Episode 11

Telehealth is More Than Health Care and RHAT’s Annual Meeting

November 3, 2020

Episode Summary

Jacy Warrell, Executive Director of the Rural Health Association of Tennessee, joins the show to discuss a few of the interesting and informative sessions at the upcoming RHAT Annual Conference. She also describes how broadband internet access may impact the overall health of a person and community.

Show Notes

Transcripts have been lightly edited for clarity and readability.

 

Stephen Smith: Our guest today is Jacy Warrell. She is the Executive Director of the Rural Health Association of Tennessee. Jacy has more than 15 years experience in the nonprofit sector and really thinks of herself as an advocate for making the world a healthier place. She’s a graduate of Western Kentucky University with a degree in Public Administration and a master’s in Public Administration from Villanova University.

Stephen Smith: I invited her on the program to talk about the upcoming conference of the Rural Health Association, and they’ve got some really great programming. Be sure to listen for that link (link here: https://rhat.memberclicks.net/annual-conference) and check out what they have lined up for that program. Some really great topics, really great speakers. I think our listeners will particularly be interested in the broadband topics, the telehealth topics. And listen to this interview where she talks about telehealth being about more than just health care. I found that really interesting. And there’s one key factor about yourself that determines a lot about your health. So hope you enjoy my interview with Jacy Warrell, the Executive Director of the Rural Health Association of Tennessee.

Stephen Smith: And thank you for joining us today on Rural Broadband Today, and I am excited to have as our guest, Jacy Warrell. Jacy is the Executive Director of the Rural Health Association of Tennessee. Welcome to the show, Jacy.

Jacy Warrell: Thank you for having me. It’s an honor to be asked.

Stephen Smith: Well, you have quite a strong agenda that has been published now on your website for the upcoming annual conference of the Rural Health Association of Tennessee. And we’re going to dive into that in just a moment. But before we do, I’d like to get you to tell our listeners a bit about the work of the Rural Health Association of Tennessee. What is the makeup of that organization? Who are the  members, and what is the mission?

Jacy Warrell: Sure, the mission of the organization is really simple. We want to improve the health of rural Tennesseans. Of course, 90% of the state is occupied in rural areas, and we know that Tennessee doesn’t always rank very highly in our health outcomes. So that is our focus as an organization. Of course, we’re a 501(c)(3) nonprofit, and we really want to be a resource to the community and to our members on “how do we help move our health outcomes in a good direction?” We are a membership organization, so many of our members are providers. They might be from a rural hospital, clinic, or practice independently. We also have most of the state’s coordinated school health directors. So Tennessee is unique in that we fund our own coordinated school health directors here in the state. Every county has one, and most of them are part of our association as well. And then we’ve got a lot of university partners as well. So Lincoln Memorial University, UT, Health Science Center, ETSU. Any program that has a rural focus, whether it’s recruiting providers into rural communities or it maybe has a policy focus. They’re typically members also. So it’s a really diverse group of people. But the common thread is we care about rural people.

Stephen Smith: Well, tell us a little bit about your path that brought you to the organization. I believe you started the first day of April as the new executive director of the association. So what is the career path that brought you to that place?

Jacy Warrell: Wow, that feels like such a long journey, but I can tell you about it. Yeah, I consider myself a public servant, so I always knew that I wanted to work in nonprofit. And I grew up in central Kentucky, a small town. I was raised on a farm in a literal holler. And I moved away for a while, like many young people I was excited to get out of their hometown and worked with various nonprofits for a while. I worked in Miami for the doctor that created South Beach Diet, Dr. Arthur Agatston. And that’s where I worked with schools in Buffalo, New York, and some rural communities in Mississippi and Florida. And basically we had a research study that looked at the effects of school-based nutrition programs and changes in the school food. So this was before low-fat cheese was found or whole grain breads were in any of our schools. And at this time I remember thinking I felt like all of the major grant dollars went to urban areas. So I was always the one raising my hand, saying, “what about the rural communities? What about the rural communities?” And I knew I eventually would come back. And I did in 2012, I came back to the Kentucky area. And now I’m in middle Tennessee. And really, I just want to serve the people. I want to help people live long, happy, healthy, and prosperous lives. And I love working with other organizations who are like-minded and have that same goal.

Stephen Smith: Well, there will be a day when you were telling stories about the time you took over the helm of a rural health organization in the midst of a pandemic, or really the beginnings of a pandemic when it comes to certainly the state response and whatnot. Tell us a bit about what that was like, and remind us — there’s been, of course, so much happening this year — remind us of where we were on April the 1st in Tennessee, particularly in terms of the pandemic.

