Episode 3 | Rural Health Care Access

Nov. 9, 2017

Show Notes:

Access to quality health care is one of the critical issues in determining a rural community’s capacity for thriving. Today, on Catch Up With Chuck, Chuck is joined by Nemaha County Hospital CEO Marty Fattig, who serves as a RFI Community Innovation Fellow.

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Full Transcript:

[0:10] Good morning. [0:11] Welcome back to Catch Up With Chuck, [0:13] a periodic live broadcast from the Rural Futures Institute [0:17] at the University of Nebraska. [0:19] I’m Chuck Schroeder. [0:20] I’m executive director of the Rural Futures Institute. [0:24] Today we’re gonna be talking about rural health care. [0:27] One thing we know is that access to quality health care [0:31] is a critical issue in determining [0:34] a rural community’s capacity to thrive. [0:37] So it’s a key concern for the Rural Futures Institute [0:41] and we’re gonna be talking about that. [0:42] Now, if you have questions or comments as we go, [0:45] I’m gonna ask you to post them. [0:46] We’ll try to respond during the broadcast. [0:49] If we can’t, we’ll get back to you one way or the other.

[0:51] Well listen, I’m so pleased, joining me today [0:55] is a friend and colleague, Marty Fattig, [0:58] who is really on the frontline of this very important issue [1:02] for rural Nebraska and rural America. [1:04] He’s both a CEO of a successful rural hospital [1:08] in Auburn, Nebraska, but Marty is also [1:11] a very important voice at both the state and national level[1:15] on both policy and the practice of delivering [1:19] effective rural health care. [1:22] And I want to quickly add that Marty is, [1:25] were proud to say, part of the inaugural class [1:28] of RFI fellows. [1:30] So Marty, thanks for joining us and talk just a little bit [1:34] about your really interesting background.

[1:36] Well thanks, Chuck. [1:37] And it has been a real pleasure to be involved [1:38] with the Rural Futures Institute and to be a fellow [1:41] for that matter. [1:42] I grew up in a small town in Wallace, Nebraska, [1:44] out in southwest of North Platte. [1:46] I tell my city friends that I graduated third in my class [1:50] and didn’t make the top 10 percent, to give you an idea [1:53] about the size of school I graduated from. [1:56] After that, I went to North Platte Junior College, [1:59] frankly because I was poor and I could afford to go [2:01] to Junior College. [2:03] With Kearney got a degree in medical technology,[2:06] which is clinical laboratory science. [2:08] Worked in a laboratory for a number of years.[2:10] Went to work in Grant, Nebraska. [2:12] Worked in Grant for 16 years, [2:13] then went to Scottsbluff for seven years, [2:16] to McCook for four and now I’ve been in Auburn [2:18] for 15 years, all of it in rural health care [2:22] because I like rural.

[2:24] Well Marty, you have demonstrated that [2:27] a small town kid can have an impact [2:30] and not only at the community level, [2:32] but state and national. [2:34] Well listen, you’re involved in a number of initiatives [2:36] relative to rural health care, but recently [2:39] you and I have been working together on a task force [2:42] that you assembled.[2:43] A very broad based task force addressing the question [2:47] how do we effectively deliver health care [2:50] in rural communities in an era [2:52] where there may be fewer hospitals, and by the way, [2:55] how do we do that without simply turning to government [2:58] for more and more investments? [3:00] So could you talk a little bit about that task force?

[3:02] Certainly, that task force has been a lot of fun [3:05] and been very, I think, enlightening [3:08] about some of the ideas that have come out of it. [3:11] It all started when a friend of mine came to me. [3:15] She is actually the president [3:17] of the Nebraska Rural Health Association [3:19] and said, Marty, how are we gonna maintain health care [3:23] in these rural communities if they can no longer [3:25] support a hospital? [3:28] And I said, I don’t know, but we probably oughta find out. [3:31] And Leslie Marsh out in Lexington asked me that question [3:34] and since that time, we have put together [3:38] a group of colleagues from various backgrounds [3:41] across the state. [3:43] A lot of the association type people [3:45] that deal in health care. [3:47] The Medical Association, The Hospital Association, [3:50] The Long-term Care Association.[3:53] We’ve involved Academia and the Rural Futures Institute [3:57] and the Nebraska Rural Health Association [4:00] along with some other colleagues that I know [4:01] are just great policy and good thinkers.

[4:05] Yeah, and some CEOs like yourself [4:06] that are progressive and doing cool things.

[4:10] Yeah, exactly. [4:11] Yeah, we have that and we have to have some of those people [4:13] in there too, I guess.

[4:15] I have been so impressed with the diversity [4:17] of the group you put together, Marty. [4:20] And it’s led to some really high quality conversations [4:24] that get down to how do we really answer this question. [4:27] Well one of the potentials that was identified [4:30] really came out in our last meeting last week, [4:33] is the potential for the creation [4:35] of regional collaborations, cooperatives, if you will, [4:39] which is a big deal here in Nebraska [4:43] that can strategically share resources [4:46] in order to achieve cost effective, [4:50] as well as people effective solutions. [4:53] There’s some real world examples going on [4:55] and I thought you might want to talk about those.

