lmilil$APIIIII I CONTENTS REGION Page *ALABANM .................................. 1 ALASKA, see Washington -Alaska -@ALBANY ................................... 5 AMERICAN SAMOA, see Hawaii ARIZONA .................................. 10 *ARKANSAS see also Memphis ............................ 11 BI-STATE .................................. 17 -CALIFORNIA ................................ 19 *CENTRAL NEW YORK ......................... 25 *COLORADO - WYOMING ........................ 31 *CONNECTICUT .............................. 37 DELAWARE, see Greater Delaware Valley *FLORIDA .................................. 42 *GEORGIA .................................. 47 *GREATER DELAWARE VALLEY ................... 53 GUAM, see Hawaii *HAWAII ................................... 56 IDAHO, see Intermountain; Mountain States ILLINOIS see also Bi-State ............................ 61 --INDIANA see also Ohio Valley .......................... 63 *INTERMOUNTAIN ............................. 67 -@IOWA ..................................... 74 *KANSAS ................................... 77 *Includes operational projects I REGION Page KENTUCKY, see Memphis; Ohio Valley; Tennessee Nfid-South LOUISIANA ................................. 86 *NMINE .................................... 88 *MARYLAND ................................ 93 MASSACHUSETTS, see Tri-State *NMMPHIS .................................. 98 *METROPOLITAN WASHINGTON, D. C. .............. 104 MICRONESIA, see Hawaii *MICHIGAN ................................. 109 MINNESOTA, see Northlands MISSISSIPPI, see also Memphis ................... 114 *MISSOURI, see also Bi-State; Memphis . . . . . . . . . . . . . .116 MONTANA, see Intermountain; Mountain States *MOUNTAIN STATES ........................... 125 NASSAU-SUFFOLK ............................ 129 NEBRASKA-SOUTH DAKOTA ..................... 130 NEVADA, see California; Intermountain NEW HAMPSHIRE, see Tri-State *NEW JERSEY, see also Greater Delaware Valley ........ 132 *NEW MEXICO ............................... 136 NEW YORK, see Albany; Central New York; Nassau-Suffolk; New York Metropolitan; Rochester; Western New York NEW YORK METROPOLITAN ..................... 140 *NORTH CAROLINA ............................ 141 NORTH DAKOTA ............................. 148 NORTHEAST OHIO ............................ 149 *NORTHERN NEW ENGLAND ..................... 151 *Includes operational projects if REGION P @e *NORTHLANDS .............................. 154 NORTHWESTERN OHIO ........................ 159 *OHIO STATE, see also Northeast Ohio; Northweste n@bhi-o, Ohio Valley ................ 160 *OHIO VALLEY .............................. 162 *OKLAHOMA ............................... 165 @OREGON ................................. 170 PENNSYLVANIA, see Greater Delaware Valley; Susquehanna Valley; Western Pennsylvania PUERTO RICO .............................. 174 RHODE ISLAND, see Tri-State *ROCHESTER .............................. 176 *SOUTH CAROLINA ........................... 182 SOUTH DAKOTA, see Nebraska-South Dakota *SUSQUEHANNA VALLEY ....................... 188 *TENNESSEE MID-SOUTH see also Memphis ......................... 192 *TEXAS ................................... 20, *TRI-STATE ................................ 210 UTAH, see Intermountain VERMONT, see Northern New England VIRGINIA ................................. 213 *WASHINGTON-ALASKA ........................ 215 WASHINGTON, D. C., see Metropolitan Washington, D. C. WEST VIRGINIA see also Ohio Valley ....................... zzi WESTERN INTERSTATE COMMISSION FOR HIGHER EDUCATION (WICHE), see Mountain States *Includes operational projects REGION Page *WESTERN NEW YORK ......................... 222 WESTERN PENNSYLVANIA ...................... 227 *WISCONSIN ................................ Z29 WYOMING, see Colorado-Wyoming; Intermountain; Mountain States INDEX .................................... 234 *Includes operational projects rv ALABAMA - I NAUE OF PROGRAM Alabama Regional Medical Program GEOGRAPHICAL REGION State of Alabama ESTIMATED POPULATION 3, 558, 000 COORDINATING HEADQUARTERS Alabama Regional Medical Program 1917 Fifth Avenue. South Birmingham, Alabama 35233 (Tel.: 205/325-5394) GRANTEE ORGANIZATION University of Alabama Medical Center EFFECTIVE STARTING DATE January 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE April 1, 1969 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1, 885,955 FUNDING FOR CURRENT $903, 105 YEARIS ACTIVITIES CHAIRMAN, REGIONAL T. JosephReeves, M.D. ADVISORY GROUP Professor and Chairman of Medicine University of Alabama Medical Center 1919 Seventh Avenue, South Birmingham, Alabama 35233 (Tel.: 205/325-4651) PROGRAM COORDINATOR *Benjamin B. Wells, M.D., Ph.D. STAFF DIRECTOR John M. Packard, M.D. ASSOCIATE DIRECTORS FOR PROFESSIONAL LIAISON J.0. Finney, M.D. FOR CANCER John R. Durant, M.D. FOR ADMINISTRATION Joseph J. Mason, Jr. FOR HEART AND STROKE Harold W. Schnaper, M.D. *Chief Executive Officer ALABAMA - 11 STAFF (Continued) ASSOCIATE DIRECTORS (Continued) FOR MOBILE AREA IvL L. Campbell, M.D. Mobile General Hospital 2451 Fillingim Street Mobile, Alabama 36617 (Tel.: Z05/473-0341, ext. 250) ASS TSTANT DIRECTOR FOR PROGRAM DEVELOPMENT Paul K. Kennedy NURSE SPECLALIST Sue Weathington, R.N. COORDINATOR FOR HEALTH INSTITUTIONS M. D. Plowden ASSISTANT DIRECTOR FOR RE- SEARCH AND EVALUATION Charles L. Joiner, Ph.D. HEALTH PLANNER