Fall 2011 - Texas Tech University Health Sciences Center

Fall 2011 Vol. 9/No.4
The
Rural and
Community
Health
Messenger
F. Marie Hall Institute Celebrates the
Inaugural National Rural Health Day
On Thursday, November 17 th ,
2011 the F. Marie Hall Institute
for Rural and Community
Health, along with the National
Organization of State Offices of Rural
Health (NOSORH), and other state/
national rural stakeholders, celebrated
the first-ever National Rural
Health Day. National Rural Health
Day was created as a way to celebrate
the innovativeness and determination
of rural communities across America,
while promoting awareness of rural
health-related issues and the efforts
of various stakeholders in addressing
those issues.
For the inaugural event at
the Texas Tech University Health
Sciences Center, the staff of the F.
Marie Hall Institute for Rural and
Community Health, spearheaded by
Melanie Clevenger, hosted a variety
of activities that included: rural
research presentations, telemedicine
demonstrations, speakers, and a
rural health photography exhibit.
The highlight of the celebration
was Dr. Linton’s keynote
address on Thursday. Dr.
Linton has practiced in rural
West Texas for over twenty
years in Hale Center and
Plainview. Dr. Linton shared a
number of memorable stories
about life as a rural doctor,
such as being paid in chickens,
how she has been the physician
to multiple
generations
of the same
families, and
the need for
a good rural
health toolkitduct
tape
included. As
approximately
62 million
people or 20% of the U.S.
populations call a rural or frontier
community home. NOSORH
Director Teryl Eisinger notes, “These
Also in this issue... page
Vice President’s Corner 2
Telemedicine Report 3
Rural Research Highlights 4
WTxHITREC Update 5
West Texas AHEC 6
AHEC Names New Director 7
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
A publication of the F. Marie Hall Institute for Rural and Community Health
Above right: Attendees
register and learn of programs
of the F. Marie Hall
Institute.
Above: Dr. Tedd Mitchell,
President of TTUHSC and
Dr. Billy Philips pose for a
picture inbetween meeting
with guests attending the
National Rural Health Day
kick-off.
Cont’d on page 6

Vice President’s Corner
Institute Seeks Ways to Affect
Rural Suicide Statistics
Philips
This issue of the Rural and
Community Health Messenger
includes a guest column by
Karin Huie, Administrative Business
Assistant in the F. Marie Hall Institute.
Karin is a great example of the
many wonderful staff in the Institute.
She has brought forth a planning
effort to address one of the most devastating
and hidden health problems
everywhere, including in West Texas.
That problem is suicide.
Most of us have been affected by
this problem in some manner and
we need to do more to prevent it,
to handle attempts or threats more
humanely, and of course we must
manage the damage done to other
lives when someone ends their own
life unexpectedly. Karin, as part of
the great team of people that serve in
the Institute, illustrates our culture
– each of us, no matter what job
duties entail, are animated by one
cardinal principle – to improve the
health of the people of West Texas.
As you read Karin’s column, you will
learn how serious this problem is and
you will find myths about it that will
be debunked. I know you will want
to help. We invite any and all ideas
that would help as we move forward
with this new initiative. - BP
2
Let me tell you a story, a fictional
story, but one that has happened
and will happen again to a
parent and their child here in Texas.
Bobby is 17. He lives in a small rural
town in West Texas. He is not into
sports; he is not into agriculture.
He’s not into science, just not into
anything in particular. He has few
friends. He is the “awkward” boy
in class. He gets laughed at, bullied
and feels like a failure. Because he’s
a quiet boy and does not complain,
no one seems to notice.
Bobby becomes more and
more depressed. His relationship
with his parents isn’t good.
Mom and Dad fought all the time
over money. Dad couldn’t keep a
job. It wasn’t his fault really, just
a rotten economy. Bobby’s parents
finally got divorced. Money is tight
so Mom has to work all the time
just to cover necessities. Bobby
spends a lot of time at home alone.
Bobby doesn’t get to see Dad much
because Dad had to move away to
look for work. Bobby doesn’t feel
like he has any one that loves him.
He feels like a failure in school.
One day, Bobby thinks he has
found the answer. Bobby attempts
suicide.
