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“Together, let us be creative in our thinking, collaborative in our work, resolute in our strategy and bold in our storytelling.”
Connie Reimers-Hild, Ph.D.
RFI Interim Executive Director & Chief Futurist
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People have the capacity to shape their own futures.

Communities are not just localities, but also networked groups of individuals working together toward a common goal and shared purpose.

Leaders are known by their vision, ideas, energy, passion and engagement in collective action.

Entrepreneurs are individuals and communities that combine strategic foresight and grit to take action to reach their desired futures.

Diverse and inclusive leadership is needed to propel communities forward.

Our complex future requires mutual respect and collaboration between rural and urban regions and communities.

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Rural Futures with Dr. Connie

 

 

 

 

 

 

The Pulse of Rural



Articles & Releases

RELEASE: Apply for RFI Scholarship to Mobile Tech Conference

July 18, 2018
Lincoln, Neb. — July 18, 2018 — The Rural Futures Institute (RFI) at the University of Nebraska is offering 10 $250 scholarships for rural Nebraska community innovators to attend the 2018 MobileMe&You national conference at the University of Nebraska–Lincoln Oct. 26-27, 2018. …

Lincoln, Neb. — July 18, 2018 — The Rural Futures Institute (RFI) at the University of Nebraska is offering 10 $250 scholarships for rural Nebraska community innovators to attend the 2018 MobileMe&You national conference at the University of Nebraska–Lincoln Oct. 26-27, 2018.

Scholarship Application »

MobileMe&You, a journalism and technology conference hosted by Gary Kebbel of the University of Nebraska–Lincoln College of Journalism and Mass Communications, focuses on new and emerging tools and best practices for storytelling on mobile media. Leading experts and researchers will discuss how to inform and engage new audiences in the mobile era.

“Mobile media are becoming increasingly critical for all aspects of life in rural areas—healthcare, agriculture, entrepreneurship and education,” said Connie Reimers-Hild, RFI Interim Executive Director. “When Professor Kebbel approached us about recruiting rural community leaders to attend, we jumped at the chance to partner. Our RFI scholarship awardees will certainly learn, but they will also bring extremely valuable and important perspectives to the presenters and other attendees.”

Conference speakers include:

  • Mark Hulsey, Big Ten Network vice president
  • Christina Kline, CNN senior mobile editor
  • Christopher Meighan, Washington Post director of emerging news products
  • And many more media professionals with mobile backgrounds!

Scholarships will be awarded based on answers to a series of questions around mobile technology use in rural communities and ideas for the future. The application is open today and will close Aug. 31, 2018. Awardees will be announced in late September.

Conference Details
Oct. 26 and Oct. 27, 2018 | 9 a.m. – 8 p.m. CST
University of Nebraska–Lincoln
City Campus Union
Extended details available at mobileme-you.com.

“I think the real key with mobile media is that it reaches everyone, and in particular, those who haven’t had the benefit of the super structure that’s in the city,” Kebbel said. “When the super highway that has 15 lanes does not reach out into rural Nebraska, mobile media do.

“Through mobile media you can get information, deal with medical issues, deal with financial issues, you can conduct your life as if you had the super highway. It’s your virtual super highway—it’s essential.”

 

Promotional Soundbites

Connie Reimers-Hild, Ph.D., RFI Interim Executive Director, talks about the importance of mobile media in rural areas and the impact rural leaders can bring to the conference.

“Mobile media are becoming increasingly critical for all aspects of life in rural areas— healthcare, agriculture, entrepreneurship and education. Our RFI scholarship awardees will certainly learn, but they will also bring an extremely valuable and important perspective to the presenters and other attendees.” (19 seconds)

 

Gary Kebbel, professor at the University of Nebraska–Lincoln College of Journalism and Mass Communications, talks about expanding mobile media to rural Nebraska.

“I think the real key with mobile media is that it reaches everyone, and in particular, those who haven’t had the benefit of the super structure that’s in the city. When the super highway that has 15 lanes does not reach out into rural Nebraska, mobile media do. Through mobile media you can get information, deal with medical issues, deal with financial issues, you can conduct your life as if you had the super highway. It’s your virtual super highway—it’s essential.” (34 seconds)

 

He also discusses the importance of delivering stories and content on mobile media to reach audiences of the future.

“MobileMe&You is a conference that basically says, mobile media are so important to the future of reaching the new audience, young people, that you’ve got to learn to reach them where they are, on whatever device they are using, whenever they want. You’ve got to accept the fact that they are in control, and mobile me and you is going to teach you how to do that.” (21 seconds)

 

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About MobileMe&You
MobileMe&You is an information and technology conference that highlights new and innovative mobile media techniques and explores how to think differently about storytelling on mobile media platforms. The 2018 conference will be held at the University of Nebraska–Lincoln campus, with speakers from The Washington Post, CNN, Univision, the Big Ten Network, Verizon, Quartz and more to discuss how to use technologies such as bots, drones, artificial intelligence, virtual reality, augmented reality and 360 video.
mobileme-you.com

About the Rural Futures Institute
The Rural Futures Institute (RFI) at the University of Nebraska leverages the talents and research-based expertise from across the NU system on behalf of rural communities in Nebraska, the U.S. and around the world. Through a culture of innovation and entrepreneurship, RFI encourages bold and futuristic approaches to address rural issues and opportunities. It works collaboratively with education, business, community, non-profit, government and foundation partners to empower rural communities and their leaders.
ruralfutures.nebraska.edu

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Episode 7: John Roberts intersects healthcare, tech, rural-urban dynamic

July 17, 2018
            Rural healthcare access, overall wellness in rural areas and the future of rural hospitals are consistently present challenges discussed in the national narrative. In this episode, Dr. Connie asks John Roberts, Executive Director of the …

 


     

 

 

Rural healthcare access, overall wellness in rural areas and the future of rural hospitals are consistently present challenges discussed in the national narrative. In this episode, Dr. Connie asks John Roberts, Executive Director of the Nebraska Rural Health Association, to weigh in on these areas, but also talk about the opportunities of the future. As a member of the board of directors of the National Rural Health Association and with more than 35 years of experience in rural healthcare, John’s perspective on policy, technology and rural-urban collaboration is important for all of us to consider and understand as we shape the future of healthcare as a country. For example, did you know that rural hospitals are actually penalized for incorporating wellness centers? Did you know that rural healthcare providers earn the same level of outcomes in their areas of service but at 4 percent less cost than urban counterparts? Educating our rural leaders and residents along with our urban partners is critical, John says.

