Issue Area 1: The Advisory Panel
needs to be prepared to track important outcome measures in order to determine
if its initiatives are successful in retaining health care professionals
in rural areas.
The Rural Health Initiative Act of 1991 declares that refocusing health sciences education will aid in the recruitment of health care professionals and their retention in the state, and improve the availability of health care services in the state, especially in rural areas. The Act also created the Rural Health Advisory Board to oversee the implementation of the rural health initiatives. The Legislature established 15 goals under the Rural Health Initiative Act.
The Legislative Auditor's review indicates that the Advisory Panel has accomplished many of the Legislature's goals. These goals serve as the foundation or infrastructure of a refocused health sciences educational process towards improving the state's retention rate and improving the availability of health care serves in under served areas. It is expected that with much of the refocus in place, the desired outcomes will be achieved. However, the initiatives take several years before any changes can be measured. Also, it is not clear to what extent the initiatives will be successful. The Advisory Panel will soon approach a critical point in which the restructured health sciences educational process will begin to show results. However, the Advisory Panel is not in good position to measure outcomes that will indicate if the program has been successful and to what extent. Currently the Advisory Panel receives its tracking data from different agencies. These agencies are not linked and the data reported from these agencies by the advisory Panel leaves gaps in trying to follow progression of Health Care Professional Students. The time has come for the Advisory Panel to establish a consolidated tracking system. Through this in-depth tracking the Advisory Panel can help in identifying the effectiveness of its programs in retaining health care professionals, especially primary care physicians in the rural parts of the state. This is important because if the program results in little or no success, problems and solutions will have to be identified.
The advisory panel is required to issue a report to the Legislature on the recruitment and retention of medical personnel. In review of the reports from 1997 to 2000, it appears that from 1997 to 1999 there is no data on the retention of medical personnel (those completing training and starting practice in West Virginia). In the 2000 report of the Recruitment and Retention Committee, the committee displayed its retention figures in a chart containing seven disciplines. The seven disciplines on the chart of West Virginia Health Professions provided accumulative information from 1991 to 1999. This data was provided by sources outside the Advisory Panel and put together by the Panel for its report. The data on practice sites of graduates was provided by the three medical schools in West Virginia then verified by the WVRHEP site coordinators. This data is most likely a low estimate since only those practitioners who could be verified were counted. The data on financial incentive programs were provided by the Bureau for Public Health and the University Systems of West Virginia (now the West Virginia Higher Education Policy Commission). First, the Advisory Panel is using accumulative information in its reporting. This makes it impossible to view the year-to-year trends. The committee is not tracking the number of West Virginia residency graduates entering rural practice in West Virginia to see if the State is retaining an increased number each year or if we are losing these trained individuals to other locations. The committee is not tracking the total number of physicians in rural practice to see if the program has impacted the rural areas by increasing the number of physicians each year, if the state is maintaining the same number year-in and year-out or if the number of rural physicians is decreasing each year. In a statement from the Vice chancellor for Health Sciences, it was stated that:
This year, WVRHEP staff are working with a consultant to put in place a longitudinal tracking system that will enable us to gauge the impact of rural training and financial incentives over time. We are also developing a survey instrument to identify the factors that influence student career choices and location decisions. The purpose of the survey is to see if curriculum changes are needed and to improve recruitment and retention of graduates. Although we will not see the full impact of rural training on the location of medical school graduates for several years, we have seen an increase in the number of graduates entering residency training in West Virginia and choosing primary care fields. Both of these hold promise for retention of our graduates.
In review, the Advisory Panel has addressed and made significant improvements in the issues put forth by the West Virginia Legislature. These improvements include surpassing legislative requirements for the number of rural training sites; requirements for students to perform rural rotations; and the creation of educational pipelines to increase the number of rural medicine students. Now that the Panel has successfully put in place the infrastructure of its program, it is time for it to establish a tracking system that can help in identifying the effectiveness of its programs in retaining health care professionals, especially primary care physicians in the rural parts of the state.
The Advisory panel should establish a tracking system that can identify how many West Virginia residency graduates are being retained in practice in rural West Virginia.
The Advisory panel should establish a tracking system that can identify how many physicians are in practice in rural under served areas of West Virginia each year to determine if the program is impacting those areas by increasing the number of physicians or if the number is staying the same or decreasing.
Until it has improved its own system, the Advisory panel should make use of the various health care profession licensing boards in obtaining information on healthcare professionals in practice.
The Advisory panel should establish a baseline of numbers in the categories tracked from the medical schools to show what impact the creation of the Rural Health Act has done to improve the number of medical personnel in rural areas.
Issue Area 2: The Advisory Panel
has Developed a Well Designed Website.
The Rural Health Advisory Panel has developed an in-depth website. This site provides detailed information on the background, the Panel's calendar, each Consortium and Committee under the Advisory Panel, and additional data available on the agency. The Advisory Panel has chose to place its published information on the internet as well as in hard copy. This use of the internet has vastly improved the accessibility to information on the agency by increasing the amount and speed in which this information is communicated. This has enabled the Panel to provide the most current information to its members, to other state agencies, and to the general public.