Statistics on suicide in adolescents
are shocking. Suicide is the
fourth leading cause of death in
children aged 10-14 and 3rd leading
cause of death in age 15-24. Did
you know that 60% of high school
students have thought of suicide
and that 9% admit to having tried
to kill themselves at least once? In
the U.S. only two things cause teen
deaths more than suicide: accidents
and homicide.
Now imagine living in one
of the many rural areas in Texas
where your only option for treat-
ment of an
attempted
suicide
could
mean
your child
spends the
night or
possibly
the weekend
in jail.
That is a
reality in Huie
many areas of rural Texas, and one
that no parent or their child would
like to experience. It’s a frightening
thought.
Presently; the recommended
treatment for suicidal behavior is a
72-hour watch, which in areas without
a treatment facility or hospital
is a cell in a rural jail, followed by
medical treatment, counseling and
medications.
Let’s revisit Bobby’s story. Bobby’s
mom comes home from work
and looks for Bobby. He’s not in the
living room in front of the TV like
most nights. She checks his bedroom
and finds him there unconscious
with a bottle of her depression
medication lying next to him.
She runs to call 911. Bobby and his
mom live in a rural County with
no local hospital. The police come.
Luckily, Bobby didn’t take a lethal
dose, this time. He is transported
to the local jail where he will be for
the weekend until arrangements
can be made for him at a treatment
center in a larger city.
This isn’t the end of Bobby’s
story, it is just the beginning.
Where will Bobby get treatment?
Not in his home town. Bobby will
be far away from his mother who
loves him. How will Bobby’s mom
Cont’d page 3

Telemedicine Report
Advanced Health Care Through Advanced Technology
All Grown Up: Twenty Years for First Telemedicine
Patient Linked to Physicians at TTUHSC
If you measure the TTUHSC Telemedicine
program using a yardstick,
at the 1-inch mark you can
place Aida Porras and her parents,
Maria and Manuel Porras.
During a recent meeting with
the family, Maria Porras relayed
her memories of the events that
occurred two decades prior. In
1991 a 19 year old Maria was 9
months pregnant and sitting at a
ballgame when twinges of pain set
in. This being her first pregnancy,
she was not sure what to expect, but
was convinced by a friend to allow
her labor to happen on its own.
Once at Big Bend Regional Medical
Center, a caesarian section was
performed and upon evaluation the
baby appeared to be in respiratory
distress. Manuel told his wife that
something could be wrong with
their baby and that they were going
to have to fly her to Odessa. Fortunately,
Manuel had two sisters
living nearby and could meet the
flight to be with baby Aida. Maria
wouldn’t be released from the hospital
for two more days. Aida spent
a week in Odessa before being
released.
As part of a telemedicine
Cont’d from page 2
Rural Suicide Statistics
afford traveling to visit him? How
will she afford his treatment? How
will Bobby cope with no one to support
him during his treatment?
We at the F. Marie Hall Institute
for Rural and Community Health
are asking these questions and
wondering how we can help with
research project, Big Bend Regional
Medical Center was equipped with
telemedicine technology that linked
the rural hospital to Texas Tech
University Health Sciences Center
(TTUHSC) in Lubbock in 1990. The
project was to determine if telemedicine
could be used as a way for
patients living in rural communities
to see their doctor for follow-up
visits after being discharged from
the hospital. But before the first
follow-up patient could be seen and
equipment tested, Dr. James Luecke
delivered Aida and determined she
was having respiratory issues. Dr.
Luecke knew that there was a telemedicine
link to TTUHSC and his
quick thinking got assistance from a
TTUHSC neonatologist that helped
get Aida stabilized before her flight
to Odessa.
Since that time Aida has had
no residual complications resulting
from her initial respiratory issues.
The family moved to Presidio where
Aida has grown up. Maria went
on to earn her teaching degree
at Sul Ross University and is currently
teaching in Presidio. Manuel
worked in construction and cared
for Aida while Maria was in school.
this rising problem. We are looking
into innovative ways to bring treatment
to rural Texas through the use
of telemedicine and research. We
are also looking into education of
schools, parents and others in rural
areas with the help of the Area
Health Education Centers. n
Nowadays,
Aida
is a very
beautiful,
bright,
sweet,
and witty
young lady
living and
working in
Alpine. As
a kinesiologystu-
Porras
dent at Sul
Ross University with aspirations of
becoming a physical therapist, she
also works at a retail store.