We hope you will listen in, rate our podcast and give us a review!

“Too many times I think we focus in on urban or rural, and you really can’t separate the two. Rural providers need urban counterparts for specialty services or services we can’t provide in rural settings and vice versa. When urban areas are being moved to this value based system, too, their incentives shift to try to make sure they get the patient back to rehab or other areas of rural Nebraska because they can do it as well and cheaper.“  
John Roberts
Executive Director, Nebraska Rural Health Association

About John

     

John Roberts is the Executive Director of the Nebraska Rural Health Association. He has more than 36 years of professional healthcare experience. John has been President of Midwest Health Consultants, Inc. for the past 16 years. He is responsible for the overall management and technical expertise of the consulting firm including business development & strategy, marketing, customer service and over-all project management

 

Show Notes

Hello and welcome back to the Rural Futures Podcast. I’m your host Dr. Connie. And joining us today is John Roberts who has over 38 years of professional healthcare experience and serves as the Executive Director of the Nebraska Rural Health Association, and he’s done that for the past 14 years. But John, I want to hand it over to you. Tell us a little bit more about yourself.

Well I’ve started my career in hospital administration back in 1980. I graduated from the University of Nebraska Medical Center with a health services administration degree. Went from there from Omaha to a little town in western Nebraska which was Ogallala Community Hospital and spend six years there as business manager, eventually the system administrator. It was a great way to get your feet wet, and I learned a lot about rural healthcare. And I think that’s really where my passion begins to develop and really love the people in rural areas. I really believe what rural providers do and the quality of life that they can create for their communities. So I left there in 1986 and came back to Lincoln, Nebraska. I worked for Nebraska Hospital Association as one of their lobbyist and your point person on small rural healthcare issues. And did that for about 12 years and then left there and started my own consulting company. We managed a couple of different associations. As you mentioned we managed the Rural Office Association, and I also managed the Dental Hygienist Association of Nebraska. So we do a lot of work with those organizations, do a lot of work with communities all across the state of Nebraska. I think I worked in every rural hospital in the state over the last 30 years or so so labor of love for sure. I also served on the board of directors of the National Rural Health Association. We’re critically involved with policy and things that are happening at the federal level and legislation and hopefully to improve the condition of rural health across the country.

Now we’re gonna get into more of that in just a second. And that’s a lot of the serious stuff about John Roberts. But I want to know too, I know our listeners want to know, what do you do for fun? Because I know there are some things that you do that I think everybody would be very interested in hearing about.

Well I like the usual stuff like golf and I do a lot of wood working in the winter time. But I love playing with my nine grandchildren who range in age from two to twelve.

I know you love the great outdoors and your family has a cabin on Lake McConaughy which is also Nebraska. One of our wonderful bodies of water. So I know you have that compassion for rural and hospitals but also this experience of rural and what that has to offer.

Yeah, I love getting out to western Nebraska. There’s a certain beauty to the Sandhills of Nebraska that you just cannot find anywhere else in the country, and I just love the culture. I love the communities in the greater part of Nebraska.

Well, here at the Rural Futures Institute, one of the things we’ve been exploring this last year are the questions of why rural, why now? You know, why should anybody care about rural that doesn’t live in rural? Rural population across the U.S. and in other places around the world is much smaller than it is when we compare to those urban centers. But I think your enjoyment of those great outdoors and the natural resources and beauty rural has to offer is part of the answer to that question. You can’t go just anywhere and have the experience that you can have in Nebraska Sandhills which I agree as is like a great secret, right? But if you truly want to experience the outdoors and what nature has to offer, that’s one of the great places Nebraska has to offer in terms of rural. With this question of why rural, why now, you know, rural health is definitely part of the huge conversation around rural right now. Why should we continue to have all of these hospitals or should we? What does the rural population need to look like and how do we provide health access and health care to them with those dwindling populations? So when you work throughout Nebraska and throughout the nation, how do you frame that? Why is investing in rural important and specifically in healthcare sector?

The way I look at it is that agricultural part of what happens in ruralnot only rural Nebraska but in rural America—is critical to our infrastructure and our way of life in the United States and, quite frankly, around the world. Rural areas of this country, including Nebraska, basically feed the world and the amount of agricultural food that comes out of rural areas is very important. And we’ve got to be able to support people who live in those rural areas, who serve them rural agricultural economy. And we need good healthcare for those folks in addition to the good schools and other things, we just need to have the infrastructure there to be able to allow those people to do what they do.

And speaking of the rural scene right now and healthcare, how would you describe yourself as a leader in this space?

I really think of myself kind of as a servant leader. My philosophy of leadership is unless you’re willing to serve those you’re leading, you’re probably not the most efficient and effective leader. So I really view things through that lens and I think that allows my leadership style to be able to get in and do the work and not really care about who gets the credit for it. But to really focus in on the outcomes and we want to get for rural America and creating a better and more sustainable rural health in Nebraska.

And speaking of that. I know you’re one of the leaders in Nebraska that’s really working on reinventing our rural healthcare sector. Please speak about some of the innovations in the leadership going on in that space right now.

