STUDENT HEALTH SERVICE
ANNUAL REPORT
July 1, 2005 through June 30, 2006
The University of Iowa
Iowa City, Iowa
TABLE OF CONTENTS
Mission of the Student Health Service................................................................................ 1
Student Health Service Staff 2005-2006............................................................................. 2
Director ............................................................................................................................... 4
Student Health Service Strategic Plan FY 2006-2010 ........................................................ 6
Business Manager ............................................................................................................... 8
Chief of Staff....................................................................................................................... 9
Performance Improvement Coordinator ........................................................................... 12
Patient Perception of Care ................................................................................................ 17
Nursing/Scheduling/Reception/Medical Records Service ................................................ 18
Health Iowa....................................................................................................................... 22
Health Iowa Strategic Directions 2003-2010.................................................................... 27
Stepping Up Project .......................................................................................................... 29
Women’s Health/Gynecology........................................................................................... 31
Psychiatry.......................................................................................................................... 34
Disease Codes ................................................................................................................... 35
Pediatric Resident Coordinator ......................................................................................... 37
Westlawn Pharmacy Report.............................................................................................. 38
Student Health Advisory Committee (SHAC).................................................................. 39
SHAC Report on Mandatory Student Health Insurance ................................................... 42
SHAC Information............................................................................................................ 54
Student Health Service Staff Council ............................................................................... 55
Student Health Service Outpatient Activity Summary ..................................................... 57
Non-Disease Contact with Student Health Service........................................................... 58
Disease-Oriented Contact with Student Health Service.................................................... 60
Student Health Service Laboratory Procedures ................................................................ 66
Students Referred to UIHC by Student Health Service .................................................... 67
Graphs of Patient Activity
Comparison of Disease Diagnoses VS. Non-Disease Diagnoses ..................................... 68
Non-Disease Breakdown by Diagnosis............................................................................. 69
Disease Breakdown by Diagnosis..................................................................................... 70
Disease and Non-Disease Breakdown by Diagnosis ........................................................ 71
MISSION OF THE STUDENT HEALTH SERVICE
The mission of the Student Health Service is to provide competent and quality health care
for all students, while recognizing their own individuality as it pertains to treating their
particular problems; to promote preventive medicine and healthy lifestyles; to develop
educational and outreach programs; and to make student visits an informational and
educational experience.
STUDENT HEALTH SERVICE STAFF
2005-2006
ADMINISTRATION
Director:
Associate Director/Nurse Manager:
Business Manager:
Administrative Assistant:
Chief of Staff:
Project Assistant
Health Iowa Coordinator:
Secretary to the Director:
Administrative Secretary:
PHYSICIANS
Mary Khowassah, MD
Paul Baumert, MD
Rebecca Chackalackal, MD
Eric Evans, MD
Mary Hacker, MD
Teri Kerkhoff, MD (started 10/05)
Ann Laros, MD
Monica Meeker , MD
Marina Usacheva, MD
Joy M. Hudson, MD
Paul W. Natvig, MD
Mary Khowassah, MD
Lisa James, RN, MSN, RNC
R. Elaine Davis, BBA, MA, CPA
Nancy Davin
Rebecca Chackalackal, MD
Nancy Ford
Sarah Hansen, MA, CHES
Linda Abel
Jennifer Tinnes
Students: Rachel Scholten (left 9/05)
Angie Hammer (started 9/05)
Kelly O’Regan (started 10/05)
Miriam Gebhardt (started 5/06)
PHYSICIAN ASSISTANT
Robin Hayward, PA-C
NURSING
Lisa James, RN, MSN, RNC, Associate Director, Nurse Manager
Rose Bollei, LPN
Teresa Brackett, Nursing Assistant
Jan Bush, RN
Beth Cannell, Clerk III
Katie Cavanaugh, RN, BSN, RNC
Holly Frank, CMA, (started 10/05)
Jennifer Hamner, RN, BSN, RNC
Kathryn Heick, CMA
Linda Hruby, RN, BSN, RNC
Peg Johnson, RN, BSN, RNC
Mary Beth Kelch, RN, BSN, RNC, Assistant Nurse Manager
Johnita Langenberg, RN, RNC
Angela Lehman, RN, BSN
Dom Mascardo, RN, BSN, RNC
Gayle Nelson, RN, MS, RNC
Kathryn Prediger, RN, BSN, MA, RNC, Performance Improvement Coordinator
Joyce Schultz, RN, RNC
Brenda Sperry, CMA, (left 10/05)
Ayantu Sultan, CMA
Graduate Assistant: Sangeetha Madhavan, TB Prevention (left 5/06)
LABORATORY
Robert Harris, MT (ASCP)
SUPPORT STAFF
Theresa Melohn - Supervisor
Dana Anderson (left 7/05)
Sherry Black
Michael Blake
Doug Eden
Mary Etre
Elizabeth Hall
Janet Ripley
Merrie Sanchez (started 11/05)
Beverly Schneider
Molly Senneff
Jeanette Stewart
Mary Swihart
Tracy Varcoe
Karen Wilcox (started 12/05)
Diane Worley
Students:
Steve Canady
Allison Frederick (8/05-1/06)
Kari Lehmkuhl
Kathleen Stillmunkes
Tara Wagner (3/06-4/06)
Amanda Woods (started 6/06)
HEALTH EDUCATION PROGRAM (HEALTH IOWA)
Sarah Hansen, MA, CHES, Coordinator
Tanya Villhauer, Health Educator MA
Ed Haycraft, LMSW, Certified Substance Abuse Counselor
Amy Fletcher, MS, Fitness Specialist
Katherine Mellen, MA, RD, LD Dietitian
Graduate Assistants:
Abigail Becker (left 5/06)
Diana Preschel (left 5/06)
Kayla Haptonstall (8/05-5/06)
Mark Morrison
Students:
Jessalyn Murray (8/05-5/06)
Jordan Lynch (left 5/06)
Renae Knox (started 5/06)
Stephanie Preschel (started 5/06)
Intern: Katie Hill (8/05-12/05)
Lucas Christain (1/06-5/06)
Megan Armstrong (started 5/06)
Trish Schiltz (started 1/06)
DIRECTOR
A primary goal of the University of Iowa Student Health Service is to provide student centered health
services to ensure retention and academic success.
Some changes have occurred this year in the provider staff. Dr. Teri Kerkhoff joined the staff on a
temporary full time appointment. She will continue as one of our permanent physicians working 50%
time and Dr. Eric Evans will fill the other 50% position. Dr. Monica Meeker will be leaving the Student
Health Service to return to private practice in Mount Vernon, Iowa. She will be replaced by Dr. Michael
Schmidt. Dr. Kathy Wittich will fill the 75% line vacated by Dr. Evans.
Kathy Prediger continues to lead the clinic’s commitment to adhering to the standards of the Joint
Commission on Accreditation of Healthcare Organizations. Her diligence and attention to detail are
beyond measure and are invaluable to the clinic.
The clinic continues its transition to a paperless environment. Radiology requisitions are now done
online as well as nurse telephone line documentations. Other areas scheduled for transitioning to the
Informm Patient Record (electronic medical record) system include Travel/Allergy, Nurse Care Room,
and administrative visits.
Funding for the Stepping Up Project ended this year. The Vice President for Student Services and Dean
of Students, Phillip Jones, has committed to continued funding for the coordinator’s position and some
support staff. The Student Health Service, together with some other University departments, has
committed resources to implement AlcoholEdu as a mandatory program for all new students attending the
University over the next four years. The Stepping Up coordinator will supervise this exciting endeavor to
reduce high risk alcohol consumption in our students.
This year, Iowa City was the epicenter for a mumps outbreak. The Student Health Service worked
closely with the Johnson County Public Health Department, the Iowa Department of Public Health and
the University of Iowa Hospitals and Clinics Department of Epidemiology and the Infectious Diseases
Department. The University’s two MMR requirement which was begun in 2003 will be continued. Many
patients diagnosed with mumps had documentation of two MMRs. On April 13, 2006 Iowa City was hit
by a tornado. There was widespread destruction but no deaths in Johnson County. The University
responded with understanding and compassion to both of these events.
This year, Provost Hogan named a task force on pandemic influenza preparedness. Professor Christopher
Atchison chaired this task force and together with other task force members created a document that will
help guide the University if a pandemic were to occur. Lisa James, Sarah Hansen and I served on this
task force.
Several reclassifications and restructurings occurred this year. Lisa James has been named Associate
Director with increased responsibilities in the area of clinical operations as well as assisting the Director
in her responsibilities and covering those responsibilities in the Director’s absence. Elaine Davis has been
named Business Manager and will be supervising all business office activities. Changes in the Student
Health Service funding will continue to be a challenge and long range financial planning to enable bond
payment responsibilities is crucial. Kathy Prediger was also reclassified to Program Associate to better
reflect her responsibilities.
I was deeply honored and very grateful for receiving the Distinguished Achievement Award this year
from the University of Iowa. I was humbled by the award itself but also very moved by the many letters
of support for my nomination. I will treasure the award always.
A special thanks this year to Bob Brooks, Associate Director for Landscape Services, for installing
benches in front of the Westlawn Building. This adds so much to staff and student satisfaction with the
Westlawn environment. Parking access cards are being implemented for use in University Parking lots.
The card contains an antenna that reflects a radio signal emitted by the reader. Features of the new cards
enhance efficiency, proper use, and safety.
The Student Health Advisory Committee was somewhat less active this year partially due to the chair’s
(Ben Darbro) being a full time medical student. Despite his other responsibilities, however, Ben has been
able to keep alive the issue of mandatory health insurance for all students. This will be discussed again
this fall with the Board of Regents.
The Student Health Service was saddened this year to learn that the Virtual Hospital, the Internet’s first
medical web site, ceased operations due to lack of funding.
The Student Health Service received a visit from Dr. Pui Yin Chiu, Infectious Diseases Expert from Hong
Kong, She and I discussed health issues that involve young people of Hong Kong and the United States.
Special thanks are extended to the following people for their ongoing interest, guidance, and support for
our clinic:
Donna Katen-Bahensky, Director and CEO, the University of Iowa Hospitals and Clinics, Dr.
Dan Fick, Assistant Dean of Clinical Affairs, College of Medicine and Senior Assistant Director,
the University of Iowa Hospitals and Clinics , and Mr. Phillip Jones, Vice President for Student
Services and Dean of Students.
The following is a list of committee memberships and other responsibilities held by the Director during
2005-2006:
• University Task Force on Infectious Diseases
• Student Services Directors Meetings
• Athletic Health Care Advisory Committee
• Student Athlete Assistance Program
• University of Iowa Health Plans Medical Advisory Board
• Robert Wood Johnson Stepping Up Coalition and Executive Committee (Chair), and
Community Policy Task Force
• Big Ten Directors Meetings
• University of Iowa Coalition Against Sexual Assault
• Introducing Iowa
• Student Insurance Committee
• SHAC (Student Health Advisory Committee)
Respectfully submitted,
Mary Khowassah, M.D.
Director
Student Health Service Strategic Plan
FY 2006-2010
The Strategic Plan for 2006-2010 provides a framework for strengthening the Student Health Service by
weaving its goals into its mission focus of providing health care for students; recognizing all students as
persons with their own individual qualities while counseling or treating them for their particular
problems; promoting preventive medicine and healthy lifestyles; developing education and outreach
programs; and making student visits an informative and educational experience. The goals and strategies
in the SHS plan directly relate to the Division of Student Services Strategic Plan and “The Iowa Promise,
A Strategic Plan for the University of Iowa.”
Goal #1: Providing quality physical and mental health care for students to ensure retention.
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Supporting Strategies:
Instituting a Regents institution-wide plan for mandatory student health insurance
Serving as lead agency in planning, implementation, and coordination of infectious disease response
(including Pandemic Influenza) for UI student population.
Providing quality health care identifying the unique needs of graduate and professional students.
Conducting an infectious disease prevention and surveillance program for undergraduate, health
science and international students.
Decreasing incidence of tuberculosis worldwide through a prevention and surveillance program for
international students.
Creating an innovative and vibrant video and orientation program to educate new international
students about American health care.
Providing ongoing training for SHS staff regarding college student cognitive and moral development
in order to support and increase student-centered health services.
Supporting and encouraging SHS staff to keep pace with technological demands for healthcare
delivery.
Providing student-centered services such as satellite immunization clinics, online scheduling, sameday appointments, on-line form submission, and online access to immunization status.
Completing successful transition to a new computerized information system through the University of
Iowa Hospitals and clinics.
Continuing collaboration with University Counseling Service, Vice President of Student Services,
Office of International Students and Scholars, Office of Housing, Public Safety, Men’s and Women’s
Athletics, College of Medicine, Liberal Arts, Admissions, Registrar’s Office, Department of Health
and Sports Studies, College of Nursing, Center for International Services, Department of College
Student Development and others.
Maintaining relationships with the University of Iowa Hospitals and Clinics and the University
Hygienic Lab in order to provide vital medical services
Continuing and maintain current relationships with American College Health Association, Joint
Commission on Accreditation of Healthcare Organizations, Johnson County and Iowa State Public
Health Departments, MECCA, Healthy People 2010, Sixth Judicial District Courts, and others.
Continuing a strong working relationship with the state and county public health departments.
Goal #2: Providing state of the art health education and promotion services related to college health
issues, including alcohol, tobacco, other drugs, sexual health, nutrition, fitness, and stress and to assist
in the facilitation of a climate of intolerance to violent, abusive, and destructive behavior.
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Supporting Strategies
Expanding alcohol education targeting all first-year students.
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Providing online offerings such as patient education tutorials, an innovative website, and health
behavior change incentive programs
Collaborating with campus and community agencies to broaden scope and integration of health
promotion offerings for residence halls, Greek organizations, academic courses, community efforts,
and recreational facilities.
Increasing health promotion staffing/programming to address key leading health indicators of
substance abuse, overweight/obesity.
Providing timely and effective substance abuse intervention services for identified students within the
graduate/professional colleges.
Creating innovative course offerings integrated into academic programs to address health topics such
as alcohol, tobacco, and resiliency.
Continuing innovative delivery of health promotion services via the web, curriculum infusion, and
satellite operations/partnerships.
Writing grants to support priorities such as integration of substance abuse screening into SHS clinical
operations.
Maintaining a commitment to reducing the harmful effects of high risk drinking by using
environmental strategies to promote a campus community where all can live, work and have fun.
Goal #3: Positioning SHS as an essential component in achieving the University of Iowa’s institutional
mission and goals
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Supporting Strategies:
Continuing the collaborative reporting relationship with UIHC and the VPSS to benefit the SHS and
students.
Continuing collaboration with University Counseling Service, Vice President of Student Services,
Office of International Students and Scholars, Office of Housing, Public Safety, Men’s and Women’s
Athletics, College of Medicine, Liberal Arts, Admissions, Registrar’s Office, Department of Health
and Sports Studies, College of Nursing, Center for International Services, Department of College
Student Development and others.
Continuing and maintain current relationships with American College Health Association, Joint
Commission on Accreditation of Healthcare Organizations, Johnson County and Iowa State Public
Health Departments, MECCA, Healthy People 2010, Sixth Judicial District Courts, and others.
Encouraging and support teaching, research and service activities among Student Health Service staff.
Continuing a strong working relationship with the state and county public health departments.
CHIEF OF STAFF
Provider Staff 2005-2006 academic year:
Director:
Mary Khowassah, M.D.
Gynecology: Ann Laros, M.D.
Primary care: Paul Baumert, M.D., Eric Evans, M.D., Mary Hacker, M.D., Robin Hayward, PA, Teri
Kerkhoff M.D., Monica Meeker, M.D, and Marina Usacheva, M.D.
Psychiatry:
Joy Hudson, M.D., Paul Natvig, M.D.
Provider Responsibilities for 2005-2006
Chief of Staff:
Performance Improvement Committee:
Staff Council:
Physician Chart Reviews:
Coordinator for Pediatric Residents:
Allergy/Travel:
Coordinator of Athletic Responsibilities:
Lab Consultant:
Health Information Management:
Preventive Health:
Pharmacy and Therapeutics:
Medical Record Review:
Psychiatry Performance Improvement:
Women’s Health:
Sentinel Events:
Health Iowa Consultants:
University of Counseling Liaison:
R. Chackalackal
E. Evans, M Hacker
A. Laros, R. Hayward
M. Khowassah
R. Chackalackal
M. Hacker
P. Baumert
P. Baumert
P. Natvig
M. Meeker
E. Evans, P. Natvig
M. Meeker, M Usacheva
P. Natvig
A. Laros
J. Hudson
R Chackalackal, J. Hudson
P. Natvig
Staffing Changes
There were several staffing changes that occurred during the 2005-2006 year. Dr. Teri Kerkhoff replaced
him with a temporary appointment in October of 2005. Dr. Monica Meeker announced that she would be
leaving Student Health Service in August 2006. Dr. Mary Hacker announced she would retire in late
2006 or early 2007. Dr. Kerkhoff was hired as a 50% time provider in June 2006. Dr. Eric Evans also
decided to cut down to 50% time. A replacement for Dr. Meeker was found and will start at the health
service in fall of 2006. A replacement for Dr. Hacker will start in December 2006.
