties in the central and southeast region of the state, 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.

UAMS South Central continues to promote the Patient Centered Medical Home (PCMH) model and has enjoyed success in improving both patient health outcomes and the efficiency of our clinical operations. Our team takes great pride in delivering excellent patient centered care through all our clinics, which consists of four separate facilities: Our UAMS Family Medicine Center, the Justiss- Lindsey Clinic, UAMS Faculty Family Medicine Center, and the Veteran’s Administration Community Based Outpatient Clinic, serving almost 3,000 area veterans.

In February 2017, UAMS South Central began planning for relocating our three family medicine clinics, residency operation, library, and administrative services to a new facility. The LEAN planning process has taken place over several months, with faculty and staff participating in the facility design. The facility selected for renovation is the 53,000 square foot Jefferson Professional Center facility, only 200 yards north of our current facility on the Jefferson Regional Medical Center (JRMC) campus. The proposed new facility will allow us to consolidate operations now in multiple locations into one location, affording more efficient operations and room for future growth. This facility will allow us to expand patient space and integrate layout and design to help facilitate resident and student training and workflows within a PCMH model of team-based care.

UAMS South Central continues to explore the establishment of a Rural Family Medicine Training Track with our sister program, UAMS East in Helena. As the first phase, we are assisting with a new family medicine clinic to be opened in late 2017 at UAMS East in Helena.

UAMS South Central provides a robust residency training experience for our Family Medicine Residents. Of the eight graduates completing the program in June 2017, seven are practicing in Arkansas, with five committed to JRMC, our sponsoring institution, as hospitalists and ED specialists; one will practice in McGehee, and one in El Dorado, Arkansas. One resident from our 2016 class who completed a fellowship this year, will practice in Helena.

Renisha Ward, Pre-Professional Recruiter helped launch several exceptional M*A*S*H programs in June, expanding the number of camps in the region. For the first time, programs were offered in DeWitt and Monticello, with plans to add Malvern next year. Through programs such as M*A*S*H, Club Scrub, CHAMPS, A Day in the Life and others, area students are introduced to medical professions as a career choice. Many participants of these programs have gone on to pursue health careers. UAMS South Central offered for the first time, a special camp, called Growing Our Own Medical Professionals, in partnership with the IVY Center and the University of Arkansas at Pine Bluff (UAPB). This innovative and intensive six-month program, targeting 9th-12th grade minority students, introduced health professions with hands-on experiences, to over 20 students.

For 40+ years, UAMS South Central has a proven track record in education, health promotion, medical care and service to our region, and we are honored to continue partnering with area organizations to improve the health and well-being of all our constituents.

Patrick Evans, MEd, RRT, RN, Director

UAMS Southwest completed another successful year serving the citizens of the Southwest Arkansas region. The Family Medical Center located on UofA Way is achieving the desired outcomes intended by design. The number of new patients and patient visits continue to increase with high patient satisfaction performance. Dr. Cheryl Verma, MD, became full-time faculty, and Advance Practice nurses, Dr. Sondra Bedwell and Mylene Crouthemal, now practice at the Family Medical Center location. All eight graduating residents passed their national boards, with seven staying in the region.

The Family Medicine Residency has a special interest in sports medicine, in part due to Dr. Michael Downs (Certificate of Added Qualifications in Sports Medicine). Besides providing sideline medical support at regional high school and university football games, the residents participate in annual sports physicals for high school athletes. This year residents and staff provided physicals for over 4,000 athletes from 10 different school districts.

Research and scholarly activity continue to increase. Drs. Sheila Omakpokpose and Kevin O’Sullivan presented four posters at the UAMS REP Colloquium this spring. Staff are currently engaged in seven separate studies with Dr. Matthew Nix, a Co-PI in the Patient-Centered Outcomes Research Institute (PCORI) funded study.

Telemedicine has expanded in a big way at UAMS Southwest. In partnership with the Department of Urology at Arkansas Children’s Hospital (ACH), a pediatric urology telemedicine clinic became reality this year. Children in this region that need to be seen by an ACH Urologist no longer have to make a four- plus hour roundtrip to Little Rock. Now they come to UAMS Southwest and see their ACH physician via telemedicine.

During this visit, a telemedicine nurse on-site uses special cameras, stethoscopes, and other technology to provide the assessment information needed by the remote specialist; all in real time. The physician and family can easily communicate through this system, and parental satisfaction has been excellent. In the fall of 2017, an ACH Telemedicine Asthma Clinic and a UAMS Tele-retinal Clinic will also begin to improve access for these services.

The UAMS ANGELS high-risk antenatal telemedicine program is the pioneer in providing specialty care to rural Arkansas. One of the leaders in the ANGELS program is Texarkana native, Michael Manley, who was guest speaker at a December Friends of UAMS event held in partnership with the Texarkana Wilbur Smith Rotary. Michael shared with 75 attendees the expanding use of telemedicine in Arkansas. Although Arkansas is a rural state, Michael highlighted how visionary leadership is using the latest technology to improve people’s health where they live.