About a year ago, several of us thought leaders in the state got together informally and started to talk about what we saw currently with the healthcare system in Nebraska and across the country, and then more importantly, what we could do about that as we move forward. We’re currently in a situation where, over the last five to six years because of several different policy changes at the federal level, we’re seeing a pretty rapid decline in the profitability and sustainability of many of our rural healthcare providers. And so we took a look at that and thought we can continue to go down this road we’re on, which the future doesn’t look real bright for many rural providers. Or we can do what Nebraska is kind of known for doing, and that is how do we collaborate together to create a better system? One that has higher quality and lower cost because that’s what government. That’s what business—that’s what insurance companies—they’re all looking for that and that’s what we’re seeing, a major shift in the last several years at the federal level. And I think we’re seeing a lot of states getting into this innovation of how can we recreate and build a better system?

So when you think about recreating and building that better systemI actually just published a paper called Strategic Foresight Leadership and the Future of Rural Healthcare Staffing in a journal, and part of that is to think about the disruption of healthcare, in particular rural healthcare. This is a three trillion dollar industry that the tech firms are getting involved with. You know, we see a lot of entrepreneurship, growth in the healthcare sector but a lot of it not necessarily focused on rural. A lot of it is focused on technology and technological solutions, and we’d love to see a little more innovation in the rural sector around some of this, particularly our rural areas and of course we’re focused on Nebraska because we’re both working and living here in many ways could be such a great playground of innovation for what could happen. Not just in rural but in urban settings as well, because there is so much going on in healthcare. So if you would look in your crystal ballI can always look in mine as a futurist. But if you look in yours John, how would you see our rural healthcare sector changing in the next three to five? What would that ideal future look like?

Well we’re definitely on a path of what we call volume to value which is changing the payment system for rural providers—not only rural providers but all providers across the country. And it goes back to this issue that we have a healthcare system spending that’s not sustainable over the long term. So we’ve got to look at ways we can increase the quality and the outcomes that we give for our patients, while at the same time lowering the cost of care for those outcomes. And so, we’re really seeing this big shift in looking at how providers can be reimbursed and incentivized to be able to take this value idea and provide high quality outcomes and high patient satisfaction, and when they do that, they will get reimbursed accordingly. The opposite effect too is if you’re not meeting those outcome standards and the patient satisfaction standards, you’ll be penalized. And so the incentives are beginning to change pretty quickly over the next probably three years.

So is that why I keep getting all those patient surveys after I visit a doctor? (laughing) Is that what’s going on there John?

Yes that’s part of it.

That’s what I’ve heard. But the one thing I wondered, and I’m sure you can shed some light on this is because it is shifting to more of a values based sort of approach and method, could we be using things like artificial intelligence, big data to help us understand those outcomes more broadly and more robustly? Are there some things happening in that space that you know about that are emerging?

If you look at over the last five years the number of venture capital that’s gone into healththese aren’t health related organizationsthey’re data and information systems, people like Microsoft, Sysco, a lot of different folks are looking at the issues you just talked about, on how we can use this data and information to do a better job with what we’re trying to accomplish and that’s high quality outcomes for our patients.

What advice would you give to somebody like a Rural Futures Institute? We’re part of the University of Nebraska, we’re system wide, and we know that healthcare is one of the—if not themajor issue facing our rural communities today. Now what advice would you give us in terms of how we could help organizations like the Nebraska Rural Health Association and others, to help find some innovative ways to provide solutions for our citizens and help keep people where they want to live and live the high quality lives in our rural communities?

I think slowly but surely rural health providers are understanding what we have to do to make this shift. But what we really need probably and probably what the organization could help us with is we really need to help communities understand what the shift is and what things might look like in the future. And that includes rural hospital boards, government leadership, community organizations to be able to make this transition and be able to do some innovative things in the state. I think we need the support of those community leaders and board of directors to be able to step out of the comfort of what they know and really start to look at what could be and how could we really redesign this system to better fit our communities. That may mean that all communities may not have a hospital, there may be different services that can provide in different regions of the state and that all takes a lot of time and energy to kind of sort through. And you have to have at least a basic understanding of where we’re trying to get to and how communities and leaders across the state can help us get there.

I appreciate that insight. I know that you’re a big proponent of sort of the co-creation with communities and having communities be part of this process and that’s so important for that innovation to happen. The future will look different then the present, and we all have a voice and a contribution to making that space. I was really interested when we had our pre-convo to get ready for this podcast, you mentioned that when a hospital puts in a wellness center they are penalized and so thinking about hospitals as economic drivers but also as center points for communities. I think it’s so important but then when you shared that with me, I thought wow. You know, here we have a lot of hospitals that are really trying to focus more on wellness not just sick care, thinking about what that might look like. But the system isn’t quite set up for that yet is it?

No, it’s really discouraging because I think everybody understands we need to move to this value based system. There needs to be more emphasis put on prevention, care coordination, chronic care management, all those types of things and yet. Currently, our reimbursement systems, mostly by the federal government because you have to remember a typical rural Nebraska hospital, 75 to 85% of their business will be Medicare and Medicaid. And so whatever reimbursement policies are implemented in those two programs has a tremendous effect on what we do and how we do it and how we get paid. The difficult part is making that transition to this new system where we might look at things like home healthcare or other types of wellness or preventative activities. But when we do that as rural providers right now, we’re penalized under the rules that currently preside over this reimbursement system. And so even if we have hospitals that want to make the right decision to do right for what’s in their community, they’re penalized for doing that. That’s the things we want to change as we’re moving forward.

You know John, I just think that’s so critical. You talked about the importance of communities and leaders being involved in embracing sort of this change in innovation, but it’s also the policy, right? And so I think that point you’re making is critical. I think it’s really great for listeners to hear that and think about that even as we see hospitals wanting to transition, sometimes the policies that they’re needing to abide by and live with are not really supporting an area of wellness and more positive living and lifestyles and that’s where we need healthcare to go.

