Grantee Spotlight – MN RMOMS

To date, what has been the biggest accomplishment or win in your program?

Johnna: We have successfully hired two high-risk obstetrics care coordinators at two of our sites. This has changed how our patients are cared for and how our practice functions. We are already seeing the positive impact in terms of ensuring that patients are connected with community resources during pregnancy and postpartum follow-up. The coordinators are helping patients get better transportation and other things that are missed in the hustle and bustle of a busy clinical practice. But, it is important and is directly tied to some of the improved outcomes that I have seen personally in some of my patients with high-risk conditions like type two diabetes in pregnancy.

Lisa: We formed a very cohesive project team and governing board structure. We really strived to make sure everybody has an equal voice at the table. Sanford Health is the grant holder, and we are a very large health system, but we really wanted to be very strategic in setting up a structure in which Sanford does not have a larger voice at that table than our other partners. Everybody on the team feels that they can raise questions, concerns, and we have had robust dialogue that is opening more doors for collaborations.

What is a tip that you would share with an organization launching a similar RMOMS program?

Lisa: From an administrative standpoint, it is really important for other awardees to think about who is going to be that day-to-day administrator of the grant. So many people wear multiple hats and do not have the capacity to spend an hour or two hours each day. But for this person, this is her sole job and I think if it was not for her in this role, we would not be as far as we are.

Johnna: Another bit of advice is to keep in mind how much time it can take to get service agreements, particularly legal agreements done when you are working on a project with two entities. That was an unanticipated challenge for us. We are making progress, but it takes a lot of time. I would even suggest that if you are thinking about doing a project that would involve having to communicate between different medical record systems or if there is data sharing happening between two different entities, get those relevant players involved in the grant planning and initial application process as early as you can.

Lisa: Yes, we did not have our legal partner or IT partners at the table early on. We did not think about all the behind-the-scenes things, so I totally agree that that was a blind spot we were not aware of early on.

How do you see participation in the Federal Office of Rural Health Policy’s RMOMS grant program impacting your broader health improvement efforts?

Lisa: The platform that we are implementing will eventually be able to be used for other specialties outside of obstetrics. We are starting with maternal patients and getting them to their appointments. But we are already having bigger conversations about non-emergent medical transport and how do we help with discharges from our hospital? How do we get an individual in for an appointment for heart failure management? We are really looking at this from a sustainability perspective using this as a foundation for women’s health but expanding it to our entire community population. Our entire community has multiple social determinants of health that we can help them address and that is how you can change the overall health outcomes in a community.

Johnna: This is challenging us to rethink the staff and the personnel teams that we put together in order to deliver comprehensive care to patients, whether that’s in an OB clinic or a primary care clinic. We are finding that there is extra support needed in order to really meet the patient’s needs — the social needs and economic needs. We are going to see some significant changes in the type of personnel you see in a typical office practice in order to support that work.

What will your organization be doing more of or differently to emerge stronger from the pandemic?

Lisa: One thing the pandemic has taught health care, in general, is you can make rapid change occur. It taught us it is okay to think outside the box and take those risks and you can implement things a lot faster than four or five years ago.

Johnna: Now that we have been utilizing telemedicine for a couple of years, we are looking at expanding how we utilize it and are seeing different applications. I think we are going to start to see some more data coming out from different institutions showing that doing care delivery remotely isn’t inferior to traditional care and it might be an acceptable model in places where we really struggle with access to specialists, transportation issues, distance, and things of that nature. We can really make a positive impact by meeting patients where they are.