Best Practices for Medical Relief Clinics Lessons Learned from Partnering with Remote Area Medical


GOOD AFTERNOON, EVERYONE. I’M DIANE BASKE, I’M THE ACTING HEAD OF THE NATIONAL NETWORK OFFICE AND WE APPRECIATE YOUR JOINING US FOR OPEN CONSUMER HEALTH COORDINATOR’S MEETING TODAY AND WE HAVE THREE SPECIAL GUESTS PRESENTERS FROM THE EAST TENNESSEE STATE UNIVERSITY, COLLEGE OF MEDICAL MEDICINE LIBRARY IN JOHNSON CITY TENNESSEE. SO FIRST WE HAVE RACHEL WALDEN, ASSOCIATE DEAN, DIRECTOR OF MEDICAL LIBRARY. RICK WALLACE IS ASSISTANT DIRECTOR OF THE MEDICAL LIBRARY AND NAKIA IS CLINICAL REFERENCE LIBRARIAN. THE LIBRARY HAS A STRONG TRADITION OF PROVIDING INFORMATION OUTREACH AND SUPPORT OF THEIR MISSION TO IMPROVE RURAL HEALTH. TODAY RACHEL, RICK AND NAKIA WILL SHARE THEIR EXPERIENCES SUPPORTING REMOTE AREA MEDICAL CLINICS AND PROVIDE BEST PRACTICES IN LESSONS LEARNED. AS WE TRANSITION INTO THE NEXT PHASE OF THE NETWORK, A GOAL IS TO INCREASE NATIONAL COVERAGE IN SUPPORT OF THESE CLINICS AND THE PATIENTS THEY MANIFEST. SO PLEASE WELCOME RACHEL AND YOU MAY TAKE IT AWAY.>>THANK YOU. SO THIS IS RACHEL AND I HAVE RICK AND NAKIA IN THE ROOM WITH ME AND WE WILL ALL BE HAPPY TO ANSWER QUESTIONS AS WE GO AND NAKIA IS WATCHING THE CHAT FOR US SO FEEL FREE TO PIPE UP WITH ANYTHING HAVE YOU QUESTIONS ABOUT. HANG ON. LET ME GET MY SLIDE. THERE WE GO. SO WE WILL TALK A BRIT ABOUT WHAT IS REMOTE AREA MEDICAL WHICH IS THE HEALTH RELIEF CLINIC, A BIT ABOUT PLANNING, BUDGETING, STAFF FOR THESE EVENTS, MATERIALS NEEDS, REPORTING AND FOLLOW-UP, THE IMPORTANT CONCEPT OF RESPECT WITH THESE EVENTS AND JUST GENERAL THOUGHTS. SO JUST TO START OUT WITH, I WILL TURN THIS OVER TO RICK FOR A MINUTE WHO WILL TELL YOU ABOUT RAM AND HOW WE GOT INVOLVED.>>WELL, FIRST CAN YOU HEAR OKAY, I’M A BIT BACK FROM THE MICROPHONE?>>YES, THIS IS MARGARET, I CAN HEAR YOU FINE. EVERYBODY ELSE I HAVE MUTED BUT EVERYBODY CAN HEAR YOU.>>OKAY, RAM STANDS FOR REMOTE AREA MEDICAL. WILL IT WAS WAS STARTED BY STAN BROCK, WHO IS THE TV SHOW OF THE WILD KINGDOM FOR SOME OF A CERTAIN AGE, YOU WON’T REMEMBER THAT, HE WAS A BRITISH GUY, GREW UP AS A COWBOY, HE GOT TO TRAVEL THE WORLD AND SAW THE WORLD POVERTY AND THE HEALTHCARE DEFICITS AROUND THE WORLD, WHEN HE FINISHED HIS MOVIE AND TELEVISION CAREER, HE WENT TO DO SOMETHING SO HE STARTED REMOTE CLINICS WHERE THEY FLY IN SUPPLIES TO PLACES LIKE GUYANA. HE CAME TO REALIZE THAT THE HEALTH CARE PROBLEMS IN APPALACHIA WERE AS BAD AS THOSE IN LESS DEVELOPED COUNTRIES AND HE STARTED TO TAKE THE SAME CLINIC APPROACH HERE IN THE UNITED STATES. YOU WANT ME TO DO THE NEXT SECTION? OKAY, SO THAT’S A BIT OF THE BACKGROUND. SO HERE’S A GUY FROM GREAT BRITAIN, MOVED TO SOUTH AMERICA, THEN MOVES TO THE U.S. AND HE STARTS THESE CLINICS. THEY WERE VERY AWARE OF THESE CLINICS BECAUSE MOST OF THEM IN VIRGINIA IN THE SOUTHWEST VIRGINIA, AND IT’S AT LEAST TWICE ON IT, ON THE 16-INCH THAT ENCOURAGE TO YOU SAY THAT, THEY HAVE A LINK AT USA.ORG ON THE WEB PAGE. AND THEN IN 2009, THEY TRIED TO GET IT ORGANIZED ON THE BRISTOL MOTOR SPEED WAY AND I GOT INVOLVED WITH THAT AND I WENT TO ORGANIZATIONAL MEETINGS AND GOT INVOLVED WITH [INDISCERNIBLE] WELL, SINCE THEN WE’VE DONE TWO MORE IN BRISTOL, ONE IN URBAN, TENNESSEE AND ONCE IN PIGEON FORGE AND TWICE UP TO THE BIG ONE IN WISE. WE SINCERELY BELIEVE THAT HEALTH INFORMATION IS AN IMPORTANT SERVICE LIKE MEDICAL, DENTAL, VISION AND WHEN WE GO, WE ACTUALLY WILL SPEAK OUT PEOPLE WHO NEED INFORMATION, WE WILL HELP PEOPLE WITH SERVICES, WE WILL GET COMPUTER AND DO SEARCHES. AND EACH TIME WE HAVE BEEN HAVE BEEN ABLE TO HELP SEVERAL HUNDRED PATIENTS WITH GOOD QUALITY INFORMATION. OKAY. SO