You would also be hard pressed
to find someone her age more compassionate.
When Aida turned 18
she worked as a dispatcher in Marfa
for first responders. She took great
interest in the events her job. The
same holds true for her current
retail job.
Aida also has a knack for outreach.
During the 2011 summer
wildfires that plagued the Alpine
area. Many people were forced to
leave their homes without being
able to pack personal belongings.
The day of the visit, Aida reported
a couple of people coming in to her
place of work looking to replace lost
clothing. Aida was instrumental in
arranging deep discounts for those
people in need, and also worked to
establish an angel tree for others
who would need assistance.
Questions about bringing Telemedicine
to your area? Contact
Debbie Voyles at 806-743-7440 or
debbie.voyles@ttuhsc.edu n
3

Institute Researcher Enjoys Great Success
in Publications
Good research is essential if we
want to find new and more
effective ways to protect and
improve the health of West Texans.
Research is only useful, though, if it is
available for people to read and learn
from. For this reason, publication of
our research results is an important
part of the work done by the F. Marie
Hall Institute for Rural & Community
Health. While several in the research
group have an established track
record of publication, few can boast
the same kind of success as our biostatistician
Gordon Gong, MD.
Hired in 2005, Dr. Gong has since
published 18 journal articles and
a book chapter. He has had three
articles published since last January,
has submitted four for review, and is
working on three more. In total, since
he began in scholarly career in 1982,
Dr. Gong has had 49 journal articles
published and made contributions
to two published books. His writing
has covered a wide variety of topics,
from bone health to genetics to
environmental exposures. He also
holds a patent for a genetic marker he
discovered that is used to detect high
bone mass.
When asked what has made him
so successful in his scholarly career,
Dr. Gong is quick to give credit to
those he has worked for and with.
“I’m lucky and grateful to have very
nice supervisors and collaborators
who are always willing to help,”
he says. This group includes other
researchers who are also well-
recognized for their work and their
4
writing: formerly, Drs. Henry Lynch
and William Pettinger at Creighton
University and, currently, Drs. Billy
Philips and Sid O’Bryant in the F.
Marie Hall Institute at TTUHSC. He
also credits his clinical background as
a cardiologist for giving him a wide
foundation of knowledge that enabled
him to recognize new avenues for
research.
What advice does he have for
others who are looking to publish?
First, find collaborators who can
Ahsan Farooqi, an MD/PhD student
at TTUHSC, announced
the theme of the 2012 Student
Research Forum. The Forum is an
opportunity for students in the health
sciences to showcase their research
on important health issues. This year
the theme is Cure Diabetes, one of the
most challenging health problems in
America and a serious threat in West
Texas. The American Diabetes Association
estimates that nearly 26 million
children and adults that have diabetes
and 79 million more that are at risk of
the disease.
This year’s forum, to be held
March 19-22, 2012, will feature the
work of students who are addressing
the basic elements of the disease
including treatment and prevention.
The keynote speakers for this 2012
event are noted scientists and
bring something new to the work,
whether that is a specific skill or
expertise, research subjects, data,
or creative ideas for new studies.
“Collaboration is key,” says Dr. Gong.
Second, use your experience and
knowledge to look at problems in
new ways. Doing so increases your
chances of publishing and can drive
future innovative work. Finally, make
publication a priority. According to
Dr. Gong, “the more you publish, the
more opportunities you will get.” n
2012 Student Research Forum
Announces Theme
clinicians, Dr. Gerald Shulman, of
Yale University School of Medicine
and Dr. Luis Fernandez of the
University of Wisconsin School of
Medicine. Dr. Shulman’s research
has led to a better understanding of
the mechanisms of insulin resistance,
a major factor in the development of
type 2 diabetes. Dr. Fernandez, is
a surgeon who has done pioneering
work in islet cell transplantation
and beta cell biology leading toward
a possible cure for diabetes. Drs.