Richard W. Thompson, Ph.D. SYSTE@ ENGINEER David R. Shaw OPERATIONS STAFF CHIEF John W. Gillespie ADMINISTRATIVE ASSISTANTS Robert J. Shaw Catherine Crooks STAFF ASSISTANT Virginia Buryn OFFICE OF COMMUNICATIONS AND PUBLIC INFORMATION Jane Davis (Visual Arts Specialist) HEALTH PLANNING LIAISON OFFICE DIRECTOR, APPALACHIAN RE- GIONAL COMMISSION .Dennis Q. Opheim Tri-County Regional Health Planning Commission P. 0. Box 1347 Decatur, Alabama 35601 (Tel.: 205/353-3800) ALABAMA - III STAFF (Continued) PLANNING OFFICE, COMPREHEN- SIVE HEALTH PLANNING Loren C. Nfiller State Department of Public Health State Office Building Montgomery, Alabama 36104 (Tel.: 205/365-2341, ext. 3435) -3- ALABAMA IV APPROVED OPERATIONAL PIROJECTS HEALTH MANPOWER PROGRANO IN THE JUNIOR COLLEGE Objectives: Pilot project at Jefferson State Jr. College to attempt to demon- strate feasibility of health service manpower training in junior colleges and vocational schools throughout the state. Immediate aim is double size of existing nursing and medical records pro- grarn. Region intends to support this institution until the Allied Health Professions Act funding is picked up. Funds requested primarily to support salaries of instructors. TRAINING PROGRAM IN REALITY ORIENTATION TECHNIQUE Objectives: To improve care and rehabilitation of older patients with cere- brovascular disease and stroke. Training will be directed toward a broad spectrum of health service personnel, with special attention to lower echelon personnel in nursing homes that therapeutic patient environment will replace custodial en- vironment. Methods developed by Dr. James C. Folsom of Veterans Administration Hospital in Tuscaloosa will be em- ployed in order to orient patient to reality. NURSING EDUCATION IN CORONARY CARE Objectives: A coordinated approach between registered and licensed prac- tical nurses in care of coronary patients. Birmingham Baptist Hospital will hold five classes of 15 Registered Nurses and 15 Licensed Practical Nurses each, and seeks support largely for personnel, office supplies, alterations and renovations, and stipends. A RADIOISOTOPE SERVICE IN A COMMUNITY HOSPITAL Objectives: Decatur General Hospital staff proposes to establish a basic service for the use of radioisotopes in diagnosis and treatment. Principal objectives will be improvement of patient care and teaching by demonstration. -4- ALBANY NAME OF PROGRAM Albany Regional Medical Program GEOGRAPHICAL REGION Northeastern New York and portions of Southern Vermont and Western @ssa- chusetts ESTIMATED POPULATION 2, 090, 000 COORDINATING HEADQUARTERS Albany Regional Medical Program Albany Medical College of Union University 47 New Scotland Avenue Albany, New York 12208 (Tel.: 518/462-75Zl) GRANTEF, ORGANIZATION Albany Medical College of Union University EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE April 1, 1967 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $2, 761, 675 FUNDING FOR CURRENT $1,110,679 YEARIS ACTIVITIES CHAIRMAN, REGIONAL I-larold C. Wiggers, Ph.D. ADVISORY GROUP Dean, Albany Medical College of Union University 47 New Scotland Avenue Albany, New York 12208 PROGRAM COORDINATOR -@Frank M. Woolsey, Jr., M.D. Associate Dean and Professor Chairman, Department of Postgraduate Medicine Albany Medical College of Union University STAFF (ASSISTANT) COORDINATORS NORTHERN DIVISION Girard J. Craft, M.D. ALBANY-VERMONT INTERFACE DIV IS ION William P. Nelson 111, M.D. CENTRAL DIVISION Ward L. Oliver, M.D. *Chief Executive Officer -5- ALBANY - 11 STAFF (Continued) (ASSTSTANT) COORDINATORS (Cont'd) SOUTHF,RN DIVISION John B. Phillips, M.D. EASTERN DIVISION Arnold W. Pohl, M.D. WESTERN DRVISION William T. Strauss, M.D. DIRECTOR OF INFORMATION James P. Mc@hon ALBANY -; III APPROVED OPERATIONAL PROJECTS TWO-WAY RADIO COMMUNICATION SYSTEM - NETWORK EXPANSION Objectives: To enlarge the already established communications network to include an additional 57 hospitals, 24 high schools, and an unstated number of headquarters of voluntary health agencies and meeting places for medical societies; to expand the program beyond practicing physicians to include allied medical personnel, administrators, members of boards of trustees, voluntary health agencies, adult education classes, and selected civic groups. TWO-WAY RADIO COMMUNICATION SYSTEM - PROGRAM PRODUCTION Objectives: To enlarge the already established communications network to include an additional 57 hospitals, Z4 high schools, and an unstated number of headquarters of voluntary health agencies and meeting places for medical societies; to expand the program beyond practicing physicians to include allied medical personnel, administrators, members of boards of trustees, voluntary health agencies, adult education classes, and selected civic groups. COMMUNITY INFORMATION COORDINATORS Objectives: To provide effective liaison, evaluate prevailing attitudes, and promote effective personal contacts with the medical and lay individuals and groups who have a role in the de- veloping regional medical program. Four former phar- maceutical representatives will be employed as coordinators. POSTGRADUATE INSTRUCTION DEVELOPMENT Objective: To identify professional educational needs of the physicians in the region and to satisfy these needs through programs of continuing education. A random group of physicians will attend sessions at the Medical