Continuing Medical Education
We continue to hold monthly CME meetings. This program is certified by the University of Iowa Roy J.
and Lucille A. Carver College of Medicine.
Noon conferences held at Student Health Service (2005-2006):
Sports and Infections
Presented by Loreen Herwaldt, M.D., Hospital Infection Control Officer and Dept. of Internal Medicine
Pap Smears, an Update
Presented by Ann Laros, M.D.
Accurate E and M Coding
Presented by Eric Evans, M.D.
Osteoporosis and College Aged Anorexia
Presented by Patricia Westmoreland, M.D., Department of Internal Medicine
Hypertension
Presented by Michael Flanigan, M.D., Department of Internal Medicine
Eating Disorders – Continuum of Care
Presented by Frank Sammat and Arnold Andersen, M.D., Department of Psychiatry
Update on Generic Medications and Other Pharmacy Topics
Presented by Kim Spading, R.Ph.
Measuring and Treating Pain, Selected Scales and Tools
Presented by Paul Pursely and Mike Shaffer, UIHC Rehab Therapies
Acupuncture
Presented by Yang Ahn, M.D. the Ahn Clinic
Runner’s Issues
Presented by George Phillips, M.D. Department of Pediatrics
Electronic Medical References
Presented by Chris Shaffer, UI Libraries
Medical Record
There were many changes to our charting system this year. In an attempt to reduce paper waste and move
toward electronic records, we ceased printing clinic notes early in the year. We began printing electronic
prescriptions or sending them directly to a pharmacy. We began ordering radiologic tests electronically as
well. We plan to move toward electronic laboratory ordering and electronic physician consults in the
upcoming year. We have plans for the Travel and Allergy clinic to document on IPR in the upcoming
year as well.
More UIHC clinics have converted to electronic charting in the past year. This has helped greatly with
communication between providers. For example, the ETC now routinely sends copies of student’s notes
to our providers. We also generally notify other providers within the clinic when we see their patients.
The University of Iowa Hospitals and Clinics has come near the end of their search for a new and better
electronic record. We have participated in this process and have given feedback. The decision will occur
soon, and there are high hopes that our new electronic record will improve charting and patient care.
Scheduling
We continue to struggle with the best way to provide care for all patients who want to be seen “urgently”.
In an attempt to improve rapid access without increased wait time, we opened more “same day” slots
(appointment times that open up first thing in the morning). We also moved regularly scheduled annual
exams or physicals to our less busy days/times. This has improved the situation greatly. We continue to
have late hours two days per week in order to accommodate student requests.
Toward the end of the year, we began exploring Open Access Scheduling. We will continue to investigate
this system of scheduling to see if indeed it would work better than our current system for both the
patients and the providers.
Mumps
We were surprised by a Mumps epidemic this year. The providers began seeing cases of parotitis early in
the year. As the cases multiplied, investigations began and Johnson County Public Health and the CDC
became involved. A total of 224 patients were evaluated for mumps. 78 of these cases turned out to be
positive for the mumps virus. Of these, 68 students had had 2 MMR immunizations and 10 students had 1
MMR immunization. Most cases were mild. There were rare complications. There were no deaths.
Drs. Usacheva and Laros presented what we learned at the American College Health Association Meeting
in New York City in May.
Outreach
We work closely with University Counseling Service. Not only do we work in close physical proximity,
but we have many patients in common. We met with the University Counseling Service staff this year in
order to discuss ways that we could improve access to both services when needed and better ways to share
information regarding patients.
Another idea that staff has had for more outreach was to make some changes to the website. The existing
website is already award winning and provides students with much necessary and desired information
about health issues. But, because students are so web savvy, we want to communicate even better with
them in this manner. Ideas to improve the site include showing how to schedule appointments and what a
typical office visit consists of. We have added direct links to approved medical websites that have reliable
medical information and self care ideas. This work will continue on an ongoing basis through a
collaborative effort of Health Iowa staff and staff physicians.
Superbill
There were some changes made to the superbill this year. This was in an effort to improve coding
accuracy and specificity. It was also an attempt to make providers more accountable for coding their
office visits correctly. Most recently, a carbon copy of the superbill has been attached to the original copy.
The original copy is given to the patient for check out and the carbon copy stays in the chart for the
coders making for a smoother procedure.
Teaching
We continue to participate in Pediatric resident education. As part of the third year resident’s
adolescent medicine rotation, they spend two days per week at our clinic. We have had some
family practice third year residents rotate through Student Health Services as well, and have
had several requests for next school year.
In addition to residents, we have both medical and athletic training students who spend time at
SHS. They shadow providers as they see patients, learning about adolescent and college
health.
Athletic Coverage
Our provider staff continues to provide primary care health coverage for the University of Iowa athletic
teams. This includes pre-participation exams on all incoming athletes. For many events our staff
members also provide sideline and locker room coverage. This includes men’s basketball, wrestling and
football and women’s basketball. Some away events are also covered, including men’s football games
and one to two band trips per year. Dr. George Phillips from the Department of Pediatrics covers the
men’s basketball primary care in collaboration with Student Health.
Summary
In conclusion, it has been another good year at the University of Iowa Student Health Service. The staff
members, both old and new, work together toward the same goal, and all contribute in diverse ways
toward the same. We continue to be Joint Commission accredited and are awaiting another JCAHO lab
and clinic review in the near future. We strive to live up to our mission and to provide the best possible
health care to the students of this fine university.
Respectfully submitted,
Rebecca Chackalackal, M.D.
Chief of Staff
PERFORMANCE IMPROVEMENT PROGRAM
The Student Health Service (SHS) Performance Improvement Program provides a framework to promote
customer safety and quality of care, improve patient outcomes, enhance practice operations, improve
organization performance and reduce risk of unanticipated adverse events. Performance improvement is a
responsibility of all employees. A multidisciplinary group of employees, the Performance Improvement
Committee, meets monthly to support the Performance Improvement Program and facilitate oversight of
the Environment of Care, Infection Control and Patient Safety Programs. The committee is chaired by the
performance improvement coordinator for which leadership delegates oversight of the program. The
coordinator is responsible for planning, management, implementation and evaluation of ongoing
performance improvement activities in the SHS.
Quality and Safety Activities
In January 2006, the Joint Commission on Accreditation of Health Care Organizations (JCAHO)
implemented a new unannounced survey process. In December 2005, the SHS began conducting mock
surveys to assess staff knowledge of key processes, identify potential practice and policy improvements
and to enhance staff comfort in talking about the care and services they provide. This has proven to be a
very useful tool in assessing compliance with JCAHO standards, educating staff and identifying
improvement opportunities. The SHS is scheduled for unannounced Ambulatory Care and Laboratory
JCAHO surveys during calendar year 2006. The surveys did not occur during the first half of the
calendar year.
The JCAHO requires annual completion of a Periodic Performance Review (PPR). The PPR is a self
evaluation of compliance with JCAHO standards and focuses on patient safety and quality of care issues.
Due to a change in the timeframe for the PPR, the SHS was not scheduled to submit a PPR during FY
2006. Work is in progress on the PPRs for both Laboratory and Ambulatory services that will be
submitted during the first half of FY 2007. During the Ambulatory PPR conducted in FY 2005, 3
standards were identified as areas for improvement. Plans of action and goals were developed and
implemented to address these standards. Since October 2005, the goals have been consistently met for
these standards.
The SHS Patient Safety Program provides the framework for reducing risk and addressing patient safety
issues. This program is evaluated each calendar year. A key component of the Patient Safety Program is
the implementation of the JCAHO National Patient Safety Goals (NPSGs). The 2006 NPSGs were
utilized to identify and implement measures to improve safety and quality of care. A number of measures
were taken to improve medication safety with a focus on collecting, reconciling and communicating
patient medication information. Steps were taken to improve medication labeling. A new process for
patient “handoffs” was implemented to ensure that essential information is communicated to the next
caregiver.
Employee input on safety is solicited through many forums. As part of the January 2006 staff survey,
employees were asked to help identify high-risk processes in the Student Health Service. The medication
management process was again chosen as the primary focus with emphasis on medication procurement
and storage. A proactive risk assessment utilizing the Failure, Mode, Effect, Analysis (FMEA) process
was initiated this spring and is in the implementation phase. The FMEA initiated in 2005, accurate
patient medication list, was completed. The SHS celebrated National Patient Safety Week in March with
an educational display in the main waiting room. The performance improvement bulletin board, in the
staff lounge, frequently focuses on patient safety issues.
Team projects utilizing the SHS PI process [I (identify the problem); A (analyze the problem); D
(design/plan the solution); I (implement the solution); M (measure results); and E (evaluate and revise)]
included the following: medication procurement and storage, labeling medications on and off the sterile
field, brochure consolidation, medication refrigerator storage, appointment utilization, accurate patient
medication list, dictation/documentation error reduction, and patient survey response rate. These projects
were either initiated in or continued through fiscal year 2006. Many additional measures were
implemented to improve quality and safety of care at the SHS.
Organizational Performance Indicators
Organizational performance indicators for FY 2006 included: Customer Perception of Care and Services,
Employee Satisfaction, Quality of Care and Financial Performance. Each indicator has 1 or more
associated measures. Some of the measures have sub-measures. Goals are established for each measure
and/or sub-measure. In addition, some measures have action levels.
Ten of the 19 measure goals were met or exceeded, 7 measures were between goal and action level and 2
fell within action level. Actions are being taken to address all areas that are below goal level.
Customer Perception of Care and Services was measured by the patient satisfaction surveys administered
in November 2005 and April 2006 (see page 17). As part of the effort to make the survey user friendly
and improve response rate, an electronic version of the survey was used on a trial basis during the
summer of 2005. As part of the transition questions were reformatted and revised. Survey response rate
was 9% during the summer trial, however improved for the fall (17%) and spring surveys (30%). The
survey was also transitioned from a number scale to a grading scale with the theme “Give Student Health
Service a Grade”. Patient satisfaction is expressed as the percentage of patients that grade each question
in a particular category as A or B on a scale of A (great) to F (poor). An average percentage and grade is
then calculated for each category. Goals and action levels were established for each category of survey
questions. The fall and spring patient satisfaction average results appear in the table below.
Ease of getting care
Waiting
Staff
Payment
Facility
Confidentiality
Safety
Use Services again
Goal 90% or >, action threshold
83.8%
<85%
Goal 90% or >, action threshold
86.8%
<85%
Goal 90% or >, action threshold
90.1%
<85%
Goal 85% or >, action threshold
77.6%
<80%
Goal 85% or >, action threshold
83.25%
<80%
Goal 95% or >, action threshold <90%94.1%
Goal 95% or >, action threshold
94.9%
<90%
Goal 95% or >, action threshold
94.6%
<90%
The Performance Improvement Committee reviews customer input obtained through the SHS surveys,
interactions, electronic mail, comment cards, the M1 Shadow Survey and the University of Iowa First
Year Student surveys. The SHS also receives student input from the Student Health Advisory
Committee. Some examples of the improvement activities that resulted from patient input were
development of a brochure about insurance, addition of information and forms on the SHS web site and
the addition of another scheduler to facilitate ease of scheduling appointments. The clinic is currently
exploring open access scheduling and other potential initiatives to improve access and flow.
Employee Satisfaction was measured by turnover rate and the annual staff survey. The annual turnover
rate was 3.8%, a decrease from 11.1% the previous fiscal year. The turnover rate is below both the
external and internal turnover rate benchmarks.
The annual staff survey was distributed in January 2006. Thirty employees responded, an increase from
22 the previous year. The survey solicited staff input in 5 areas: high risk processes, culture of safety, job
satisfaction, customer satisfaction, and staff educational needs. The staff satisfaction percentage is based
on the number of staff that responded they were “satisfied” or “very satisfied” on a 5 point scale of very
dissatisfied to very satisfied. The satisfaction rate was 80%. This is a decline from 90% the previous
year, however remains above the 61% rating in 2004. No staff responded that they were “very
dissatisfied. Staff received a written summary report about the survey. Administration utilized the input
to identify employee learning needs and SHS improvement opportunities.
Staff turnover rate
Employee satisfaction
survey
External benchmark 6.7% Goal: less than
6.7%
SHS turnover rate average 10.5%
90% or greater staff will be satisfied or very
satisfied.
3.8%
80%
The Quality of Care performance indicators included consistency of diagnosis, next day return rate,
physician chart review annual variation rate and surgical and gynecological procedure component rates.
The consistency of diagnosis rate was 100%. The average annual next day return rate was 2.6%. This is
a decrease from 3.1% the previous year.
The physician chart review annual variation rate was 0.40%, a slight increase from 0.34% the previous
year. It remained below the 1% threshold. The criterion with highest variation was E&M coding. An
annual coding compliance audit was initiated in January 2006. Monthly meetings were held to address
coding and documentation issues. These meetings will continue in FY 2007.
The rates of compliance or variation for 5 key measures of surgical and gynecological procedure
components were averaged for the fiscal year. The surgical and gynecological procedure goals were met
for 4 of the 5 key measures. The average annual rate of documentation of the verification/time out
process (part of the Universal Protocol) was below the goal of 100%. It has remained at goal (100%)
since January, 2006.
Physician chart
review
Consistency of
Diagnosis
Surgical and
Gynecological
Procedures
Note: This data is for July 05-May 06.
June 06 data was not available at the
time this report was completed.
Significant complications/ infections
Documentation of suture removal
Tissue not sent to pathology but
indicated
-Communication of results
documented
Documentation of verification/time
out process (as described in Universal
Protocol)
Next Day Return
Rate
Average annual variation rate
will not exceed 1%
0.40%
Greater or equal to 95%
consistency
Goal of 5% or less
Goal of 95% or >greater
0%
100%
Goal of 5% or less
0.5%
Goal of 95% or greater.
98.9%
Goal of 100%
98.3%
Not to exceed 5%
2.6%
100%
The Financial Performance indicator was the Consistency of Budget Plans monitor. The goal was for the
annual actual income and expenses to be within +/- 10% of the projected budget. This goal was met.
End of year financial plans
Annual actual income and expenses will be
within +/-10% of the projected budget
Income:
+1.2%
Expenses: 0.6%
Annual Performance Improvement Goals
Five of the 9 FY 2006 Performance Improvement Program goals were met. Two were not applicable and
2 were partially met in FY 2006. The goals that were not applicable or partially met will be continued
into FY 2007
Goals for FY 2005 included:
• Continued emphasis on enhancing quality through activities including:
o
o
o
Self assessment of quality and safety of ambulatory care and laboratory services utilizing the
JCAHO Periodic Performance Review tool. Submission of self assessment results to JCAHO
within the required time frame. (not applicable)
Participation in JCAHO unannounced surveys of the ambulatory care services and laboratory
and maintenance of accreditation. (not applicable)
Initiation of tracers during low volume time periods. (met)
•
Continued emphasis on surgical and gynecological procedure process and documentation
improvements to improve quality of care, patient safety and achieve organizational indicator
goals. (partially met)
•
Continued emphasis on patient safety through activities including:
o Implementation of JCAHO 2006 NPSGs (met)
o Emphasis on staff education and monitoring of compliance with all JCAHO NPSGs (met)
o Performance of at least one proactive risk assessment using the FMEA process. (met)
o Obtainment and maintenance of an accurate patient medication list on IPR. (partially met)
•
Evaluation and improvement of the Environment of Care, Medication Management Infection
Control and Patient Safety Programs. (met)
Goals for FY 2007 include:
• Continued emphasis on enhancing quality through activities including:
o Self assessment of quality and safety of ambulatory care and laboratory services utilizing the
JCAHO Periodic Performance Review (PPR) tool.
o Submission of PPR self assessment results to JCAHO within the required time frame.
o Participation in JCAHO unannounced surveys of the Ambulatory care services and
Laboratory and maintenance of accreditation.
o Conducting at least 10 mock survey tracers during the fiscal year.
•
Continued emphasis on patient safety through activities including:
o Implementation of JCAHO 2007 National Patient Safety Goals (NPSGs).
o Emphasis on staff education and monitoring of compliance with all JCAHO NPSGs
o Performance of at least one proactive risk assessment using the FMEA process.
o Continued emphasis on the medication reconciliation process.
ƒ When asked during mock survey tracers, 100% of clinical staff will accurately describe
the process (create a list with patient participation, reconcile the list when medications are
added, communicate the list to the patient and caregivers)
ƒ Medical record audits will demonstrate 100% compliance for at least 3 consecutive
months prior to January 1, 2007.
o
•
Implementation, improvement and evaluation of the Environment of Care, Medication
Management, Infection control and Patient Safety Programs.
Focus on both internal and external customer satisfaction
o Measures will be taken to raise Ease of getting care and Payment categories on the survey
above action levels.
o Continue to solicit staff input formally and informally regarding measures the clinic can take
to improve staff and customer satisfaction. Review and implement measures when feasible.
o Customer service in-service will be held for all departments during FY 2007.
The Performance Improvement Committee is vitally important to the success and smooth operation of the
clinic. A special thanks is extended not only to the committee members but also to all staff for
participation in the many activities that maintain and improve the quality of care provided at the Student
Health Service.