HOW, [INDISCERNIBLE]–SIMILAR PROJECTS LIKE THIS ACROSS THE U.S. I’M SURE THERE’S SIMILAR GROUPS FOR REMOTE AREA MEDICAL PLUS IF YOU GO TO RAM’S WEB PAGE, YOU WILL SEE THEY DO THESE CLINICS NOT JUST IN TENNESSEE AND VIRGINIA, BUT THEY DO IN ALL THE COUNTRY. ONE REASON THEY DO SO MANY, BUT ALSO, TENNESSEE AND VIRGINIA OUT OF STATE PRACTITIONERS TO COME IN FOR A WEEKEND AND A MEDICAL LICENSE IS ISSUED. FOR RECENTLY FOR EXAMPLE, RAM STARTED HAVING THE ANNUAL CLINIC IN LOSANGELES, WE HAVE MADE CONTACTS WITH [INDISCERNIBLE], THE FIRST EDUCATOR THEY EVER HIRED AND WE CAN DISCUSS WITH HER, POSSIBLY NLM OR FUNDS WE CAN USE, FUNDS THAT WE HAVE LEFT OVER FROM ONE OF OUR PROJECTS WHERE WE MIGHT BE ABLE TO FIND SOME CONSUMER HEALTH INFORMATION FOR HPV VACCINATIONS THAT THEY WILL GIVE TO THEIR CLINICS IN 2016 AND YOU KNOW FOR THEM TO BE AWARE THERE’S OTHER OUTREACH, FOR THESE, WORKING WITH RAM FOR EXAMPLE ANNE DUESING WITH THE FDA. DO WE HAVE QUESTIONS SO FAR OR SHOULD WE PLAN TO GO ALL THE WAY THROUGH AND THEN IF YOU NEED TO PIPE UP, GO AHEAD?>>SO WE’LL GO THROUGH A FEW SECTIONS HERE, PLANNING TIPS, RICK MENTIONED THAT HE WAS INVOLVED IN THE PLANNING MEETINGS AND RAM HAS AN EDUCATION COORDINATOR AND WE THINK IT’S IMPORTANT TO TRY TO WORK WITH THOSE ORGANIZERS AND EXPAND THEIR VISION OF WHAT EDUCATION IS, YOU ALL KNOW WHO THE END CONSUMER HEALTH WORK, THAT THERE ARE PEOPLE WHO CONSIDER PATIENT EDUCATION AND CAN BASICALLY BE, HERE’S YOUR ONE PAGE DISCHARGE SHEET AND WE THINK, YOU KNOW WITH THE EXPERTISE OF THE MEDICAL LIBRARIAN, WE CAN DO SOMETHING MORE SOPHISTICATED AND MORE COMPREHENSIVE THAT THAN AND WORKING WITH THE ORGANIZERS CAN HELP EXPAND THEIR VISION AND GET YOU THERE. YOU KNOW SOME OF THE THINGS YOU WANT TO DO, GET INVOLVED IN PLANNING THE EVENT, SOME OF THESE THINGS WE HAD A LOT OF SUCCESS WITH ARE BEING ON THE FORMS AND THE PAPERWORK AT THE EVENT. BEING IN LINE AT THE CHECK OUT PROCESS, SO WHEN PEOPLE FINISH UP WITH THEIR HEALTHCARE, AT THE RAM CLINIC THEY MAY HAVE TO GO THROUGH KIND OF A CHECK OUT LINE AND GET DIFFERENT BITS OF INFORMATION AND DO DIFFERENT THINGS AND IF THE LIBRARY CAN KIND OF BE IN THAT PROCESS, THEN IT’S JUST A NATURAL, EVERYBODY COMING AND GOING AND IT EVERYBODY WILL HAVE AN OPPORTUNITY TO CONIN ECTOMYOSIN WITH YOU. AS YOU ARE PLANNING, YOU NEED THINK ABOUT THE SITE AND SIZE OF THE EVENT, YOU KNOW YOU’RE PRINTING OUT A LOT OF CONSUMER HEALTH INFORMATION AND YOU WANT TO HAVE A REASONABLE ETC. EXCISION OF HOW MANY OF THOSE YOU NEED, HOW MANY STAFF MEMBERS YOU NEED, WE WOULD STRONGLY ENCOURAGE EVERYBODY TO CONSIDER COORDINATING WITH OTHER LOCAL LIBRARIES AS RICK MENTIONED, YOU KNOW I THINK WE CAN ALL WORK BEST TOGETHER SO YOU DON’T WANT TO BE IN A SITUATION WHERE FOR EXAMPLE, YOU KNOW IF THE RML WAS FUNDED TO A PUBLIC LIBRARY AND A LIBRARY LIKE US AND WE COMPETE AT THE SAME EVENT AND YOU WANT TO COORDINATE THAT EFFORT. ONE THING TO THINK ABOUT IS WHETHER YOU MIGHT NEED TO DO ANY SEARCHING FOR MATERIALS ONSITE. MAYBE YOU’LL DECIDE THAT’S MORE THAN YOU CAN DO, BUT IF YOU DO WANT TO DO IT, YOU REALLY NEED TO CONSIDER THE INFRASTRUCTURE MAY NOT BE THERE FOR YOU TO DO THAT. YOU MAY NEED TO BRING YOUR OWN LAPTOP, YOUR OWN NETWORK CONNECTION, YOU CAN’T COUNT ON INTERNET, PRINTER OUTLET THOSE THINGS MADE AVAILABLE, WHEN WE DID THIS AT THE BRIT OLDER PEOPLE MOTOR SPEED WAY, OUT IN THE RACE TRACK, OUT IN THE LAND BETWEEN THE TRACK, AND YOU DON’T HAVE A LOT OF TECHNICAL INFRASTRUCTURE JUST STANDING OUT IN THE PARKING LOT. AGAIN WE WILL ENCOURAGE NLM AND THE RML TO CONTINUE FUNDING THIS WORK AND AS PART OF GETTING IN THAT CHECK OUT PROCEDURE, THE PATIENTS THERE MAY BE GET BEING