The Mississippi Health Care Alliance evolved from a brainstorming meeting between leadership from Mississippi Baptist Medical Center (MBMC) of Jackson and North Mississippi Medical Center (NMMC) on January 3, 2007.
Chuck Stokes CEO, Murray Estes MD, Barry Bertolet MD, Butch Guest MD and George Hand, Cath lab Director of NMMC met with Gerald Cotton CEO and Steve Jackson VP of MBMC and Cindy Lynch RN of Schering Plough.
Consideration of a hospital based quality program to include a data registry CRUSADE, sponsored by Duke Clinical Research Institute and Schering-Plough was the purpose of the meeting. Discussions centered on the impact of cardiovascular disease, specifically CMS’s recognition of ST Elevation Myocardial Infarction (STEMI) and Non-ST Elevation Myocardial Infarction (NSTEMI) as separate treatable conditions, and the impact of each on complications, length of stay, cost and mortality.
Mississippi Baptist Medical Center and North Mississippi Medical Center agreed to work together sharing best practices. They would ask Forrest General Hospital (FGH) in south central part of the state and Singing River Health Systems (SRHS) on the coast to join and form the framework of the Mississippi Health Care Alliance (MHCA). It was hoped to eventually join all major hospitals in this mission.
On January 17, 2007 these four hospitals came together for the first meeting of the Alliance held in the board room at Mississippi Baptist Medical Center. Attendees included Gerald Cotton CEO, Steve Jackson VP, and Heather Sistrunk CV Director of MBMC; Bill Oliver CEO and Angela Pace, Quality Director of FGH; George Hand CV Director of NMMC; Larry Shoemaker CMO of SRHS and Cindy Lynch RN of Schering-Plough.
Discussions centered on the many devastating diseases that plague our state. It was decided that the Mississippi Healthcare Alliance needed to address cardiovascular disease (CVD), the number one cause for admissions, mortality and consumption of health care resources, $2.5 billion annually. Three problematic areas within CVD were identified—STEMI, NSTEMI and Heart Failure. The Alliance hospitals agreed to set the standards in striving for excellence in the care and treatment of cardiovascular disease by leading efforts surrounding the STEMI patient.
The Mission and Vision of the Alliance was formed:
Mission: Improve the health status of Mississippians
Vision: Unite stakeholders to bring about an alignment of efforts that reduce morbidity, mortality, and cost associated with problematic disease process that plague our community
The Mission and Vision would be carried out through four pillars of focus: Education, Marketing, Community and Networking.
The Alliance continued to form its foundations, share best practice and plan for roll out across the state through May 2008. At that time the cardiology community in the capital went through dynamic changes and the Alliance was put on hold.
December 2008 Dr. Harper Stone, Cardiologist of Jackson Heart Clinic decided to revive the Alliance. Dr. Stone met with Heather Sistrunk, Cindy Lynch and Tobey Houston to discuss Mission, Vision, initial areas of focus and fundamental pillars. It was decided to pull together the founding members.
ACC MS Chapter held its Annual Meeting on Saturday, May 30, 2009 at the Oxford Conference Center in Oxford, MS. This meeting was held in conjunction with MS State Medical Association Annual Meeting. In attendance were Dr. Harper Stone, Dr. Bryan Barksdale, Dr. Michael Mansour, Dr. Thad Waites, Dr. Murray Estess and Heather Sistrunk. Dr. Stone gave a presentation to the attendees to introduce them to the MS Healthcare Alliance and explain to them how the mission of the Alliance was to improve quality of care in our state. He discussed the means whereby we as a statewide entity would work to get this mission accomplished.
The first true Statewide Meeting of MHCA called by Dr. Stone was held at River Hills Country Club in Jackson on August 6, 2009. Those in attendance include Dr. Harper Stone, Dr. Murray Estess, George Hand, Dr. Barry Bertolet, Tobey Houston, RN, Dr. William Harper, Mark Slyter, Jerry Cotton, Heather Sistrunk, RN, Mike O’Leary, Lester Diamond, Dr. Richard Rayford, Dr. Thad Waites, Dr. Bob Wilkins, Evan Dillard, and Cindy Lynch, RN. The agenda included an overview and call to action of national and Mississippi statistics of heart disease, governmental regulation of problematic diagnoses with starting poing-CVD. The fundamentals of a State System of Care would include:
- Standardized practice based on evidenced based medicine
- Maximized Health Care Access
- Professional and community Education
- Demonstration of Quality Performance through data collection, review and process improvement
- Participation in research opportunities
This would later become a state project to include all 19 Percutaneous Coronary Intervention (PCI) Hospitals, Non-PCI Hospitals, Emergency Medical Services and other healthcare partners. It was decided to use the model of North Carolinas approach, the Reperfusion AMI of Carolinas Emergency Department (RACE), and the ACTION registry to identify metrics measure the process. At this time all 19 Centers agreed to provide seed funding for MHCA to jumpstart the processes.