Respectfully submitted,
Kathy Prediger MA, RNBC
Performance Improvement Coordinator
Jul-05
Percent
Satisfaction
Response Rate
Ease of getting care:
Ability to get in to be seen in a timely manner
Hours clinic is open
Convenience of location
Promptness in returning telephone calls
Waiting:
Time to check-in
Time in waiting room
Time in exam room
Waiting for test results
Staff:
Scheduler was friendly and helpful
Receptionist was friendly and helpful
Provider listened to me
Provider took enough time with me
Provider explained what I wanted to know
Provider gave good advice and treatment
I was given information on pain management
Nurses/MA's were friendly and helpful
Nurses/MA's answered my questions
Payment:
Explanation of charges
Explanation of payment options
Facility:
Ease of finding clinic
Ease of parking
Comfort while waiting
Confidentiality of my personal information:
Safety:
Safety of the care I received from the doctors, PA, and nursing
staff
Safety of the lab services I received
Safety while waiting
Given a choice, would you use our services again?
228/2442 (9%)
88.4
92.3
86.8
85.4
89.1
90.4
93.7
87.8
90.0
90.1
93.3
85.9
88.5
97.0
95.4
Nov-05
Grade
B
AB
B
BAA
B
AAA
B
BA
A
Percent
Satisfaction
299/1807
(17%)
85.0
85.0
84.2
82.9
88.0
88.6
91.7
86.6
89.6
86.4
91.5
85.1
88.3
84.6
93.3
May-06
B
B
B
B
B+
B+
AB
B+
B
AB
B+
B
A
Percent
Satisfaction
363/1208
(30%)
82.5
81.5
81.9
78.5
88.1
85.0
92.3
79.8
85.3
82.7
88.7
82.1
85.4
93.5
91.6
Grade
Grade
B
BBC+
B+
B
A
C+
B
BB+
BB
A
A-
96.0
95.8
92.4
94.1
94.2
81.9
81.8
82.0
86.6
89.6
77.9
92.4
93.7
N/A
A
A
AA
A
BBBB
BC
AA
N/A
93.7
92.6
91.1
92.7
92.6
83.2
83.7
82.7
84.7
88.6
76.3
89.1
93.8
94.6
A
AAAAB
B
BB
B+
C
B+
A
A
90.6
90.6
86.6
90.0
88.0
72.0
72.6
71.3
81.8
89.8
70.9
84.7
94.4
95.2
AAB
AB+
CCCBB+
CB
A
A
N/A
N/A
N/A
97.3
N/A
N/A
N/A
A
94.9
94.1
94.8
95.0
A
A
A
A
95.8
95.2
94.7
94.1
A
A
A
A
A+
A
AB+
B
BC+
C
CD+
D
DF
Scale
98.0-100
93.0-97.9
90.0-92.9
88.0-89.9
83.0-87.9
80.0-82.9
78.0-79.9
73.0-77.9
70.0-72.9
68.0-69.9
63.0-67.9
60.0-62.9
0-59.9
NURSING
It has been a busy and rewarding year for the nursing staff. The nursing-provider team concept
implemented last year is going strong, and it has been a great satisfier for both providers and nurses.
Continuity is much improved, and this benefits the patients who have frequent visits to SHS. Our
environment is fast-paced, and the abilities of nurses to anticipate provider and patient needs is enhanced
by this team approach.
We hired Holly Frank as a new Medical Assistant in October. She was a Kirkwood student who did her
MA externship with us, and we were very happy to have her join our team.
Our staff is composed of:
ƒ
10 Registered Nurses; the majority of our RNs are certified in College Health Nursing and others
are exploring specialty certification.
ƒ
1 Licensed Practical Nurse
ƒ
3 Medical Assistants, also cross-trained to provide lab coverage
ƒ
1 Nursing Assistant
ƒ
1 Clerk III
Travel and Allergy Clinic
Mary Beth Kelch, RNC, ANM, Gayle Nelson, RNC, Linda Hruby, RNC, and Jennifer Hamner, RNC
provide leadership in this nurse-directed area. This clinic serves students who are planning travel abroad
by providing vaccinations and destination-specific health information. In addition, we provide allergy
injections for students in consultation with their local allergists and our SHS physicians.
ƒ
Total Travel and Allergy visits:
1,851 visits (slight decrease from last year)
Nurse Care Room
This nurse-directed room is staffed primarily by the nurses listed above, in addition to Johnnie
Langenberg, RNC. Students utilize this area of our clinic to meet health-related registration requirements,
and to receive follow-up testing after visits with our providers. We held “walk-in” clinics in the weeks
before early registration in the fall and spring, so that students could receive any required vaccinations,
tests, or titres at their convenience. In the fall, we traveled to the athletic facilities and the IMU to provide
flu vaccinations for students.
Activities that take place in the Nurse Care Room include:
ƒ
Health requirements review and vaccinations
ƒ
Lab sample collection (blood draws, urine collection)
ƒ
Blood pressure monitoring
ƒ
Respirator mask fit-testing
ƒ
PPD placement and assessment
ƒ
Counseling and treatment of latent tuberculosis infection
ƒ
Total Nurse Care Room visits:
8,082 (slight decrease from last year)
Nurseline Program (Telephone Triage Nurse)
Another area of our clinic that is increasingly utilized by students is our telephone triage nurse line. The
Nurseline is staffed by RNs. We had an extremely busy year and the mumps epidemic on campus greatly
impacted this area of the clinic. Our nurses were valuable sources of information for students, parents,
and faculty who had questions and concerns about the mumps. The Nurseline staff function in a critical
role when our clinic appointments are full, ensuring that students who require urgent care receive
appropriate and timely access to our clinic services. Many students and parents simply need to speak to a
health care professional with questions and concerns, and the Nurseline RNs fulfill this important need.
18
Most frequent types of calls include:
ƒ
Requests for health information
ƒ
Requests for test or lab results
ƒ
Pharmacy refill requests and questions
ƒ
Total number of calls:
17,311 (14% increase from last year)
Primary Care
Our two primary care clinics are the hub of patient care activity. Team I consists of Dom Mascardo,
RNC, Katie Cavanaugh, RNC, and Holly Frank, CMA. Team II is Joyce Schultz, RNC, Peg Johnson,
RNC, and Ayantu Sultan, MA. Our upstairs clinic houses our women’s health area in addition to primary
care. Team III consists of Angie Lehman, RN, Rose Bollei, LPN, and Katie Heick, MA. Beth Cannell,
Clerk III, and Teresa Brackett, NA, round out the group of dedicated staff members who contribute to the
care of our patients. A strong nursing focus in this setting is implementation of specific goals of Healthy
People 2010, which emphasizes wellness and other health maintenance practices, such as keeping
immunizations up to date. The nursing staff that work in this area provide strong leadership in directing
the efficient flow of patients through the clinic. When appointments are full for the day, RNs expertly
triage patients so that those who need urgent care are evaluated as quickly as possible.
Blood-Borne Pathogen Exposure Program
Joyce Schultz, RNC, guides this important program in the clinic and on campus. She oversees the annual
review and update of our program for education, protocol development, and follow-up of student
exposure. All providers and RNs in the clinic are specially trained to care for students with a blood borne
pathogen exposure.
Activities related to this program include:
ƒ
Collaboration with UIHC ETC staff, UIHC Infection Control, Epidemiology, Deans of Health
Science Colleges, UIHC Employee Health Clinic
ƒ
Providing and updating information on the Student Health Service website
ƒ
Training and competency review for nursing and provider staff
ƒ
Presentations to student groups on campus
ƒ
Tracking of blood-borne pathogen exposures in the UI student population
We continue to work closely with UI faculty and the UIHC Emergency Treatment Center in the timely
evaluation and treatment of students with blood-borne pathogen exposures. We continue to explore ways
to educate health science students on the importance of placing safety first, and encouraging them to seek
timely follow-up should an exposure occur.
Numbers of Blood-Borne Pathogen Exposures:
July 1, 2005 through June 30, 2006
Student Population
College of Medicine
College of Nursing
College of Dentistry
College of Pharmacy
Other UI Students
Reported Exposures
17
5
33
0
4
Of these exposed students, 3 were initially started on a course of prophylactic antiviral medication due to
source patient risk factors; no students required completion of the full course. Our BBPE numbers for this
year are similar to last year, with the exception of the College of Medicine, which showed a slight
decrease.
19
Control of Communicable Disease
Surveillance, prevention and control of infection in the Student Health Service and on the UI campus are
the responsibility of the Associate Director, in consultation with the UIHC Department of Epidemiology,
the Johnson County and Iowa Departments of Public Health. The Associate Director and the Director are
members of the Infectious Disease Task Force, a UI campus/community committee to address issues that
arise. The over-riding goal of this program is to prevent and minimize the spread of communicable
disease on campus, so that our students can perform all of their academic responsibilities in a state of
good health.
In the spring, we participated in the UI Pandemic Influenza Task Force, and worked with other disciplines
on campus to formulate a university-wide plan for dealing with a pandemic. The Student Health Service
will be and integral part of the University’s response to pandemic influenza. This work is on-going and
future exercises are being planned.
Infection control activities include:
ƒ
ƒ
ƒ
Infectious disease exposure management, tracking and follow-up
Providing required and optional immunizations to prevent disease outbreaks
Providing education to the staff and students regarding prevention and control of communicable illness
The mumps epidemic in Iowa definitely was the highlight of our infection control focus on campus this
year. We were one of the college campuses that first began to see cases of the mumps, and it is a credit to
our providers that they pursued this diagnosis despite the belief that the likelihood of mumps in our highly
vaccinated student population was extremely low. Patient volume increased across our clinic because of
the mumps outbreak- the testing and follow up required was very labor intensive. We strived to
communicate with our staff, students, faculty, parents, and the media, and provided frequent updates on
our website. It was a challenging time, and I was very proud of how our staff handled the increased
pressure and workload. Several of our staff presented our experiences at the national American College
Health Association meeting in New York City in June.
Fortunately, other communicable diseases were at a relatively low level on campus this year. We had a
cluster of pertussis cases in the fall, but the influenza season was generally late and mild.
We are planning implementation of an education program related to new meningitis legislation that
requires us to provide information to all incoming students on meningitis disease and the vaccine, and to
track the meningitis vaccination rates of all freshmen who live in University Housing.
Tuberculosis Surveillance and Prevention Program
Gayle Nelson, RNC, is in charge of coordinating and overseeing this ambitious activity in our clinic. It is
a comprehensive program that includes collaboration with many other departments on campus, including
the Office of International Students and Scholars, the Health Science Colleges, the UIHC Departments of
Epidemiology and Internal Medicine, and the Johnson County and Iowa Departments of Public Health.
We are fortunate to have a graduate assistant, Sangeetha Madhaven, who assists Gayle with data
management, planning and implementation of TB-related activities. In the past year, we screened 1,687
students from all colleges at the UI. Like last year, we diagnosed a case of active TB disease in our fall
screening clinic, a validation of the importance of this activity and this program in protecting the health of
our students on campus, their families, and our community.
Activities of the TB Surveillance Program include:
ƒ Screening clinics for all incoming non-immigrant international students
ƒ Annual PPD skin test screening for all health science students
ƒ PPD skin test screening for travelers and for completion of employment physicals
ƒ Counseling and treatment of latent TB infection, exposure management and contact follow-up
20
Educational Activities
Our clinic leadership shows strong support for the provision of continuing education and professional
development of the staff. Nurses have attended regional and national meetings of the American College
Health Association, in addition to local offerings related to college health, including women’s health
conferences, office nurse conferences, and other programs. We actively utilize staff development
programs offered by the UIHC and the UI in an effort to help our staff grow professionally and improve
work performance.
The staff actively participates in the education of students from our own College of Nursing, and from
Kirkwood’s Medical Assistant program. These students have done preceptorships with our nursing staff
and experienced the fast pace of our college health setting. Our nurses also provide skillful guidance to
pediatric residents from the UIHC who rotate through our clinic. We value the opportunity to teach young
people entering these health care professions, and our staff does a great job in this capacity.
Outreach Activities
The SHS staff plays an integral role in the summer orientation sessions that the UI holds for incoming
students and parents. For each of the nine sessions at the IMU, our staff held an immunization clinic and
administered meningitis, hepatitis B and MMR vaccinations to new students. We value these orientation
sessions as a great opportunity to interact and connect with new students and their parents.
SCHEDULING
The Scheduling area remains an extremely busy part of the clinic. Mary Swihart, Clerk III, continues as
the Lead Scheduler. Bev Schneider and Molly Senneff make up the rest of the scheduling team. Due to
the volume of calls and the workload, Karen Wilcox was hired as an academic year scheduler in
December. Jennifer Tinnes and Mary Etre are great assets as back-up schedulers when the need arises.
Our schedulers are responsible for taking incoming calls, providing information, assisting students in the
clinic with appointment scheduling, making appointments for patients in multiple clinic areas and with
numerous providers and managing clerical duties for our psychiatrists. I have a great respect for the
challenging work they do every day.
ƒ
ƒ
ƒ
Total number of incoming calls:
Average number of calls per month:
Highest volume month (April):
51,175 (2% increase)
4,264
5,633
RECEPTION AND MEDICAL RECORDS
Often, the first personal contact that students receive in our clinic is from the front desk and medical
records staff. Theresa Melohn, Clerk IV, is the direct supervisor of the front desk staff (Sherry Black,
Tracy Varcoe, Mary Etre, Janet Ripley and Jeanette Stewart), Health Information Technicians (Michael
Blake and Doug Eden), and students (Kat Stillmunkes, Kari Lemkuhl, Steve Canady, and Allison
Frederick). The front desk has the important job of greeting and checking in patient visits, and they also
provide assistance and answer questions from students who call or come to our clinic for general
information. The health information technicians have adeptly handled an increasing workload and
provide valuable education to our staff regarding coding and reimbursement issues. Everyone in the
reception and medical records staff is committed to helping students have a good experience in our clinic.
Respectfully submitted,
Lisa James, RN, MSN, RNC
Associate Director
21
HEALTH IOWA REPORT
During 2005-06, Health Iowa’s comprehensive health promotion program reached 28,733 individuals
through individual consultations, group workshops, teaching, and training, a 12% increase over the
previous year. We had significant increases in both our individual consultations and our outreach
programming. Each Health Iowa staff member plays a vital role in Health Iowa’s mission to support
student learning through educational and health promotion services that help students create healthy and
balanced lifestyles.
Health Iowa revised our Strategic Directions, based on the Healthy Campus 2010 benchmarks. The
document is included in our report.
The SHS website remains a key information gateway for students, faculty, staff and public, with over
750,000 page views yearly. Anonymous questions answered by Health Iowa and SHS staff now number
over 800. The SHS website was successfully re-accredited this year by the Health on the Net (HON)
Foundation. We join over 5,000 websites in 72 countries who hold HON accreditation.
A new collaborative effort this year was implementing AlcoholEdu, a three-hour evidence-based online
alcohol education course required of all incoming first year students, beginning fall 2006. Working
together with the Office of the Provost, Vice President for Student Services, University Housing,
Stepping Up and others, we did extensive planning and implementation for the summer rollout including
speaking to many parents at Summer Orientation. We anxiously await the data from this intervention.
NUTRITION
Nutrition services were provided to students, professionals and the community through a variety of
channels over the past year. Nutrition information continues to be a topic of high interest.
For the second consecutive year, the number of nutrition visits increased by 10%. Frequent referral
sources included physicians, other campus services, athletics, and self-referral. The majority of students
were seen for weight management (39%), healthy eating (23%) or eating disorders (14%).
Over 1000 students received nutrition information via classroom lectures and presentations. Topics such
as shopping for food, healthy snacks, and hydration were presented to student athletes at a total of 14
different presentations. Another 11 presentations for Greek organizations and residence halls covered
topics ranging from healthy eating and eating disorders to eating healthy on campus. Didactic
presentations focusing on current nutrition trends, obesity, eating disorders and sports nutrition were
made to health promotion students, medical students, physical therapy students, and physical education
skills instructors.
The poster session “No Time for Physical Activity? Don’t Wait, Walk!” was presented at the ACSM
Walking conference, October 2005. The poster showed the results of the point-of-decision study
conducted on campus, which indicated that when signs encouraging students to walk rather than wait for
the bus were posted at bus stops, students were 2-3 times more likely to walk when compared to bus stops
without signs.
Over the past year, 185 individuals completed the anonymous online eating disorder screening via the
SHS website, of which 79% were females. This year, 76% screened positive, a 5% increase from last
year. Of those who screened positive, 33% indicated they planned to seek further treatment.
o "The nutritional services provided by Health Iowa through Student Health have been the
highlight of my visits to Student Health. Kathy has been an amazing resource, not only providing
guidance to help me develop healthier eating habits, but also serving as an amazing resource
that has greatly helped me through this portion of the journey towards better health. She has
provided expert guidance in nutrition, but has also acted as a listener, a soundboard, and a
friend, looking at me as a person and working to make sure this journey is a lifelong journey.
Without her, this process would've been much more difficult."
22
TOBACCO CESSATION
Health Iowa’s tobacco cessation program offers U of I students a personalized tobacco cessation program
with initial consultations and optional follow-up services. Fifty-two initial consultations were provided
during 05 – 06, with 174 follow-up contacts, including individual consultations, emails, and phone calls.
