History - Mississippi Healthcare Alliance

The Mississippi Health Care Alliance (MHCA) originated from a brainstorming meeting on January 3, 2007, between leaders from Mississippi Baptist Medical Center (MBMC) and North Mississippi Medical Center (NMMC). They discussed creating a hospital-based quality program, focusing on cardiovascular disease, specifically STEMI and NSTEMI, and agreed to collaborate and share best practices. By January 17, 2007, MBMC, NMMC, Forrest General Hospital (FGH), and Singing River Health Systems (SRHS) formed the MHCA to address cardiovascular disease, the leading cause of admissions and mortality, costing the state at that time 400 million dollars. The Alliance hospitals agreed to set standards for excellence in the care and treatment of cardiovascular disease by leading efforts surrounding STEMI patients and using national registry data to support process improvement.

Reviewing National and state statistics, Governmental regulation of problematic diagnoses with the starting point-CVD. The fundamentals of a formal System of Care would include:

Standardized practice based on evidence-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 that included 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 the North Carolina approach, the Reperfusion AMI of Carolinas Emergency Department (RACE), and the ACTION registry to identify metrics to measure the process. At that time, all 19 Centers agreed to provide seed funding for MHCA to jumpstart the processes. The STEMI System of Care was formed in 2008 and adopted by the Mississippi State Department of Health (MSDH) in 2010.

In 2011, MHCA began efforts to develop a Stroke System that would include the same fundamentals as a formal System of Care. At that time, the Stroke System included 58 self-designated stroke hospitals participating in the American Heart Association’s Get with the Guidelines-Stroke registry. The Stroke System was adopted by MSDH by 2013. ASLS (Acute Stroke Life Support) Provider and Instructor training began in MS in 2016.

Since its inception, MHCA has launched several major initiatives through lobbying efforts within the MS State Legislature:

In 2017, MHCA offered grants to STEMI Receiving Hospitals to participate in Pulsara, a HIPAA-compliant app that unites the entire care team, reducing treatment times and costs while improving patient and caregiver lives[^i^]. MHCA also enrolled in CARES, a national cardiac arrest registry, funding participation costs to ensure free access for EMS agencies and hospitals. By 2022, 28 EMS agencies and 68 hospitals were participating, covering 81.9% of the MS population.
In 2018, MHCA provided Targeted Temperature Management (TTM) equipment to STEMI Receiving Centers, developing a protocol to improve survival for post-arrest patients.
In 2019, MHCA awarded Paramedic Education grants to six MS students.
In 2020, MHCA provided AutoPulse automatic chest compressor devices to seventeen qualifying EMS agencies.
During the COVID-19 pandemic in 2020, MHCA developed the MS COVID-19 System of Care, organized expert teams to draft protocols, and rolled out the system statewide per Governor Tate Reeves’ Task Force request.
In 2021, MHCA allotted a portion of the legislative funding to help hospitals start with RapidAI. This advanced cerebrovascular imaging product empowers clinicians to make faster, more accurate diagnostic and treatment decisions for stroke and aneurysm patients using clinically proven, data-driven technology.
In 2022, MHCA focused on the life-threatening problem of sepsis in MS and formed a task force of clinical experts across the state to meet periodically and plan prehospital and hospital sepsis early recognition and treatment protocols. MHCA had expanded its participation in the CARES (Cardiac Arrest Resuscitation to Enhance Survival) national registry, covering 81.9% of the MS population with 28 EMS agencies and 68 hospitals participating.
In 2023, MHCA provided funding for EMS and Hospitals to deliver the new American Heart Association Advance Life Stroke Support courses for healthcare providers and instructors. MHCA also partnered with AHA and the MS Fire Academy to fund over 300 CPR in School Kits through and the training of school staff on the program.
In 2024, MHCA expanded the Pulsara network, enabling a stronger spoke-and-hub concept, improve EMS communication, deliver crucial information swiftly and accurately, provide a telemedicine platform, and patient recovery through armband utilization.

History Continuation

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.