Shulman and Fernandez will speak on
March 22, 2012 at 11 a.m. and 1 p.m.,
respectfully, at the lecture halls in the
academic classroom building. Lunch
will be available for all attendees and
will be served at noon. If you are
interested in attending these events or
have any questions please call Ahsan
Farooqi at 254-466-4248. n

Growth and Success of the WTxHITREC
The West Texas Health Information
Technology Regional Extension
Center (WTxHITREC) is
one of a select group of 62 organizations
throughout the U.S. designated
as having the experience and capacity
necessary to assist health care providers
with the task of modernizing their
practices with certified Electronic
Health Records (EHR). WTxHITREC
received grant funding of 8.4 million
dollars to assist 1,133 Priority Primary
Care Provider’s, 46 Critical Access Hospitals,
and 31 Rural Hospitals with consulting
services to achieve successful
adoption and meaningful use of EHR’s.
At the end of September 2011, the
WTxHITREC has seen tremendous
growth through provider enrollment,
as well as, staff members. From June
2011 to the end of September 2011,
the Regional Extension Center has just
about doubled in provider enrollment
with an approximate total of 600
enrolled priority primary care providers
(PPCP’s).
In a short time the WTxHITREC has
rapidly grown to over 740 members.
With the addition of provider and
hospital enrollment, the WTxHITREC
has been able to recruit highly qualified
staff to support and serve all our 108
counties. The Center has also hired
regional staff members to be able to
focus their support efforts and maintain
strong relationships with our providers
and hospitals in our most rural areas of
Texas.
In addition to growth, the
WTxHITREC has been able to recognize
physician champions for their leadership
in the national transition toward
electronic health records. Over the last
few months, Dr. Beverly Nixon-Lewis of
Texas Tech University Health Sciences
Center (TTUHSC) School of Medicine in
Amarillo, Dr. Jose Luna of Centro San
Vicente in El Paso, Dr. Walker Jackson
of Physician Healthcare Associates in
El Paso, and Dr. Tamara Bavousett of
Compass Pediatrics in Odessa have
been recognized as champions for
their movement to EHR’s. During this
transition to EHR’s the WTxHITREC, in
addition to each provider, has been able
to witness the added benefit of adopting
an electronic health record system.
Dr. Bavousett stated, “Using an
EHR provides a more thorough process
of charting a patient’s history, physical,
and exams. In time, we have learned to
use our system more effectively. In turn,
our patients are better taken care of.
The EHR has helped me become a better
health care provider”.
“Having the EHR has provided many
benefits to our practice and has enabled
us to practice better, faster and more
efficiently” stated Dr. Beverly Nixon-
Lewis.
Success stories of EHR adoption
support this transition of healthcare
and the ability to provide better
care to patients. WTxHITREC
champions, although very advanced
in their adoption, still appreciate
their membership with the Regional
Extension Center.
As an early adopter, Dr. Luna stated
“WTxHITREC will provide Centro San
Vicente assistance in preparing the
clinic in its drive towards meaningful
use, help support connectivity
through health information exchange,
and assistance with EHR incentive
attestation.”
Dr. Bavousett said the WTxHITREC
provided assistance to her practice
as they approached EHR roll-out and
go-live, which helped create a smooth
implementation process. In addition, the
WTxHITREC worked with our office to
help us register and attest for Medicaid
EHR incentive payments and are
currently reviewing our Meaningful Use
dashboard.
Medicare and Medicaid incentive
payments are available to eligible
professionals and hospitals when
they adopt, implement, upgrade or
demonstrate meaningful use of a
certified electronic health record.
Payments, made through federal
Medicare and Medicaid programs,
mean physicians and other eligible
professionals can qualify for as much as
$44,000 through Medicare or $63,750
through Medicaid. Texas providers
are already receiving their incentive
payments and the WTxHITREC can
provide attestation support as well.
“We received a quick turnaround,
while attesting under the Medicaid
Adopt, Implement, and Upgrade
Rule in April, we received our first
payment of $21,250 in May” states Dr.
Bavousett.