College and by radio. Pre and post testing will be used to evaluate the effectiveness of the project. -7- ALBANY - IV APPROVED OPERATIONAL PROJECTS (Continued) COMMUNITY HOSPITAL LEARNING CENTERS Objectives: To establish learning centers in hospitals to accelerate the dissemination of new medical knowledge and, as a broader aim, to enhance the concept of the community hospital as a focus for continuing medical education. Automated audio- visual aids will be installed in the initial 8 hospitals. Evalua- tion will be based on use of the facilities. CORONARY CARE TRAINING AND DEMONSTRATION PROGRANO ALBANY MEDICAL CENTER Objectives: To serve as a prototype of the best care available for the patient with an acute myocardial infarction; and to provide training for physicians and nurses interested in establishing facilities in their own communities. This project would augment the existing Coronary Intensive Care Unit at the Albany Medical Center. COMMUNITY HOSPITAL CORONARY CARE TRAINING AND DEMON- STRATION PROGRAM - VASSAR BROTHERS HOSPITAL, POUGHKEEP- SIE Objectives: To establish a coronary care unit at Pittsfield and expand an existing one at Poughkeepsie as a demonstration and educa- tional project for other hospitals in the region. A con- tinuing educational program will serve the permanent Unit Staff and staffs from smaller hospitals. COMMUNITY HOSPITAL CORONARY CARE TRAINING AND DEMON- STRATION PROGRAM - AFFILIATED HOSPITALS, PITTSFIELD, MASSACHUSETTS Objectives: To establish a coronary care unit at Pittsfield and expand an existing one at Poughkeepsie as a demonstration and educa- tional project for other hospitals in the region. A continuing educational program will serve the permanent Unit Staff and staffs from smaller hospitals. COMMUNITY HOSPITAL CORONARY CARE TRAINING AND DEMON- STRATION PROGRAM - HERKIMER MEMORIAL HOSPITAL, HERKIMER, NEW YORK Objectives: To establish a coronary care unit in a small community hospital without house staff and train selected nurses and physicians to use the equipment. ALBANY - V APPROVED OPERATIONAL PROJECTS (Continued) COORDINATOR FOR CANCER IN SCHENECTADY AREA Objectives: To establish a coordinator for cancer to implement and expedite more effective professional and lay education, assure better clinical care, organize more complete follow- up of cancer patients, and provide coordination in evaluating effectiveness of all oncol.ogy activities in the area. CORE PROGRAM Objectives: To support administrative and planning functions. ARIZONA - I NAUE OF PROGRAM Arizona Regional Medical Program GEOGRAPHICAL REGION State of Arizona ESTIMATED POPULATION 1, 663, 000 COORDINATING HEADQUARTERS Arizona Regional Medical Program University of Arizona College of Medi- cine Tucson, Arizona 857ZI (Tel.: 6OZ/884-2701) GRANTEE ORGANIZATION University of Arizona College of Medi- cine EFFECTIVE STARTING DATE April 1, 1967 OF PLANNING ACTIVITIES TOTAL FUNDING TO DATE $563,865 FUNDING FOR CURRENT $138, 095 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Richard 0. Flynn, M.D. ADVISORY GROUP Z210 South Nfill Avenue Tempe, Arizona 85281 PROGRAM COORDINATOR *Dermont W. Melick, M.D. STAFF DEPUTY COORDINATOR James R. Shaw, M.D. CHIEF OF OPERATIONS John F. Flynn INFORMATION AND PUBLIC RELA- TIONS Frank L. Riggs APPLICANT ADVTSOR Kenneth L. Brown ASSISTANT COORDINATOR Myron L. Miller, M.D. CHIEF NURSE (Miss) Margaret F. Knapp CHIE.F-SOCIAL WORKER (Mrs.) Greta AUnn *Chief Executive Off icer -10- ARKANSAS NAME OF PROGRAM Arkansas Regional Medical Program GEOGRAPHICAL REGION State of Arkansas ESTIMATED POPULATION 1, 986, 000 COORDINATING HEADQUARTERS Arkansas Regional Medical Program 500 University Tower Building 12th at University Little Rock, Arkansas 72204 (Tel.: 501/664-5?53) GRANTEE ORGANIZATION University of Arkansas Medical Center EFFECTIVE STARTING DATE April 1, 1967 OF PLANNING ACTIVITIES EFFECTRVE STARTING DATE February 1, 1969 OF OPERATIONAL ACTIVLTIES TOTAL FUNDING TO DATE $1,05?.,599 FUNDING FOR CURRENT $7?.9. 9?.4 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Thomas H. Wortham, M.D. ADVISORY GROUP 813 Marshall Road Jacksonville, Arkansas 72076 PROGRAM COORDINATOR *Roger B. Bost, M.D. STAFF ASSISTANT PROGRAM COORDINATOR W. Richard Ellis DIRECTOR OF HEART DISEASE Malcolm B. Pearce, M.D. NURSIND COORDINATOR (Mrs.) Jacqueolyn S. Walter DIRECTOR OF CARDIOPULMONARY EDUCATION FOR NURSES (Mrs.) Dorothy B. McPhail LIBRARIAN (Mrs.) Sally Kasalko DIRECTOR OF INFORMATION (Mrs.) Carol V. Adams BIOMETRIST John M. Long, Ph.D. DIRECTOR OF EVALUATION (ACTING) Ferris Baker *Chief Executive Officer -11- ARKANSAS STAFF (Continued) DIRECTOR OF AUDIO-VISUAL COMMUNICATIONS Robert C. Donaldson ADMINISTRATIVE ASSISTANT (Mrs.) Jeane Moore COMPUTER PROGRAMMER TECH- NICIAN (Mrs.) Norma Haughay ARTIST-DRAFTSMAN Ronald M. Tribell ARKANSAS - III APPROVED OPERATIONAL PROJECTS CORESUPPORT Objectives: This project would continue the support of core staff and central administrative expenses after the planning grant expires. CORONARY CARE AND SUPPORTING DIAGNOSTIC UNIT FOR POST- GRADUATE TRAINING OF PHYSICIANS Objectives: This project would provide two-week courses for physicians and the opportunity for medical students, interns, residents, and fellows to learn about the operation of Coronary Care Units. A portion of the project involves the development of a computer module to simulate patients in various