Heart of New Ulm Project at New Ulm Medical Center

New Ulm Medical Center
New Ulm, MN
45 Beds

The Problem
New Ulm Medical Center, a critical access hospital that is part of Allina Health, is a not-for-profit health care system that includes more than 90 clinics, 11 hospitals, 15 pharmacies and specialty care centers and medical services. New Ulm Medical Center is located in New Ulm, Minnesota, a town of 13,500 residents. Key to New Ulm Medical Center's population health focus and rural health model is its strategic foundation, which includes an integrated health care team, electronic health records, coordinated clinical service lines and community health engagement.

In the mid-2000s, New Ulm government and business leaders identified health and wellness as a top priority. In 2006, New Ulm achieved “Governor's Fit City” status in recognition of the city's commitment to improve the health of its residents by encouraging physical activity. The community was approached in 2008 to see if it would be interested in improving health and preventing heart attacks through Hearts Beat Back: The Heart of New Ulm Project. Throughout all of the project's activities, the commitment and engagement of the entire community has been critical.

The Solution
In 2008, Allina Health collaborated with the Minneapolis Heart Institute Foundation to launch the Heart of New Ulm project. Heart of New Ulm is designed to reduce the number of heart attacks that occur in the New Ulm area over a 10-year period by helping residents make lifestyle changes, such as getting more physically active, making healthier eating choices, maintaining a healthy weight, managing stress and quitting smoking. The Heart of New Ulm project applies evidence-based practices in the community, health care, worksites and environment. To help plan and promote health initiatives, a 36-member steering committee includes representatives from a broad, multi-sector base, including local employers, the City of New Ulm, Chamber of Commerce, churches, school district, local colleges, New Ulm Medical Center, Brown County Public Health and the general community.

Project interventions include worksite wellness programs and consultations with local businesses; tobacco control policy work; restaurant, convenience and grocery store programs; physician continuing medical education; free community heart health screenings; and community educational programs and health challenges. To help New Ulm Medical Center patients who are at high risk for heart disease or who have diabetes or heart disease, a free phone-coaching program is provided. Individuals are proactively invited to participate based on data from their electronic health record, as well as referrals from New Ulm Medical Center's primary care providers. The program provides patients with supplemental education and support between regular office visits with their primary care provider. The community provides an enthusiastic group of volunteers. Numerous local employers and their employees have embraced worksite wellness initiatives, local schools have developed opportunities to improve wellness for their staff as well as students, and local produce farmers are working to provide more fruits and vegetables to the community.

The Result

The Heart of New Ulm project has had considerable success in improving community health. Comparing data from community heart screenings held in 2009 and 2011, the project has recorded an increase in healthy lifestyle behaviors. Changes include:
Increase in the number of people eating five or more fruits and vegetables per day from19 percent to 33 percent;
Improvement in the number of people taking daily aspirin from 32 percent to 40 percent;
Increase in the percent of people getting 150 minutes a week of moderate exercise from 67 percent to 77 percent.

Data trends from electronic health record data—which represents between 75 percent and 81 percent of the population in the 40 to 79 age group—show solid improvements in biometric risk factors:
Decrease in the percent of residents with high blood pressure from nearly 21 percent to less than 18 percent;
Decrease in the percent of residents with high cholesterol from nearly 11 percent to less than 9 percent;
Decrease in the percent of residents with high triglycerides from nearly 34 percent to just under 32 percent.

Lessons Learned
Community buy-in and a sense of ownership from the onset are critical. Throughout all of the project's activities, the commitment and engagement of the entire community has been important. By using the electronic health records as the primary population surveillance tool, project planners can target population segments and disease risk levels with the goal of identifying, implementing and tracking interventions. Strong support from physicians and the health care team is critical, as they play a key role in advocating for Heart of New Ulm's services and contribute significantly to improving the health of patients in the community.

Contact Information
Toby Freier
President
New Ulm Medical Center
(507) 217-5108
Toby.Freier@allina.com

Jackie Boucher
Vice President of Education
Minneapolis Heart Institute Foundation
(612) 863-1636
JBoucher@mhif.org

This case study was originally featured in the HPOE guide: 'The Role of Small and Rural Hospitals and Care Systems in Effective Population Health Partnerships,' published June 2013.