WTxHITREC services are
customized to fit individual practices
and include:
• Initial practice assessment
• EHR vendor evaluation/selection
• Practice workflow analysis and
process redesign
• Implementation and postimplementation
review
• Meaningful use gap analysis
• Assisting practices in meeting
requirements to help secure CMS
incentive payments
• Partnering with state and
national health information
exchange
For more information about the
WTxHITREC, contact Carson Scott at
806-743-7960 ext. 356 at
carson.scott@ttuhsc.edu or visit
www.wtxhitrec.org n
5

6
National Rural Health Day Activities
Cont’d from page 1
small towns, farming communities
and frontier areas are wonderful
places to live and work; they are
places where neighbors know each
other and work together, and the
hospitals and providers serving
these rural communities not only
provide quality patient care, but
they also help keep good jobs in
America.” Locally West Texas
communities are contributing
resources and ingenuity that are
powering Texas and having a global
impact. These communities like
so many other rural communities
face a number of unique healthcare
challenges already, Eisinger points
out from accessibility issues to
lack of healthcare providers.
These challenges are becoming
more complex every year as rural
hospitals are threatened with
declining reimbursement rates and
disproportionate funding levels.
Full Circle: From Student to Scientist in
Rural Health Research
In 2006, Hilda Benavides could
not have predicted the path her
life would take. Today she is
the psychometrician and assistant
research coordinator for the Texas
Alzheimer's Research Consortium
(TARC) TTUHSC site, run by the
Research Division of the F. Marie
Hall Institute for Rural & Community
Health. Back in 2006, though,
she was a sophomore at Texas Tech,
majoring in Microbiology and minoring
in Chemistry.
While her educational plan
allowed her to use her interest in
and talent for science, she was sure
her degree would ultimately confine
her to a career in a lab. Then she
saw an advertisement for a student
group focused on helping the
surrounding community. The group
- the Double T Health Service Corps.
The staff of the F. Marie Hall
Institute works in collaboration with
the people of West Texas to overcome
these challenges, and advance
health through imaginative and
scholarly research, innovative use of
technology, comprehensive education
and outreach. Planning is already
underway for next year’s celebration
to showcase the “power of rural”,
and is slated for the third Thursday
of November. n
The group's sponsoring organization
- the F. Marie Institute for Rural &
Community Health.
After attending that first meeting
of the Double T Health Service
Corps, Hilda joined and spent three
years in the organization, eventually
serving as the group's Recruitment
Officer. She says those three years
taught her a lot about herself.
Specifically, she discovered a strong
drive for serving her community
and learned that she could pursue
her passions for service and science
at the same time. After graduation,
Hilda worked as the Clinical
Research Coordinator for a Lubbock
endocrinologist on eight separate
pharmacologic clinical trials. Last
July she was hired into her current
position, coming full circle to work
with the Institute that helped her get
Above Top: TTUHSC staff members
register for NRHD
Above: Doctor Linton gives talk on the
benefits of being a rural physician
Left: Third year medical students gain
knowlege of Telemedicine equipment.
Benavides
started down this path.
Hilda credits her time in the
Double T Health Service Corps with
helping her find what she really
wanted to do with her life and says
her favorite part of that experience
was "having a group of students who
were able to set everything aside and
focus on others instead of ourselves."
Now, she gets to do just that through
her work every day.
For information on the Double T
Health Service see www.ttuhsc.edu/
ruralhealth/studentorg.aspx n

AHEC Update
WEST TEXAS AREA HEALTH EDUCATION CENTER PROGRAM
F. Marie Hall Institute Announces
New Director, West Texas Area Health Education
On November 1, 2011, Rebecca
Condit became the new Director
of the West Texas Area
Health Education Center. Ms. Conditt
most recently was the Director of
the Capital AHEC in Austin and prior
to that Piney Woods AHEC in Nacogdoches,
Texas. Conditt has 18 years
combined experience in the East
Texas Area Health Education Center
Program. She also has served as the
Executive Director of the Texas Rural
Health Association, the advocacy
and education organization for rural
health issues in Texas.
Dr. Billy Philips, Vice President
and Director of the F. Marie Hall
Institute for Rural and Community
Health says, “Ms. Conditt is a
colleague and someone that we have
worked with to develop innovative
health programs in rural East Texas
and will bring that keen knowledge
and creativity to her new post with
the West Texas AHEC. She has
worked in nearly every position
within regional AHECs and is ideal
for working with the staff of our five
regional centers and the people they
serve.”