conditions that will be encountered in coronary care units. The sys- tems design will be provided from programs already de- veloped by the Intermountain Regional Medical Program. NURSES CORONARY CARE COURSE - ARKANSAS BAPTIST MEDICAL CENTER Objectives: This program provides four-week courses to be offered six times a year with eight trainees per course. Preference in selection of trainees will be given to clinical supervisors or head nurses and staff nurses in hospitals which have existing or planned Coronary Care Units. CARDIOPULMONARY RESUSCITATION PROGRAM Objectives: This project will expand a Cardiopulmonary Resuscitation program initiated by the Arkansas Heart Association. The Region has been divided into 14 subregions. Each will be provided with an adequate corps of physician and lay in- structors and necessary training aids in order to conduct an adequate Cardiopulmonary Resuscitation program in accord- ance with the priorities established by the Cardiopulmonary Resuscitation Committee of the American Heart Association. -13- 356-998 0-69-2 ARKANSAS - IV APPROVED OPERATIONAL PROJECTS (Continued) COMPUTERIZED TUMOR REGISTRY FOR ARKANSAS (BASIC PROGRANO Objectives: The purposes of this project are to collect diagnostic, therapeutic and survival data on all patients with neoplastic diseases in Arkansas; stimulate systematic follow-up; im- prove patient care; provide feedback to the patient's doctor and to the hospital medical staff for clinical conferences; and computerize the existing registry. The Central Cancer Registry now located at the University of Arkansas and operated by the State Cancer Commission will become the nucleus of the Regional registry. District registries will participate and receive services of the Commission. NORTHWEST ARKANSAS REGIONAL CANCER PROGRAM Objectives: No large medical center is located close to this remote area of Arkansas and Oklahoma. This project will fulfill some of the services generally supplied by such centers. It will establish a cancer registry at the nine hospitals in the area, send the data to Little Rock to be computerized and inform area physicians of the results of the patients in the registry. Cancer conferences and clinics will be held in the hospitals. A speakers bureau will be established and programs of public education will be presented. HEALTH CAREERS RECRUITMENT Objectives: This project is designed to coordinate programs in the health field directed at solving the manpower shortage. A climate for the recruitment will be created through an inten- sive advertising and public relations campaign. The actual job of recruitment will be done by the various schools offer- ing training and the career related organizations. The pre- college student will be the prime target. -14- ARKANSAS - V APPROVED,OPERATIONAL PROJECTS (Continued) REGIONAL HOSPITAL MEDICAL LIBRAKY SYSTEM Objectives: This is a three-year program designed to upgrade the Region's medical library resources. During the first year, local con-ununity hospitals will be assisted in building library collections, and librarians from community hos- pitals will be trained through workshops at the University of Arkansas Medical Center Library and follow-up in the local hospital setting. Physicians and other health per- sonnel will be oriented to use local libraries and the Uni- versity of Arkansas Medical Center library reference service, the latter by a toll-free communication system. During the second year, a medical library network will be developed and a computerized union list of serials and catalog monographs will be distributed to each library. NUCLEAR MEDICINE TECHNOLOGY TRAINING PROGRAM Objectives: Arkansas currently has one nuclear medicine technologist, no training programs, and six hospitals with nuclear medicine equipment but no trained personnel to operate it. This project would train four students per year in Little Rock at the St. Vincent Infirmary where nuclear equipment and the nuclear medicine technologist are now available. The course will last one year. Students will be full-time. Annual seminars will be offered as a continuing education program. WESTERN ARKANSAS CANCER STUDY - ST. EDWARD MERCY HOSPITAL OF FORT SMITH Objectives: This project has several elements designed to meet needs of seven counties in western Arkansas and three counties in eastern Oklahoma. It involves a local cancer registry, which will be included in the Regionwide registry; a tumor board and clinics, seminars for nurses, physicians, and dentists; and a lay education. A standing committee on cancer will oversee the operation of the project. -15- ARKANSAS - VI APPROVED OPERATIONAL PROJECTS (Continued) CONTINUING EDUCATION FOR NURSING PERSONNEL AND CITIZENS ARKANSAS LEAGUE FOR NURSING Objectives: To take continuing education programs to the Region's registered nurses, licensed practical nurses, and concerned citizens. The project will be developed over a three-year period. The first year will be devoted to planning and organization, and two sessions will be held for professional nurses in leadership positions throughout the state. By the next year, the project will involve a minimum of 500 nurses and 450 citizens. BI-STATE - I NAME OF PROGRAM Bi-State Regional Medical Program GEOGRAPHICAL REGION Southern Illinois and Eastern Missouri ESTIMATED POPULATION 4, 800, 000 COORDINATING HEADQUARTERS Bi-State Regional