[4:57] Well, a lot of these examples are just in their infancy, [5:00] but we are getting started. [5:03] I think it was very useful for this group [5:07] that we’re meeting with, being rural people, [5:10] they said, why can’t we do what agriculture has done [5:14] and develop these cooperatives, [5:16] which have been quite successful in rural areas, [5:19] especially in Nebraska. [5:20] So that is actually being done out in the central [5:24] part of the state. [5:26] Holdrege and Lexington and Minden [5:29] and Alma and Cambridge have formed a cooperative out there [5:34] and they’re doing some things together. [5:35] They’ve been together a little over a year [5:37] and they’re starting to do some work together. [5:40] Jim Orrick in New York hospital is talking about [5:43] getting together with some of his colleagues [5:45] and seeing what they can do collaboratively. [5:48] Whose had some success previously. [5:50] Previous success when he was at McCook [5:52] working with the Oberlin Hospital. [5:54] Even across state lines this works. [5:56] And I have the intention that I’ve been sending out emails [5:59] and talking with CEOs in southeastern Nebraska [6:03] to see if we can get together and talk about [6:04] some things we can do collaboratively.

[6:07] Marty, what I thought was especially interesting [6:09] in those conversations is we got down to okay, [6:12] what are the key elements and two things came out. [6:16] Number one, the effective use of technology. [6:19] We talk a lot these days about Telehealth [6:21] and its potentials. [6:23] I mean, ranging from record sharing to virtual reality. [6:27] You know, from diagnostics to ways in which [6:31] patients can stay in their home longer, self-monitoring. [6:34] So the technology is important. [6:36] But what also came out is, you know what, [6:40] it’s all about leadership. [6:41] It still comes down to if we’re gonna create [6:43] regional collaborations. [6:45] It comes down to leaders who are able [6:49] to build relationships, who are able to build [6:52] trust relationships. [6:54] Across borders, that we know historically [6:57] are not easy to cross. [6:58] But those seem to be the key elements. [7:01] Am I on track?

[7:02] You’re exactly on track, Chuck. [7:05] The RFI talks a lot about just being a high tech, [7:08] high touch time in our life [7:12] and in development of rural areas. [7:17] We see the same thing in health care [7:20] that we talk in health care, I was just in a meeting [7:25] on the east coast the other day [7:26] and they talked about the successes in a hospital [7:33] many times are 80% [7:39] based on process, 20% based on technology [7:43] and 100% based on culture. [7:45] So I don’t think we can forget that culture piece either [7:49] because it is so important in whatever we do.

[7:51] I’ve heard you say that and, by the way, [7:53] I’ve been to Nemaha County Hospital [7:55] and seen it demonstrated just hanging around there with you. [7:58] The kind of collaborative relationship [8:02] that you’ve established, not only with your staff [8:05] from docs to janitorial services, [8:09] but the relationship you have with your patients. [8:11] They see that and it influences the way they feel [8:14] about their health care.

[8:17] Listen, those of you that have seen [8:19] the Rural Futures Institute’s strategic plan [8:22] that we developed early this year, [8:25] you know that our big hairy audacious goal [8:29] is a thriving high touch, high tech future [8:33] for Nebraska and the Great Plains by 2040. [8:36] We are so pleased to be working with leaders [8:38] like Marty Fattig and a key element of that [8:41] in the health care realm and, by the way, it goes beyond, [8:43] but who are demonstrating on a daily basis [8:46] the high tech, high touch approach,[8:48] how it can be done effectively and, by the way, [8:52] create a genuine brighter future for rural. [8:56] So we’re gonna be collaborating in the coming months. [8:58] We had a little meeting before this broadcast this morning [9:00] talking about how the Rural Futures Institute, [9:04] working with Marty and others in the health care, [9:07] community leadership, cooperative realm, [9:11] can in the coming months do the three things [9:13] that we think we do well at RFI. [9:15] Number one, convening diverse talents [9:17] around a critical issue. [9:19] Number two, contributing to the future by highlighting [9:23] some important potential solutions. [9:26] And number three, celebrating rural successes.[9:28] Really elevating the voice of rural for those folks [9:32] that are out there making a difference. [9:34] Marty, you’re a leader who is helping [9:37] to genuinely build hope for rural communities. [9:40] We’re proud to be associated with ya. [9:42] Thanks for what ya do for your involvement [9:44] with the Rural Futures Institute [9:46] and let me give you a chance to say [9:47] whatever else you might like to today.

[9:49] Well thanks for this opportunity, Chuck. [9:51] It’s been great to get together with you again [9:53] and we always have a good time when we get together. [9:55] But I think it’s really important to note [9:57] that you have done a lot of work on the key elements [10:00] of building a successful community, [10:02] a vibrant, progressive community.[10:06] And what I have learned in my association with you [10:09] and with Rural Futures Institute [10:11] is those same elements are vitally important [10:14] to successful health care organizations. [10:18] We need to do exactly the same things [10:20] that you try to develop in rural communities. [10:25] So it’s important, I think, that we work together [10:27] for the success of both our organizations.

[10:31] Collaboration is the key. It sure is. [10:33] So listen, I just encourage you to stay in touch [10:36] with the Rural Futures Institute through our [10:39] newly redesigned website. [10:41] We’re pretty proud of that. [10:42] And know that we’re gonna be back [10:44] with Catch Up With Chuck in weeks ahead. [10:46] Again, looking at people and places, [10:50] innovators, leaders who are making rural communities [10:55] the best choice for worthwhile living. [10:57] Thanks for being with us.

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