Jacy Warrell: Yeah. So April 1st was my first technical day on the job. And if I remember right, it was April 2nd where Governor Lee really announced that it was strongly recommended that people stay at home and things shut down for a bit. So it has definitely been a challenge as far as I haven’t had the opportunity to meet my members and connect with them. Of course, I have met a lot of people via Zoom. And like everybody else right now, thankfully, I have worked in a remote environment before. In a previous job, my team was spread across five time zones, so that wasn’t different to me, but at least I had the opportunity to know those people before I started. So like I said earlier, many of our members are health care providers. So obviously they just had so many needs and were so covered up. And I’ll always remember the hardest part is just the speed of information, the speed that everything was happening. Every day there was a press conference. It felt like every day there was an executive order. And I was still trying to figure out how to get my email set up and keep track of everything else that was happening to support our members. So it’s been challenging. But, you know, I feel like most people have said this too. There have also been a lot of opportunities as well. And so I’ve been looking for those silver linings and finding new ways to work and advance our mission in ways that maybe we wouldn’t have before.

Stephen Smith: Well, I’m sure that planning for the conference was already underway to some degree when you began your work there. At what point in the planning process did you and your team come to the realization that this conference that is in November — we’re recording is towards the end of October and so the conference is coming up quickly — at what point did you realize this is going to have to be a virtual format, and we have to shift?

Jacy Warrell: Wow, that’s such a good question. I will say it was a very, very difficult decision and a very emotional decision for a lot of people. Of course, I’m coming in new, so I was able to remove myself and be a little bit more objective. So when I came in April, the conference committee actually had not yet convened because they were waiting for the new director. And I kind of knew — I think it was by the end of April — I knew that’s probably where we were going to have to go. But of course, in any leadership position, especially when you’re new to an organization, you really need to solicit the input of others and build support, and I went through that process. And we took it to the conference committee to get to our board.

Jacy Warrell: And I think, if you remember back in May and June, there was this kind of sense of, well, maybe after summer and maybe after this. There was just kind of like, we just want to wait and see a little bit longer. But it wasn’t until July when we finally decided that we had to make a decision because we wouldn’t be able to plan. Just the planning aspect of it would be hard. So we made the decision. It was really hard. We tried to think. We considered, if we did it in person, how many people could we have? And for the space that we had reserved, it would have cut our attendees by two-thirds, and then deciding who got to come and who didn’t. We just didn’t want to do that. So we made the decision in July and started building our conference. And we’re really excited about the offerings. And I think we’re going to reach people that we haven’t reached before.

Stephen Smith: Well, let’s dive into that agenda. It looks like you have a pre-conference and a conference. Tell us about the difference and give us those dates for your conference.

Jacy Warrell: Ok, yes. The conference is November 18th, 19th and 20th. Each of those days, we essentially have only four hours of content each of the days. So we don’t start until 10:00 a.m. central, and we’ve got several breaks throughout. We’ve really built it understanding that probably not everybody is going to go to every session. But we wanted there to be lots of options. So we did tack on some pre-conference dates of November 10th, 11th and 12th. And essentially most of the conference is kind of geared towards more population health of trying to bring together all of our different member groups and constituents. I think what many of your listeners may be interested is our plenary sessions, which are during the pre-conference and regular conference in the 10 a.m. to 11:00 a.m. central slot. All of those speakers are government officials. So we’ve got Commissioner Williams with Department of Substance Abuse and Mental Health Services, Commissioner Schwinn, Department of Education, and the Director of TennCare, Stephen Smith. Then on the conference day, the opening will be Dr. Lisa Piercey, who is the Commissioner of Public Health. And I’m really excited about this speaker. Also, it’s a little bit different, but Johnny Stevenson, who is a Director of Office and Strategic Analysis and Communications for NASA Marshall Space Flight Center. He is going to be talking about change management and reading through a hard time, including working remotely, and what it’s like to be disconnected from your teammates. And he’s going to make some parallels there for leaders in health care. And on the last day is Dr. Kenyatta Lovett, who is Assistant Commissioner, Workforce Development.

Jacy Warrell: Since all of those people are government officials, we’re making those free and open to the public. And then throughout the rest of the agenda, we’ve got everything from telehealth and broadband to how COVID has impacted delivery of care, some conversations on vaccines and where misinformation comes from. We’re seeing that people are not getting their prevention screenings the same as they were a year ago and some suicide prevention. All sorts of topics that would really appeal to everybody.