We’re really interested in approaching the federal government which in this case is the Centers for Medicare and Medicaid, their innovation part of their department looking to develop a plan in Nebraska to really approach them to say give us an opportunity to make the changes that make sense for our state and our communities to try a different path of reimbursement system and policy and let’s see if it works and let’s see what we learn from it and take those learnings and apply those to other states across the country. We’ve seen that in a couple of states here in the last couple of years. Maryland has gone to a global budget and a policy. They are in their second year of that innovation project. And they’ve really produced some pretty meaningful results. The other state is Pennsylvania who just started in January 1 of 2017 in their innovation project and they’re gonna work over the next few years to try to get 30 rural hospitals to participate in their program and again it’s a global budget concept. It shifts the incentives for what providers do and like we talked about. Those incentives shifts go towards more prevention, more case management, looking at the things I think we need to go to.

I think it’s so great to have leaders in our state and around the nation really focused on innovation in this space. I actually have worked with several rural hospitals—one in particular in southeast Nebraska—did a year long leadership engagement with them focused on innovation. How do we, as leaders within those hospitals, innovate? Because we have leaders in those hospitals, and a lot of our hospitals do provide great paying professional jobs, they are a hub of our communities. They’re an economic driver as I said before and I think so much of the conversation about rural has been if the school closes we lose a community. I’m not disputing that there are challenges around that, but I think if people were concerned about depopulation before, if we see a closing of a lot of hospitals with nothing else to replace it and people don’t have access to healthcare, we’ll see even more people need to move to areas that have that healthcare access or choose to live there in any case and not choose to locate in a rural community.

Yeah, absolutely. Over the last 10 years about 80 to 85 rural hospitals closed across the country, and that’s more than we’ve seen in the last 20, 25 years. And a lot of those have happened in the deep south and so when you look at states like Georgia, where they’ve had probably 10 to 12 rural hospitals close, when you go back and look at those communities later, it has a devastating effect on their culture, their community, access to healthcare. But as you mentioned, most of the time hospitals are either the first or second largest employer in the community and they draw money from outside sources into those communities. And so it’s really devastating to the community to lose their hospital and lose access to those healthcare services.

I often think of our hospitals and healthcare systems as places where people can connect as well. When my father in law had to start dialysis they could no longer live on their farm in southeast Nebraska, and it was hard for them to uproot everything they knew, everyone they knew, their whole community to relocate. Not that other communities aren’t great but when you’ve lived somewhere for your whole life and then suddenly have to make a change like that just to have access to healthcare, it has other consequences for your mental and emotional and psychological well being as well.

You know, we can tally the direct cost of a hospital closing in a community, but there’s also the secondary or the intangible costs of driving an hour or two to get the medical care, taking off work to be able to do that. All those things are cost to not having those providers in your community. And the other aspect of it is data at the national level that shows that for the services we provide versus urban. It’s usually right around 4% less in cost and yet we produce the same kind of outcomes. And so when we see these rural hospitals close, you’re shifting people to other higher cost services which cost the Medicare and Medicaid program even more over the long term so that’s why we think there’s a significant policy that needs to be worked on at the federal and state level to kind of insure that these rural providers have the opportunity to be successful and sustainable long term.

You know that’s really fascinating just think about the interplay between rural and urban in terms of healthcare. I think there’s a technological aspect of that where technology is developed in urban can be used in rural and that’s a lot of the conversation around this but you bring to light something completely different. And that’s thinking about if we can keep people in rural and have that positive ROI in those rural facilities. It actually benefits the rural community but also the urban communities that don’t have to take on those additional loads so the work load is distributed a little bit differently. But then also federally in terms of the financial ROI to the government but ultimately the taxpayer is even better. So that’s a great piece of information for us to all learn and know about in terms of why rural, why now? How urban and rural work together in so many ways but also how this is a larger ecosystem in play here and I think so many times we separate rural and urban. But as we thought about it more here as the Rural Futures Institute, we really see it as a dynamic ecosystem where we all need each other. And what you’re talking about there really proves a point even in the area of healthcare so going beyond agriculture.

You’re absolutely right. Too many times I think we focus in on urban or rural and you really can’t separate the two. Rural providers need urban counterparts for specialty services or services we can’t provide in rural settings and vice versa. When urban areas are being moved to this value based system too, their incentives shift to try to make sure they get the patient back to rehab or other areas of rural Nebraska because they can do it as well and cheaper if you’re on a fixed budget.

 

(Music Transition)

Let’s dive into the technology aspect just a little more here in the conversation. What role do you see in terms of this technology being developed in healthcare? We know it’s a huge space right now, a lot of investment in this space. How do you see the potential of holograms, for example, used in rural healthcare?

Yeah, I think we’re on the verge of some major changes. We’ve gone quite a ways with what we call telehealth services in rural areas of the country which helps us provide services that we may not normally be able to provide or allows us to get consultation from outside experts which really helps our rural providers feel like they have a backup in Nebraska. We’ve implemented quite a few of what we call tele-emergency services where if you come and present yourself in a rural hospital emergency room, they can connect that to urban facility where you have a specialty physicians that are board certified in emergency medicine, consult on the patient and be able to provide those rural providers with consultation on how best to treat the patient. The other thing I think is gonna be really disruptive as we move forward is the whole smartphone technology. We’re seeing some real major trend shifts in rural areas of the country of people dropping their home internet services and relying strictly on cell phones, smart phones or their information and internet connection and again as I mentioned earlier, we’re seeing a lot of investment by folks in this area looking at how they can use technology to improve the health of people across the country.

Yeah, I think that’s really exciting. We have dropped our land line at home actually several years ago. We live in a rural area and our internet still isn’t that fast, and we thought it was gonna get a lot faster, still not that fast. My cell phone is my best source of connectivity, so I’m really excited about things like Doctor on Demand, lab-on-a-chip technology where you could potentially even diagnosis something in your home. I think that’s a tremendous development and seeing more of his happen at home is really exciting. Singularity University is a group I follow quite intently and they have this whole XPRIZE concept where they get this big purse of money together and crowd source from all over the world people that can develop it. And one of the things that they had actually funded, Qualcomm actually funded the purse, but a team actually developed the first tri-quarter. So if people remember back to Star Trek when you could scan your body with this instrument and it tells you what’s wrong and so now the first prototype has been developed and launched and they will continue to make that better and it’s actually developed for home use. It’s not necessarily, the intent wasn’t just for hospitals, it’s to have cheap accessible affordable healthcare wherever you are. And so thinking about the smartphone and other tools like that and how that could potentially help people all over the world and specifically in our rural communities when they don’t have access to a lot would be awesome or even in those crowded and congested urban areas where you can’t always get into the provider. Because we do have such a shortage of doctors and healthcare professionals around the world, technology could be a huge help.