August 28, 2010, MHCA hosted its first statewide symposium for all 19 PCI Centers including representation from Cardiologists, Emergency Physicians, Hospital Administrators, Nurses, EMS, insurers and other partners to begin providing education related to forming a STEMI system of care. Partners with the alliance include The American Heart Association, The American College of Cardiology, the State Department of Health, Mississippi Hospital Association, and Wise Carter Child and Caraway, P.A. Lieutenant Governor Phil Bryant closed the symposium with remarks and a call to action.
Since August 2009 the Alliance has held regular meetings with hospitals and partners working to enhance communication and care among all healthcare providers, including statewide medication protocols, educational symposiums and regional structure. All hospitals are submitting data through ACTION/Mission Lifeline registry, and Mississippi will be the first state to generate a state report. This report will demonstrate areas for focus and educational opportunities as well as best practices. In 2011, MHCA began efforts to develop Stroke System of care. In October 2012 Dee Howard, RN was named Executive Director, and Angie Carter was named Executive Assistant. January 2013 MHCA received 501(c)3 designation with IRS in order to receive funding through the MS Legislature as a line item in the MSDH Health Bill.
The Stroke System of Care was adopted by MSDH October 9, 2013. Mississippi became the first state in the United States to have three Systems of Care to include Trauma, STEMI, and Stroke.
The creating of the Dial Don’t Drive Campaign began in 2011 with filming of television commercials regionally highlighting local physicians emphasizing to the public the importance of Dialing 911 for symptoms of heart attack and stroke. Continuation through the years with Amacker, Inc. marketing/advertising agency has grown into creation of many new television commercials and radio advertising to include stroke patient scenario emphasizing the importance of EMS assessment time at the scene. An MHCA Facebook page was begun to also boost the awareness of the mission of the Alliance. Through data collection we find that education is continually needed for Mississippians to Dial 911 for heart attack and stroke symptoms.
ASLS (Acute Stroke Life Support) Provider and Instructor training began in MS in 2016. Regional ASLS Training Centers were begun at North MS Medical Center, St. Dominic Hospital, and Pascagoula Hospital-Singing River Health System. ASLS training is free for participants.
In 2017 MS became the first state in the nation to provide CPR in Schools for the entire state by providing a monetary grant to AHA to purchase “Hands Only” CPR training kits for public and private schools.
Also, in 2017 MHCA offered grants to STEMI Receiving Hospitals to participate in Pulsara, a software platform that is a HIPAA-compliant, secure, easy-to-use app that unites the entire care team — even if they are in different departments or organizations. (rural or urban). By replacing multiple phone calls, radio reports, faxes, and pagers with one unified patient channel, care providers see reduced treatment times, reduced costs, and improve the lives of both patients and caregivers.
In 2017 MHCA enrolled in CARES (Cardiac Arrest Resuscitation to Enhance Survival), an out of hospital presumably cardiac in origin cardiac arrest national registry. CARES begin with two EMS agencies AMR Jackson and AMR Gulfport. Expansion across the state to enroll other MS EMS agencies and addition of MS hospitals ensued. MHCA funds the yearly participation cost so that CARES is free for EMS agencies and hospitals to participate. As of 2022 MS has 28 EMS agencies and 68 hospitals participating to include 81.9% of MS population covered.
Our goal to have all MS EMS agencies and hospitals tracking cardiac arrest outcomes.
In 2018 MHCA provided TTM (Targeted Temperature Management) equipment for all STEMI Receiving Centers that did not have the therapy. OHCA patients who qualify post arrest can now receive this AHA/ECC Class 1A targeted temperature management therapy to improve survival. A MS TTM Protocol was developed to share with hospitals providing this lifesaving therapy.
In 2019 MHCA awarded Paramedic Education grants to six MS students currently enrolled in a paramedic training programs.