We also reached approximately 1200 students, faculty and staff through outreach events. All of the
students returning evaluations rated the program favorably. About 44% of students reported during their
last interaction with the Health Educator that they had quit tobacco use over the course of the year.
Through grant funds from Four Counties for Tobacco Control (4C4TC), we marketed the tobacco
cessation program and provided qualified students with a coupon to subsidize the cost of some nicotine
replacement therapies (NRT). Thanks to the partnership with Westlawn Pharmacy, 57 coupons were
redeemed this year.
o
o
“The most important and helpful part of the program was the contact and consultations I had
with the consultant…it’s more helpful (for me at least) to have had someone to help encourage
me - Kudos.”
“I couldn’t have successfully quit without the help of (the health educator) and the tobacco
cessation program.”
SEXUAL HEALTH
Sexual health education presentations reached 903 participants, a 45% increase from last year. Health
Iowa took a team to downtown Iowa City during National Condom Week and distributed approximately
2000 condoms at 10 local bars. Dr. Ann Laros was the “Sexpert” in “Ask the Sexpert”, an event to
promote a Q&A session in the Residence Halls. To promote safe sex and emergency contraception, 3000
condoms were distributed on the Pentacrest and an evening with a panel discussion was held, in
partnership with the Feminist Majority Leadership Alliance (FMLA) student organization. About 20
students attended an emergency contraception panel discussion with Dr. Ann Laros, Westlawn Pharmacist
Kim Spading and Emma Goldman’s Karen Kubby.
HEALTH FAIRS
In addition to smaller health events throughout the year, the annual
Health Fair was held in March at the UI Field House. The fair was very
successful with approximately 3500 participants. The theme for this
year’s event was “Choose Health”. Over fifty exhibits were on hand to
provide educational materials and health screenings through a wide
variety of creative displays. An “Action Plan” component prompted
participants to focus on 1 – 3 stage specific behavior change strategies.
Over 140 participants completed Action Plans for a practice or
behavior(s) that they wanted to incorporate. After the event, participants
were emailed and directed to Health Iowa/Student Health Service
resources. Three-hundred and thirty-two (332) health fair evaluations
were completed and 100% of participants rated the event as good or
excellent.
INCENTIVE PROGRAMS
“Health Links”, a 4-week online incentive program, was offered in the fall. The program encouraged
students to participate in many different health-related activities and earn “links” for each one they tried.
Over 250 students participated. “Fastlane to Fitness”, offered in the spring, challenged students to
participate in cardiovascular, resistance, and flexibility exercises. Evaluations indicate that 94% of
respondents were motivated to participate in physical activity and 70% increased their activity as a result
of the program. Additionally, eighty individuals participated in the Taking Strides pedometer program
and 176 individuals registered for the Healthy Running online activity log.
23
o
o
o
I liked the variety of ideas it offered about healthy living. Most programs focus solely
on the body, but Health Links included having a healthy mind and healthy friendships
as well.
I was able to step back and look at my habits and make appropriate changes.
I appreciate that Student Health makes an effort to provide programs Fastlane to
Fitness. Thank you!
PHYSICAL ACTIVITY
Health Iowa conducted a variety of physical activity and fitness programs to help students initiate and
maintain a physically active lifestyle. Individual fitness appointments served 223 students.
Approximately 1650 students participated in fitness assessments across campus and in academic courses.
Interactive screenings for blood pressure, body fat, and grip strength were conducted across campus,
including new student orientations, the Student Housing picnic, and Night Games. A total of 1078
individuals participated in the fitness component of these events.
The Fitness Specialist provided training to 20 residence hall fitness center staff and we provided
educational outreach within the fitness centers through body fat and blood pressure screenings and
bulletin board information throughout the year.
We implemented a second iteration of our Take the Stairs program as residence hall
floors participated in a competition format and climbed 379,000 flights of stairs in
just two weeks. Point-of- decision signage reminded students of the benefits of
taking the stairs and tally sheets in the halls motivated them to compete for floor
prizes. Residents and Resident Assistants rated this intervention very positively and
we plan to continue it in some format. We partnered with UI Wellness to
implement similar interventions in two non-resident buildings, the Field House and the University
Services Building (USB). Increases in step usage were observed at both buildings with a 5% increase at
USB after signage was placed.
o
o
o
I have found working with Amy to be a huge benefit to me. She has been very encouraging and I
feel more positive about increasing my physical activity than I have felt for a long time.
I think it’s great that Student Health has a consultant in this area!
Amy was extremely helpful during my fitness evaluation. She exceeded all my expectations and
obviously went the extra mile in looking for information I had requested.
ALCOHOL AND DRUG ASSISTANCE PROGRAM
Health Iowa provides research-based interventions including treatment, education, and prevention
specifically designed for the college environment. Early intervention programs include the Alcohol
Education Workshop (AEW) and the Seminar on Substances (SOS). AEW served 309 students. The 4hour SOS series was provided for 220 students. Substance abuse evaluations are provided in both group
and individual formats. Thirty-one (31) students attended the group evaluation, while 248 students were
seen for individual evaluations, an increase of 34% for FY 2005-06.
During FY 2005-06, 108 students completed the University Short Term Outpatient program (USTOP) or
Extended Outpatient level treatment. The University Aftercare program provided ongoing support for 43
students. A Marijuana Information Series (MIS) was created for low risk marijuana offenders. The series
uses personalized feedback model similar to SOS. A total of 56 students completed MIS.
24
Online screenings, educational presentations, academic classes, health
fairs, and awareness campaigns also provide substance abuse information.
Health Communications graduate students evaluated the “Extreme
Drinking” media campaign, developed by Health Iowa and Stepping Up,
and found that the campaign was better received than most other health
campaigns. Information on message refinement led to the next iteration of
the campaign, titled “Keep it to a Few”, which rolls out fall, 2006.
ACADEMIC COLLABORATIONS
Health Iowa staff collaborated with the department of Health and Sport Studies for the second year to
offer these courses:
28:020 Alcohol and Your College Experience
28:021 Tobacco and Your College Experience
Both courses were approved by the General Education Core Committee as electives in the Health and
Physical Activity General Education program and numbers of sections increased. The additional sections
were taught by a Graduate Assistant from the Health and Sport Studies department, with oversight from
Tanya Villhauer. The classes filled for all sections offered. Health Iowa staff also consulted with UCS
psychologists to design and implement a third section of the College Experience series, titled “Resiliency
and Your College Experience.” Students rated all three courses very highly.
A particularly rewarding aspect of our work is mentoring new and developing professionals as they join
the student development or health promotion field. We are invigorated by having students here working
with us, and the students benefit from gaining ‘real world’ experience working in college health.
o
My experience as a practicum student provided an incredible opportunity for both
personal and professional growth. I learned important and useful information
about the health and wellness issues facing college students and I gained valuable
facilitation and teaching experience. I was also able to have wonderful discussions
with the Health Iowa staff about maintaining professional life and personal life
balance. This has been one of the most significant experiences during my graduate
school career. Lucas Christain, Practicum Student 05-06
o
I really enjoyed this class and felt like I got a lot out of it. I really liked talking about
the current events and legislative processes…some great discussions…as a nonsmoker I feel like I have a new perspective. -Student in Tobacco and Your College
Experience Course
25
CAMPUS/COMMUNITY INVOLVEMENT
Health Iowa staff members participated in the following campus and community activities:
o Executive Committee and Administrative Council member for the Stepping Up Program
o Coalition Member for 4 Counties 4 Tobacco Control Grant
o Wellness Advisory Group member
o Johnson County Health Improvement Planning process
o American Cancer Society Volunteer Leadership Group
o Coordinator, Volunteer Recruitment/Staffing, Café Johnson County, “Walk for Clean Air”
o Adjunct Faculty in the Department of Sport, Health, Leisure and Physical Studies, College of Liberal
Arts and Sciences (4 staff members)
o Adjunct Faculty in Student Development in Postsecondary Education, College of Education
o Orientation Advisor Selection Committee
o UI Parent Orientation: “Staying Healthy, Keeping Safe”
o Co-administrator AlcoholEdu online course
o North Central College Health Association: “Why Ask Y: Understanding the Implications of
Generational Experience in Health Care Delivery”
o College of Pharmacy Alcohol Awareness seminar
o Fitness screenings at River Run Health Fair, Iowa City Recreation Center, VA Employee Wellness
Fair, and Iowa City Fire Department.
o “Healthy Eating during Marathon Training” -Team in Training group
o “Nutrition for Distance Runners” - City High School cross country team
o “Healthy Eating on Campus” - Coe College students.
o Courses
28:144 Peer Health Education
n=17
28:075 Health in Everyday Life
n=142
28:148 Practicum in Health Promotion
n=16
28:020 Alcohol and Your College Experience n=58
28:021 Tobacco and Your College Experience n= 45
7C:333 Practicum in Student Services
n=12
Respectfully Submitted,
Sarah Hansen, M.A., CHES
Associate Director for Education
Health Iowa Coordinator
26
HEALTH IOWA STRATEGIC DIRECTIONS, 2003-2010
Mission: To support student learning through educational and health promotion services that help students create healthy lifestyles.
Goal: To provide services and direct interventions aimed at the following Healthy Campus 2010 objectives.
Goal
Data Source/Potential
Data Source
Supporting Data/Current UI Data
National/College
Baseline
2010 UI Targets
27-5 Increase smoking
cessation attempts by college
student smokers.
Cessation program data;
Health Interests and
Practice Survey; Harvard
Data
% of smokers reporting at least 1 quit attempt: 46%
(2001) to 59% (2004)
41% (National)
Cessation
attempts: 65%
30-day prevalence:
15%
1-3a Improve access to
comprehensive, high-quality
health care services (physical
activity or exercise).
Fitness program data;
Health Interests and
Practices Survey
Fitness consultations:
2002: 214
2003: 191
2004: 239
30-day prevalence of smokers: 28% (2001) to 24%
(2004)
Nutrition consultations:
2002: 431
2003: 400
2004: 440
27
11-4 Increase the proportion of
health-related World Wide
Web sites that disclose
information that can be used
to assess the quality of the
site.
Health on the Net
Foundation Accreditation
Accreditation renewed, 2006
25-11 Increase the proportion
of sexually active UI students
who abstain or always use
condoms during sexual activity.
Health Interests and
Practices Survey
2001: 35%
2004: 44%
(20% of males and 25% of females reported no sex)
47% (College –
includes those who
abstained or used
condoms at last
intercourse)
Abstain from
Sex/Condom use:
90%
22-2/3 Increase the proportion
of college students who engage
in physical activity at least 3
days per week that includes
moderate physical activity for
at least 30 minutes, or
vigorous physical activity for
20 or more minutes per
occasion.
Fitness program data;
Health Interests and
Practices Survey
2003: 48%
2004: 50%
40% (College)
Physical activity:
55%
12-12a Increase the proportion
Fitness program data;
Will add this question to 2006 HIP survey
of college students who have
Health Interests and
had their blood pressure
Practices Survey
measured within the preceding
2 years.
Health Iowa participation numbers: 2002-03: 24,308, 2003-04: 23,204, 2004-05: 25,635, 2005-06: 28,733
27
Continued renewal
HEALTH IOWA STRATEGIC DIRECTIONS, 2003-2010
Goal
Data Source/Potential
Data Source
Supporting Data
National/College
Baseline
2010 Targets
19-5/6 Increase the
proportion of college students
who consume at least five
daily servings of fruits and
vegetables.
Colorful Choices program
data; Nutrition program data;
Health Interests and Practices
Survey
Colorful Choices program data: % reporting
eating more veggies (up to 5 a day) went from
8% to 97% from pre-post program
7.4% (College)
5 a day: 25%
22-14 Increase the proportion
of trips made by walking
Cambus study data; Health
Interests and Practices Survey
Cambus study data: 2 to 4- fold increases in
number of individuals who walked versus rode
the bus when point-of-decision signs were
posted at three intervention sites. No change at
control sites or 2 intervention sites.
Will add this question to 2006 HIP survey
17% (National)
Take the Stairs Competition:
Fall 2005: Pilot, residents in 3 halls climbed
159,871 flights of stairs
Spring 2006: Students in 10 halls climbed
391,000 flights of stairs
Pilot with UI Wellness in USB and Field House: %
of those taking stairs increased 5% in USB and
2% in Field House.
28
Will add this question to 2006 HIP survey
26-6a Reduce the proportion
of college students who report
that they drove after drinking
any alcohol at all during the
previous 30 days.
Health Interests and Practice
Survey; Harvard Data;
Substance abuse program data
2001: 33%
2004: 22%
31% (College)
Drove: 15%
26-13 Reduce the proportion
of UI students who report
negative consequences as a
result of their own or another
person’s alcohol use.
Health Interests and Practices
Survey; Harvard Data; Referral
numbers; Substance abuse
program data
Negative consequences that have increased or
remained steady:
Hangover: 66% (up 1%)
Vomiting: 44% (up 8%)
Blackout: 46% (up 1%)
Injuring self: 25% (up 4%)
Regretted sex: 29% (up 2%)
Property damage: 12% (even)
ACHA- NCHA
(College) past year
consequences:
Blackout: 34%
Injure self: 20%
Regretted sex: 18%
Injure other: 8%
Targets:
Hangover: 45%
Vomiting: 40%
Blackout: 34%
Injuring self: 20%
Regretted sex: 18%
Prop. damage: 8%
Miss class/work:
30%
Arguments: 30%
Injure other: 3%
Arrest: 5%
Negative consequences that have lessened:
Missing class/work: 38% (down 3%)
Arguments: 41% (down 2%)
Injuring someone else: 8% (down 3%)
Driving after drinking: 22% (down 11%)
Arrest: 10% (down 5%)
28
THE STEPPING UP PROJECT
A ROBERT WOOD JOHNSON GRANT ADMINISTERED BY THE AMERICAN
MEDICAL ASSOCIATION
Introduction
Our community and campus coalition to reduce the harmful effects of high-risk drinking has just
completed the third year of a four year, $466,729.00 continuation grant awarded September 2002 from the
Robert Wood Johnson Foundation. The University of Iowa and the Iowa City community comprise the
coalition, which is one of 9 coalitions in the nation to receive this continuation grant. The continuation
grant advances the work begun in 1996 to reduce the negative consequences of high-risk drinking. Each
of these grants is administered by the American Medical Association.
The Stepping Up Project’s coalition is guided by a 20 member Executive Committee and the 2 co-chairs
of the coalition. The Executive Committee, a subset of the coalition, consists of key leaders from the
University, the University of Iowa student government, student services personnel, the City of Iowa City,
Public Health, the Iowa City Community School District and business leaders in the community. The
larger coalition includes representatives from community health care, law enforcement, alcohol treatment
centers, local parents and students.
The executive committee meets bi-monthly and a smaller administrative council meets in those months
when the executive committee has no scheduled meeting. The administrative council provides advice and
guidance to the coordinator and makes policy recommendations for consideration by the executive
committee.
The five goals of this grant renewal period are: 1) to communicate information regarding high-risk
drinking to students, faculty, staff and community members; 2) to increase effective enforcement of
community and university policies; 3) to decrease accessibility/availability of alcohol; 4) to increase
social alternatives to high-risk drinking; 5) to change the larger environment within the state of Iowa as it
pertains to high-risk drinking. The work of two permanent task force groups, Community Policy and
Outreach/Communications (with co-chair Sarah Hansen) supports goals 1, 2, and 3 while task force
groups with a specific time period and goal are organized from time to time to support goals 4 and 5.
Actions
This was the final year of the Stepping Up Project grant from the Robert Wood Johnson Foundation. The
Stepping Up Project has been going strong for 10 years with the help of the Robert Wood Johnson
Foundation and the American Medical Association. The grant will not be renewed again as Robert Wood
Johnson has decided to shift focus to substance abuse outcomes. Members of the Stepping Up Executive
Committee went to the last A Matter of Degree (AMOD) meeting to present on the project’s
accomplishments through the years and say thank you. Members present at the San Francisco meeting
included Phillip Jones, Sarah Hansen, Jim Clayton, Steve Parrott, and Angie Reams.
As the end of the grant drew near planning for another transition took place. The Stepping Up Project
began to transition into the Office of Student Services Campus and Community Relations in early
summer 2006. The focus of the new office will be to direct and coordinate the efforts of the University
and community coalition to enhance the safety, health, and civility of the campus and community
environment through initiatives to curb the harmful effects of alcohol and substance abuse and physical
and sexual assaults through educational programs, policy research and recommendations,
community/campus taskforce actions, and promotion of campus and community programs. The Stepping
Up Project Executive Committee and Administrative Council will continue to meet regularly during the
29
academic year to maintain its focus on the mission and goals of the Project. New members to the
Executive Committee this year included Sam Hargadine, Iowa City Chief of Police; Janet Lyness,
Assistant County Attorney; and Ross Wilburn, Iowa City Mayor.
Another new initiative that was researched and began early implementation in late July was AlcoholEdu.
