October 28, 2009

Udall: Rural America Spurs Health Innovation

Speech is Fifth in a Series on Health Care by Senate's Freshman Class


WASHINGTON – U.S. Senator Tom Udall, D-NM, and eight of his fellow freshman senators took to the floor of the U.S. Senate today for the fifth in a series of speeches to highlight the need for health insurance reform. This week the senators used their remarks to discuss how communities across the nation are spurring innovations in health care that should be incorporated into reform.

Udall used his remarks to highlight two programs in New Mexico that are helping rural communities provide quality, affordable health care to their residents, who are more likely to be uninsured than their urban counterparts, have higher rates of chronic disease and often must travel hundreds of miles to receive medical care.

The following is Senator Udall’s speech as prepared for delivery:

“Last week, during our gathering of freshmen senators in this chamber, I talked about how health care reform must benefit rural America. As I explained then, rural Americans face unique challenges in finding quality, affordable health care. And rural health care systems face increased strain due to doctor shortages and insufficient funding.

“Successful reform hinges in large part on how we meet the challenges of health care in rural America. But what many might not realize is that rural America – precisely because of these challenges – has become an incubator for the very innovation that will help us achieve our goal.

“Rural America is trying to meet these health care challenges head on with innovative programs in communities across the country. In the process, they’re offering a blueprint for the nation as we work to enact reform that will benefit all Americans, no matter where they call home.

“In my home state, several innovative programs are already paying dividends. The two I’d like to talk about today are the result of partnerships between our rural communities and one of our key academic institutions – the University of New Mexico.

“Academic health centers like the one at UNM have the potential to be hubs of knowledge and expertise not just for the communities where they are physically based, but for the entire state. UNM recognized this potential and reached out to partners in rural areas throughout New Mexico. They asked two basic - but often overlooked – questions: “What do you need?” and “How can we help?”

“What emerged from these conversations was the development of a statewide Health Extension Rural Office program. Through this program – which we call HERO for short – agents live and work in the communities they serve, and act as liaisons and resources to health partners in the area. We know this extension model for agriculture, and we’re proving it can work for health services, too.

“Here’s one example: In the frontier county of Hidalgo in southwest New Mexico, HERO agents discovered that the community needed help recruiting local health professionals. To meet that need, HERO helped establish a partnership between UNM and community providers to offer free local housing for UNM medical residents during their regular rural rotation.

“It was a win-win for everyone. Hidalgo County got increased access to doctors and other specialists. The doctors got free housing during their rural rotations. UNM increased its profile and reputation in Hidalgo County. And the communities got the opportunity to persuade these young doctors to continue their medical careers in the area.

“That’s just one example of HERO’s work.

“In addition to increasing the number of doctors in a community, HERO also helps develop plans for addressing health issues like diabetes and teen pregnancy; for retaining pharmacy services after a community loses its only pharmacist; or for establishing a “one-stop-shopping” model for medical, dental, behavioral health and social services.

“In addition to its work with the HEROs project, UNM also is achieving breakthroughs in the delivery of medical care through a project founded by one of its physicians – Dr. Sanjeev Arora. It’s called Project ECHO – which is short for Extension for Community Healthcare Outcomes.

“Back in 2002, Dr. Arora was a physician specializing in Hepatitis C. He had become increasingly frustrated with lack of treatment options for the thousands of New Mexicans suffering from the disease. Many of these patients lived in the state’s rural and frontier areas. There just weren’t enough specialists to treat them – and local providers often didn’t have the expertise to provide treatment themselves.

“What Dr. Arora did was establish what he calls a “one-to-many” knowledge network, which includes a specialist and up to 40 rural providers. The doctors meet by videoconference to co-manage patients and to eventually teach these rural medical professionals to be mini-specialists themselves.

“Over the years, what began as a program designed to treat hepatitis C patients has grown and expanded. Today, it includes more than a dozen “knowledge networks” and tele-health clinics on a wide variety of specialties – including HIV, diabetes, pediatric obesity and psychotherapy.

“In closing, Mr. President, I believe these two programs – along with other initiatives discussed by my freshman colleagues today – are strong reminders that American innovation doesn’t always begin in the halls of Congress or down the street on Pennsylvania Avenue. Historically, the greatest American innovation is a grassroots phenomenon, bubbling up from individuals and communities across America, from enterprising folks who recognize a problem and work together to develop a solution that best meets their needs.

“This health reform remains a work in progress. It’s our job as legislators to seek out programs like HERO and Project ECHO, to seek out these best practices, to find programs that work. And it’s our job to expand on that knowledge and ingenuity for the benefit of all Americans.”