I ran across the dermatology app not too long ago and thought, well I’ll give it a shot, see how it works. So I took a picture of my skin or some imperfection and sent it off to someone and within 24 hours I had a diagnosis of what it was, what the treatment was. It took care of the situation. I didn’t have to go to my primary care physician. I didn’t have to be referred to a specialist. I didn’t have to take time off work. What started as kind of curiosity at the end of it was really looking at wow that worked pretty well and I probably would do it again.

Oh absolutely. I mean I think anything that can save time and money but then also just create more accessibility and affordability is such a huge win. So I think healthcare is one of the most exciting spaces right now in terms of innovation in the future because we all need our health. Health is the basis of life and I think to be healthy is such an important part of who we are. We take that for granted a lot of times until something does happen and suddenly you’re sending a picture to a lab or getting a procedure performed or you find yourself on crutches and you forget how important health is. I think sometimes until something like that happens and it inconveniences you or worries you or even thinking about more long term challenges such as a cancer diagnosis. You know health is life and I think keeping that at the top of our mind is so important. That’s why making sure we have investments and great leaders like yourself in innovation. The space is so important. We thank you for that important work John.

Yeah we’re excited. I think one of the things that Nebraska is known for around the country is our collaboration with each other with providers and different communities, something we take for granted in Nebraska that a lot of other states just don’t have and we’re really gonna use that and test that as we look at how we can develop innovation to really solve these issues as we’re moving forward in rural health.

Well I would just make a plug for Nebraska out there to anyone that might be listening in the tech space. We’re a small population which actually makes us kind of like a start up for a state. I think our small population is actually an advantage right now and we are highly collaborative as you’ve mentioned, John. So thinking about how do we position Nebraska to be the place where innovation and rural healthcare happens and in a big way? So it starts here but actually can then expand to other states and other nations as well. You know we have a strong medical center, we have a lot of research but we also have a lot of people and a lot of leaders who are willing to do some innovative creative work around this to provide access to people and to communities.

(Music Transition)

I’d love for you to leave our listeners with sort of your top three leadership tips that they could use in their lives.

You know I think that when I’m counseling a lot of our providers and when I go to across the state, one of the things that they need to do is to get comfortable with being uncomfortable. We know we’re gonna go through a pretty major change in the next three to five years and not only rural Nebraska but across the country. And I truly believe that it won’t be the strongest that make that transition the best or the one’s that are most financially strong at this point. I really believe it’s gonna be the ones who can adapt to change the best and who are able to manage that change as we go through this process. So that’s one of the tips I kind of give them. The second one is to really look at what it is we need in our communities and really go back to that. Trying to break down our mental models of what we think the way things should be. For instance, we know that we can provide additional services outside of what we would call a traditional hospital. And to really begin to look at what is it that people really need? And how can we provide that? And get away from kind of the mental models that we’re kind of used to. And then the final thing is, I mentioned earlier is getting everybody in the community and across the state to really think about what’s happening. How we could take this apart and put it back together in a way that works for our communities and works for our state? And hopefully eventually can be a model for other states across the country as we make this transition to this value based system in healthcare.

I so appreciate your philosophy about the co-creation of the future with communities with people, with those end users and partners involved and I think definitely in this area of disruption of healthcare. That’s such an important piece of all of this. So thank you John.

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This Week In Serviceship: Week Eight!

July 13, 2018
Broken Bow, Neb. Just like the infamous taco truck showing its potential by making regular appearances around Broken Bow, our projects are starting to show their potential and even have begun to wrap up! We finished our promotion cards for …

Broken Bow, Neb.

Just like the infamous taco truck showing its potential by making regular appearances around Broken Bow, our projects are starting to show their potential and even have begun to wrap up! We finished our promotion cards for Sturgis this past week and have plans to distribute them to Christian biker groups that ride through Broken Bow on the way up to Sturgis as well as the bikers that go to the neighboring town of Arnold this coming weekend for Devil’s Den. Devil’s Den is a biker rally in which they also do a poker run to raise money for several different causes.

“It really does seem like we just arrived and started on our projects yesterday, but that isn’t the case. The connections we have made and lessons learned have been super helpful in our projects and future plans.”

JESSICA WEEDER
SERVICESHIP INTERN, BROKEN BOW, NEB.

 

On Jul. 2, the YMCA project really got moving. During that morning, we and the steering committee, which we put together, met with Denny Placzek who is the CEO/Executive Director of the Kearney YMCA. The steering committee showed their strong interest in getting a YMCA facility to the city of Broken Bow. Denny had mentioned during that meeting that he has never seen such a driven group of community members determined to get things moving so quickly.

Because the National YMCA does not currently give out any more charters for new YMCAs, we would need to be a branch of Kearney’s. Due to Kearney being in the middle of their own capital campaign, we discussed that the next step for Broken Bow would be to bring an activities/programs director in. This way, community members can get used to the idea of using YMCA programming and then potentially move into a facility in a year or so.

On Tuesday, Jul. 10, our project continued to gain momentum as we went around to area YMCAs with a few members of the steering committee to address questions as well as get a better feel for what could be in Broken Bow. The members attending the YMCA tours were Andrew Ambriz, Don Cantrel, Veronica Schmidt, Jack Lindstrom, Leanne Gamet and Jessica Weeder. Looking at the YMCAs in Gothenburg, Lexington and Kearney showed what a potential YMCA in a community this size could look like. The different directors and CEOs we met with were able to answer questions as well as bring up topics that weren’t even thought of previously.