Stephen Smith: That is a very rich agenda, and I’m certainly looking forward to sitting in on some of those sessions. I’d like to get you to give us a teaser on some of these that may encourage folks to register. On November 18th, you have a session called “Telehealth and Collaborations — A Case Study Between Lee University and Tennessee Schools.” Give us a little background on that on that collaboration.

Jacy Warrell: Ok, sure. First, I have to say, Dr. Brenda Jones, who is the main speaker on this, she’s an Assistant Professor of Nursing with Lee University, and she is a board member with the Rural Health Association of Tennessee. And this session came about because one day I called her, and I said, “Dr. Jones, I thought I knew what telehealth was, but I’m learning that I know nothing about what telehealth is. Can you talk to me like a fifth grader, what it means and what people are talking about when they’re telling me these things?” And she was so patient and so gracious to spend some time with me and kind of walk through things and clear some things up for me. In fact, I think later we’re going to do a Telehealth 101 because we’re seeing that people throw that word around a lot. And really there is a lot of nuance and complication, especially if you’re a provider and seeking reimbursement and things. But throughout that conversation, I just found her so engaging and so knowledgeable and I asked her if she would mind putting together a session on how they’re actually implementing telehealth at the university and working with the school system. So she has schools that she works with. They are Bradley County and Cleveland, Tennessee city schools. And she’s going to talk about how they partner their nursing students and work with the schools to set up their system and to be able to offer some support to the students and the school nurses in those school systems. And that gives training to their nurses in the school of nursing, and then that also provides support to the city schools. So she’s going to talk about how they do that and give a little bit of that, kind of like basics, like these are the lessons that we learned in incorporating this into our curriculum. And then also what I’m really excited about is just understanding the benefits as well as the limitations of telehealth. So I never want to talk about anything as if it’s the silver bullet — that doesn’t exist in the policy world. And then, of course, the collaboration piece is important. And I think you’ll find that anywhere. And actually this is this is where I shine, is really bringing people together. And so, you know, the issues that we’re trying to solve are just too big for any one person or organization. And so I’m really interested in just how she made this collaboration work and how can it be replicated in other places.

Stephen Smith: Hmm, that’s a fascinating approach. And speaking of broadband, I noticed you also have Crystal Ivey leading one of the sections. He’s the Broadband Director for the Tennessee Department of Economic and Community Development. And so tell me as we’re looking through this agenda and we see telehealth and leveraging community assets and strengths, some topics like that, what do you see, especially since you’ve had a very rapid education in telehealth, what do you feel like the role of broadband in health care delivery is, particularly in rural America?

Jacy Warrell: Right. Well, I mean, we’ve seen now, like never before, just how critical [broadband] is for people: for their education, their work and their health. And I want to back up just a second to make sure that we understand when we’re talking about health, we’re not just talking about health care. Our health is influenced by a lot of factors, including education and work, in addition to things like genetics and personal habits. So your audience members who aren’t immersed in public health and health policy might be interested to learn that a person’s zip code is the number one predictor of health. We can look at any zip code in the United States, and based on things such as access to transportation or health or environment, impact health. Now, to bring it back to what your audience may understand even more than me is how zip codes influence your access to broadband. And that, in a very disruptive way, became an essential ingredient to health care and education and work. And so I think that any conversation that I have had — I had an interview last week. Someone called and they wanted to talk about the rural health disparities, and they were particularly interested in racial disparities in rural areas. And it’s interesting, I started off saying something about broadband, and she didn’t really get it, which was fine because that’s not why she called. But as we were talking, we ended up going in a full circle, and it came back to broadband again. And, you know, if we’re touting telehealth as a solution to access to care in rural communities, we cannot talk about that as a solution, as a way to help people that don’t have access to a hospital or don’t have access to a clinic. We can’t talk about those things and not also talk about broadband because it’s just not in their rural communities, the same as it is other places.

Stephen Smith: Hmm, very interesting. Tell me what you have seen since coming on board there from some of your members, association members. What are some ways that you see them leveraging broadband to benefit the public?

Jacy Warrell: We’ve seen a lot of organizations come together with community partners that offer Wi-Fi and hotspots and try to get the actual technology into student hands. And actually, I’m sorry when you asked about the session that Crystal is going to be on. So she’s going to talk about the state of broadband in Tennessee, but also on that panel is Evan Freeman with the Electric Power Board of Chattanooga. And this goes as far as what we’ve seen this past summer, they announced a partnership with Hamilton County schools to provide free Internet access and hardware to homes of kids that were on free or reduced lunch programs. And so the initiative they call HCS EDConnect. And I think what’s particularly interesting for me, again, it’s all about those partnerships. So I’m interested in how they fund-raised for this program, how they structured the partnership, and the challenges they faced.