Medical Program 607 North Grand Boulevard Saint Louis, Missouri 63103 (Tel.: 314/535-9755) GRANTEE ORGANIZATION Washington University School of Medicine EFFECTIVE STARTING DATE April 1, 1967 OF PLANNING ACTIVITUES TOTAL FUNDING TO DATE $935,587 FUNDING FOR CURRENT $644,922 YEARIS ACTIVITIES CHAIRMAN, REGIONAL G. Duncan Bauman ADVISORY GROUP Publisher Saint Louis Globe-Democrat 12th Street at Delmar Saint Louis, Missouri 63101 PROGRAM COORDINATOR *William Stoneman 111, M.D. STAFF ASSOCIATE DIRECTORS I-IEART Kenneth C. Price, M.D. (Washington University) Edwin E. Westura, M.D. (Saint Louis University) CANCER E. James Potchen, M.D. (Wash- ington University) Donald R. Judd, M.D. (Saint Louis University) STROKE William B. Hardin, Jr., M.D. (Washington University) Edward L. Eyerman, M.D. (St. Louis University) ALLIED HEALTH @NPOWER Harry E. Davis -17- BI-STATE - if STAFF (Continued) ADMINISTRATION @tthew J. Costello FIELD COORDINATORS REGIONAL Donald K. Young METROPOLITAN Clarice Murphy COMMUNICATIONS SPECIALIST AND DIRECTOR OF PUBLIC RELATIONS Edna Carroll RESEARCH ASSISTANTS MEDICAL PLANNING Aleene K. Schneider EDUCATION AND MANPOWER Ruth D. Dodge -18- CALIFORNTA - I NAME OF PROGRAM California Regional Medical Program GEOGRAPHICAL REGION State of California, plus Reno-Sparks and Clark County (Las Vegas), Nevada ESTIMATED POPULATION 19, 782, 000 COORDINATING HEADQUARTERS California Committee on Regional Medical Programs 655 Sutter Street, Room 600 San Francisco, California 94120 (Tel.: 415/771-5432) GRANTEE ORGANIZATION California Medical Education and Research Foundation EFFECTIVE STARTING DATE November 1, 1966 OF P LANN ING AC T rV IT IES EFFECTIVE STARTING DATE July 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $7,589,482 FUNDING FOR CURRENT $3,399,924 YEARIS ACTIVITTES CHAIRMAN, REGIONAL Roger 0. Egeberg, M.D. ADVISORY GROUP Dean, School of Medicine University of Southern California 2025 Zonal Avenue Los Angeles, California 90033 PROGRAM COORDINATOR *Paul D. Ward STAFF ASSOCTATE DIRECTORS Acton Barnes William Boquist Richard Sasuly COORDINATOR OF EVALUATION Jack E. Thomson (cq), Ed. D. COORDINATOR OF ADMINISTRATION (Mrs.) Chris Roberts AREA COORDINATORS AREA I Elliot Rapaport, M.D. San Francisco General Hospital 22nd and Potrero Avenue San Francisco, California 94110 *Chief Executive Officer -19- CALIFORNIA 11 STAFF (Continued) AREA 11 Reed M. Nesbit, M.D. University of California - Davis School of Medicine Davis, California 95616 AREA III John L. Wilson, M.D. Stanford University 703 Welch Road - Suite G-1 Palo Alto, California 94304 AREA IV Donald Brayton, NL D. 15-39 UCLA Rehabilitation Center West Medical Campus Los Angeles, California 90024 AREA V Donald W. Petit, M.D. USC School of Medicine 1 West Bay State Street Alhambra, California 91801 AREA VI John P ete r s on, M. D. Lon-ia Linda University School of Medicine Loma Linda, California 92354 AREA V 11 Joseph Stokes III, M.D. 7816 Ivanhoe Avenue La Jolla, California 92307 AREA V III Robert C. Combs, M.D. University of California - Irvine California College of Medicine Irvine, California 92664 -20- CALIFORNIA - III APPROVED OPERATIONAL PROJECTS CORONARY CARE TRAINING - AREA I (UCSF) Objectives: Will develop and establish a confederation of Coronary Care Units throughout northwestern California. Training will be provided for nurses and physicians in patient care and for nurse educators and nurse administrators. Supportive pro- grams will be coronary care conferences; a reference in- formation center andnewsletter; and consultation on unit design, management, and specific care problems. ROSEVILLE PILOT PROGRAM - AREA 11 (U. C. Davis) Objectives: Will be a living laboratory for development of programs in continuing physician education, inservice training for paramedical personnel, multiphasic screening, community information and education, tumor'board consultation, and cerebrovascular disease and CNS malignancy diagnosis and evaluation. Applicable to entire Area. A TRAINING PROGRAM FOR PHYSICIANS IN CORONARY CARE - AREA IV (UCLA) (Cedars-Sinai Medical Center) Objectives: To provide training programs for physicians who will occupy positions as directors or associate directors of Coronary Care Units in community hospitals and who will ultimately provide leadership in cardiology at the community level. A basic training course will be given, followed by continuing education and consultative services, and seminars and workshops for continuing liaison between the medical center and community hospitals. WATTS-WILLOWBROOK POST-GRADUATE EDUCATION - AREA IV (UCLA) AND AREA V (USC) Objectives: Joint proposal of University of California at Los Angeles and University of Southern California Medical Schools, the County of Los Angeles, the Charles Drew Medical Society, and the Community of Watts-Willowbrook. A combination planning-operational proposal. This project will coordinate the establishment of a Watts-Willowbrook district Regional Medical Program with the development of a postgraduate medical school. CALIFORNIA - IV APPROVED OPERATIONAL PROJECTS (Continued) RMP MEDICAL TV NETWORK - A CENTER FOR THE CONTINUING EDUCATION OF HEALTH CARE PROFESSIONALS USING TELEVISION. AND OTHER AUDIO-VISUAL MATERIALS - AREA IV (UCLA) Objectives: Based on the UCLA campus and ETV Station KCET, Los Angeles, the project will support production of programs and their broadcast