DOCUMENTS AS WELL, THAT ARE CHECK OUT DOCUMENTS WHERE THE LIBRARY PARTICIPATING COULD BE MENTIONED THERE. FOR BUDGETING, THAL HAS BEEN A STRUGGLE WITH WHAT TO SHARE BECAUSE AT FIRST I WAS THINKING LET’S SHOW THEM AN EXAMPLE BUDGET WHERE OUR RML HAS INVOLVED MORE AND FUNDED UP WITH THE EXHIBIT MONEY IN THE PAST BUT IT VARIES A LOT BY EVENT. YOU KNOW SOME EVENTS ARE LARGER, SOME ARE SMALLER, YOU MAY NEED A LARGER BUDGET FOR MATERIALS, YOU MAY NEED A LARGER BUDGET FOR STAFF TRAVELS OR PER DIEM, YOU MAY HAVE MORE TRAVEL OR LESS INTENSIVE. IT DEPENDS ON THE SITE, HOW MANY PEOPLE YOU’RE EXPECTED, HOW MANY HEALTH TOPICS YOU’RE COVERING, HOW MANY PEOPLE WANT MAILINGS BACK AFTER THE FACT, VERSES E-MAIL AND WE’LL TALK ABOUT FOLLOW UP A BIT MORE IN A MINUTE. YOU KNOW THE WAY WE TYPICALLY HANDLE IT, THESE EXHIBIT GRANTS DON’T COVER THE INDIRECT COST SO OUR LIBRARY CONTRIBUTES AND IN THIS CASES MAY PROVIDE ADDITIONAL MATERIALS OR GIVE AWAYS OR SOMETHING LIKE THAT. IF ANYBODY WANTS TO CONTACT US, FOR AN EXAMPLE OF THE BUDGET, WE WOULD BE HAPPY TO SHARE THAT BUT AGAIN, I WOULD SAY IT VARIES BY THE SITE, BUT WOULD YOU SAY MOST OF OUR–MOST OF OUR EVENTS HAVE BEEN TWO-4000-ISH? UNDER TWO?>>[INDISCERNIBLE]>>UNDER TWO, YEAH, SORRY. THEY HAVE VERY LITTLE BIT THAT’S BEEN TWO OR LESS. THE STAFFING, IT’S OKAY TO SAY WE HAVE ONE APPROXIMATE OTHER THAN WHO CAN GO OUT AND DO THIS EVENT FOR THE DAY. WE WOULD REALLY ENCOURAGE TO YOU HAVE MULTIPLE STAFF AT ANYONE OF THESE EVENTS AND TO THINK ABOUT HOW IT MAY VARY BY DAY AND REALLY WORK WITH THE ORGANIZERS TO FIGURE OUT WHEN THE BUSIEST DAYS ARE BUT YOU NEED MORE THAN ONE PERSON, PEOPLE GET PULLED AWAY, PEOPLE NEED BATHROOM BREAKS, WHEN WE GIVE THE ONE–MOST RECENT ONE WE DID AT BRISTOL WE HAD FIVE PEOPLE ON THE FIRST DAY AND ESPECIALLY IF YOU’RE IN THE CHECK OUT LINE. YOU DON’T WANT ONE PERSON THERE, WE’VE ALL HAD THESE SORT OF INTENSIVE CONSUMER HEALTH CAN REQUESTS WHERE ONE PERSON KIND OF TAKES A LOT OF TIME TO WORK WITH. I MEAN YOU DON’T WANT TO HOLD UP THAT WHOLE CHECK OUT LINE BY HAVING NOT ENOUGH CAPACITY TO HANDLE THAT. YOU WANT TO THINK ABOUT WHICH DAYS ARE THE MULTIDAY EVENT ARE BUSIER, FIRST COUPLE DAYS AND THE EVENT, MAYBE THE BUZZIEST, YOU REALLY WANT TO BE SUPER PREPARED. YOU COULD BE PREPARED FOR WATER, IT COULD BE COLD, IT COULD BE RAINY, IT COULD BE SONNY, WINDY AND YOU MAY NEED WEIGHTS FOR ALL THOSE PAPER MATERIALS. YOU MAY NEED TO BRING YOUR OWN FOLDER, CAMP, CHAIRS, WATER, SNACKS, THE LAST TIME AT BRISTOL IT WAS COLD, WE WERE FREEZING THROUGHOUT THE DAY, THEY PROVIDED LUNCH BUT YOU MAY NEED TO BRING MORE SUPPLIES THAN THAT. YOU SHOULD THINK ABOUT WHICH STAFF MEMBERS YOU’RE BRINGING. PEOPLE MAY NEED TO STAND, THEY MAY NEED TO BE–YOU CAN GET PHYSICALLY TIRED JUST STANDING THERE ALL DAY, THEY NEED TO BE ABLE TO GET COLD, WET, COUGH AND JUST REMEMBER THAT YOU MAY BE OUTSIDE AND EXPOSED IN AN ENVIRONMENT, FOR PEOPLE, AROUND A RACE TRACK. YOU KNOW, AND WE DO THINK IT’S A LITTLE DIFFERENT STAT THAN ANYTHING LIKE THIS THAN–STAFF THAN ANYTHING LIKE THIS THAN A CONFERENCE. YOU NEED THAT MIND SET GOING IN, YOU NEED THAT ATTITUDE OF RESPECT, YOU CAN’T HAVE ONE PERSON TABLING AND THEY CAN WALK AWAY AND TAKE A BREAK, YOU 92 ED TO BE COVERING THAT THE WHOLE TIME AND THE OTHER THING TO THINK ABOUT IS, HAVING THE PEOPLE IN STAFF ALSO CONNECT WITH THE HEALTHCARE WORKERS THERE. THEY MAY NEED HELP SEARCHING FOR INFORMATION AND YOU MAY CONNECT WITH THEM AND LET THEM KNOW THAT YEAR THERE HO HAND OUT MATERIALS AND BE PROACTIVE AND LETTING THEM KNOW YOU’RE THERE, A LOT OF THEM MAY BE VOLUNTEERS AND THEY MAY COME FROM OUT OF STATE, SO YOU MAY KNOW THEM WELL AND BE PROACTIVE