On Wednesday, Jul. 11, we had the opportunity to tour BD, a local medical tool manufacturer here in Broken Bow. It was amazing to see the scale that they produce things such as medical tubes and cups. The entire facility has such a rhythm and it was very cool to see how every part of the factory worked together.

“We have gotten so much more done than I could have ever expected here in Broken Bow. It has been so cool to have community members ask us about our progress and be able to say that things are really moving forward.”

LEANNE GAMET
SERVICESHIP INTERN, BROKEN BOW, NEB.

 

Market on the Square continues to happen here in the community. The farther into the summer, the more and more vendors they have gotten. There is a wide variety of things from baked goods, to homemade jewelry, to food trucks that most of the businesses around the square support during the lunch hour. This week featured sidewalk sales and 92.3 KBEAR Country was on-location.

 

 

Columbus, Neb.

Recently, Dr. Helen Fagan asked us to think about the legacy that we are leaving with this community. The answer to that question revolves around the letter R. Recruitment. Reach. Retention. Results.

Recruitment. We post job openings, help design marketing materials, and help make connections that will benefit the community in the future. The best way to find out what and who Columbus really needs is to visit with businesses around the community. That has lead us to take several business tours while we are in town. This effort has also lead us to meet with various “movers and shakers” in the community. Columbus has introduced us to many people and we have been able to pick their brains on various topics related to their industries.

Reach. To reach the community and connect them with events around town, we have redesigned the community calendar, known as “GOOD Times,” and are running a campaign during the county fair to increase awareness. This calendar will include events from businesses and organizations from all around Columbus. Citizens will be able to look at the calendar and know what is happening on any given day and find events that they may be interested in.

Retention. These projects all relate back to quality of life and pride in the community. One of the quality of life events we helped with is Red, White, and Kaboom, the Columbus’s Independence Day celebration. We have also been running our 10 Days of Something Good Trivia Challenge. This event is designed to help bring awareness to the community brand and to encourage people to be proud of their community. The event is getting great traction on social media, which is really exciting! Another retention effort we are working on is the Young Nebraskans Week Conference that will take place in September. We are finalizing plans and working with our committee to gather speakers and sponsors for the event. On top of all that, we help plan and run Interns’ Night Out. This is an event for summer interns to get together and network as well as learn a little about what the community has to offer.

“Collaboration is a key element here in Columbus. Everyone is always working together. It starts with volunteers and continues up the chain of command. In this community, collaboration turns dreams into reality.”

AMBER ROSS
SERVICESHIP INTERN, COLUMBUS, NEB.

 

Results. As the summer winds down, we find ourselves looking to our hosts to see what our role was this summer. Kara Asmus, Workforce Coordinator for the Chamber, said we are encouraging people to embrace the community brand, which is what the Chamber is really trying to do. KC Belitz, Columbus Area Chamber President, said that we are getting results. “The obvious answer is that you are getting work done. There are projects we wouldn’t have gotten to this summer. We never would have done them without you guys. Your internship may end in three weeks but you’re not going anywhere!”

In sum, RFI’s involvement in Columbus this summer has been invaluable to the community. Recruitment. Retention. Reach. Results. The Rural Futures Institute has allowed us to leave a positive legacy here in Columbus.

 

 

 

Cozad, Neb.

This week, we wrapped up our Music Mondays concert series. Music Mondays have been such a success that the Cozad Development Corporation is hoping to find another group in town to continue it next year. The past few weeks we have hosted Miles From Dublin, The Wonderful World of Woody, and wrapped up the series with a children’s band – The String Beans. Attendance grew with each concert bringing the whole community together for some summer entertainment.

“It’s time to think differently about our small communities. Cozad is taking a creative approach to solving challenges.”

CHRISTY COOPER
SERVICESHIP INTERN, COZAD, NEB.

 

Two weeks ago we hosted our three finalists for ‘Pitch It Cozad: Win This Space’ for their final presentations. Our selection committee had a wonderful time hearing the business ideas and had such a difficult time choosing a winner that we created a prize package for our runner-up as well. Jody Laird won our original building and prize package with her business Double L Embroidery. The Cozad Development Corporation purchased another building in downtown Cozad so that Chelsie Michalewicz could start her business, Sweet Water Outfitters, a western boutique. Cozad is excited to build their downtown as a shopping destination with these two new businesses.

Most recently, Jen and Christy headed to Lincoln for the Nebraska Diplomats Banquet and the Nebraska Governor’s Economic Development Summit. The Nebraska Diplomats are a group of community leaders who use their personal and professional connections to promote the state’s quality of life for future business. Our lead mentor, Jen, was asked to speak about our Pitch It in Cozad project at the Governor’s Summit the next day. Governor Pete Ricketts applauded Cozad’s work during his final remarks. It was an incredible opportunity to network with other community leaders and hear the great work they are doing.

 

 

 

 

Norfolk, Neb.

Time is flying as we are already finishing our eighth week in Norfolk, Neb.! We have been primarily working with the Norfolk Visitor’s Bureau lately, while also tying up loose ends on our projects for Daycos.

Our work with the Visitor’s Bureau has consisted of brainstorming and strategizing how we can improve the retail and service sector in Norfolk. We have completed our research of secret shopping and completing windshield assessments of businesses across town. We have attended a meeting with the Downtown Norfolk Association and other strong retail business leaders to discuss our mission in Norfolk and to get their perspective. Overall, we have found some common themes: strong customer service and cross-promotion are incredibly needed for the future of retail. Therefore, we have come up with multiple strategies and plans on how to upsell and cross-promote Norfolk. We have planned to host a focus group discussion on Jul. 16 with retail business leaders to share our research and talk about what changes need to be made. Essentially, we want to communicate why it is important to create an experience for shoppers and to refer other Norfolk businesses, then brainstorm different processes on how to do that. We are also in the process of creating strategies for incentivizing upselling in Norfolk, creating a customer service training program, marketing Norfolk retail as a whole and analyzing how to improve the retail options across town. We plan to give these strategies to the Visitor’s Bureau in their final portfolio at the end of our time in Norfolk.

