Bowen Center for Health Workforce Research

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Bowen Health Workforce Newsletter

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The Health of Our State: Improving Maternal and Infant Care

by Kristina Box, MD, FACOG, Indiana State Health Commissioner

Infant mortality is the number one indicator of health status in the world. Yet here in Indiana, more than 3,000 babies have died before their first birthdays in the last five years. That is enough to fill nearly 42 school buses. As an OB/GYN for more than 30 years, I have personally delivered thousands of babies and I understand the devastation and loss behind the statistics. These deaths are a disheartening reflection on the health of our state. We must get better at addressing the causes of infant mortality in Indiana.

More than two-thirds of Indiana adults are overweight or obese. More than 21 percent of our adults smoke. Among pregnant women in Indiana, the smoking rate is twice the national rate. At the root of the problem is the disparity in healthcare outcomes across Indiana. About 27 percent of all infant deaths in Indiana occur in three percent of the state’s ZIP codes.

The concentration of these deaths highlights significant racial and geographic differences. Additionally, 31 counties in Indiana either don’t have a hospital or are without a hospital that offers delivery services. Governor Eric Holcomb has set a goal of having the lowest infant mortality rate in the Midwest by 2024. To achieve that goal, healthcare resources will need to be refocused on the state’s highest-risk ZIP codes with the highest volumes of women of childbearing age. This means increasing utilization of these services by our at-risk populations and improving access to obstetrical care closer to home in our rural areas.

The Indiana State Department of Health (ISDH) is creating home visiting and community paramedicine partnerships to provide care along with community health workers to act as navigators for our obstetrical populations both during pregnancy and after delivery. We are promoting additional support to pregnant women through the Indiana Tobacco Quit line (1-800-QUIT-NOW). ISDH is also gathering data, mapping obstetrical service providers to determine gaps in access to care and studying the impact that Indiana’s opioid epidemic has on our state’s newborns so we can tackle it more effectively. Redirecting our healthcare resources to programs like these is the first step toward reducing Indiana’s disparities in maternal and infant care and creating a state where every person has an opportunity to live a long, healthy life.

Research: Pediatric EMS Runs in Indianapolis

Have you ever wondered what types of medical emergencies pediatric providers actually see while in practice?  Dr. Matt Yuknis and colleagues from the Indiana University School of Medicine departments of Pediatrics and Emergency Medicine recently collaborated with Dr. Hannah Maxey and colleagues at the Bowen Center to answer just that question. Their original research article, entitled “Frequency of Pediatric Emergencies in Ambulatory Practices,” matched the geocoded Indiana Physician Workforce data with emergency medical service data from the Indianapolis area to objectively define the number, location and workforce characteristics of ambulatory practices from which pediatric EMS transports originated over a three year period. Data were also matched to the illness types and interventions required by the patients. Their study is the first to use geocode matching to verify large scale EMS data and one of the first major updates to this topic in almost 20 years. Their hope is to improve the readiness of pediatric providers to care for emergently ill patients, to refine current guidelines on equipment and medications available at pediatric ambulatory practices, and to inform the training of current and future pediatric providers.

Data: Bowen Health Workforce Information Portal – What’s New?

Since the Bowen Portal was launched in June of 2017, the Bowen Center has continued its collaborative effort with the Polis Center to identify new and innovative data visualization features that will improve the usability of health workforce data. The newest feature that has been added on the Bowen Portal is the Report Generator. With this feature, users will have the ability to create customized fact sheets with formatted tables and an accompanying map. To begin using this feature, users will first select a theme, profession and indicator of interest that will be displayed geographically (similar to the Interactive Mapper). Next, users can choose up to three geographic regions for which all health workforce data from the selected theme will be displayed in a formatted table, along with the state average as a reference. These selected regions will also be highlighted in the accompanying map. As with the data download feature, users will be required to register or log in before utilizing the Report Generator. It is our hope that this new feature will improve the efficiency of producing easily digestible information for stakeholders and policymakers. Start discovering, using and sharing health workforce data now at bowenportal.org

Evaluation: Mental Health and Addictions Loan Repayment Assistance Program

In the spring of 2018, the Bowen Center was commissioned by the Division of Mental Health and Addictions (DMHA) at the Family and Social Services Administration to conduct a program evaluation of its three-year loan repayment assistance program for behavioral health providers. This evaluation included a voluntary telephone survey which asked participants about their impression of the program as well as their professional characteristics. Of the 139 individuals who participated in the program between 2015 and 2017, 75 (54%) volunteered to complete the survey. Though this program offered assistance to many behavioral health professionals, the largest proportion of respondents were psychologists and social workers. Of those who reported working in an underserved area during their obligation period, 44% remained at the same practice site after their period ended. Many respondents also indicated gratitude for the financial assistance which enabled them to work in areas of greatest need and further their education and training. A full evaluation report has been submitted to DMHA and can also be found on IUPUI ScholarWorks. This program has potential to engage the behavioral health workforce and expand providers to communities in Indiana in greatest need of mental health care.