over closed-circuit television to more than 70 Southern California hospitals via the Medical Tele- vision Network (MrN). The best of these programs then are recorded on videotape for distribution by mail to sub- scribing hospitals wherever located (in ZO states). Partially funded by a Public Health Service contract (expired June 30, 1968), MTN began as a cooperative educational venture by six medical institutions. Now to produce and establish programs through an expanded arrangement within the California Region and with other Regions, the MTN will continue as a community educational endeavor; all programs are approved for credit by the American Academy of General Practice. PROGRAM FOR TRAINING PHYSICIANS AND NURSES IN CORONARY CARE TECHNIQUES - AREA V (USC) Objectives: The program will begin with a central training center at the Los Angeles County-USC Medical Center and three coopera- ting hospitals (Good Samaritan, St. Joseph's and St. Vin- cent's). This central program will provide a base to initiate training for the entire region and will be expanded to include six additional hospitals in the second year. Physi- cians and nurses selected for training will represent their hospitals and will share common training backgrounds in coronary care unit techniques and management. TRAINING OF PHYSICIANS IN INTENSIVE CARE FOR SMALL HOSPITALS - AREA I (USC) (Pilot Program - Pacific Medical Center) Objectives: A pilot project (one year only) designed to train physicians in skills, as applicable in a small general hospital, in order to provide intensive care to patients with acute myocardial infarction. (Designed for hospitals not covered under the Coronary Care Training - Area I project.) HYPERTENSION - AREA I (UCSF) Objectives: Demonstrationtrainingprogramformedicalandalliedhealth personnelintencommunityhospitalsforreferralandfollow- up of hypertensive patients. Includes computerized registries. -22- CALIFORNIA - V APPROVED OPERATIONAL PROJECTS'(Continued) PEDIATRIC PULMONARY -AREA VIII (U. C. Irvine) Objectives: Irvine Pediatric Pulmonary Demonstration Center. Center will demonstrate the proper diagnosis and treatment of children with respiratory problems; to investigate the relation of pediatric pulmonary disease to chronic condi- tions of later life. A REGIONAL CANCER PROGRAM-' Objectives: Expand modern techniques in cancer diagnosis and treat- ment. Coordinated by Committee including members from both sponsoring centers, University of California Medical Center and Mt. Zion Saroni Tumor Institute. Basic philosophy is to provide assistance to-peripheral medical groups, building on their existing strengths and resources, and to assist these groups in developing capacity for com- plete cancer management. Has 3 components: (1) clinical oncology, (?.) data retrieval service, and (3) educational services. CHRONIC RESPIRATORY DISEASE* Objectives: Will offer formal seminars and comprehensive consultations as teaching aids for the development in practicing physicians of early detection and management abilities for chronic obstructive respiratory disease. The "Breathmobile" screening program will be utilized. SAN FERNANDO VALLEY AND PACOIMA HEALTH PLANNING PROJECT Objectives: The program is designed to alleviate difficulties of health care in this suburban area for low income and indigent families (approximately 800, 000). All segments of the six communities of the Northeast San Fernando valley will he involved in determining the nat'ure and degree of their health problems, planning solutions and establishing the basis for developing service. *Approved but not funded -23- CALIFORNIA - VI APPROVED OPERATIONAL PROJECTS (Continued) A PROPOSAL FOR REHABILITATION AND CONTINUITY OF CARE SERVICES* Objectives: Develop role of "Liaison Nurse" (nurse with Public Health training who coordinates "discharge planning services"). Proposal has 3 components, involving 7 counties (1) Ala- meda-Contra Costa Project, (2) Humboldt-Del Norte Area, (3) Sonoma-Mendocino-Lake Counties. Each of the three areas differs somewhat in its methodology and objectives. Each area has a nurse coordinator and secretary with a nurse project director and staff to administer the grant located in San Francisco. Workshops proposed to promote understanding of "discharge planning services". INTENSIVE TRAINING COURSE IN CARDIOPULMONARY RESUSCITA- TION FOR EMERGENCY RESCUE PERSONNEL* Objectives: Training Courses in Cardiopulmonary Resuscitation would be conducted for representatives of rescue and emergency personnel in a 7-county area in Northern California. Courses would be developed by California Heart Association and fully supported by the Association after two years. Faculty would include internists, inhalation therapists, ambulance and rescue instructors, and a legal counsel. UNIVERSITY MEDICAL CENTER - RURAL COMMUNITY HOSPITAL DEMONSTRATION COOPERATIVE PROGRAM IN PRIMARY PHYSICIAN TRAINING AND CONTINUING EDUCATION* Objectives: Support involvement of Division of Ambulatory and Com- munity Medicine of University of California San Francisco Medical Center in an ongoing general practice residency program at the Sonoma Community Hospital. A COMPREHENSIVE STROKE PROGRAM* Objectives: Based on Orange County and Long Beach (Area V III, UCI- CCAO. Would encompass prevention, diagnosis, treatment rehabilitation, and long term care of stroke patients through- out