ABOUT LETTING THEM KNOW WHAT YOU PROVIDE WHILE YOU’RE THERE. LET’S SEE, SO, SO MATERIALS, YOU KNOW OBVIOUSLY A BIG GOAL IS CONNECTING TO PEOPLE WITH CONSUMER HEALTH INFORMATION, WE TEND TO BRING PRINT OUTS OF TOPICS FROM DIFFERENT TOPICS AND A LOT OF TIMES THEY’RE DOING BASIC MEDICAL AND DENTAL CARE, SO YOU MAY BE TEMPTED TO FOCUS YOUR MATERIALS ON THAT BUT DON’T FORGET CAREGIVERS, MENTAL HEALTH STUFF, COPING MECHANISMS, I PERSONALLY, THE FIRST ONE OF THESE I DID WAS REALLY AMAZED BY HOW MANY PEOPLE CAME UP AND THEY TOOK MATERIALS BUT IT WAS FOR A PARENT OR A CHILD OR SISTER OR SOMEONE, YOU KNOW THEY WERE THERE GETTING HEALTHCARE FOR THEMSELVES BUT THEY SAID HEY THIS IS SOMETHING THAT’S GOING ON WITH MY MOM, CAN YOU GIVE ME MATERIALS ON THAT AS WELL. OBVIOUSLY, THINK ABOUT YOUR LANGUAGE NEEDS. THINK ABOUT YOUR MENTAL HEALTH STUFF, A LOT OF POPULAR TOPICS WERE STRESS REDUCTION, ANXIOUS, YOU DON’T GET MENTAL HEALTH SERVICES FROM CARE PROVIDERS AT THESE EVENTS BUT THE PEOPLE ATTENDING DO NEED THAT INFORMATION. SOME OF THE OTHERS REALLY POPULAR MATERIALS WERE ANXIOUS, EXERCISE, WAYS FOR PEOPLE TO GET EXERCISE WITHOUT JOINING A GYM FOR EXAMPLE, WE HAVE SOMETHING ON USING HOUSEHOLD ITEMS AND YOUR ENVIRONMENT TO GET MORE EXERCISE. THE MEDLINE PLUS MAGAZINE HAVING COPIES OF DIFFERENT ISSUES AND THOSE ARE VERY POPULAR AS WELL. LET’S SEE, SO ANOTHER THING TO THINK ABOUT, IS JUST THAT YOU GET–PART OF WHAT YOU CAN DO IS EDUCATE–PART OF WHAT YOU CAN DO IS REALLY ENTERTAIN AND MAKE IT EASIER FOR PEOPLE. AT THE BRISTOL RAM FOR EXAMPLE, YOU KNOW PEOPLE ARE CAMPED OUT IN THEIR CAR ALL NIGHT, THE NIGHT BEFORE, THE LINE UP TO GET A CHANCE FOR THE NEEDED HEALTHCARE. AND SO–SORRY WE HAD A QUICK QUESTION. SO ANYTHING YOU CAN DO TO KIND OF MAKE THAT EASIER FOR THEM, IS GOOD. SO IF YOU–YOU KNOW MAYBE YOUR LOCAL PUBLIC LIBRARY HAS PAPER BACKS THAT THEY DIDN’T SELL IN THE LAST BOOK SALE, THEY WOULD LET YOU HAVE AS A GIVE AWAY, MAYBE YOU CAN HAVE CHEAP CRAYONS AND COLORING PAGES FOR KIDS AND WHILE THESE PEOPLE ARE IN LINE AND CAMPED OUT FOREVER, YOU AND GIVE THEM SOME OF THIS STUFF THAT HELPS THEM WITH THE LONG WAY AND HELPS THEIR EXPERIENCE BE EASIER. ONE OTHER MATERIAL ITEM THAT YOU MIGHT HAVE IS, YOU KNOW KNOWING WHAT YOUR NATIONAL COMMUNITY–YOUR COMMUNITY HEALTH RESOURCES ARE. YOU MAY HAVE PEOPLE GOING AND THEY ARE HAVING TEETH EXTRACTED BUT MAYBE THAT PARTICULAR EVENT IS NOT PROVIDING FOLLOW UP ANSWERS, FALSE TEETH, THAT KIND OF THING, SO IF YOU KNOW OF WAYS THAT PEOPLE GET GET THAT FOLLOW UP COMMUNITY THAT’S A GOOD RESOURCE TO HAVE, IF THE EVENTS ORGANIZERS ARE NOT PROVIDING THAT MAYBE YOU CAN COME UP WITH IT AND I THINK THAT’S A REALLY GOOD ARGUMENT FOR HAVING LOCAL PEOPLE INVOLVED IN THIS EVENT. SO WHEN WE DO IT IN THIS AREA, WE KNOW WHAT’S AROUND FOR FOLLOW UP CARE AND FIND OUT AND VERIFY IT EASILY, IF YOU’RE DROPPING IN FOR THE EVENT AND YOU KNOW DON’T REALLY KNOW ANYTHING ABOUT THE LOCAL COMMUNITY, YOU MA I NOT HAVE THAT AS A RESOURCE. AND WE ALSO HAVE A DISCLAIMER WE PROVIDE THAT WE GIVE OUT TO PEOPLE, YOU KNOW WE DO THE BEST WE CAN, WE MAY MISS SOME THINGS, KIND OF COVERING THAT AND I DID NOT GET THE WHOLE THING ON THE SCREEN BECAUSE IT’S KIND OF LONG BUT IF ANYBODY WANTS A COPY OF THAT, WE CAN SEND THE TEXT OUT AND/OR WE COULD GIVE IT TO MARGARET AND MAYBE SHE COULD SHARE THAT WITH YOU ALL. HANG ON ONE SECOND. SO LET’S SEE, REPORTING AND FOLLOW UP, PEOPLE THAT GRET MONEY FOR DOING THESE EVENTS THEY NEED REQUIREMENTS FOR FOLLOW UP, YOU KNOW ONE OF THE THINGS WE DO WITH THE PATIENTS THAT WE WELCOMER WITH DIRECTLY AND WE GIVE THEM FOLLOW UP CONTACT INFORMATION AND WE ALLOW THEM TO RETURN A REQUEST FOR