Team Member Spotlight

My name is Olivia Johnson, I am an Undergraduate Research Assistant at the Bowen Center for Health Workforce Research & Policy. I am a student at Indiana University Purdue University at Indianapolis in pursuance of a Bachelor’s of Science in Dental Hygiene. I have been at the Bowen Center since October 2016 assisting with the policy sector of the organization. I help with the policy fact sheets, research requests and workgroup initiatives tasked by the Governor. I am passionate about people and helping advance others towards success and my time spent at the Bowen Center has allowed me to fulfill that passion. I would like to thank Hannah Maxey, Courtney Randolph, Marnie Baker, and the rest of the amazing team at the Bowen Center for being a part of my story and helping me grow as a college student, a team member and as an individual.

“Unless someone like you cares a whole lot, nothing is going to get better. It’s not.”

– Dr. Seuss, The Lorax

As a Research Assistant at the Bowen Center, Analise Dickinson is involved with various projects and assignments. She has helped with literature review and citations for upcoming reports and assisted with data analysis and write up of the Primary Care Needs Assessment (PCNA). Of those projects the most challenging but rewarding has been helping with the PCNA report. She feels that working on this report has given her a new perspective on how research can influence health policy. In her personal life, Analise is a Graduate student receiving her MPH in Epidemiology. She is eager to complete her degree and join the workforce. Meanwhile, she enjoys spending her time playing soccer, traveling and reading as much as her free time will permit. Analise values her experience gained at the Bowen Center and has enjoyed her time as a Research Assistant immensely.

The Results Are In!

On March 16th, 2018, Governor Holcomb signed Senate Enrolled Act 223 into Public Law (authored by Senators Head and Charbonneau). This bill requires specified health professionals to provide certain information when renewing their professional license online (beginning January 1, 2019), including: educational characteristics, specialty or field of practice, and additional practice characteristics. This initiative builds on existing state efforts to quantify and describe the health workforce for the purpose of informing policy, supporting program development and evaluation, identifying workforce shortages, and allocating resources.  Previously, this information was collected as a voluntary part of health professional license renewal. This new requirement will provide Indiana with more comprehensive, high-quality data than has ever been previously available. Enhancing the availability and quality of information on the health workforce is critical to ensuring Indiana is positioned to respond to health crises. This law specifies that a report is to be delivered to specific agencies (Office of Medicaid Policy and Planning, Department of Workforce Development, Commission on Improving the Status of Children in Indiana, the legislative council, and the Office of the Attorney General). The Bowen Center looks forward to partnering with the state of Indiana to support data-driven discussions on the health workforce.

A Word From Our Partners

by: Indiana Senator, Randy Head

Since I began my public service career, one of my top priorities has been to address health issues that are a concern for Hoosiers. To do this, I have authored numerous bills to address issues like suicide prevention and curbing drug abuse. However, what many people do not realize is the number of individuals who play key roles in preparing and passing legislation every year. For example, several of my bills this session are a result of the work by the Task Force on Substance Abuse and Mental Health for Children, which I co-chair. The Task Force works to find treatment and resources for children in need of mental health and substance abuse services. This session, two important Task Force bills were suggested by Dr. Hannah Maxey and the Bowen Center.

Senate Bill 223 would help provide our state with information on Indiana’s health workforce by requiring some licensed health practitioners to provide information related to their work when renewing their license online.

Senate Bill 225 would require licensed health care practitioners to receive continued opioid prescription and abuse training. Under the bill, if licensed practitioners apply for registration or re-registration, they must have completed two hours of continued opioid prescribing and opioid abuse education during the previous two years. If passed by the House and signed by the governor, these bills could greatly impact Hoosiers’ health. I thank Dr. Maxey and the Bowen Center for their hard work and dedication to the well-being of our state.

How Can We Assist You

Looking for data or technical assistance? The Bowen Center for Health Workforce Research & Policy provides stakeholders with critical information on Indiana’s health workforce that can be used for evaluation, original research and reporting. Contact us today to discuss how we may assist you!

Give Now

Philanthropic support helps to advance research in the Bowen Center for Health Workforce Research & Policy and the Department of Family Medicine that will benefit Hoosiers throughout Indiana. Your gift also supports the training of the next generation of physicians who benefit from the expertise of our dedicated faculty. For additional information about the various ways to give, please contact Joshua Lee at 317.278.2124. Gifts to the Bowen Center for Health Workforce Research & Policy and the Department of Family Medicine can be made online by clicking the “Gift Giving” tab on the top of the page at family.medicine.iu.edu/hws. Thank you for making a difference!