As Director of the West Texas
AHEC, Ms. Conditt will oversee five
regional offices and an expansive
program that is jointly funded
by Texas State appropriation and
federal grant funding. The mission
of the West Texas Area Health
Education Center (AHEC) is to
address the health care provider
shortage and improve health care
access in West Texas through
education and development of the
healthcare workforce. The West
Texas AHEC focuses on introduce
youth, K-12, to health careers,
supporting rural clinical training
for students who are in the health
professions, providing practice
support to existing healthcare
professionals, promote healthy
living, and assisting in communitybased
health planning. The Texas
HOTJobs website, school curriculum
and booklets are provided to
every junior
high school
student in
Texas through
the West Texas
AHEC.
When
asked what her
immediate plans
were related to
her new role, Conditt
Ms Conditt said,
“I am honored to be chosen for this
position. I look forward to learning
more about the region and how the
institute and specifically the AHEC
can work with the communities to
make West Texas a healthier place to
live. AHEC is a wonderful program
that can do tremendous things. I
am energized about this wonderful
opportunity.”
Conditt can be reached at 806-
743-1338 or Becky.Conditt@ttuhsc.
edu. n
Poster Highlights Economic Value of Community
Based Education
The staff from the F. Marie Hall
Institute recently presented
a poster at the 2011 Association
of American Medical Colleges
(AAMC) Annual Meeting in Denver,
CO. The poster focused on the economic
value of community based
education and how it related to the
various stakeholders involved. The
findings show the West Texas AHEC
program exceeded eleven million
dollars in economic value for community
based education for the 2010-
2011 academic year.
Three major areas of economic
impact were identified; value of
donated instruction to health
profession schools, value of housing
to students, and the value of health
profession students to the local
community. In looking forward
it will be important for medical
schools to accurately value the
return on investment of community
based education, and for policy
and decision makers to be better
informed to balance the cost
effectiveness of medical education. n
7

HEALTHBeat
Most of us take
our vision for
granted, but
being able to see significantly
impacts our
daily activities and
quality of life. There
are many different
things that can affect
the quality of our
vision—being nearsighted
or far-sighted,
aging, cataracts, eye injuries, diabetes, or
glaucoma.
Some vision problems are easily detectable.
We can perceive if our vision is getting
blurry; we can’t quite make out the
words on the street sign like we used to be
able to. Or maybe we see things now with
a brownish haze, which is what happens
when the lens becomes cloudy with a cataract.
Other diseases, like glaucoma, that
affect vision are not so easily identified
without testing. Glaucoma is a group of
diseases that damage the eye’s optic nerve
and result in vision loss and blindness.
Three million Americans have glaucoma.
Glaucoma is the leading cause of
blindness in African Americans, and the
second leading cause of blindness in all
Americans, according to the National Eye
Institute.
At first, glaucoma has no symptoms
and vision is normal. As time passes with
no treatment, a person with glaucoma will
begin to miss objects to the side and out of
the corner of his eye. Eventually, peripheral
vision is lost, and straight-ahead vision
can also be lost.
That is why regular eye exams are
important for early detection. There is no
cure for glaucoma, but there are treatments
that can slow the progression of the
disease. Glaucoma treatments include
medicines as well as laser or conventional
surgery. Treatments can save remaining
vision, but cannot restore vision already
lost to glaucoma.
For more information about glaucoma,
visit your eye care professional.
General information about glaucoma
and other vision disorders can be found
on the National Eye Institute’s website at
www.nei.nih.gov/index.asp.
F. Marie Hall Institute for
Rural and Community Health
3601 4th Street STOP 6232 | Lubbock, TX 79430
ADDRESS SERVICE REQUESTED
F. Marie Hall Institute for
Rural and Community Health
FOR UPCOMING ACTIVITIES VISIT YOUR
REGIONAL AHEC’S WEBSITE
Borderland
AHEC
AHEC of the Plains
2417 Yonkers; P.O.Box 1116
Plainview, TX 79072
806.291.0101 www.ahecplains.org
Border Region
221 N. Kansas #1000
El Paso, TX 79901
915.772.2002 www.borderlandahec.org
Big Country Region
3702 Loop 322
Abilene, TX 79602
325.672.0495 www.bigcountryahec.org
Panhandle Region
WTAMU Box 61003
Canyon, TX 79016
806.651.3480 www.panhandleahec.org
Permian Basin Region
3510 North A Street, Bldg. A
Midland, TX 79705
432.685.8306 www.permianbasinahec.org
F. Mari
Rural a
F. Marie
Rural and