JUNE 2001

Table of Contents

Regional Programs

Area Health Education Centers
Rural Outreach
Designated VA Outpatient Clinics
The Fight against Tobacco
Delta Health Education Center
M*A*S*H* Summer Program
Rural Hospital Program
Video Teleconferencing
Rural Service Highlights

Area Health Education Centers

The Area Health Education Centers (AHEC) Program was founded in 1973 as the primary educational outreach effort of UAMS and the principal means of decentralizing and distributing medical care and health education in Arkansas. (See Figure 1.) Six centers – in El Dorado, Fayetteville, Fort Smith, Jonesboro, Pine Bluff and Texarkana – serve as training sites for students in the fields of medicine, nursing, pharmacy and allied health professions. Two of these centers, Fayetteville and Jonesboro, have developed satellite clinics in Springdale and Mountain View respectively. Many medical residents specializing in family practice complete a portion of their training at these sites. 410 family physicians previously trained at AHEC sites now practice in 102 Arkansas communities including 64 of the state's 75 counties.

Through Initiated Act 1 and subsequent actions by the Arkansas General Assembly and the Governor, residents in the Delta region of the state will soon enjoy the benefits of the AHEC Program right in “their own backyard.” A seventh Delta AHEC will be established in Helena and will have two satellites, one in West Memphis and another in Lake Village.

Figure 1. AHEC Resident Practice Locations, 1976, 2000.

Rural Outreach: Overcoming the boundaries of distance and access, AHEC faculty physicians, residents, and staff provide and continually improve its services in health-care fields to the people of Arkansas, including those living and working in rural and medically underserved areas. (See Table 1.) Community partnerships emphasize the preparation of health-care providers and encourage young physicians to locate and practice in rural areas.

Table 1. Rural Clinical Training Sites in Health Professional Shortage Areas.

Designated VA Outpatient Clinics

AHECs in Jonesboro and El Dorado also serve as federally recognized community based outpatient clinics in association with the Veterans Healthcare System. Veterans from outlying regions of the state can now access quality health care much closer to home.

Tar Wars: The Fight against Tobacco

The anthem of many anti-smoking education programs is, "Start with the young." Recognizing this, a family physician initially developed "Tar Wars" and hoped it might become a model program for the nation. It grew into a national phenomenon and is now sponsored in 35 states – including Arkansas – by the American Academy of Family Physicians and the Society of Teachers of Family Medicine.

The faculty and residents of the AHEC/Northeast in Jonesboro fight the “tar wars” battle where it can be waged most effectively – in fifth-grade classrooms with 10- and 11-year-old youngsters. This is the age of easy vulnerability to advertising by the tobacco industry and a time of "first experimentation" with tobacco in several forms.

Directed by Dosha F. Cummins, Pharm.D., and armed with about 80 color slides and curriculum materials, the residents present educational programs in local schools. Begun about five years ago in the Jonesboro area, this proven program is now active in Craighead County at four Jonesboro schools and one county school. Every school year, about 80 to 100 fifth-grade students see and hear "the rest of the story" that the tobacco industry doesn't want them to know. A major feature of the program is its Poster Contest for the students, and the residents serve as judges. Local and state contest winners have gone on to the national level of this competition. Approximately 500 fifth graders in northeast Arkansas have benefited from this health education outreach effort.

Delta Health Education Center

Created in 1990, the Delta Health Education Center (DHEC) has the mission of improving the health status and health care delivery to citizens of the Arkansas Delta – Chicot, Crittenden, Desha, Lee, Monroe, Phillips and St. Francis counties. DHEC fulfills this mission by providing direct health education to residents, facilitating partnerships among rural Delta communities and health care professional training programs, and coordinating resources to maximize the impact of available health care. Since 1995, DHEC has provided direct services to over 19,000 Delta residents. During the five-year period from 1995 to 2000, health-care services increased 41 percent for children, 179 percent for youth and 160 percent for adults.

Medical Application of Science for Health (M*A*S*H*)

Begun in 1988, the Medical Application of Science for Health (M*A*S*H*) was developed to stimulate young people to explore the application of scientific concepts in the healthcare field. Through a variety of experiences, students interact with a large number of health care experts, such as physicians, nurses, medical technologists, radiological technologists, respiratory therapists, pharmacists, and dieticians. With a special emphasis on rural youth, M*A*S*H has allowed teenagers to experience the real world of medicine, nursing, pharmacy, dentistry, and allied health with the hope that they will pursue a health career and, ultimately, bring those skills back to their home towns.

Since 1988, more than 3000 students from 71 of the state's 75 counties have participated in this summer enrichment program. In survey results, 90 percent stated that the M*A*S*H* experience caused them to consider a healthcare profession. More than half of those enrolled in college at the time of the survey were majoring in a healthcare career. As of May 2000, there were a total of 42 former participants enrolled in UAMS colleges:

22 in medicine
11 in pharmacy
5 in nursing
4 in health related professions.

Rural Hospital Program

Rural hospitals are essential for delivery of basic and emergency medical care in rural Arkansas. If primary health care is not available locally, it must be sought elsewhere. This often creates a serious burden on residents, so many will seek care only after becoming very ill, which will make treatment more expensive and outcomes less certain.

The economic life of a rural community is closely tied to the viability of its hospital. A small community hospital in Arkansas contributes an average of $24.5 million to the community in which it is located. Many hospitals in small Arkansas communities are struggling to survive. Nine have closed within the past ten years.

Established in 1991, the Rural Hospital Program based within the AHEC Program at UAMS strengthens rural hospitals in Arkansas by sharing resources. Its goals are to:

• create an environment where rural hospitals define the needs of their own communities
• demonstrate cost-effectiveness
• expand health-care resources and access to quality health care

List of rural hospitals affiliated with UAMS

Video Teleconferencing

The Rural Hospital Program extends rural health care delivery in Arkansas through TELEHEALTH/Telemedical Communications, an interactive video network that links UAMS to 42 hospitals across the state. (See Figure 2.) Arkansas is the only state that currently has this capability within 30 miles of every hospital as show by this map.

Through the TELEHEALTH/Telemedical Communications network, community physicians and affiliated rural hospitals can instantly share medical information with specialists at UAMS. By exchange of x-rays, EKGs, heart and lung sounds, and related medical information, a local physician can collaborate with a UAMS specialist and present a diagnosis and plan of treatment. Patients can receive optimum medical care in a local hospital and avoid both the cost and emotional distress of travel to a distant facility.

Figure 2. UAMS Compressed Video Network.

Service Highlights

To date, more than 500 UAMS faculty and staff have committed their time, energy and expertise to delivering services to rural hospitals. They have contributed hundreds of hours of continuing medical and health education courses, staff development, mini-residencies, outreach clinics and patient consultation. During the fiscal year ended in June, 2000, UAMS provided services to 51 rural counties and offered:

• 255 clinical patient consultations
• health education to 10,421 consumers
• 875 patient care and specialty clinics
• 3,486 workshops and staff development courses
  

Rural Hospital Program (RHP) affiliates received more than $4.5 million in grant funds because of the writing and editorial support of the RHP staff.

© 2001 University of Arkansas for Medical Sciences
Division of Institutional Advancement
4301 W. Markham St., Slot 716
Little Rock, AR 72205
501-686-5685

06/25/01