the area. Besides enhancing patient care, project seeks to assist in the process of regionalization. Every acute care hospital in area was contacted, as were representatives from extended area facilities, and many health service agencies, with "unanimous" support from all. The com- munity would support the program at some unspecified future time. *Approved but not funded -24- CENTRAL NEW YORK - I NAME OF PROGRAM Central New York Regional Medical Program GEOGRAPHICAL REGION Syracuse, New York and 15 surroimd- ing counties ESTIMATED POPULATION 1,848,811 COORDINATING H]EADQUARTERS Central New York Regional Medical Program Upstate Medical Center State University of New York 750 East Adams Street Syracuse, New York 13210 (Tel.: 315/473-5600) GRANTEE ORGANIZATION Research Foundation of State University of New York EFFECTIVE STARTING DATE January 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE July 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1,061,356 FUNDING FOR CURRENT $460, 314 Y EAR IS ACT IV IT IES CHAIRMAN, REGIONAL Clarke T. Case, M.D. ADVISORY GROUP 1402 Genesee Street Utica, New York 13502 (Tel.: 315/RA4-462.6) PROGRAM COORDINATOR *Richard H. Lyons, M.D. STAFF ASSOCLATE PROGRAMCOORDINATOR Thomas W. Mou, M.D. ASSISTANT PROGRAMCOORDINATOR John Murray TEACHING COORDINATOR Walter Curry NURSING COORDINATOR (@s.) Margaret Sovie DIRECTOR OF PUBLIC RELATIONS (Mrs.) Sandra Anglund 968 James Street Syracuse, New York 13203 (Tel.: 315/GRg-6644) *Chief Executive Officer -25- CENTRAL NEW YORK - 11 STAFF (Continued) PROJECT DIRECTORS MOBILE REHABILITATION UNIT Leo Jivoff, M.D. FAMILY PRACTICE PROGRAM Francis S. Caliva, M.D. 301 Prospect Avenue Syracuse, New York 13203 ONEIDA COUNTY TUMOR CONFER- ENCE Isio Wasserman, M.D. 264 Genesee Street Utica, New York 13502 MEDICAL BRIEFS BY TELEPHONE W.S. Gibbs, M.D. Robert Packer Hospital Sayre, Pennsylvania 18840 THE NEW YORK STATE SIGMOIDO- SCOPIC DEMONSTRATION TEACHING PROGRAM John H. Powers, M.D. Cooperstown, New York 13326 NURSING CORONARY CARE TRAIN- ING PROGRAM (ST. LUKEIS; HOSPITAL) Willard H. Willis, M.D. 430 Court Street Utica, New York 13502 NURSING CORONARY CARE TRAIN- ING PROGRAM (ST. ELIZABETH HOSPITAL) Vincent deLalla, M.D. 291 Genesee Street Utica, New York 13502 REGIONAL LEARNING RESOURCES CENTER Richard L. Muller Department of Instructional Com- munications State University of New York Upstate Medical Center 766 Irving Avenue Syracuse, New York 13210 -26- CENTRAL NEW YORK - III STAFF (Continued) CATEGORICAL COMMITTEE CHAIR-6 MEN HEART DISEASE George S. Sturtz, M.D. 199 Pratt Street Watertown, New York 13601 STROKE Herbert K. Ensworth, M.D. 1301 Trumansburg Road Ithaca, New York 14851 CANCER Daniel Burdick, M.D. 713 East Genesee Street Syracuse, New York 13210 -27- CENTRAL NEW YORK - IV APPROVED OPERATIONAL PROJECTS CONTINUING NURSING EDUCATION Objectives: To update local nursing skills. Programs will be offered in several ways: in-c.enter programs and remote presentations via telecommunications, both followed by on-site visits; programs at sub-regional centers; and programs designed to train additional teachers in the region. There will be continuous planning and monitoring to identify needs, re- sources, and the like. REHABILITATION CONSULTATION SERVICE Objectives: This project would focus on stroke using a mobile team which would provide consultation, service, and educational programs in peripheral hospitals and other health care facilities in the region. The proposed team would be under the direction of a physician and be composed of physical and occupational therapists, speech pathologists, and orthotists. Additional consultative services would be avail- able from other Departments of the Upstate Medical Center which has an established rehabilitation program and is designated as a primary rehabilitation facility by the state. ONEIDA COUNTY TUMOR CONFERENCE Objectives: The proposed series of teaching conferences would build upon a previously conducted cancer clinic program. It would initially involve seven cooperating hospitals in Oneida County, each of which already has appointed a Cancer Com- mittee. The purpose of this project is physician and nurse education. Ten monthly conferences would be presented under the direction of the participating hospitals on a rotating basis. Outside consultant-lecturers would be used and the conferences would be open to the entire medical community. It is anticipated that the conference program might be ex- tended to four additional counties in the future. FAMILY PRACTICE PROGRAM - ST. JOSEPHIS HOSPITAL Objectives: To provide consultants and lecture services in the areas of heart disease, cancer, stroke, and related diseases. -28- CENTRAL NEW YORK - V APPROVED OPERATIONAL PROJECTS (Continued) NURSING CORONARY CARE TRAINING PROGRAM AT ST. LUKE'S AND ST. ELIZABETH'S HOSPITALS, UTICA, NEW YORK Objectives: Twenty nurses in Utica area will each receive 20 days of clinical and didactic training in coronary care each year. Because both hospitals are presently supporting their own coronary care units, this request is primarily for the ad- ditional efforts the nursing supervisors and physicians will spend in this training program. HOME DIALYSIS TRAINING PROGRAM* Objectives: Establishment of home care dialysis training program at the Upstate Medical Center in Syracuse for training patients in home dialysis and