The Need Rural Americans grapple with:• Access to Quality Care • Severe shortages of healthcare

providers • Private Foundation Dollars: The

upper Midwest received only 1.3% of private foundation dollars allocated in 2007.

Rural Healthcare Program Principals • Strengthening healthcare institutions

in rural communities • Fostering incentives for physicians

to serve rural areas. • Support the development and

training of healthcare personnel • Increase the use of computers and

technology to allow for long-distance specialty consultation

The Leona M. and Harry B. Helmsley Charitable Trust

Established in 1999, The Trust supports a diverse range of organizations with a major focus on health and medical research, human services, education and conservation.

Focus Areas of The Helmsley Charitable Trust• Type I Diabetes • Digestive diseases research • Conservation• NYC education, S. Bronx• Legacy giving• Rural Healthcare Program

Rural Healthcare Program Focus

• Cancer Care• Health Technology Delivery• Healthcare Workforce Preparedness

History of Rural Healthcare Program

• January 1, 2010: first staff hired• Only office outside of NYC• One of five focus areas of the Helmsley Trust• Currently 4 on staff• Portfolio of $100

million in 98 grants

Cancer Care

• Fund equipment upgrades from analog to digital mammography

Digital Mammography Funded

• North Dakota 7 • South Dakota 12 • Nebraska 7 • Wyoming 7• Minnesota 2

Total 28 $17million+

Cancer Treatment

• Electron Beam Therapy • Brachytherapy• Digital Breast Biopsy

• North Dakota 2 projects• South Dakota 2 projects• Total: $11 million+

Intra Operative Electron Radiation Therapy (IOeRT)

Health Technology Delivery

Avera eCare™ Services

eEmergency 26 sites live,16+ in implementation

5 states $11+ million

Physician in Hub

Nurse and patient in remote emergency room

eEmergency Benefits

• Over 900 patients impacted (Up to 25% of all ED patients at some facilities)

• Avoided 190 unnecessary transfers• Increase of admission revenue est. $615,000, or

$2,800 / month / hospital• Influenced recruitment of 2 physicians• Reduced door-to-physician time

– When eEmergency was used prior to local physician arrival, eEmergency physician saw the patient an average of 25 minutes before local physician

ePharmacy 19 sites live, 7+ in progress, 4 states

$7+ million

ePharmacy Benefits

• 6,000 patients impacted• 1,200 serious safety events avoided• Hospitals meeting CMS requirements for 24-hour,

first dose review by a pharmacist• Significant cost savings achieved through avoided

adverse drug events and implementation of automated dispensing units

Avera eICU® CARE 33 hospitals – 125 beds

6 states, $6,084,291

eICU® is a registered trademarkof VISICU, Inc.

Avera eICU® CARE Benefits

• 27,000 patients monitored since 2004• Saved 601 patient lives• Reduced length of stay 25%• Reduced patient transfers• Improved use of evidence-based medicine

LivingWell@Home

Largest not for profit long term care provider in the nation.

Locations in 22 states

Goal: To Help Seniors Enjoy Life (in their own home)

1 grant – 5 states - $8,154,981

Elderly Care

• Fastest growing segment of the population

• Elderly want to stay in their own home• Technology now available to help

them live well in their own home• Will save the government, private

payers, and citizens money

Technology & Services include:

• Sensors in homes • Telehealth equipment • Home and community

services by registered nurses and social workers

RN at monitoring station

To deploy and test efficacy of three technologies to support independence among at-risk seniors living in community settings.

Telehealth (Genesis DM by Honeywell)Personal emergency response system (Philips)

Sensor technology (WellAWARE)

Study Purpose

Research Portion of the GrantHypothesis:

• Reduce health care costs (e.g., out-of-pocket costs and costs to payers such as health systems, Medicare and Medicaid)

• Reduce overall utilization of medical services

• Yield better health outcomes (e.g., self-reported health status, quality of life and functional independence)

• Delay transitions to higher levels of care

Pre-Hospital Care and Training

American Heart Association $8,428,494Mission Lifeline SD

South Dakota Dept. of Health $5,580,725Simulation In Motion- South Dakota

•Comprehensive system of care for heart attack patients

•Enable pre-hospital diagnosis and activation of sophisticated treatment directing ambulances to the best available hospital

•Reduce mortality and disability rates for all heart attack victims

•169 Ambulance services will receive 12-lead ECG with technology to transmit directly to six hospitals capable of performing life-saving angioplasty

First statewide project of it’s kind for American Heart

Train emergency response personnel and healthcare professionals to provide optimal responses to trauma and other emergency medical cases.

Goals

• Enhance quality of care for trauma patients

• Enhance training of pre-hospital and hospital personnel in all hazard preparedness

• Strengthen relationships and transitions between pre-hospital and hospital personnel to assure consistency of care

First such training program of it’s kind world-wide

Collateral Initiatives

• National Rural Health Association

• Gold Standard study of eCare

• Public awareness events eExploration for partners and payers

• Journalism training and rural fellowships

• Opportunity Grants – Abbott House – Children’s Home

Society – St. Francis House – SD Wildlife

Foundation – Farm Rescue

Impact of The Helmsley Trust Rural Healthcare Program

• $100 million committed to Rural Healthcare in 6 states.

• Commitment to make projects sustainable and replicable

Vision for the future

• Continue to support eCare (telehealth) projects for Critical Access Hospitals

– We have currently touched only 19% of the 301 Critical Access Hospitals in our area

• Replicate Mission Lifeline in other upper Midwest states

• Enhance cancer care to reduce treatment time and travel for rural patients

• Use state of the art technology to attract and support the rural workforce

• Investigate partnerships and models for tele- behavioral health services

• Investigate tele-cardiology• Invest in healthcare

educational programs & workforce development (Grow Your Own nursing, PA/NP & physician rural residencies, etc.)

How can we help you provide the best patient care possible in your area?• We want to hear from you• First annual Helmsley Rural Healthcare

Partners meeting (Save the date: September 29, 2011)

• Thank you for what you do every day! “Whether you live or die shouldn’t depend on where you live.” --telemed physician @ ATA