“Making a difference is very possible through work in a small town. Norfolk has been such a positive example of a rural community with self-determination to constantly improve. It is inspiring to think about how Nebraska as a whole can be improved through work like this in rural communities.”

SAMANTHA GUENTHER
SERVICESHIP INTERN, NORFOLK, NEB.

 

As for Daycos, we have started creating our final portfolio to give them at the end of the summer, as well. We will be facilitating a final meeting at the end of the month to share the videos, hiring process outline, and wall of aim projects that we have completed. We are very grateful that Daycos has treated us well during our summer in Norfolk. We are proud to have been a part of such a great company that we have learned so much from.

Additionally, we have continued to submerse ourselves in the Norfolk community. Big Bang Boom fireworks show debuted on Ju. 1. We were both invited to a behind the scenes get-together and were able to attend the spectacular show. We have attended a company picnic with Daycos to celebrate the beginning of summer. We have shared our project details with the Visitors Bureau Advisory Board. We have also been invited to attend and speak at the Rotary Club meetings. The Norfolk community has continued to be welcoming and warm, even after we have been here for some time. We are very grateful to be partnered with such a great community.

“We are so grateful to have Cheyenne and Samantha here this summer with us at Daycos for 5 weeks. We did not know what to expect when we applied to have RFI interns with us and were nervous that we would not have enough for them to do or have a clear enough picture about the outcomes we were hoping for with the work,” said Tammy Day, co-owner of Daycos, Inc. “How silly it was for us to worry! These young women have been an excellent addition to Daycos, are incredibly intelligent, creative and self-motivated, and have added so much value to our company that we are sorry we only have them for half the time. What a wonderful opportunity for us to work with such amazing young people who are interested in life and work in rural places. Thank you for matching Cheyenne and Samantha with us! We will be so sad to see them go.”

 

 

 

Omaha Land Bank

It is crazy that week eight is ending at the Omaha Municipal Land Bank. With only having two weeks left at the Land Bank, Sydney and Kyle are excited to start finishing up and perfecting their projects. Sydney has been able to help with many different parts of OMLB.  She has been busy working on communications with Laura. Planning and setting dates for future social media posts has took up a large part of her time the last few weeks. She has also been helping Marty, the executive director, with documenting and updating certain documents on the OMLB company eProperty site.

Throughout this whole internship it has been a learning experience. Sydney has been able to help with multiple projects and loves having the variety in her day. She has been able to talk and understand what each person in the office does and how they contribute to the Omaha Land Bank team. Each of the team members plays a vital role in the success to the Land Bank. With the Land Banks success, it seems work will only continue to build up which is very exciting. Working here has really made Sydney realize the importance of teamwork and how well the Land Bank does it. She hopes to be a part of a team like this in her future.

This week through the Land Bank, Kyle had a chance to participate in a community project that was put on through the City of Omaha Planning Department. The City of Omaha chooses a focus area where development and change should happen in a concentrated area for three years at a time. This area focused on an old street car node today located at the intersection of 24th and Pratt. In this area there is a large vacant lot that measures approximately 125’ x 165’. The goal of the group was to first walk around the neighborhood to get a feel for the area and the existing infrastructure. After about an hour of inventory as a group the Salvation Army hosted us to brainstorm and discuss with others what might best benefit the area. This grouping was of those not from the immediate area to provide a set of fresh eyes and recommendations for the Neighborhood Association in the area to look over and compare with lists they have made as well as those created by planning sessions held by the City Planning Department.

One major takeaway was to highlight that those in different areas all have the same desires for their neighborhoods and that different areas have strengths that may not be immediately apparent. Another fun fact was that the intersection was the original site of The University of Omaha. The chance to be involved in community development that will be enacted by mid-November is exciting as this is something I will see progress made on while attending school after I have finished my time as an RFI intern. In the last couple of weeks Sydney and Kyle will be looking for as many opportunities in Omaha as we can to learn from others and try to contribute a small piece of the larger picture.

 

 

 

Red Cloud, Neb.

In the last two weeks here in Red Cloud we have mostly been getting everything ready on our end for our economic development plan to be the most updated it can be for our presentation of it this Friday, Jul. 13, for city council and other members of the community. We have made a lot of updates, added a lot of information and have reached the stage where we really need feedback from key people in the community to know what we need to update and change to have it completely ready to go by the time we leave Red Cloud in less then 3 weeks. Our presentation on Friday will be given at two times during the day, and will have a PowerPoint accompanying it along with hard copies of the plan, and a flyer that summarizes the plan and the main actions from it.

We do have a final presentation planned for our last day here which will be to present the final copy of the plan and will be open to everyone in the community, but this meeting being one that is focused on getting feedback from the key members of the community it is mainly invite only. After this presentation we will be able to dive back into the economic plan and have our last two weeks to update and change it so that it is as effective as it can be.

“Looking back, it is hard to believe how little I had known about community development. In only a few weeks I’ve become far more competent and confident about what it takes to move a community forward.”

TRENTON BUHR
SERVICESHIP INTERN, RED CLOUD, NEB.

 

Over the weekend we had the opportunity to attend the Good Living Tour that was been hosted in Red Cloud this past Friday, Jul. 6. This was a great chance to attend a community event just as fellow Red Cloud citizens, and it was a lot of fun!

Other than working on our main goal these last two weeks and having some fun we have been working on some supplementary things for the plan and some other projects for the community. We picked up work on a clean up project that was started back in June, it involved working on a nuisance home in Red Cloud that the Board of Public Trust, a public group that buys and sells homes through the authority of the city similar to a land bank, owns, and is hoping to be able to sell soon. We were able to work on it this week and got all of the paint scraping done, so now it will just need painted, and a majority of the exterior work is done!