AlcoholEdu is a research-based online alcohol education program that includes specific instruction on
sexual violence related to alcohol. The program is based on best practices outlined in the NIAAA Report
to College Presidents, including challenging student expectations that alcohol will facilitate sexual
activity and is currently being used at many top institutions of higher education. Evaluation indicates
students who complete AlcoholEdu learn more about alcohol experience fewer negative side effects and
increase their understanding of alcohol and its role in sexual violence, including the inability to give
consent. The program content will be customized for our campus, including adding links to our specific
policies related to alcohol use, student conduct, violence and harassment. We will also add specific
questions related to sexual violence. This course is being required of all incoming freshmen to The
University of Iowa. They must complete part I of the program before coming to campus, wait 45 days,
and then complete part II in order to receive a complete for the course. Students who do not comply with
the requirement will have a hold place on their spring class registration. We have been satisfied with the
program thus far and look forward to further implementation in future years.
Vice President Jones will continue the parental notification project this semester. He also is collaborating
with Tom Baker to create a report for the Iowa City Chief of Police, Sam Hargadine, to use when
reviewing whether an alcohol establishment can renew their liquor license. The report will include
student comments about where they were drinking, how much was provided to them, and where their last
drink was if they drank off campus.
The alcohol free tailgate area will again be available at each home football game again this fall thanks to
the Athletic Department’s willingness to provide financial help to support the initiative. A major part of
Stepping Up was providing funds to organizations that provided alternative activities in the evening,
especially small organizations that were just starting out. Many organizations were disappointed that this
would be the last year to provide funds for alternative activities. Stepping Up had been a significant, and
sometimes sole, monetary sponsor of these events since their inception, but we hope organizations find
other sponsors to continue their efforts that our initial support will enable.
The executive committee continues to work on policies, such as keg registration, responsible beverage
service, and zoning, to reduce the harmful effects of high-risk drinking. We know there is not one
solution, but we hope the small steps will accumulate to impact our community and campus
environments.
Respectfully submitted,
Angela Reams
Project Coordinator
30
WOMEN’S HEALTH
It was a year of changes with regard to Pap smear screening and surveillance, HPV prevention and STI
testing in women. For contraception, Ortho-Evra lost favor with studies confirming a 2-3 fold increased
of DVT/PE above the risk of current OCPs. Plan B, emergency contraception, was in the national news,
before finally being approved for over the counter distribution to women over 18, beginning January
2007.
Reflecting changes implemented by The American College of Obstetrics and Gynecology, initiation of
Pap smear screening was changed from coitarche or age 18, to 3 years after coitarche or age 21. This
allowed many students to receive contraception without the fear/barrier of a pelvic exam. The ability to
screen for gonorrhea and chlamydia with a urine sample, in place of a cervical swab, also provided noninvasive testing.
Gardasil, a quadrivalent HPV vaccine, targeting 2 of the HPV type that cause 90% of genital warts and 2
that cause 70% of cervical cancer, received FDA approval 6/8/06 followed rapidly by ACIP
recommendation for young women 11-26. Insurance approval is still pending for the majority of
providers.
Outreach/Talks
“HPV Update”, SHS CME series (Sept 2005)
“New Guidelines for Pap smear, SHS CME series (Dec 2005)
Plan B panel, Feminist Majority (Mar 2006)
Student Health Fair (Mar 2006)
“Sexpert” (Open Q&A session), Associated Residence Hall (Apr 2006)
“Mumps in the Midwest”, American College Health Association; NY, NY (May 2006)
“Mumps at Iowa”, Student Health Inservice (June 2006)
Pap STATS
One thousand nine hundred and seventeen (1917) Pap smears were submitted from the Student Health
Service between 7/1/05 and 6/30/06. This represents a decrease of 300 Paps; despite a comparable
number of annual gynecologic exams.
Changes in age of first Pap, frequency of follow-up testing (from every 3-4 months to every 6 months
with the advent of the liquid based sampling) and increasing use of “reflex HPV testing” over repeat Pap
smear in the face of an ASCUS Pap all contributed. Additionally, secondary to a change in State Law,
Student Health no longer had the ability to bill directly for the Pap smears. The renegotiation of the
contract with the UIHC resulted in a significant increase in the cost of a Pap smear to $95-180; this
caused a small efflux of students to Planned Parenthood.
Of 1913 Pap smears, 5 were unsatisfactory. Of the remaining 1908 Pap smears, 17.2%
(330) were abnormal, as compared to 15.3% last year and 13% in 2003.
Again, of the abnormal Paps, slightly less than one third were atypical—91 ASCUS (atypical squamous
cells of undetermined significance), 2 AGC (atypical glandular cells). Of patients offered, reflex HPV
testing on their first time ASCUS Pap smear, 27 accepted; 21 declined, opting instead for a repeat Pap
smear in 6 months. As per the literature estimate, about half of the ASCUS Paps tested were HPV
negative, half positive.
198 (10.9%) of Pap smears returned LSIL, encompassing HPV and mild dysplasia; 36 (1.9%), HSIL,
encompassing moderate dysplasia (23) and severe dysplasia (13). This represents a significant increase in
high grade disease, hopefully a blip and not a trend.
31
Two Pap smears interpreted as Adenocarcinoma-in-situ, after colposcopy were confirmed to have cervical
cancer—one, microinvasive squamous cell cancer (Stage 1A), treated with cone biopsy; one,
adenocarcinoma of the cervix (Stage 1B1), clinically; Stage IIIB, surgically), treated with radical
hysterectomy, radiation and chemotherapy.
Both remain as students.
Colposcopy
With a full time gynecologist, colposcopies increased from 78 in 2004-5 to 145 this fiscal year. There
were no complications. Two cancers were diagnosed. Dr. Laros continues to attend cytopathology and
pathology case conferences at the university.
LEEP
More colposcopies and higher grade disease on Pap smear, resulted in more LEEPs (loop electroexcisional procedures). Twenty nine (29) LEEPs were performed this year, compared to 11, in the
previous year. All LEEPs were performed for high grade disease, moderate or severe dysplasia on
cervical biopsy. There was one “See-and Treat” LEEP for an HSIL, encompassing severe dysplasia/CIS
Pap, which confirmed high grade disease. This represents a slight increase in the percentage of LEEP
procedure per colposcopy (from 14% to 20%). Some if this is accounted for by fewer referrals, some by
the increase in high grade disease, some perhaps by HPV screening for ASCUS, which eliminated some
low risk colposcopy patients. This trend however should be watched.
Contraception services
Birth control pills
Title XX supported subsidized pills continue to be available to underinsured students at the Westlawn
pharmacy in addition to a complete array of commercially available pills.
8876, subsidized pack were sold, this represents a 24% decrease. These continued to be available at
$13/cycle. Three brands were available.
Contraceptive patch
The Ortho-Evra patch was available at a discounted rate ($25), only early in this year, this combined with
the concerns of increased risks of thrombotic events, decreased distribution of the patch from 795, to 301.
This remains an effective form of contraception in this low risk population.
Depo-Provera
147 injections of Depo-Provera were given, down from 215 last year. This again reflects the FDA
recommendation to limit use to 2 years, to minimize risks of osteoporosis.
Plan B
Emergency contraception remains available by prescription only.
225 packs were dispensed from the pharmacy, representing a 19% increase.
By January of 2007, it is anticipated that this will be available over the counter at approved pharmacies
and clinics to those 18 and over.
Diaphragms
Ten students were fit for diaphragms.
IUDs (Intrauterine devices)
Two Mirena (progesterone IUDs) were placed.
Three students had IUDs removed to start a family.
32
There has been a noticeable increase in the number of students considering the IUD for contraception.
This year, the FDA approved the copper-IUD (Paraguard) for use in the nullipara.
Respectfully submitted,
Ann Laros, M.D.
Staff Gynecologist
33
PSYCHIATRY
For the 2005-2006 academic year, the psychiatry section provided a total of 2,531 visits. Of these visits
533 were for new patient evaluations. The total number of visits represents a slight decrease over the
previous academic year. The decrease may have been due in part to the change in process of
documentation. All progress notes are now done on IPR. The transition to this system did require some
patient care slots being set aside for administrative time.
There were no changes in the types of diagnoses seen. The most common continue to be depression (48%
of psychiatric diagnoses) and anxiety disorders (30% of psychiatric diagnoses). Other diagnoses treated
in the clinic include attention deficit disorder, schizophrenia, bipolar disorder, sleep disorders, and eating
disorders. As in previous years the number of females seen (64%) is greater than the number of males
(36%). It is known that women are twice as likely to suffer from a depressive disorder as men.
Approximately half of the visits to the psychiatry section are for a depressive disorder; this then accounts
for the ratio of females seen being higher.
The psychiatry section continues to work closely with the University Counseling Service. A Student
Health Service psychiatrist attends monthly staffings. A Student Health Service Psychiatrist gave two inservices on Psychotropic medications to the University Counseling Service. Communication between the
two services remains good, facilitated in part by the close proximity.
A Student Health Psychiatrist participated in a panel discussion of suicide on campus. The panel was
sponsored by the Vice President for Student Services office. This was attended by staff from the advising
center. The panel included discussion regarding services available on campus, and how to access them for
students in need of mental health treatment.
The website for the Student Health Service offers screening for depression, anxiety disorders, alcohol and
eating disorders. For depression there were 332 screenings; of which 85% screened very likely or likely
for depression. For Bipolar (manic-depressive) illness there were 130 screenings; 22% were positive. For
generalized anxiety disorder there were 178 screenings; 85% were positive. For post traumatic stress
disorder there were 44 screenings; 66% were fully or partially positive. Of those who were positive, the
majority indicated they would seek treatment. Due to the continued value of the online screenings, it will
be continued again for the coming academic year.
In order to improve access to Psychiatric services a change was made in the process of scheduling new
patient evaluations. Some new patient slots were frozen and are scheduled from in house referrals, urgent
referrals from the University Counseling Service and from the nurse call line. The rate of no-show
appointments was down over the last year. The new scheduling process may have been a factor in this.
The new system does allow more flexibility in how Psychiatric services can be accessed.
Respectfully submitted,
Paul Natvig, M.D.
Staff Psychiatrist
34
DISEASE CODES 2005-2006
Substance Abuse Related
Diagnoses (CPT Code)
Total Male
Total Female
Total
Misc.Alcohol related Dx
Alcohol dependence 303.9
Alcohol abuse 305.0(2)
Cannabis abuse/dependence
Opiod dependence/abuse 304.00, 305.5
Cocaine dependence 304.20
Drug abuse unspecified 304.8
Tobacco use disorder 305.1
Total
7
35
458
116
1
1
6
88
712
5
27
95
34
1
20
4
87
273
12
62
553
150
2
21
10
175
985
Psychiatric Diagnoses (CPT code)
Total Male
Total Female
Total
Adverse CNS med. effect
History of mental disorder (various)
Relation problem V61.1, 2
Educational problem V62.3
Psychological stress V62.89
Drug induced mental d/o 292.9
Schizophrenia 295.3-8
Major depression 296.2-3
Bipolar disorder 296.0-89
Depression NOS 311
Psychosis (Affective) NOS 298.9-299.9
Anxiety NOS 300.0-09
Generalized Anxiety D/O 300.02
Panic disorder 300.01, 21-22
PTSD 309.81
Phobias (various)
Social phobia 300.23
Obsessive-compulsive disorder 300.3
Dysthymia 300.4
Somatoform disorders (various)
Sexual disorder 302.71-79
Tourettes/ Tics 307.23
Eating Disorders
Personality D/O
Insomnia/sleep disorders (various)
Adjustment disorders (various)
Attention deficit disorder 314.0-01
Learning disorders
Unarmed fight/brawl
Rape
Conversion/dissociative
Stuttering
Total
2
1
1
22
10
5
9
302
54
153
15
282
59
32
5
2
18
49
116
2
22
0
12
0
119
31
150
3
16
0
1
4
1497
1
12
10
13
6
13
4
682
49
403
2
419
191
49
17
17
52
37
252
5
2
11
170
5
90
66
65
3
2
4
10
1
2663
3
13
11
35
16
18
13
984
103
556
17
701
250
81
22
19
70
86
368
7
24
11
182
5
209
97
215
6
18
4
11
5
4160
35
Medical Disorders with Possible Psychosomatic Component
Diagnosis (CPT code)
Total Male
Total Female
Total
Obesity 278.00-01
Tension headache/ headache 307.81
Irritable bowel syndrome 564.1
Premenstrual tension 625.4
Myalgia/myositis NOS 729.1
Dizziness/giddiness 780.4
Fatigue
Chest pain
Total
133
360
10
16
68
156
553
163
1459
48
132
1
0
31
46
139
63
460
36
85
228
9
16
37
110
414
100
999
PEDIATRIC RESIDENT COORDINATOR
Part of the third year pediatric resident’s Adolescent Medicine rotation involves rotating through Student
Health.
This year’s residents included the following:
Dr. Ahmad Charaf Eddine, Dr. Oleg Shchelochkov, Dr. Justin Boe, Dr. Rene Gonzalez, Dr. Amy Stier,
Dr. Sonali Patel, Dr. Miltos Douvoyiannis, Dr. Huda Elshershar, Dr. Heather Zimmerman and Dr. Shadi
Tabba.
The residents typically spend 2 days per week at the Student Health Service. Due to restricted maximum
work hours, they may not be able to work if they are post-call. During this month, they are on call in the
pediatric ICU and work in their own clinics at the University Hospital.
While at the health service, residents work side by side with one primary care physician. They also spend
one afternoon per week with our gynecologist. In this supportive environment, they are able to evaluate
patients, come up with a plan of care and learn from our staff physicians. They are responsible for
charting the information on our electronic medical record. The physicians also benefit from this
arrangement, for in teaching; they often rethink a clinical situation and learn about health and disease
more in depth.
As preventive care and healthy lifestyle are an important part of adolescent medicine, the clinicians
attempt to emphasize this during the rotation. The residents spend one day working with our substance
abuse counselor. They observe one scheduled appointment and have the opportunity to ask questions.
Dr. Mary Larew is the Pediatrician that is in charge of this rotation. In addition to the time with patients,
she provides relevant reading material that is available for the residents during their time here.
The staff physicians perform electronic evaluations of the residents. We, in turn, get feedback from the
residents’ evaluations of their time here. In our most recent evaluations, residents consistently answered
that they were given appropriate responsibility. They felt they had adequate teaching and gained new
knowledge during their rotation at Student Health Service.
Respectfully submitted,
Rebecca Chackalackal, M.D.
Staff Physician
Pediatric Resident Coordinator
37
WESTLAWN PHARMACY
2005/2006 was a year of growth for Westlawn Pharmacy. During the first full year of business, the
pharmacy filled a total of 20,726 prescriptions. Approximately 4,000 of the prescriptions filled were for
SHS Oral Contraceptive products. In addition, the pharmacy sold over 4,000 over-the-counter items.
Westlawn Pharmacy continues to serve as a full-service pharmacy, striving to provide best care for
students, faculty and staff. The pharmacy has increased the number of insurance plans accepted and now
takes over 25 different plans. The pharmacy has collaborated with Health Iowa and Four Counties for
Tobacco Control to provide an easier way for students to obtain discounted nicotine products to aid in
their smoking cessation efforts. The pharmacy staff serves as a resource for Student Health Service
providers, and encourages providers to call with drug therapy questions at any time.
Staffing at the Westlawn Pharmacy continues to include one full-time Pharmacy Practice Specialist (Kim
Spading, R.Ph.), with fill-in coverage provided by Chris Johnson, R.Ph. or Nic Lehman, Pharm.D.
Pharmacy students completing their final year of Clinical Rotations provide staffing assistance for 5
weeks at a time. The pharmacy is currently evaluating need for a part-time pharmacy technician as
continued growth of the pharmacy is expected.
Thanks to all of the Student Health Service providers and staff for their continued support.
Respectfully submitted,
Kim Spading, R.Ph.
Pharmacy Practice Specialist
Westlawn Pharmacy at the Student Health Service
38
STUDENT HEALTH ADVISORY COMMITTEE
(SHAC)
Committee Chair: Ben Darbro
Committee Members: Jennifer Kroeger, David Hennessy, Marcina Matthias, Chloe Mellecker, Manish
Aggarwal, Victoria Sharp, Ruth Spieker, and Linda Liedtke
Administrative Liaison: Mary Khowassah
Student Health Liaison: Lisa James
Health Iowa Liaisons: Sarah Hansen and Tanya Villhauer
Committee Charge (from the University of Iowa Operations Manual): The Committee shall be governed
by the terms of the General Charter. In addition, the Committee shall 1) advise concerning policies
regarding the health care provided to students and student families at The University of Iowa, including
(among others) those policies and practices respecting preventive health measures and health maintenance
services both physical and mental, immunizations, health counseling, health education, screening, dental
care, identification of "high risk" persons, and referral to medical and other health facilities within the
University and outside it; 2) Provide information concerning student health insurance plans; 3) Advise
concerning student participation in health surveys; 4) Advise concerning the dissemination of information
in the campus community about the availability of health care.
Meeting Dates:
June 21, 2005
August 4, 2005
September 8, 2005
October 21, 2005
November 16, 2005
February 10, 2006
April 4, 2006
Activities, Conclusions, and Recommendations:
1.