INFORMATION BY MAIL OR BY ONE TACT E-MAIL, AND WE WILL ACTUALLY MAIL THEM INFORMATION PACKETS AND FOLLOW UP IF WE HAVE IT ON HAND AND IF THEY DON’T HAVE ANI MAIL ADDRESS, SO THINK ABOUT THAT AS PART OF YOUR BUDGET AND DON’T BE STAIRED THAT YOU’RE GOING TO BE COMPLETELY OVERWHELMED BY WANTING PEOPLE AFTER THE EVENT. WE HAVEN’T HAD–OUR EXPERIENCE HAS NOT BEEN THOSE NUMBERS ARE SO HIGH THAT IT DISRUPTS OUR REGULAR WORK. YOU DO WANT TO PROBABLY TRACK KIND OF A NUMBER OF PEOPLE YOU CAN REACH BUT THAT CAN BE SIMPLE. YOU DON’T HAVE TO OVERCOMPLICATE IT, WE HAVE DONE–IF THE PAPER WAS FOR TICK MARKS WAS FOR PEOPLE AT THE EVENT AND GIVES US KIND OF A MARK OF HOW MANY PEOPLE WE REACH. SO–HANG ON ONE SECOND. I THINK WE HAVE A QUESTION. SO ONE SUGGESTION WAS TO–TO TALK TO THE MEDICAL DIRECTOR ABOUT THE MOST FREQUENTLY SEEN OR ANTICIPATED HEALTH PROBLEMS. WHEN THINKING ABOUT YOUR MATERIALS ON EVERYTHING. SO THEY MAY HAVE AN IDEA. YOU KNOW IN OUR REGION IT MAY BE A SET OF CERTAIN THINGS AND OUR REGION ACROSS THE COUNTRY WITH A LOT MORE FINANCIAL RESOURCES, YOU KNOW MAYBE THEY’RE SAYING DIFFERENT HEALTH PROBLEMS SO TALK TO THE MEDICAL DIRECTOR AND FIND OUT WHAT THEY’RE SEEING. AND YOU KNOW IF YOU ARE WORRIED ABOUT THE FOLLOW UP AND SENDING PEOPLE INFORMATION AFTER THE FACT AND WHETHER THAT’S GOING TO BE A HUGE LOAD, MAYBE HAVE OTHER STAFF MEMBERS, MAYBE LIBRARIES HAVE OTHER STAFF MEMBERS THAT CAN HELP WITH THAT. DOESN’T NECESSARILY HAVE TO BE SOMEBODY–IT COULD BE ANYBODY WHO COULD BE CONSUMER HEALTH. SO ONE OF THE FINAL THINGS WE REALLY, REALLY WANT TO HAMMER HOME IN PLANNING FOR THIS AND FOR AWE ULTIMATELY, IF YOU DO THIS WORK DIRECTLY, IF YOU ARE FROM THIS WORK, IF YOU ARE TALKING TO OTHER LIBRARIANS ABOUT THE MOST IMPORTANT THINGS TO DO, PROBABLY ONE OF THE THINGS WE HEAR THE MOST ABOUT IS RESPECT. THESE PEOPLE THAT ATTEND THESE EVENTS, THE RAM EVENTS THEY WAITED A VERY LONG TIME JUST FOR A CHANCE TO GET CARE, THEY MAY HAVE CAMPED OUT IN A CAR, PARKING LOT OVERNIGHT TO GET A NUMBER AND HOPE THEY CAN BE SEEN. SO BY THE TIME YOU’RE YOU GET THERE AND THEY’RE STARTING FOR THE DAY, THEY HAVE PUT IN A WHOLE DAY ALREADY JUST WAITING SO ANYTHING CAN YOU DO TO MAKE IT EASIER FOR THEM AND JUST REALLY RESPECT THE CHALLENGES THAT THEY’RE FACING. YOU KNOW UNDERSTAND THAT THE PEOPLE YOU’RE TALKING TO MAY BE EMBARRASSED OF HEALTH PROBLEMS THEY CAN’T TAKE CARE OF BEFORE, THEY MAY BE EMBARRASSED OF NOT HAVING PREVIOUS CARE ISSUE. REMEMBER THIS IS A HIPAA AND PRIVATE EVENT. WE WANT PEOPLE TO BE SMART ABOUT IT, DON’T THINK THAT NOBODY WHO WAS THERE WILL SEE IT. THE I’M SURE WE’VE SEEN PEOPLE DO TRAININGS AND COMPLAIN AFTER THE FACT, THE FOOD WAS TERRIBLE OR SOMEBODY SAID SOMETHING I THOUGHT WASN’T SMART OR WHATEVER, DON’T DO THAT AND DON’T SEND PEOPLE TO THESE THAT YOU THINK MIGHT DO THAT. REMEMBER THAT WE’RE THERE THAT DAY FOR THEM, NOT FOR US, SO, FOR US, IN ACADEMIC LIBRARY, WE HAVE TO KIND OF SAY, OUR RESEARCH, OUR PUBLICATIONS, ALL THAT STUFF, NONE OF THAT MATTERS, WE’RE THERE TO PROVIDE INFORMATION, YOU KNOW REMEMBER THAT THE PEOPLE YOU’RE SERVICING ARE NOT STUPID, THEY MAY BE POOR BUT THAT DOESN’T MEAN THEY’RE DUMB, EVERYBODY KNOWS THEY NEED TO KNIT SMOKING, THEY DON’T NEED TO BE TOLD TO QUIT, THEY NEED HELP DOING IT. WE NEED PEOPLE WHO WILL GO IN AND SERVE PEOPLE, NOT BE ARROGANT. REMEMBER THE ATTENDEES ARE NOT ALL THE SAME, THEY COULD BE YOU BUT FOR A LITTLE BIT OF LUCK. AND YOU KNOW, AGAIN, WE THINK THAT THE BEST GROUPS TO REALLY DO THIS WORK FOR THE LOCAL GROUPS. THAT THEY UNDERSTAND LOCAL RESOURCES, UNDERSTAND THE LOCAL HEALTH PROBLEMS, UNDERSTAND WHAT CHALLENGES ARE BEING FACED AND THAT THEY CAN KIND OF HAVE A