This year saw the All for Kids Pediatric Clinic move to a larger clinical space on the 2nd Floor of our Downtown facility. All for Kids is an important training location for our Family Medicine Residents, who provide care to almost 7,000 area children. Special Health Resources for Texas, a Federally Qualified Health Center and strategic partner, is locating a dental clinic and adult care clinic on the same floor as All for Kids. Their proximity will increase collaboration opportunities, such as dental and behavioral health services, and managing Texas Medicaid patients.

Community resources were compiled and made available to practitioners, patients, and the public through the UAMS Southwest website, where staff can direct patients or look up resources to connect with during their appointment. In addition to health resources, the page also includes resources that address other social determinates of health such as housing, food, shelter, etc.

Don Heard, EdD, Director

This year, UAMS West has worked to position itself to meet the challenges of an ever- changing health care environment. UAMS West worked with architects, contractors, and members of the UAMS Design and Construction Department to plan and build a new state-of-the-art, 30,700 square foot medical facility three blocks from Sparks Medical Center, our affiliated teaching hospital, and one block from our prior clinic location. This new space will allow UAMS West to accommodate an increased number of health profession trainees and to efficiently and effectively expand patient care services in all areas including: acute care, preventive services, chronic disease management, wellness, and mental / behavioral care. In addition, the new facilities have been designed to facilitate the training and delivery of patient centered and team-oriented care.

In the area of quality improvement, UAMS West, under the leadership of Tabasum Imran, MD, Katherine Irish- Clardy, MD, Virginia King, RN, Brenda Morris, RN and Jessica Binz, PharmD, continued to implement systems and train faculty, residents, and staff in methods to improve patient care. These efforts have resulted in our continued recognition as a level III Patient Centered Medical Home (PCMH) by the National Commission for Quality Assurance (NCQA). In addition, UAMS West was selected by Medicare as a Comprehensive Primary Care Plus (CPC+) quality improvement participant beginning January 1, 2017.

UAMS West launched a marketing campaign via TV, radio, billboards, and internet. The focus of this was to promote our quality medical services, to spotlight our new facility, and to clearly brand our center as a regional campus of UAMS.

During the year, UAMS West provided 33,355 outpatient and 10,443 inpatient exams, delivered 247 babies, conducted 251 OB ultra-sounds, and performed 1,569 patient procedures in our clinic and within the hospital. We also provided educational opportunities for 41 medical students, 6 pharmacy students, 6 APRN students, and 18 Physician Assistant students, and 34 nursing students.

Our faculty and residents conducted many scholarly, research and community activities. Notably, Dr. Lyndsey Kramp and Dr. Tabasum Imran led an effort with residents to conduct two studies to “Reduce ER Preventable Trips” and “New Strategies to Decrease No Shows in New Patients.” Dr. Kramp and residents started four other quality improvement projects. Dr. Bryan Clardy also developed a Community and Sports Medicine curriculum with pre-participation physicals and side-line medical care with Darby Junior High School in Fort Smith.

UAMS West was active in Pre-Health Recruiting efforts, with Monique Bracken conducting 213 events in 23 cities, reaching nearly 7,000 students. M*A*S*H programs conducted this fiscal year at Sparks Hospital and Mercy Health Systems, provided over 100 high school students with the opportunity to learn about careers in the health care industry.

Our faculty, residents, and staff participated in community health fairs and student career days; provided education for churches, civic groups, and schools; provided sports physicals for schools; and served on numerous local, state, and hospital boards and committees. In addition, several residents spent time providing prostate exams, health education, and screenings. Finally, all ten ofour graduating residents passed Board exams, and our residency continues with full accreditation.

Overall, we had a very successful year and our faculty, management and staff look forward to the coming year and new opportunities to serve patients and educate trainees. We will continue to strive for excellence in all areas.

We are extremely grateful for the leadership and commitment of our center directors, faculty, and staff, the support of our affiliated hospitals and other community partners, and the commitment to educational outreach of the various UAMS colleges.

UAMS

Educational programs at UAMS Regional Programs 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 and interviewing process and also teach classes on campus and via IVN.

Regional Partners

Regional Programs Faculty

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

We are extremely indebted to our affiliated community-based teaching hospitals, clinics, and other providers and facilities with whom we work to promote cooperative solutions to local health problems. Our M*A*S*H programs are made possible through the long-term support of Arkansas Farm Bureau, Arkansas Blue Cross/ Blue Shield, and Baptist Health. We collaborate with the Community Health Centers of Arkansas and the Arkansas Office of Rural Health and Primary Care on rural and primary care workforce issues. We also partner with the Arkansas Department of Career and Technical Education on career pipeline programs. Other partnerships with UAMS Centers on Aging and Veterans Administration help meet the 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.

Regional centers hold formal agreements with the community hospitals listed below as host institutions and training facilities. We extend 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