This week, Trevor has created the two resolutions and ballot language that will be needed to pass both LB840 and LB357. Meanwhile, Trenton as been working on getting everything ready for the city to apply for the leadership designation, which will most likely happen after we are gone from Red Cloud, but it is great to see the groundwork laid by him!

“Everything is starting to come together, and I can actually see what the final result of our time here will look like! I honestly never could have imagined that we could of created such a huge impact in this short of an amount of time, and I cannot wait to see what Red Cloud is able to do with the groundwork we are laying out for them!”

TREVOR HARLOW
SERVICESHIP INTERN, RED CLOUD, NEB.
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Letter from recently appointed RFI Interim Executive Director Connie Reimers-Hild, Ph.D.

July 10, 2018
  Dear advocates of a thriving rural future: It is with great anticipation that I write to you as Interim Executive Director of the Rural Futures Institute at the University of Nebraska, a role that I accepted upon the June …

 

Dear advocates of a thriving rural future:

It is with great anticipation that I write to you as Interim Executive Director of the Rural Futures Institute at the University of Nebraska, a role that I accepted upon the June 30, 2018, retirement of RFI’s Founding Executive Director Chuck Schroeder.

In assuming this role, I am full of hope for what meaningful action RFI can accomplish with you during the next year across the following areas of critical need and strength for rural areas:

  • Leadership
  • Technology
  • Rural-Urban Collaboration

I am also full of expectation—expectation for the kinds of futures we can design and build together in this time of constant change, growth and opportunity.

 

As a futurist, I must start with a discussion about the future—not just about a sustainable future for our rural areas, but our desired rural-urban futures. I see a future with:


Diverse and inclusive leadership that embraces differences in experience and skill set for mission, purpose and genuine personal growth. We must prepare ourselves and the generations of leaders to come.

“An inclusive leader is someone who is emotionally intelligent, who has the developmental capacity to bring people from all walks of life together and help them innovate and create things that didn’t exist before.”
— Helen Fagan, Ph.D.
RFI Director of Leadership Engagement


Continued exponential changes across technology, human ability and the point of innovation where the two infuse. With a realistic understanding of the challenges the fourth industrial revolution brings, we must think and strategize about the possible, not just the probable.

“I’ve looked at technology a lot for the past 30 years, and there is a graveyard of really cool, innovative technology concepts that failed to pass the people testultimately, technology has to be used by people. It’s really the interplay of how does technology meet a social or people need and, one might argue, that it’s actually the people and social needs that are more compelling.”
— Andy Hines, Futurist
Graduate Program in Foresight
University of Houston


A dynamic ecosystem of rural and urban challenges and opportunities overlapping and coinciding for win-win scenarios. Through our recent work with Microsoft, Tufts University and the Japan Society, we know our future is not mutually exclusive based on geography. In fact, we are incredibly interdependent on the success of each other. A mindset of abundance can generate new opportunities.

“To think that the challenges that are faced and the solutions are always totally different in rural environments, whether it’s in Nebraska or in Honduras, or anywhere in the world, and that they are also totally different from the challenges in urban areas—I actually don’t believe that. There are differences, but there’s also similarities.
— Tim Griffin, Ph.D.
Director of the Agriculture, Food and Environment
Tufts University

 

It is also with great gratitude that I enter this role.

Gratitude to my family, friends, mentors, colleagues, members of the RFI team, and the students, organizations and communities that continue to support our work. My ability to serve in this role is only possible with the support of others, especially my husband and two children.

To Chuck Schroeder, thank you for your wisdom and your incredible relationship building with mavericks across Nebraska with whom we will continue to call upon out of incredible respect for their expertise, work ethic and fundamental belief in a thriving rural future.

To Mike Boehm, University of Nebraska Vice President of Agricultural and Natural Resources; Susan Fritz, University of Nebraska Executive Vice President and Provost; and Hank Bounds, University of Nebraska President, thank you for your vision. It is because of your leadership that the Rural Futures Institute continues the University of Nebraska’s priority to truly impact the lives of rural people.

 

I would be remiss if I did not provide an update regarding our recent past. RFI’s budget reductions during the 2017-2018 fiscal year were wild cards that significantly impacted the trajectory we set out in our July 2017 strategic plan. We have removed staff, and we are now in the midst of transitioning our meaningful programs.

RFI Fellows. The formal commitments of the inaugural class ended June 30, 2018. The intention is to create a second, smaller class, but on a delayed timeline.

RFI Competitive Awards. RFI will no longer fund research and teaching projects; however, we will continue to share impacts and outcomes of projects in progress. We are exploring other opportunities to stimulate innovative research and teaching projects in conjunction with communities and partners.

RFI Student Serviceship. The summer 2018 experience will be the final experience under RFI administration. The program is currently being led and evaluated by Dr. Helen Fagan, and she is working to transfer leadership to the University of Nebraska–Lincoln College of Agriculture and Natural Sciences.

Connecting Young Nebraskans. CYN has been transferred to the Nebraska Community Foundation, though it is our understanding that its vision will remain under the CYN Steering Team.

While these direct outcomes of the budget reduction are difficult, we are choosing to create needed focus for RFI’s energy and needed clarity around RFI’s role within the University of Nebraska system, the state of Nebraska and as a catalyst of innovation for rural areas around the country.

 

In my anticipation, I ask of all of us—together, let us be creative in our thinking, collaborative in our work, resolute in our strategy and bold in our storytelling.

Thank you for you for your time, dedication and advocacy. Our passion for rural areas in Nebraska, the U.S. and the world ignites our energy and our collaboration with you is the vessel by which we can work together toward thriving rural futures for all.

 

Sincerely,

Connie Reimers-Hild, Ph.D., CPC
Interim Executive Director & Chief Futurist
Rural Futures Institute
University of Nebraska

 

Dr. Reimers-Hild’s Bio

Strategic Foresight

Rural Futures podcast

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