UI Student Involvement Fair: This was the second year SHAC had a booth at this event. Student
Health Service personnel and SHAC members staffed a booth for the duration of the event. We
provided a variety of items including blood alcohol content wheels, condoms, stress balls,
highlighter pens, as well as a variety of brochures aimed at educating UI students about safer sex,
drug/alcohol abuse, and healthy lifestyles. We also used this event as an opportunity to inform
students of what SHAC is and what types of programming we conduct around the University
community. We developed an informational brochure (see attachment) outlining what SHAC is
currently working toward and Charter Committee applications so those who were interested could
apply for a student position on SHAC. As with last year, we again received very positive
feedback from those who stopped by the booth and with the continued assistance of Student
Health Service, SHAC plans to participate in the event next year.
2.
Carver College of Medicine Student Activities Fair: This was the first year SHAC participated in
this event. We held a drawing for an anatomy textbook (Netter’s Atlas of Human Anatomy).
This textbook is widely regarded by medical students as the premier anatomy resource. We
received a great degree of interest in our booth and engaged several first year medical students in
discussions of how SHAC can better promote healthy lifestyles amongst college students. SHAC
will continue to participate in this event with the assistance of SHS.
39
3.
Homecoming Parade Float: This was the first year SHAC participated in the homecoming parade.
SHAC helped co-sponsor this activity with SHS. We provided both funds for the entrance fee
and helped design and build the float. The theme of the homecoming parade this year was
“Hawkeye Fever…It’s Contagious!” SHAC and SHS designed a float describing the Top Ten
Signs of Hawkeye Fever. This event was a wonderful opportunity for members of SHAC and
SHS to get to know each other better and form a stronger working relationship with one another.
The float went on to win first place! This event not only provided a great deal of entertainment to
the members of the University community, but also served as one more opportunity to inform
students that SHAC exists and can be used as a liaison between students and SHS. Considering
the great exposure we received, the furthering of SHAC’s relationship with SHS, and positive
feedback from both students and other members of the University community SHAC decided this
would be a great event to continue in the future.
4.
Student Health 101: SHAC decided to try something new for its fall programming event this year.
Part of SHAC’s charge as a Charter Committee is to advise and assist in measures to disseminate
health information and educational materials to students at the University of Iowa. We had
previously constructed and distributed Health Kits to first year students which contained several
healthcare related products but little information pertaining to healthy lifestyles and common
college specific healthcare issues. This year, SHAC decided to team up with a group called
Student Health 101 (http://www.studenthealth101.com/index.asp) to distribute several healthcare
information magazines to first year students. The original plan involved distributing an initial
informational magazine at the beginning of the school year (Aug/Sept) followed by three
supplements to be distributed throughout the rest of the school year. This program cost SHAC
nothing to participate in and could have actually worked as a source of revenue if we had
distributed enough magazines. SHAC and Student Health 101 successfully distributed the first
magazine to students in the fall; however, Student Health 101 itself had several funding issues
and was unable to supply SHAC with further supplements. SHAC did succeed in distributing the
first magazine to a wide audience that extended beyond just first year students. Unfortunately,
Student Health 101 is now moving towards a subscription based health information magazine that
SHAC has decided not to pursue due to the cost of the program.
5.
Health Fair: SHAC regularly participates in the spring Health Fair and did so again this year. As
in previous years, we staffed a booth that specializes in offering resources to students preparing to
go on Spring Break. Our booth has provided information on safe travel (Destination Health
Advice Cards), predatory drugs, and safer sex, as well as providing condoms, blood alcohol
content wheels, and sunscreen samples. Three years ago, SHAC began cooperating with Health
Iowa to provide free cholesterol screening tests to students. We have had a phenomenal response.
Cholesterol screening is of vital importance due to its predictive value in assessing one’s risk of
future cardiovascular disease. Members of SHAC continue to be very proud of their involvement
in the Health Fair and there is every indication that SHAC will continue to be involved with the
Health Fair for years to come.
6.
American College Health Association Conference: Each year SHS provides funds for one
member of SHAC to attend the yearly American College Health Association Conference. Each
year a member of SHAC brings back myriad ideas for new programming events we could initiate
at the University of Iowa. In the summer of 2005, SHAC chair Benjamin Darbro attended this
conference in San Diego, CA. He reported back to the committee several ideas including
information on the Student Health 101 magazine campaign mentioned above. Ben was also able
to bring back several ideas concerning the mandatory student health insurance proposal SHAC
has been working on over the last three years. This summer (2006), SHAC sent Marcina
Matthias to the ACHA conference in New York City. Having demonstrated a strong commitment
to SHAC, Marcy will share her experience from the conference with the 2006-2007 SHAC.
7.
SHS Physician Interviews: One problem that all Student Health Services face is acquainting the
student body with the services offered and creating a trust with students so that they feel more
40
comfortable seeking care at their facilities. In an attempt to familiarize students with the services
and personnel of the UI SHS, SHAC has taken the initiative to interview the various health care
professionals that practice at Student Health so that students can come to student health with a
better understanding of who will be treating them. It is SHAC’s hope that this program will
create a better understanding amongst students of what to expect when coming to Student Health
and make the choice of receiving their care here at the UI more comfortable and easier. SHAC
did not see this program come to full fruition this year but has already received the first of what
we hope to be several responses from SHS physicians. In the future, SHAC will place these
responses on our website (http://www.uiowa.edu/~shac) with the ultimate hope of eventually
getting these profiles published in the Daily Iowan.
8. In addition to these programs, SHAC researches, develops, and sends letters of support for many
campus and community wide programs. This year, SHAC members began the process of
developing an informational brochure for students on generic medications and researching the
IowaCare health insurance program to determine how UI students could benefit from this
resource. It is our hope that the next SHAC continues with these goals and uses the information
we have already collected. In addition, for the last several years, SHAC has discussed at length
mandatory health insurance for all students at the University of Iowa. In the attached report,
SHAC has compiled ideas from our earliest discussions as well as several initiatives that took
place during the 2005-2006 year. Please reference this report for our current position and
recommendations regarding this important issue.
9. It is also my pleasure to report that SHAC was honored this year as one of the University of
Iowa’s most outstanding student organizations. At this year’s Hawkeye Student Organization
Leadership and Service Awards Program (Hawkeye Awards), SHAC was awarded the 2006
Outstanding Student Organization Award. The criteria for this award included demonstration of
consistent flexibility, initiative, creativity, and perseverance; having made meaningful
contribution to students, University, or surrounding communities; valuing stewardship; attracting
members from different backgrounds, life experiences, and those with diverse perspectives;
working in collaboration with other organizations to enhance organization's goals; and
exemplifying integrity in all areas of the organization.
It has been an outstanding year for SHAC. We accomplished a great deal this year and laid the
groundwork for several future programs.
Respectfully submitted,
Benjamin Darbro
Benjamin W. Darbro
2005-2006 SHAC Committee Chair
41
Student Health Advisory Committee Report on
Mandatory Student Health Insurance
Spring 2006
42
In 2004, the Student Health Advisory Committee (SHAC) drafted a statement in support of
mandatory student health insurance for all students at the University of Iowa. The following is
that statement:
After having thoroughly researched and discussed the issue, the members of the Student Health
Advisory Committee have decided to endorse mandatory health insurance for all students at the
University of Iowa. We realize that the cost of education can be a determining factor in whether
a student chooses to remain at the University of Iowa, thus, several financial considerations were
factored into our decision. We believe that thousands of dollars in healthcare related bills, as
opposed to a small monthly insurance fee, is far more likely to financially prevent a student from
continuing his or her education. Furthermore, the cost of mandatory health insurance can be
defrayed in part through specific financial aid awards, thus, sparing those students already
struggling to afford college an additional expense. Ultimately, we feel mandatory health
insurance for all students is a small price to pay for the lasting protection it offers.
Specific thoughts and comments on both the “financial considerations” and other considerations
were taken into account by the Student Health Advisory Committee and are presented below.
At the root of our financial considerations was the question: What solution will most confidently
provide a student the best opportunity to complete his or her education at the University of
Iowa?
Since the proposal would mandate an additional cost to students, and cost is often a limiting
factor in whether a student begins or continues his or her education at the University of Iowa, we
examined how this additional cost would affect the “financially struggling student”.
Financially Struggling Student
FINANCIAL AID
Currently, health insurance can be
included in a student’s application
for financial aid and the additional
cost of insurance can be covered in
this way.
SCHOLARSHIPS
Scholarship awards can possibly be
adjusted to cover the cost of health
insurance and the additional cost of
insurance would be covered in this
way.
NO FINANCIAL AID OR
SCHOLARSHIPS
Student is struggling to afford
approximately $467 a month ($5,612
per year) in tuition and needs to
come up with an additional $70 a
month (approximately %15 of
tuition expenses).Figures from 2005
The question then became: How does requiring the student with no financial aid or scholarships
to pay an additional health insurance expense on top of tuition provide the best opportunity for
that student to complete his or her education at the University of Iowa?
43
Financial Reasons
1.
Possibility of an Unexpected Health Problem
A.
Basic Rationale: Whereas it is possible that having to pay an additional 15% more
money a month may result in a student discontinuing his or her education at the
University of Iowa, having to pay an additional 200-300% more (percent based on
yearly tuition costs) most definitely would result in that same student lacking the
financial resources to continue his or her education (and likely place the student in
a financial debt that would last well beyond their college years).
B.
Examples of Possible Unpredictable Health Problems
1.
2.
Experience has
shown that these
kind of incidents
DO happen to
college students
regardless of any
perceived health
(see appendix)
3.
4.
5.
C.
Viral Meningitis: Average charges for inpatient stay and ER visit = $9,225
Appendectomy without Complications: Average charges for inpatient stay
and ER visit = $13,100
Alcohol Related Incidents
a.
Intoxication Related Accident (Fight or Fall): ER visit and
professional charges from treatment of the injury
b.
Alcohol Poisoning: Ambulance call, ER visit, and professional
charges for treatment
c.
Treatment of Alcohol Abuse: Enrollment in an intensive outpatient
program or partial hospitalization
Maternity/Child Birth
Automobile Accident
Pascal’s “Insurance” Wager
No Insurance
No Incident
Incident
Insurance
Student may potentially
save anywhere from
$3000-$4000 over the
course of 4-5 years
Student may potentially
lose anywhere from
$3000-$4000 over the
course of 4-5 years
Result: Student will not be
financially burdened by
premiums
Result: Student may not
continue education due to
premium cost
Student may potentially
lose anywhere from
$10,000-$20,000 over
the course of 4-5 years
Student may potentially
save anywhere from
$10,000-$20,000 over the
course of 4-5 years
Result:
Student
will
certainly
discontinue
education
Result: Student may
continue education and
will not have future debt
44
2.
Premiums May Lower in Cost if Health Insurance was Mandatory Across All Iowa
Campuses
A.
Basic Rationale: If student health insurance were mandatory across all Iowa
campuses the cost of the premiums may go down, thus, making the cost of health
insurance more affordable to students already struggling to afford tuition.
B.
In addition, higher enrollments in a state wide university insurance program may
provide for better coverage making the cost of the insurance more of a deal for
students who would otherwise not be able to afford comprehensive private
insurance plans.
1.
NOTE: The University of Iowa Student Health Insurance Plan (SHIP) is
more than just catastrophic coverage. SHIP now covers additional
healthcare expenses including:
a.
b.
c.
2.
3.
Maternity
Well-Baby/Well-Child Care
Prescription Drugs
NOTE: SHIP also provides a great opportunity for students who cannot
get insurance due to pre-existing medical conditions.
UISG Resolution SA-R-0505-0xx
In May 2005, the University of Iowa Student Government (UISG) passed resolution SAR-0505-0xx that concerned the increased financial burden of mandatory health insurance
and “request[ed] the Board of Regents to reject the proposed mandatory student health
insurance”. Specifically, this resolution stated that, “mandatory health insurance presents
a significant financial burden for many students and is expected to rise, inhibiting many
students from receiving education at the UI.”
Following this resolution, SHAC further expanded the concept of the financial burden mandatory
student health insurance would create and how it may prevent students from receiving an
education at the University of Iowa. There were two conditions that we felt were representative
of this situation:
1) The increased cost of mandatory student health insurance would prevent students from
applying to and enrolling in classes at the University of Iowa, and
2) The increased cost of mandatory student health insurance would prevent currently enrolled
students from continuing their education at the University of Iowa.
45
To address the first of these conditions, SHAC conducted both paper and electronic surveys of
first year students to determine whether mandatory student health insurance, and the financial
burden it may bring, would have prevented them from coming to the University of Iowa.
A.
Paper Survey (conducted during several 2005 Summer Orientation Sessions)
1.
Incoming students (and on some occasions, parents of incoming
students—these results were compiled separately)
2.
Questions and Results of 144 Incoming Students
1. How important do you think it is to have health insurance?
Not Important
1
2
3
Very Important
4
5
6
7
8
9 (9.34) 10
2. Do you have health insurance? Yes (91.7%) No (3.5%) Don't Know (4.2%) Not
Determined (0.7%)
3. If you did not have health insurance would you voluntarily pay for a policy? Yes (66.0%)
No (14.6%) Not Determined (19.4%)
4. If health insurance were mandatory for all students would you still have been able to
attend the University of Iowa? Yes (97.2%) No (2.8%) Not Determined (0.0%)
Note: Costs of mandatory health insurance can be figured into financial aid packages
3.
Questions and Results of 128 Parents of Incoming Students (asked to fill
out the survey as they felt their student would do)
1. How important do you think it is to have health insurance?
Not Important
1
2
3
Very Important
4
5
6
7
8
9 (9.82) 10
2. Do you have health insurance? Yes (99.2%) No (0.0%) Don't Know (0.0%) Not
Determined (0.8%)
3. If you did not have health insurance would you voluntarily pay for a policy? Yes (83.6%)
No (2.3%) Not Determined (14.1%)
4. If health insurance were mandatory for all students would you still have been able to
attend the University of Iowa? Yes (95.3%) No (3.1%) Not Determined (1.6%)
Note: Costs of mandatory health insurance can be figured into financial aid packages
B.
Electronic Survey (conducted via mass email to all first year students and
redirection to a web-based survey-Spring 2006)
46
1.
2.
All first year students were sent the mass email (with a line stating that if
they had already filled out this survey over the summer that it is not
necessary that they do so again)
Questions and Results of 317 first year students (all other non-first year
student responses were excluded)
1. How important do you think it is to have health insurance?
Not Important
1
2
3
Very Important
4
5
6
7
8
(8.97) 9
10
2. Do you have health insurance? Yes (89.0%) No (4.7%) Don't Know (6.3%) Not
Determined (0.0%)
3. If you did not have health insurance would you voluntarily pay for a policy? Yes (72.2%)
No (27.8%) Not Determined (0.0%)
4. If health insurance were mandatory for all students would you still have been able to
attend the University of Iowa? Yes (94.0%) No (6.0%) Not Determined (0.0%)
Note: Costs of mandatory health insurance can be figured into financial aid packages
(see appendix for individual comments made by students at the end of this survey)
C.
Combined Results
1.
Both the paper and electronic surveys
2.
Questions and Results of 461 first year students
1. How important do you think it is to have health insurance?
Not Important
1
2
3
Very Important
4
5
6
7
8
9 (9.08) 10
2. Do you have health insurance? Yes (89.8%) No (4.3%) Don't Know (5.6%) Not
Determined (0.2%)
3. If you did not have health insurance would you voluntarily pay for a policy? Yes (70.2%)
No (23.7%) Not Determined (6.1%)
4. If health insurance were mandatory for all students would you still have been able to
attend the University of Iowa? Yes (95.0%) No (5.0%) Not Determined (0.0%)
Note: Costs of mandatory health insurance can be figured into financial aid packages
D.
Review of Paper and Electronic Survey Results
1.
The vast majority of incoming students HAVE health insurance already
and would therefore not be required to purchase health insurance prior to
enrollment and registration at the University of Iowa
47
2.
3.
The vast majority of incoming students would still HAVE been able to
attend the University of Iowa if health insurance were mandatory
Conclusion: Mandatory student health insurance would be VERY
UNLIKELY to prevent students from COMING to the University of Iowa
To address the second of these conditions, that the increased cost of mandatory student health
insurance would prevent currently enrolled students from continuing their education at the
University of Iowa, SHAC would suggest one of the two following options.
E.
Grandfather Clause
1.
Following acceptance of a mandatory student health insurance policy all
current students should be informed that they are exempt from this action
but are highly recommended to purchase health insurance if they are not
already insured
2.
Following the acceptance of a mandatory student health insurance policy
all prospective students should be informed that this is a requirement of
enrollment/registration that they will be expected to fulfill throughout their
college careers
F.
Delayed Enforcement
1.
Following acceptance of a mandatory student health insurance policy all
current students should be informed that they have up to 1-2 years to
purchase health insurance before any penalties would be incurred or
before they are automatically enrolled in the SHIP program
2.
Prospective students would still be informed that mandatory health
insurance is a requirement that they will be expected to fulfill throughout
their college careers
In summary, we feel that the financial considerations raised by the UISG were appropriate and as
such we spent our time and resources to research these situations and potential solutions. We
found that the financial burden carried with a mandatory student health insurance policy would
very likely NOT result in significantly fewer students being able to attend the University of
Iowa, and that consideration should be given to those current students that may be affected by
this policy as such a policy was not in existence at the time they were decided to attend the
University of Iowa.