CLOSER TO THE GROUND IDEA OF WHERE TO REFER PEOPLE GOING FORWARD. AND SO I DON’T THINK WE CAN TALK ABOUT THAT ASPECT ENOUGH. THE LIKE, YOU REALLY HAVE TO BE RESPECTFUL IF YOU’RE GOING DO THIS AND KIND OF CLOSING THOUGHTS, THIS IS AN OPPORTUNITY FOR US TO ELEVATE THE PROFESSION, MEANINGFUL WORK WE CAN DO, ONE STRATEGY TO IS TO TAKE ADVANTAGE OF THE LIBRARIES IF I GO TO ONE OF THESE EVENTS, I’M NEVER GOING TO SAY, I’M THE ASSOCIATE DEAN OF BLAH, BLAH, UNIVERSITY. WE’RE GOING TO SAY WE’RE LIBRARIANS, AND THAT REALLY PUTS PEOPLE AT EASE, SO MUCH MORE THAN SAYING, I MET SO AND SO UNIVERSITY. PEOPLE TRUST LIBRARIANS TO SOME EXTENT AND YOU WANT TO USE THAT TRUST TO CONNECT WITH THEM. YOU KNOW TAKE A MORE PUBLIC LIBRARY SERVICE TYPE OF APPROACH AND REMEMBER, THAT YOU WERE THERE, TO MAKE IT EASIER FOR THE ATTENDEES, HOWEVER POSSIBLE AND TO HELP THEM REALLY TAKE CARE OF THEIR OWN HEALTH AND TO GIVE THEM THE TOOLS TO DO THAT. SO THAT’S REALLY THE OVERVIEW OF WHAT WE THOUGHT ARE KIND OF THE LESSONS LEARNED FROM OUR EXPERIENCES, IF THERE ARE QUESTIONS OR IF YOU WANT TO ADD ANYTHING AT ALL?>>YEAH, –I THINK WE COVERED EVERYTHING, BUT WE’RE MORE THAN HAPPY TO TAKE QUESTIONS AND THAN HAPPY TO TAKE FOLLOW UP QUESTION FIST ANYBODY WANTS TO E-MAIL US TO SEE THE DISCLAIMER OR THE COST BREAK DOWN, SAMPLES, ANYTHING LIKE THAT WE’RE MORE THAN HAPPY TO SHARE.>>WELL, THANK YOU SO MUCH RACHEL, RICK AND NAKIA AND I JUST WANT TO REMIND ALL THE PARTICIPANTS THAT RIGHT NOW I HAVE EVERYBODY MUTED BUT OF COURSE, CAN YOU UNMUTE YOURSELF AND PLEASE ASK YOUR QUESTIONS: AND WE HAVE A QUESTION NOW.>>HI, IT’S DIANE, NO, RACHEL RICK AND NAKIA, THANK YOU FOR THIS, IT WAS GREAT. SO MY FIRST QUESTION IS, IF WE WANTED TO START DOING THIS, HOW DO WE GET STARTED, HOW DO WE APPROACH RAM OFFICIALS AND HOW LONG–HOW LONG–WHAT IS THE LAG TIME OF GETTING STARTED TO WHEN AN EVENT WOULD ACTUALLY GET STARTED.>>YOU YOU WANT TO TAKE THAT?>>WHAT YOU NEED TO DO IS GET INVOLVED ON A LOCAL LEVEL, SO YOU COULD GO TO THEIR SCHEDULE AND SEE WHERE THEY’RE HAVING THEIR CLINICS, YOU KNOW THE CLINIC IS ALMOST A MISSED NUMBER OF CALLS BECAUSE THE ONE IN VIRGINIA, THEY’VE HAD UP TO 5000 PEOPLE THERE. BUT, SO, IF YOU WORK AT THE LOCAL RAM PEOPLE, THAT’S USUALLY HOSPITAL WORKERS, ET CETERA, AND THEN GO FROM THERE. THAT’S ALL WE’VE ALWAYS DONE. ACTUALLY I WOULD GO TO THE [INDISCERNIBLE], THERE AND I LEARNED A LOT OF WHAT WAS GOING ON. BUT THEY DO HAVE A SCHEDULE FOR THE YEAR FOR–OR WEBPAGE.>>SO RICK, THIS IS MARGARET, SO I THINK WHAT I HEAR YOU SAYING IS THAT THE LARGER ORGANIZATION SCHEDULES THE EVENT AND THEN AT SOME POINT THE LOCAL GROUPS START THEIR PLANNING MEETINGS AND THAT’S WHEN YOU SUGGEST GETTING INVOLVED?>>U-HUH, AND YOU I’VE BEEN SO IMPRESSED BY THE AMOUNT OF WORK. THEY’LL START PLANNING A YEAR OR SO IN ADVANCE SO IT’S VERY COMPLEX AND IT’S ALL VOLUNTEERS. FOR EXAMPLE, THERE WAS ONE AT A COLLEGE 30-MILES FROM HERE LAST FALL, NEW ONE, IT’S TUSCAN COLLEGE AND IT WAS IN TENNESSEE WE DID NOT PARTICIPATE IN THAT BUT IF WE WANTED TOO, THAT’S WHAT WE WOULD HAVE DONE. I WOULD HAVE CALLED AROUND TO DIFFERENT PEOPLE I KNOW IN GREENVILLE AND ASK WHO’S LEADING THIS COMMUNITY AND ASK IF WE COULD EITHER SPEAK WITH THEM OR COME TO ONE OF THEIR MEETINGS AND TELL THEM WHAT WE CAN DO.>>YEAH, I THINK PART OF WHAT I HEARD RICK SAY WAS DON’T WAIT FOR AN INVITATION. FIND THE EVENT AND MENTION TO US OR SAY, HEY WE HEARD THIS OTHER LIBRARY DOES THIS IN THE TRI-CITIES AND WE WANT TO DO IT HERE. JUST, IT SOUNDS LIKE KIND OF INSERT YOURSELF, FIND THE EVENT AND THEN SHOW UP AND VOLUNTEER.>>BE A REGISTERED VOLUNTEER.