In 2020 MHCA provided AutoPulse automatic chest compressor devices for seventeen qualifying EMS agencies.
In March 2020 COVID-19 cases began to be documented in MS. It quickly became apparent that this virus was becoming more and more widespread and deadly across our country, and MS needed a public health plan. Mississippi Governor Tate Reeves signed Executive Order No. 1457 on March 4, 2020, which designated MSDH as the lead state agency to coordinate emergency response activities related to COVID-19 and established the Mississippi Coronavirus (COVID-19) Preparedness and Response Steering Committee. On March 14, 2020 Governor Reeves declared a State of Emergency to provide for the coordinated response of all levels of government and provide health officials with the necessary resources and guidance to effectively combat the spread of COVID-19. The same day the Mississippi State Board of Health issued a proclamation, which stated in part: “the State Health Officer, upon the documentation of the need for the waiver or amendment may, in writing, waive or amend any rule or regulation promulgated by the Mississippi State Board of Health.”
On April 3, 2020, Governor Tate Reeves’ Task force requested MS Healthcare Alliance President Dr. Harper Stone to assist with development of a MS COVID-19 System of Care. MHCA immediately went to work organizing teams of experts to draft protocols:
- Prehospital/EMS Protocols
- Clyde Deschamp, PhD
- Rick Carlton, MD
- Hospital Protocols/Hospital Tiers
- Fred Duggan, MD
- Steve Stogner, MD
- Convalescent Protocols
- Jim Craig, MPH, MSDH Senior Deputy and Director of Health Protection
On April 7, 2020, MHCA held a webinar to review protocol planning with stakeholders.
On April 8, 2020, COVID-19 System of Care documents were approved by MS State Board of Health.
On April 9, 2020, MHCA held a Webex to roll out the COVID-19 System of Care to the state.
On April 10, 2020, MHCA developed critical care/pulmonary physician consult call schedules for hospitals regionally across the state.
On April 15, 2020, Dr. Stone and Dee Howard meet with Jim Craig of MSDH to update the COVID-19 System of Care. Documents were updated April 19, 2020. On April 22, 2020, MHCA updated existing Dial Don’t Drive commercials to educate public to continue to Dial 911 even in a pandemic for STEMI and stroke symptoms.
On April 27, 2020, phone interviews with regional cardiologists and radio stations were scheduled to educate the public to Dial 911 during the pandemic for STEMI and stroke symptoms. People across the nation had been known to avoid going to the hospital even for life-threatening heart attack and stroke symptoms because they feared contracting the coronavirus. Many people unfortunately died at home due to lack of seeking emergency care.
On June 15, 2020/July 1, 2020, MHCA and MSDH held COVID-19 SOC updates and needs awareness meetings. MSDH graciously acknowledged MHCA for being instrumental in the development of the FY2020 MS COVID-19 System of Care Plan.
In 2021 MHCA allotted a portion of the legislative funding to help hospitals get started with RapidAI, an advanced cerebrovascular imaging product that empowers clinicians to make faster, more accurate diagnostic and treatment decisions for stroke and aneurysm patients using clinically proven, data-driven technology. Often the patient in a rural hospital may need transfer to a Level 1endovascular stroke hospital for treatment of a large vessel occlusion. RapidAI can identify these patients for you. This software importantly helps eliminate needless transfers.
In 2021 MHCA brought attention to the state and national EMS crisis. Live radio interviews and newspaper articles across the state were produced to educate the public about the shortage of prehospital EMTs and paramedics. Links to EMT and paramedic training programs located in MS were provided.
2020-2022 MHCA focused on the life-threatening problem of sepsis in MS. Dr. Clyde Deschamp formed a taskforce of clinical experts across the state to meet periodically and plan prehospital and hospital sepsis early recognition and treatment protocols. These protocols were introduced at the July 2021 MHCA Regional Symposiums held in Tupelo, Jackson, and Hattiesburg. In February 2022 MHCA hosted a critical care/pulmonology physician expert to speak on “Optimizing Sepsis Care in 2022” at the Statewide Symposium. Plans were made for a MS Sepsis System of Care with MSDH to be written in FY23.
In 2022 after ten years in her position as the first MHCA Executive Director, Dee Howard, BSN-RN announced plans to step down from her role in order to transition into retirement and spend more time with family and friends. Christy McGregor, MSN-RN was hired August 2022 as the second MHCA Executive Director.