Following the adoption of a mandatory student health insurance policy, future students will have
to consider this requirement in their application process. Based on our research, it is unlikely
that this requirement will directly prevent prospective students from applying to and attending
the University of Iowa, however, this requirement may pose a financial problem when these
students continue in their education and eventually are no longer covered under their parent’s
health insurance policies. However, in contrast to current students, these prospective students
will have advance knowledge of this requirement and can factor this condition into their decision
to attend the University of Iowa. Also in contrast to current students, prospective students will
have ample time to make financial plans before such a requirement becomes an issue.
48
In addition to the financial consideration, SHAC considered several other reasons for why a
mandatory student health insurance policy is necessary at the University of Iowa. Several of
these reasons are outlined below. We feel that these reasons are just as important as financial
considerations and should not be viewed as any less significant.
Student and Public Health Related Reasons
1.
Mandatory Health Insurance May Increase the Number of Students Who Take Advantage
of Preventive Care Options and General Healthcare
A.
Basic Rationale: Research has shown that both uninsured individuals and
specifically uninsured students have lower rates of use of preventive healthcare
services and healthcare in general, thus insured students may take advantage of
these services more often and be in better health.
B.
Examples
1.
2.
Uninsured Students have lower use rates of the following preventive care
services
a.
Mammograms (9% insured vs. 7% uninsured students at the
University of Minnesota)
b.
Pap Smears (64% vs. 54%)
c.
Routine Physical Exams (40% vs. 34%)
Uninsured Individuals have lower rates of the following general healthcare
services
a.
Mental Health Services (13% insured vs. 4% uninsured
individuals)
b.
Compliance with Medical Treatments (39% vs. 13%)
c.
Filling Prescriptions (30% vs. 12%)
d.
Receiving Care for Serious Medical Problems (20% vs. 3%)
Specific Scenario: A student living in a residence hall develops a headache, sore neck, and flulike symptoms. Statistically, if this student does not possess health insurance he or she would be
less likely to seek medical care for what may be a case of meningitis. Meningitis is a contagious,
potentially fatal disease that can spread quickly within a dorm environment. Any delay in
seeking medical treatment for this disease can be costly not only to the student who initially
comes down with this disease but every other student within that living environment that has
close contact with the student.
3.
Mandatory Health Insurance May Reduce the Risk of Death for Students in Severe
Accidents
A.
Basic Rationale: Research by Joseph Doyle of MIT’s Sloan School of
Management has shown that victims of severe accidents who lacked insurance
were 37% more likely to die from their injuries than those who had insurance,
49
thus insured students may not suffer from any acute care discrimination that may
result in their death.
B.
FACT: Unintentional accidents is the leading cause of death amongst 18-24 year
olds, therefore prevention of acute care, insurance based discrimination is of
utmost importance to college students.
Other Considerations
1.
General Trend Amongst Other Peer Universities
2.
Recommended by the American College Health Association (ACHA)
3.
Helps to Address the Nationwide Problem of Uninsured Americans
A.
Research shows that 18-29 year olds make up the highest percentage of uninsured
Americans
B. Uninsured college students make up approximately 8-10% of the nation’s uninsured
D.
Uninsured Rates for College Students are as Follows:
1.
2.
3.
Full-time Students: 17%
Part-time Students: 25%
College Students 23-24 years old: 38%
Appendix
Story from May 6, 2005 Daily Iowan
When UI student Scott Monsma began a road trip east in 2004, he never dreamed he would end
up in a Tennessee intensive care unit, tethered by IVs.
Nor did the otherwise healthy 24-year-old expect to hear that the lining of his esophagus had
ruptured, requiring laser surgery and a surge of unforeseen expenses.
The 16-mile helicopter flight to Knoxville was $500.
The emergency room was roughly $1,200.
The longer he stayed, the higher the bill: $90 for blood transfusions, $80 for X-rays, more than
$1,800 for gastrointestinal procedures, and a staggering $18,700 for four days in intensive care.
The hospital even forgave $6,000.
Still, Monsma left the hospital with more than $20,000 in bills and no insurance to help pay for
them.
50
The communications major, who is filing for bankruptcy this week while working temporarily as
a city landscaper, perfectly illustrates the need for UI students to have health insurance, local
agents and experts say. His plight is particularly important given the university's recent proposal
to mandate health insurance for all students.
The proposal, if approved by the state Board of Regents, would require all students to pay an
extra $70 for coverage. At present, 3,000 to 4,000 UI students - roughly 20 percent - are
uninsured.
Statewide, 67,000 Iowans ages 19-29 lacked coverage in 2003, according to Families USA, a
nonpartisan consumer-interest organization. Current UI seniors could join those ranks one month
after graduation, when many lose the coverage that protects them as students.
Some will go on to jobs with full coverage plans. But others, such as Monsma, will not qualify
for benefits from employers.
In Iowa City, a healthy 25-year-old female nonsmoker can expect to pay between $300 and $400
per month for a comprehensive care plan through an independent agent, experts say. For males
of the same health status and age, monthly payments could range from $150 to $200. The greater
expense for women is due to possible pregnancy costs.
Besides high cost, young people are also uninsured because Medicaid restrictions fail to cover
their needs, said John Sopher, an income-maintenance supervisor with the Johnson County
Department of Human Services. To qualify in Iowa, applicants must be disabled, pregnant, or
have a dependent child younger than 18 while showing financial need.
The system's complexity can be daunting, especially for young adults, said Tom Alger, a
communications director for the Iowa Insurance Division.
"It's definitely a complex issue," he said. "There's a lot to learn, a lot of decisions to make."
The Free Medical Clinic, housed in the lower level of the Wesley Center, offers free care for
anyone without insurance.
Graduates can also qualify for health care through State Papers, a program for Johnson County
residents who are treated at UI Hospitals and Clinics but not insured. The county-run program is
meant for those who cannot afford treatment. Since his incident, Monsma said he has learned all
about these programs.
State aid wouldn't cover his mounting medical expenses, though, because his emergency
happened outside of Iowa. Nor would his parents' plan, because he was not a student at the time.
Meanwhile, the soft-spoken landscaper said he is living "paycheck to paycheck" with $1,000 in
bankruptcy fees in addition to rent, food, and cell-phone bills.
51
Though the incident left no physical scars, the bankruptcy will be on his credit report for eight
years.
Now, he plans to get good health insurance: "I'd be stupid not to."
Student Comments from Web-Based Survey(unedited)
I have insurance through the University and it is a great plan and relatively cheap. I think health
insurance is a really good thing because if for some reason I was to get sick myself or my family
would not have to pay as much for the pricey hospital bill.
I don't think it should be mandatory for all students. Most students receive it from their parents
anyway, but it would be just another payment to add it to financial aid money.
I am currently under my parents health insurance policy.
I feel the choice to have health insurance (or not to) is dependent on many individual factors. If
the University were offer a lower cost insurance policy to students it would be put to good use by
those who may not be able to afford it otherwise. Insuring the health and well-being of U of I
students should be a priority; moreover, the University has no right to refuse attendance on an
issue of free choice.
Is it going to be mandatory? I can't afford health insurance now....
I think health insurance is a very important thing.
What are the reasons behind requiring it? Student health services are free, and it seems there's no
reason. Niether of my parents can get any kind of health insurance through work, so it would be
a really high extra expense for us. I don't qualify for any kind of financial aid either, so the note
on number five makes no difference.
I do not support mandatory health insurance. Costs are high enough.
Let it stay optional, seeing as the University keeps increasing tuition, mandatory health insurance
will drive many students away due to the costs.
Why does student health only accept certain insurance companies?
I think health insurance should cover dentenstry
I love student health! ;)
my insurance isn't through the University
How much would a mandatory healthy insurance rate cost?
52
I think making it mandatory would be absurd because it should be left up to the individual
whether or not they think they need health insurance. I think having it be optional but educating
students more on their options would be a much better, more popular way to go.
I have a private insurance policy that covers upwards of $18,000 worth of prescription drugs. I'm
probably the exception to the rule.
Not everyone is as fortunate as me to have funds for health insurance, and it should
DEFINATELY NOT be manditory to attend the university.
I would not wish to have mandatory health insurance, but I wouldn't refuse to attend the
university because of it.
If i think i have ADD and think i need riddelin does would that go on my health insurance?
I don't think health insurance should be mandatory for students. It's an adult decision on whether
or not they want it, and we are all pretty much adults. But on the otherside, for those who may
not be able to afford it, the thing about it being in the financial aide would probably be a bonus.
Probably because most of those who don't have it probably can't afford it.
Question 5 seems to indicate you are thinking of requiring students to have health insurance. If
you make admission requirements that are that stupid and unrelated to ability you will lose good
applicants. Even though I could have come here with that as a requirement it would be a big
black mark against Iowa.
I don't fully understand it!
Leave it optional. Out-of-state students pay enough.
I would hate to see health insurance become mandatory if it was expensive because i don't think
anyone should be denied te right to go to college because of their financial difficulties. Maybe
there could be some sort of sliding scale in which financial situations would be factored into how
much each student has to pay for insurance.
poor people who can't afford health insurance should be helped.
Research statistics compiled from the March 10-17th, 2003 Student Health Spectrum journal (a
publication of the Chickering Group)
53
Student Health Advisory Committee (SHAC)
WH
AT
IS
The Student Health Advisory
Committee is a university charter
committee that exists to advise the
administration on issues and policies
regarding the health care provided to
students and student families at the
University of Iowa, including (among
others) those policies and practices
regarding preventive health measures
and health maintenance services both
physical and mental, immunizations,
health counseling, health education,
screening, dental care, identification
of "high risk" persons, and referral to
medical and other health facilities
within the University and outside it.
In addition, SHAC is responsible for
providing information concerning
student health insurance plans,
advising on student participation in
health surveys, and dissemination of
information
in
the
campus
community about the availability of
health care.
Who is SHAC?
Visit Us on the Web!
See us at:
www.uiowa.edu/~shac
SHAC is made up of UI students,
faculty and staff as well as liaisons
from Student Health Services and
Health Iowa. There are six students,
two faculty, and one staff member on
SHAC. Students interested in being a
member of SHAC must fill out a
charter committee application and
submit it to the University of Iowa
Student
Government
(UISG)
Nominations Committee. Following
submission
of
a
completed
application an interview will be
scheduled at which interested
students can express why they want
to be a member of the committee.
Applications for charter committees
are available outside the UISG office
(48 IMU) and the Office of Student
Life (145 IMU).
54
SHAC PROJECTS
Student Health 101: SHAC is
responsible for disseminating health
information
to
the
university
community. One of the ways in
which we accomplish this goal is by
distributing brochures to all the
residence halls.
These brochures
cover a wide range of health topics
and are distributed four times a year.
Student Health Insurance: SHAC is
currently in the process of evaluating
a proposal that would mandate health
insurance for all students at the
University of Iowa. Health insurance
not only protects a student’s
educational investment but also the
well being of the entire university
community.
SHAC has been
gathering a substantial amount of data
on the topic and will be presenting
this information to members of the
university administration, UISG, and
the Board of Regents.
Health Fair: Each Spring, SHAC
participates in the annual Health Fair.
We present information to students
on how to have a safe spring break
and collaborate with Health Iowa to
provide free cholesterol screening to
members
of
the
university
community.
Homecoming Parade: This year,
SHAC is co-sponsoring the Student
Health Services homecoming float.
The theme of this year’s parade is
“Hawkeye Fever…It’s Contagious!”
Members of SHAC will be helping
decorate the float and walking along
side it during the parade.
Activities Fairs: SHAC attends
several activities fairs throughout the
year in an effort to both disseminate
health information and answer
questions students have concerning
health care issues.
STUDENT HEALTH STAFF COUNCIL
Committee Chair: Jennifer Tinnes (administrative secretary)
Committee Members: Gayle Nelson RN, Robin Hayward PA, Ann Laros MD, Tracy Varcoe (support
staff), Beverly Schneider (support staff), Beth Cannell (nursing clerk), Katie Heick
(medical assistant), & Kathy Mellen (dietitian)
Our Mission:
ƒ Maintain and improve communication among all staff members.
ƒ Identify ways to improve/strengthen staff satisfaction with work environment.
ƒ Plan, organize and coordinate SHS social functions, e.g., annual staff recognition day, holiday
party, summer picnic, etc.
ƒ Identify and acknowledge staff life events, e.g. memorials, retirements, births, etc.
ƒ Serve as a liaison to the community by participating in service events (e.g., March of Dimes
Walk, Homecoming parade), charitable giving (food drives, sale profits from t-shirts, etc.), and
strengthening the campus/community connection by promoting SHS as part of the broader
Johnson County public health community and Iowa City/Coralville business community.
Student Health Staff Council strives every year to construct new ideas to positively promote Student
Health Service to our students and community. Last year we teamed up with the Student Health Advisory
Committee and constructed a float for the homecoming parade. The theme for last year was “Hawkeye
Fever, it’s Contagious.” Now what better theme for a health service to use to make a float? The
construction and planning was fun and it really had Student Health and SHAC working as a team with the
same goal in mind, to get our name and services out to the community. The float turned out to be a huge
success winning 1st prize. We had a lot of fun and will attempt to do this again this coming fall.
Another big part of Staff Council is staff recognition. We have planned out certain weeks of each year to
recognize various departments of our clinic by posting banners and giving recognition “treats”. Also once
a year, we do a Staff Appreciation lunch, in which we honor all staff. This continues to be a big success.
This year we applied and received funding toward this event. We also give out a small appreciation gift
to each employee.
55
Staff Council also organizes and plans potlucks, a holiday evening potluck, and a summer picnic.
Staff Council funds are generated from a bi-weekly rotation of volunteer employees taking our pop cans
in for recycling. We also do periodic fundraisers such as Student Health shirt sales; we had a garage sale
and have had a cookbook sale. A portion of our profit is donated to the Johnson County Food Bank.
Another way we accumulate funds is by a yearly donation. We ask all staff to donate $1/month. Not only
does this money go for staff events, but a big portion of the money goes into a separate account used for a
memorial fund.
The memorial/donation fund is used the following way:
A $25 donation and a card are sent when an employee has a death in the immediate family including the
following.
1. Employee’s Parents
2. Spouse
3. Employee’s Children; includes step-children
4. Mother and Father – in – law
5. Employee’s Siblings
6. Employee’s Grandparents
Any other death not listed above will be given a card from SHS. (Example: spouse’s or significant
other’s grandparents)
Employee with a lengthy illness or long hospital stay will receive a card and a $25 donation/gift.
Other events:
Retirements are handled by SHS Administration as far as gift and reception. Departments can do what
they want in addition.
First Births, Adoptions, Weddings, Showers, or any other events are the responsibility of each department
or co-workers to arrange.
It has been a great honor and privilege to represent a committee that strives not only to help and
contribute to our community but also being a part of planning and organizing events in recognizing our
staff for all the great jobs they do each and every year for our clinic. Recognition is very important and
we will continue to strive as a committee to implement more ways for our staff to feel appreciated and
acknowledged for their teamwork and their dedication in helping make our clinic such a big success.
Respectfully submitted,
Jennifer Tinnes
Administrative Secretary
Student Health Staff Council Chair
56
STUDENT HEALTH SERVICE OUTPATIENT ACTIVITY SUMMARY
2005-2006
Routine Patient Encounters and Consultations
MD Consultations ............................................................................ 27,163
Nurse Consultations ........................................................................... 9,933
TOTAL ......................................................................................................................... 37,096
Health Iowa Encounters and Consultations
Workshops ....................................................................................... 24,754
Individual Consultations .................................................................... 3,979
TOTAL ......................................................................................................................... 28,733
Nurse Call Line............................................................................................................. 17,311
Insurance Transactions................................................................................................... 8,635
Laboratory Procedures
Student Health Service....................................................................... 7,518
UIHC.................................................................................................. 6,841
University Hygienic Lab.................................................................. 10,656
TOTAL ......................................................................................................................... 25,015
57
NONDISEASE CONTACT WITH STUDENT HEALTH SERVICE
2005-2006
Immunizations and Inoculations
Mumps Vaccine..................................................................................... 44
Measles Vaccine...................................................................................... 7
Rubella Vaccine ...................................................................................... 7
Measles, Mumps, Rubella Vaccine ................................................... 1063
Measles, Rubella Vaccine ....................................................................... 0
Polio Vaccine ........................................................................................ 70
Typhoid Vaccine (IM and Rx) ............................................................ 124
Varicella Vaccine .................................................................................. 43
Yellow Fever Vaccine ........................................................................... 76
Tetanus, Diphtheria Vaccine ............................................................... 164
Diphtheria-tetanus-Pertussis (Tdap).................................................... 607
Influenza Vaccine............................................................................. 2,260
Pneumococcal Vaccine............................................................................ 9
Rabies Vaccine...................................................................................... 98
Hepatitis A Vaccine ............................................................................ 220
Hepatitis B Vaccine............................................................................. 555
Hepatitis A-B Vaccine......................................................................... 140
Meningococcal Vaccine ...................................................................... 425
Encephalitis Vaccine ............................................................................. 46
Immune Serum & Specified Hyperimmune Globulin Vaccines ........... 46
Pollen Injection (Allergy)................................................................. 1,193
Other Vaccine (NEC) ............................................................................ 12
TOTAL ......................................................................................................................... 7,209
Contraceptive Management
General Counseling ............................................................................... 11
Initial Birth Control Pill Prescription .................................................. 339
Initiate Contraception NEC ................................................................... 68
Emergency Contraception ................................................................... 237
Diaphragm Fitting/Cervical Cap ........................................................... 10
IUD Insertion........................................................................................... 2
Refill Birth Control Pill Prescription................................................ 1,477
IUD Removal .......................................................................................... 3
Implantable Subdermal Contraceptive .................................................... 0
Other Birth Control Methods (including Depo-Provera Injection) ..... 288
Other Contraceptive Management....................................................... 228
TOTAL ..........................................................................................................................