>>SO SOMETHING NAKIA MENTIONED IF YOU WORK WITH THE LOCAL COMMUNITY AND YOU’RE ALL SET UP TO PARTICIPATE IN THE EVENT, WHEN IT AM CANS CLOSE TO THE ACTUAL EVENT, YOU MAY NEED TO REGISTER ON THEIR WEB SITE AS A VOLUNTEER, WHICH WILL–THAT PROCESS WILL LOOK A LITTLE BIT WEIRD BECAUSE THEY’RE EXPECTING YOU TO BE LIKE A DOCTOR OR SOMETHING LIKE THAT. BASICALLY YOU CAN PUT IN A NOTE AND SAY THIS IS THE WHATEVER LIBRARY. WE’RE SET UP TO HAVE A BOOTH AT THIS EVENT AND THIS IS WHAT WE WANT. SO YOU DO NEED TO REGISTER A HAD THE OF TIME AND THAT WILL LOOK A LITTLE BIT STRANGE BUT THAT WILL BE PART OF THE PROCESS.>>WE ACTUALLY HAVE IN SOME OF THE EVENTS TOO MANY VOLUNTEERS THAT’S WHY THEY REGISTER AND THEY GET TOO MANY GENTLEMEN VOLUNTEERS AND THEY FOUND OUT FROM PAST EXPERIENCE THAT PEOPLE START GETTING IN THE WAY.>>SO ANOTHER QUESTION I HAVE AS FAR AS THE HEALTHCARE PROVIDERS, DO THEY KNOW IN ADVANCE WHEN A LIBRARY IS GOING TO BE THERE, WHEN LIBRARY FOLKS ARE GOING TO BE THERE HANDING OUT HEALTH INFORMATION, OR? WELL, USUALLY PROBABLY NOT I MEAN THIS WOULD JUST DEPEND ON THE LOCAL SITUATION, A COUPLE TIMES AT THE BIG FINDINGS MEETINGS I TOAD UP AND TOLD THEM WHAT WE PLAN TO DO. SOMETIMES WHEN THERE WERE MEDICAL PEOPLE AND PHARMACISTS FROM ETSU, I WOULD WORK IN ADVANCE WITH THEM, PLUS THEY ALREADY KNEW SOME OF IT WHICH WAS HELPFUL. ONE TIME THERE WAS A NURSE WHO WAS TRIAGING EVERYBODY AND ASKED HER IF SHE COULD WORK WITH USA AND CONSUMERS HEALTH LEAGUES AS THEY CAME IN. SO I HAVE HAD SOME FAILURES AND SUCCESSES. ANOTHER GROUP WAS WITH NLM WAS HEALTH WAGON, THEY’VE BEEN FEATURED ON 60 MINUTES ALSO. WE’RE ABLE TO GET INTO PAPER WORK THERE, WHERE THIS IS THE BIG ONE. THEY ACTUALLY HAVE SOMETHING ON THE PATIENT WORK, SOME OF THE NEEDS CONSIDER HEALTH INFORMATION AND THEN THEY GIVE THOSE TO US. ONE YEAR WE HAD 400 THAT WE HANDLE AND NAWAS JUST–WE HAD DONE THIS AND IN THE GRANT PROJECT AND THE PEOPLE FROM THE HEALTH WAGON WHO ACTUALLY ORGANIZED WISE RAM THAT WAS NETWORKING.>>SO RICK WOULD YOU SAY SOME OF THE MEDICAL CARE PROVIDERS VOLUNTEERS THAT ARE JUST SOING US THAT DAY, RIGHT? SO GOING AROUND MIGHT EVENT KNOW THAT YOU’RE THERE IS PROBABLY IMPORTANT TO YOU ONCE YOU GET THERE ONSITE.>>IT IS. LET EVERYBODY NEEDS HEALTH INFORMATION, THERE’S SOME UPSTAIRS, VISION FOLKS AND WE DO KIND OF LET THEM KNOW.>>THIS IS [INDISCERNIBLE] FROM NLM, YOU MENTIONED EARLIER ABOUT PARTNERING WITH EITHER LOCAL LIBRARIES OR PUBLIC LIBRARIES, WHAT IS YOUR EXPERIENCE DOING THAT? AND HOW DOES THE COORDINATION WORK OUT?>>WELL WE HAVE A GROUP, THE TRI-CITIES HEALTH SCIENCE REHABILITATION RESEARCH CONSORTIUM, LOCAL HEALTH SCIENCE LIBRARY GROUP, SO WE MADE THE EVENT THEIR EVENT TOO, EVEN THOUGH IT WAS PRETTY MUCH US AND WE GOT THESE HOSPITAL OPERATORS TO COME AND THEY WERE GREAT. WE ALSO HAVE A LOCAL PUBLIC COOP GROUP SO WE SPREAD THE WORD WITH THEM AND THEY BECAME SOME OF OUR BEST WORKERS. RACHEL MENTIONED THAT ONE IDEA IS TO BRING OLD NOVELS AND THROW AWAY BOOKS AND WE HAD SOMEBODY DO THAT AND THAT WAS A HOOK TO GET PEOPLE TO COME. SO JUST BY USING OUR GREAT PROFESSIONAL ORGANIZATIONS WE WERE ABLE TO THROW THE NET OUT, GET VOLUNTEERS. WE WANT IT TO BE A VERY MUCH MULTI LIBRARYIAN EFFECT, NOT JUST [INDISCERNIBLE] EVENT AND IT HAS BEEN EVERY TIME WE’VE DONE IT.>>AND THAT’S SOMETHING THE RML MAY WANT TO LOOK OUT FOR AS THEY GET FUNDING APPLICATIONS FOR THIS THING, TOO, WE TRY TO COORDINATE BUT FOR EXAMPLE, IF RML GOT AN APPLICATION FROM US AND ALSO ONE FROM OUR PUBLIC LIBRARY, HOPEFULLY THEY WOULD COME BACK AND SAY, HEY YOU GUYS ARE GOING TO BE THERE WHY DON’T YOU WORK TOGETHER.>>SO THAT’S SOMETHING ON THE RML HAND AND THAT HAY HAVE IT INCORPORATED MAYBE YOU CAN ENCOURAGE THAT.>>THANK YOU.