Jacy Warrell: And as far as other areas, though, Hamilton County is not all rural, although I think we can learn some lessons from them. Again, that’s another health and school, private and public partnership that we’re trying to show how to replicate. But other communities, you know, they were putting hot spots at the local restaurant in town, so people could go in the parking lot and access Internet. I think, too, for some of our providers, being able to take devices out to cars and as people go to receive care and able to do some check-ins and things like that.

Jacy Warrell: So people in rural communities have to be pretty creative problem solvers a lot of times because we don’t have the same resources. But again, if they can find those right partnerships and the access piece, we somehow make it work. Maybe it’s not the best system, and maybe it’s not sustainable long term, but I’ve seen some pretty creative ways they’ve been able to get people the access they need.

Stephen Smith: I love your statement earlier that telehealth is not just about health care, but health in general. And let me ask you to look into the future a bit here. What do you think — I’ll put it this way. How do you believe the events of 2020 are going to change the way we view health care delivery and public health in general for rural America?

Jacy Warrell: Wow, that’s a big question. That sounds like it should be somebody’s dissertation for a [inaudible] program. Well, definitely. It feels like we’re in a moment where we’re never going back. It’s just that things have changed, and they’re going to continue on this trajectory. We’ve just advanced light years, and we’ve got a lot of things to work out in terms of telehealth. A lot of regulations have been eased or through executive order or otherwise through this time. And so there’s going to be some policy discussions and things like that. But I mean, it’s here to stay, I think. You know, like I said earlier, there’s no perfect [solution]; it’s not going to solve all of our issues, but I think it is going to open a new world to people in rural communities. I think we talk about how transformative the Internet was. Well, in the sense that this is just going to open a whole new world to be able to get specialty care. It’s going to reduce travel times. It’s going to help keep people close to home. But we know with that, there may be some trade-off also that we’re just going to have to wait and see.

Stephen Smith: Well, tell us again the dates of your conference and give our listeners the information they need to go and register so that they can take advantage of these wonderful sessions that you put together.

Jacy Warrell: The conference dates are November 18th, 19th and 20th and the pre-conference dates are November 10th, 11th and 12th. One registration gives you access to all of the sessions. The sessions will be available through the end of February. We are offering nursing CEUs, social worker CEUs, and then ETSU is providing general CEUs for people that need the continuing education credits. If you can’t attend classes, you have up to a month to watch the sessions and take the assessment needed for CEUs.

Stephen Smith: Ok, and where can we go to register for the conference?

Jacy Warrell: Our website is R-H-A-T, that stands for Rural Health Association of Tennessee, .org. So rhat.org. And actually, we’ve got a new page that launches next Monday. So it’s going to have a new look and feel, and we’ll be connected directly to our event page. So everybody will get instructions on how to log in and access all of our sessions.

Stephen Smith: Oh, new website. That’s exciting. And we’ll point out that also your conference coincides with the National Rural Health Day, right?

Jacy Warrell: Oh, yes, thank you for mentioning that. Yes, yes. So November 19th is National Rural Health Day, and we’ve got a great line-up of the speakers that day also to help celebrate that day. So one of the sessions that I think is going to be really interesting is from ETSU’s Rural Health Research Center, and they are going to talk about the strengths and assets of rural communities. And instead of just focusing on the disparities and the inequities, they’re really going to highlight the strengths, which is, you know, we’ve got a strong faith community. We’ve got strong collaborations and partnerships, and how we can leverage those to keep moving rural health forward.

Stephen Smith: Well, that sounds like a very interesting session. Well, thank you so much for sharing with us today. My guest has been Jacy Warrell. She is the Executive Director of the Rural Health Association of Tennessee and their conference is coming up here very soon. Be sure to check out the website and register for some of those great sessions. Jacy, thanks so much for joining us.

Jacy Warrell: Thank you for having me.

Stephen Smith: And thank you for listening to Rural Broadband Today where we take a look at the people and the issues shaping the rural broadband story across America. I’m your host, Stephen Smith, and this program is produced by WordSouth — A Content Marketing Company. Please share this episode with your network and help us tell the rural broadband story. Thanks again for listening.

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