2,663
Reproduction and Development
Pregnancy State
Incidental ............................................................................................ 6
Normal Pregnancy ............................................................................ 36
High Risk Pregnancy.......................................................................... 7
Antenatal Screening ........................................................................... 0
Postpartum Care and Examination .......................................................... 0
Procreative Management....................................................................... 33
TOTAL ............................................................................................................................. 82
58
NONDISEASE CONTACT WITH STUDENT HEALTH SERVICE (CONT)
2005-2006
Health Advice Education or Instruction
Dietary Consultation ............................................................................. 528
Fitness Consultation.............................................................................. 239
General Consultation (Health Advice, Education or Instruction) ........... 64
Substance Use/Abuse Counseling ..................................................... 484
HIV Counseling ................................................................................. 902
Sexually Transmitted Disease Counseling ........................................ 989
Normal Exam; No Disease...................................................................... 37
Administrative Consultation ................................................................. 141
Other Medical Consultation .................................................................. 119
TOTAL .......................................................................................................................... 3,503
Medical Screening and Examinations
Physical Examination
Routine .............................................................................................. 218
Administrative (includes school admission)...................................... 655
Defined Subpopulation (includes pre-employment screening) ......... 177
Other .................................................................................................... 51
Observation for Suspected Diseases ....................................................... 36
Routine Gynecology Examination (Annual Exam) ........................... 1,919
Pregnancy Screening (Negative)........................................................... 223
Pregnancy Screening (Positive) .............................................................. 26
Diagnostic Laboratory Procedure (Primary Diagnosis).......................... 35
PPD Screening ................................................................................... 3,438
Venereal Disease Screening............................................................... 2,118
Screening or Malignant Neoplasm’s..................................................... 785
Hypertension Screening.......................................................................... 45
Special Screening for:
Thyroid Disorders.............................................................................. 359
Diabetes ............................................................................................. 108
Endocrine (Inc. Cholesterol) Disorders ............................................. 377
Anemia ................................................................................................ 20
Viral Diseases................................................................................. 4,261
Bacterial Diseases........................................................................... 2,294
Other Infectious Diseases .................................................................... 52
Other .................................................................................................. 229
SPECIAL SCREENING SUBTOTAL ...................................... 7,700
Postoperative and Aftercare Consultations and Services...................... 363
Transvaginal Ultrasound (SHS)................................................................ 0
Other ..................................................................................................... 154
TOTAL .........................................................................................................................17,943
TOAL NON DISEASE CONTACTS............................................................................................... 31,400
59
DISEASE-ORIENTED CONTACT WITH STUDENT HEALTH SERVICE
2005-2006
Disease Contact Without Diagnosis ................................................................................. 312
Infectious and Parasitic Diseases
Intestinal Infection and Infestation ......................................................... 46
Tuberculosis.............................................................................................. 1
Strep Infection (Group A)..................................................................... 100
Chicken Pox .............................................................................................. 5
Herpes ................................................................................................... 235
Rubeola and Rubella ................................................................................. 0
Hepatitis .................................................................................................... 5
Mumps .................................................................................................... 77
Infectious Mononucleosis ..................................................................... 438
Wart ...................................................................................................... 674
Human Papilloma Virus.......................................................................... 17
Viral Infection (Unspecified and NEC*) .............................................. 386
Chlamydia (Trachomatis) ..................................................................... 130
Lues (Syphilis) .......................................................................................... 0
Gonococcal Infection ................................................................................ 8
Dermatophytosis ................................................................................... 176
Monilia Vaginitis (Candidal Vulvovaginitis) ....................................... 336
Trichomoniasis.......................................................................................... 2
Pediculosis ................................................................................................ 5
Scabies .................................................................................................... 38
Other ..................................................................................................... 570
TOTAL .......................................................................................................................... 3,249
Neoplasms
Lipoma ................................................................................................... 18
Benign Neoplasm (Skin)....................................................................... 113
Other Site ........................................................................................ 11
Malignant Neoplasm................................................................................. 1
Neoplasm of Uncertain Behavior............................................................ 22
Carcinoma in situ .................................................................................... 44
Other ................................................................................................. 112
TOTAL ............................................................................................................................ 321
Endocrine, Nutritional, and Metabolic Diseases, Diseases of the Blood, Blood Forming Organs
Thyroid Disorder................................................................................... 176
Diabetes .................................................................................................. 58
Hypoglycemia ......................................................................................... 10
Gout ........................................................................................................ 22
Obesity .................................................................................................. 133
Anemia.................................................................................................... 77
Adenitis/Lymphadenitis.......................................................................... 14
Other ..................................................................................................... 374
TOTAL ..............................................................................................................................864
*Not Elsewhere Classified
60
DISEASE-ORIENTED CONTACT WITH STUDENT HEALTH SERVICE (CONT)
2005-2006
Psychiatric Consultation - No Mental Disorder
Marital/Partner Problem............................................................................ 8
Other Family Problem............................................................................... 7
Psychosocial Problem ............................................................................. 17
Observation for Suspected Mental Condition ....................................... 290
Other ....................................................................................................... 34
TOTAL ............................................................................................................................. 356
Psychoses
Schizophrenic Disorder........................................................................... 13
Major Depressive Disorder (Single) ..................................................... 281
Major Depressive Disorder (Recurrent)................................................ 703
Other ..................................................................................................... 180
TOTAL ...........................................................................................................................1,177
Neurotic, Personality, and Non-Psychotic Mental Disorders
Neurotic Disorders ............................................................................. 1,583
Personality Disorder.................................................................................. 6
Psychosexual Dysfunction ...................................................................... 23
Alcohol Dependence............................................................................... 72
Drug Dependence.................................................................................... 32
Tobacco Use Disorder........................................................................... 175
Non Dependent Abuse of Alcohol ........................................................ 555
Non Dependent Abuse of Drugs ........................................................... 151
Physiological Malfunction Due to Mental Factor..................................... 5
Eating Disorder ..................................................................................... 182
Tension Headache................................................................................... 29
Stress Reaction (Acute)........................................................................... 34
Adjustment Reaction............................................................................... 86
Depressive Disorder (NEC) .................................................................. 522
Attention Deficit Disorder .................................................................... 215
Other ....................................................................................................... 50
TOTAL .......................................................................................................................... 3,720
Diseases of the Nervous System and Sense Organs
Epilepsy .................................................................................................... 1
Migraine Headache ............................................................................... 234
Other Nervous System Disorder ............................................................. 30
Contact Lens Problem............................................................................... 7
Conjunctival Disorder........................................................................... 681
Inflammation of the Eyelid ................................................................... 112
Episcleritis/Scleritis .................................................................................. 1
Other Eye Disorder ............................................................................... 255
Otitis Externa ........................................................................................ 154
Impacted Cerumen ................................................................................ 106
Eustachian Tube Disorder..................................................................... 117
Otitis Media .......................................................................................... 430
Tympanic Membrane Rupture ................................................................ 20
Labyrinthitis.............................................................................................. 0
Tinnitus ................................................................................................... 16
Other ..................................................................................................... 142
TOTAL ........................................................................................................................ 2,306
61
DISEASE-ORIENTED CONTACT WITH STUDENT HEALTH SERVICE (CONT)
2005-2006
Diseases of the Circulatory System
Hypertension ......................................................................................... 210
Cardiac Dysrhythmia .............................................................................. 25
Phlebitis/Thrombophlebitis....................................................................... 9
Thrombosis ............................................................................................. 10
Varicose Vein............................................................................................ 1
Hemorrhoid ............................................................................................. 53
Hypotension .............................................................................................. 2
Other ....................................................................................................... 69
TOTAL ......................................................................................................................... 379
Diseases of the Respiratory System
Nasopharyngitis (Cold)............................................................................. 6
Sinusitis................................................................................................. 912
Pharyngitis (Acute) ............................................................................ 1,635
Tonsillitis (Acute) ................................................................................. 758
Laryngitis/Tracheitis (Acute)................................................................ 106
Acute URI .......................................................................................... 1,935
Bronchitis.............................................................................................. 301
Allergic Rhinitis.................................................................................... 662
Pneumonia .............................................................................................. 69
Influenza (Clinical Diagnosis) .............................................................. 181
Asthma .................................................................................................. 374
Pleurisy ..................................................................................................... 4
Pneumothorax ........................................................................................... 0
Other ..................................................................................................... 401
TOTAL ...................................................................................................................... 7,344
Diseases of the Digestive System
Gingival and Periodontal Disease ........................................................... 18
Dentofacial Anomaly .............................................................................. 79
Stomatitis .................................................................................................. 7
Aphthous Ulcer (Canker Sore)................................................................ 50
Glossitis .................................................................................................... 3
Esophagitis................................................................................................ 7
Peptic Ulcer............................................................................................... 0
Gastritis/Duodenitis ................................................................................ 73
Dyspepsia................................................................................................ 95
Appendicitis .............................................................................................. 3
Hernia...................................................................................................... 20
Gastroenteritis/Colitis ........................................................................... 245
Irritable Bowel ........................................................................................ 10
Anal Fissure ............................................................................................ 24
Other ..................................................................................................... 564
TOTAL ...................................................................................................................... 1,198
62
DISEASE-ORIENTED CONTACT WITH STUDENT HEALTH SERVICE (CONT)
2005-2006
Diseases of the Genito-Urinary System
Upper UTI............................................................................................... 68
Kidney Stone............................................................................................. 6
Cystitis (Lower UTI)............................................................................. 139
Urethritis ................................................................................................. 65
Prostatitis ................................................................................................ 16
Epididymitis............................................................................................ 31
Breast Dysplasia and Disorder.............................................................. 155
Pelvic Inflammatory Disease (NOS)......................................................... 7
Cervicitis ................................................................................................. 81
Vaginitis................................................................................................ 305
Dysplasia of the Cervix......................................................................... 183
Dysmenorrhea ......................................................................................... 97
Amenorrhea............................................................................................. 47
Menstrual Disorder ............................................................................... 468
Other .................................................................................................. 1,440
TOTAL ...................................................................................................................... 3,108
Complications of Pregnancy, Childbirth and the Puerperium
Spontaneous Abortion............................................................................... 4
Hemorrhage in Early Pregnancy ............................................................... 3
Excessive Vomiting in Pregnancy ............................................................ 0
Other Complications of Pregnancy ........................................................... 4
Complications of the Puerperium ............................................................. 0
Other ......................................................................................................... 2
TOTAL ........................................................................................................................... 13
Diseases of the Skin
Furuncle/Boil .......................................................................................... 60
Cellulitis/Paronychia............................................................................. 175
Lymphadenitis (Acute) ............................................................................. 1
Impetigo .................................................................................................. 24
Pilonidal Cyst.......................................................................................... 93
Seborrhea ................................................................................................ 27
Atopic Dermatitis...................................................................................... 7
Eczema and Contact Dermatitis............................................................ 382
Psoriasis .................................................................................................. 12
Pityriasis Rosea....................................................................................... 38
Pruritus.................................................................................................... 52
Corns and Callosities ................................................................................ 8
Ingrown Nail ......................................................................................... 102
Folliculitis ............................................................................................. 114
Acne ...................................................................................................... 388
Sebaceous Cyst ..................................................................................... 111
Urticaria .................................................................................................. 70
Other ..................................................................................................... 653
TOTAL ...................................................................................................................... 2,317
63
DISEASE-ORIENTED CONTACT WITH STUDENT HEALTH SERVICE (CONT)
2005-2006
Diseases of the Musculoskeletal System
Arthritis (Rheumatoid).............................................................................. 1
Chondromalacia (patella).......................................................................... 0
Arthralgia (Joint Pains) ......................................................................... 693
Back Pain .............................................................................................. 428
Ganglion.................................................................................................. 26
Coccydynia ............................................................................................... 8
Enthesopathy........................................................................................... 38
Synovitis/Tenosynovitis........................................................................ 125
Bursitis ...................................................................................................... 6
Myalgia/Myofascitis ............................................................................... 68
Neuralgia/Neuritis..................................................................................... 5
Other ..................................................................................................... 932
TOTAL ...................................................................................................................... 2,330
Congenital Anomalies .................................................................................................... 34
Symptoms, Signs, and Ill-Defined Conditions
Syncope................................................................................................... 50
Convulsive Disorder ............................................................................... 20
Dizziness and Giddiness ....................................................................... 156
Sleep Disturbances................................................................................ 209
Fever of Unknown Origin (Pyrexia) ..................................................... 204
Fatigue/Malaise..................................................................................... 553
Hyperhidrosis.......................................................................................... 42
Paresthesia/Numbness............................................................................. 81
Rash ...................................................................................................... 480
Subcutaneous Nodule.............................................................................. 47
Weight/Nutrition/Metabolic Problem ..................................................... 99
Headache (NDS) ................................................................................... 331
Epistaxis.................................................................................................. 30
Lymphadenopathy/Swollen Glands ...................................................... 222
Cough................................................................................................. 1,340
Chest Wall Syndrome ............................................................................. 76
Urinary Problems .................................................................................. 372
Abdominal Pain .................................................................................... 647
Abdominal and/or Pelvic Mass/Swelling/Lump ..................................... 12
Viremia ..................................................................................................... 4
Glycosuria ................................................................................................. 2
Abnormal Pap Smear ............................................................................ 719
Positive PPD Converters....................................................................... 782
Elevated Blood Pressure W/O Diagnosis.............................................. 245
Other .................................................................................................. 1,855
TOTAL ...................................................................................................................... 8,578
64
DISEASE-ORIENTED CONTACT WITH STUDENT HEALTH SERVICE (CONT)
2005-2006
Injury and Poisoning
Fracture ................................................................................................... 79
Dislocation .............................................................................................. 26
Sprains and Strains................................................................................ 284
Concussion.............................................................................................. 33
Open Wound ......................................................................................... 133
Superficial Injury .................................................................................. 226
Contusion .............................................................................................. 130
Foreign Body .......................................................................................... 24
Burn ........................................................................................................ 25
Injury – Nonsuperficial ......................................................................... 346
Frostbite .................................................................................................... 4
Heat Exhaustion ........................................................................................ 0
Allergic Reaction to Medication Properly Administered........................ 20
Other ....................................................................................................... 62
TOTAL ...................................................................................................................... 1,392
TOTAL DISEASE ORIENTED CONTACT................................................................................... 38,998
65
STUDENT HEALTH SERVICE LABORATORY PROCEDURES
2005-2006
Student Health Service Laboratory Procedures
CBC ................................................................................................... 1,273
CBC (with manual differential) .............................................................. 25
WBC ......................................................................................................... 3
WBC – Differential................................................................................... 0
Hematocrit ................................................................................................ 6
Hemoglobin ............................................................................................ 10
Hematocrit – Hemoglobin......................................................................... 0
Blood Sugar .......................................................................................... 105
Occult Blood, Fecal .............................................................................. 133
KOH Prep ............................................................................................... 91
Heterophile Antibody (Mono Test)....................................................... 927
Platelet Count............................................................................................ 0
Sedimentation Rate ................................................................................. 60
Scabies ...................................................................................................... 1
hCG Urine/Serum (269/18)................................................................... 287
Strep Screen ....................................................................................... 1,946
Wet Prep (Trich) ................................................................................... 715
Urine Culture ............................................................................................ 2
Urinalysis (with microscopy)............................................................. 1,252
Urinalysis (dipstick).............................................................................. 603
Influenza Screen...................................................................................... 79
TOTAL ...................................................................................................................... 7,518
66
STUDENTS REFERRED TO THE
RADIOLOGY/NUCLEAR MEDICINE DEPARTMENT OF
THE UNIVERSITY OF IOWA HOSPITALS AND CLINICS
BY STUDENT HEALTH SERVICE
2005-2006
Radiology/Nuclear Medicine
X-ray
Chest.................................................................................................... 378
Facial Bones ............................................................................................ 1
Ribs ......................................................................................................... 7
C Spine .................................................................................................. 17
T Spine .................................................................................................. 14
L Spine .................................................................................................. 33
Sacroiliac................................................................................................. 2
Pelvis ....................................................................................................... 8
Hip......................................................................................................... 12
Shoulder ................................................................................................ 41
Arm, Elbow, Hand .............................................................................. 137
Leg, Knee, Foot................................................................................... 297
Abdomen ................................................................................................. 5
Upper G.I................................................................................................. 3
SUBTOTAL ...................................................................................... 955
Ultrasound ........................................................................................... 225
Computerized Tomography (CT).......................................................... 67
Magnetic Resonance Imaging (MRI) .................................................. 106
Other...................................................................................................... 32
SUBTOTAL ...................................................................................... 430
TOTAL................................................................................................................... 1,385
67
59
68
69
70
71