>>SO IT’S DIANE AGAIN. I HAVE ANOTHER QUESTION. SO YOU MENTIONED SEVERAL NLM RESOURCES AND ALSO THE NEED FOR FUNDING, IS THERE ANY OTHER NLM RESOURCES OR MATERIALS THAT YOU THINK WE SHOULD CONSIDER PROVIDING?>>[INDISCERNIBLE].>>WE DO A TON OF DIFFERENT THINGS FROM NLM OR YOU KNOW MEDLINE PLUS–I REFER PEOPLE TO MEDLINE PLUS, PRINT OUT INFORMATION SHEETS FOR THINGS, AGAIN IT’S THE MEDLINE PLUS MAGAZINES ARE SUPER POPULAR FOR SOME REASON. YEAH, AND THEY MENTIONED, CLINICALTRIALS.GOV. JUST TAKING ADVANTAGE OF THAT, PRINTING IT OUT, MAKING IT AVAILABLE. TAKING ADVANTAGE OF THAT STUFF.>>YOU KNOW OUR DREAM IS IF YOU COULD TO THE EVENTS AND PEOPLE LIKE US SET UP AND YOU COULD COME TO WATCH VIDEOS, EVEN SOME OF THE OTHER PROVIDER VS LOOKED INTO THIS, I DON’T KNOW IF THAT’S SOMETHING NLM DOES OR PEOPLE IN THESE CUES WAITING TO GET ALL THE TEETH PULLED THEY COULD WATCH ENTERTAINING BUT YET VERY GOOD HEALTH VIDEOS AND THINGS.>>[INDISCERNIBLE].>>EXACTLY, YEAH, THESE FOLKS ARE VERY LOW LITERACY FOLKS. GOOD POINT NAKIA.>>ON ONE OF YOUR SLIDES YOU MENTIONED LANGUAGE NEEDS SO DO YOU CONSIDER THAT OR DO YOU MAKE CONTACT WITH THE ORGANIZERS TO SEE IF YOU NEED TO BRING–BRING ANY STAFF WITH PARTICULAR LANGUAGE SKILLS?>>YOU COULD DEFINITELY DO THAT AND I THINK HAVING YOU KNOW JUST BEING AWARE OF THAT LOCAL COMMUNITY AND WHAT THE MOST PREVALENT LANGUAGES ARE, IS IMPORTANT AS WELL, WE MIGHT NEED SOME SPANISH LANGUAGE MATERIALS, BUT SOMEBODY ELSE MIGHT NEED, YOU KNOW ANOTHER AREA, MIGHT NEED A WIDER VARIETY OF ALTERNATE LANGUAGE ITEMS. SO I THINK, KNOWING YOUR LOCAL AREA IS IMPORTANT FOR THAT, TOO.>>THANK YOU.>>ANY OTHER QUESTIONS FOR US?>>PLEASE DON’T FORGET TO UNMEET YOUR PHONE AND ASK ANY QUESTIONS IF YOU HAVE ANY.>>THIS IS CATHY BURROS IN THE PACIFIC NORTHWEST REGION AND I WANT TO SAY THAT I LOOK ON THE RAM SITE AND THEY HAVE A SCHEDULE THAT LISTS SIX OR SEVEN STATES THAT THEY’RE PLANNING ON HAVING EVENTS IN BUT IN THE STATE OF WASHINGTON THEY HAVE PARTNERED WITH THE LOCAL CLINICS HERE TO PUT ON A FREE HEALTH CLINIC SO I THINK THAT’S ONE OTHER AVENUE THAT THE RAM DOES IS WORK WITH PARTNERS AND THOSE SCHEDULES WOULDN’T NECESSARILY BE ON THE MAIN WEB SITE JUST AS AN FYI.>>YEAH, YOU KNOW AND I DON’T THINK IT WOULD HURT TO CONTACT THEM AND SAY, HEY, YOU KNOW, ARE YOU ALL EVER PLANNING TO DO SOMETHING IN OUR AREA OR DO YOU KNOW OF SOMETHING? DO YOU KNOW IF OF ANY OTHER GROUPS DOING SOMETHING SIMILAR IN OUR AREA. I DON’T THINK WE WOULD MIND TO HEAR THAT FROM YOU AT ALL.>>AND REMEMBER ONE AREA THEY HAVE, FOR THE CLINICIANS TO COME IN AND PRACTICE FOR LIKE TWO DAYS ON [INDISCERNIBLE], STAN [INDISCERNIBLE] IS GONE, TESTIFIED BEFORE STATE LEGISLATURES AROUND THE COUNTRY TO GET THEM TO DO THIS. [INDISCERNIBLE]>>YEAH AND SOMETHING FOR TO YOU THINK ABOUT IN YOUR PERSONAL CONTACT WITH YOUR LEGISLATORS AND THAT SORT OF THING, IF YOU EVER SEE BILLS THAT COME UP IN YOUR STATE, BAR CLINICIANS FROM COMING IN, YOU WANT TO THINK ABOUT THIS KIND OF EVENT AND THE EFFECT IT WOULD HAVE.>>SOME OF THE ISSUES WE’VE HAD COME FROM ALL OVER, WE HAVE DENTISTS THAT COME AND MAKE IT THEIR HOBBY TO COME TO THE RAM EVENTS.>>I’M CHECKING RIGHT NOW.>>WELL I DON’T THINK ANYONE ELSE HAS QUESTIONS SO I THINK WE WILL GO AHEAD AND END HERE WITH THE CAVEAT THAT IF ANYONE DOES HAVE ANY QUESTIONS AFTERWARDS IF YOU HAD FOLLOW UP THOUGHTS OR QUESTIONS PLEASE CONTACT THE NETWORK OFFICE OR I’M ASSUMING RACHEL OR NAKIA OR RICK WOULDN’T MIND AN E-MAIL AS WELL. SO THANK YOU FOR THAT PRESENTATION, IT WAS FABULOUS, WE APPRECIATE YOUR TIME.>>THANKS.>>THANK YOU.>>THANK YOU EVERYONE FOR ATTENDING.>>THANK YOU SO MUCH.

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