serving as functional unit in care of patients for training of public health nurses, other nurses, physicians and medical students. THE NEW YORK STATE SIGMOIDOSCOPIC DEMONSTRATION TEACHING PROGRAM Objectives: To acquaint physicians with incidence, symptoms and recog- nition of common tumors of the rectum; to teach correct methods for the performance of proctosigmoidoscopic exami- nations; to keep adequate records of utilization and value of the course to the physician;and, to assist previous physician- students in their offices if help is desired. Has been planned by advisory group of physicians and pilot program has been funded through the Division of Chronic Disease. MEDICAL BRIEFS BY TELEPHONE AT ROBERT PACKER HOSPITAL, SAYRE, PENNSYLVANIA Objectives: Provide local physicians specific and up-to-date information on tape recordings available by toll-free telephone. Current information on heart disease, cancer and stroke will be supplied twenty-four hours a day. EQUIPMENT GRANT REQUEST FOR COMMUNITY-GENERAL HOSPITAL, SYRACUSE, NEW YORK* Objectives: Purchase of equipment to be used in educational activities at the Community-General Hospital in Syracuse. *Approved but not funded -29- 356-998 0-69-R CENTRAL NEW YORK - VI APPROVED OPERATIONAL PROJECTS (Continued) REGIONAL LEARNING RESOURCES CENTER FOR NURSING CONTINUING EDUCATION Objectives: To show, in a pilot program, the effectiveness of educational technology in producing behavioral changes in the professional activities of health science practitioners. To develop teaching materials for independent and small group use, to test these for effectiveness and to make them available to practitioners in the Region. These materials will relate to the fields of heart disease, cancer, stroke, and related diseases. -30- COLORADO-WYOMING - I NAME OF PROGRAM Colorado-Wyoming Regional Medical Program GEOGRAPHICAL REGION States of Colorado and Wyoming ESTIMATED POPULATION 2,358,000 COORDINATING HEADQUARTERS Colorado-Wyoming Regional Medical Program University of Colorado Medical Center 4200 East Ninth Avenue Denver, Colorado 80220 (Tel.: 303/394-7506) GRANTEE ORGANIZATION University 'of Colorado Medical Center EFFECTRVE STARTING DATE January 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE January 1, 1969 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1, 568,994 FUNDING FOR CURRENT $1,003,902 YEARIS ACTIVITIES CHAIRMAN, REGIONAL John J. Conger, Ph.D. ADVISORY GROUP Vice President for Medical Affairs University of Colorado Medical Center 4200 East Ninth Avenue Denver, Colorado 802?.O VICE-CHAIRMAN, REGIONAL Thomas Nicholas, M.D. ADVISORY GROUP 500 West Lott Buffalo, Wyoming 82834 PROGRAM COORDINATOR Paul R. Hildebrand, M.D. STAFF PROGRAM DIRECTOR *Howard W. Doan, M.D. EXECUTIVE ASSISTANT Rex D. Stubblefield PROJECT ADMINISTRATION & HEALTH INFORMATION SYSTENS DRVTSION James C. Syner, M.D., Associate Director Warren C. Morse, Ph. D. Douglas R. Currin, "D. William 0. Hastings Arthur E. Lagace, Jr., M.H.A. Nancy A. McGuire, R. R. L. Alan Weinstein, IvL B.A. *Chief Executive Officer -31- COLORADO-WYOMING - II STAFF (Continued) PROFESSIONAL ACTIVITIES DIVISION Richard E. Boyle, M.D., Associate Director James E. Dyson, Ph.D. Anne M. Gough, M.P. H., R.N. CARDIOLOGY DIVISION Robert C. Jones, M.D., Associate Director F. R. Normile, M.S.P.H., M.A.D. COMMUNICATIONS AND INFORMATION OFFICE James P. Smith, Chief Phyllis Record, Staff Assistant -32- COLORADO-WYOMING - III APPROVED OPERATIONAL PROJECTS CORESTAFF Objectives: This project is to support core planning and evaluation activities of the Colorado-Wyoming Regional Medical Pro- gram. Staff is divided into four offices and three divisions. Full-time equivalent staff are requested as follows: Office of Coordinator, Office of Director, Office of Division of Professional Activities, Division of Planning and Operations, and Division of Health Data and Program Evaluation. Costs include a subcontract with the System Development Corpora- tion to complete the development and collection of com- munity health profile data and for PAS/MAP participation charges for 15 hospitals. COLORADO STATE CANCER REGISTRY Objectives: The basic objective of this project is to develop a computer- ized statewide cancer registry to improve follow-up to as near as 1000/o as possible and through utilization of registry data, to provide the cancer patients of Colorado with the best care and earliest diagnosis possible. Improved follow-up of (1) treatment failure, (2) second primaries in Kansas Cancer patients, and (3) determination of need for treatment changes in those patients known to have cancer. Extension of regis- tries to all hospitals, improved continuing education and constant evaluation are also goals. This project relates to the third National Cancer Institute Survey of Cancer Incidence and Prevalence and a proposed six-state Rocky Mountain Tumor Registry. The Colorado Department of Public Health will be the headquarters for this activity. MULTI-MEDIA EDUCATION Objectives: This continuing education project will develop a prototype system for videotape exchange and closed-circuit TV involving first, the Denver Medical Society, the University of Colorado Medical Center, Presbyterian Hospital and St. Joseph's Hospital of Denver, and later, seven other Denver hospitals. The TV system will be converted to color later and if CCTV is extended throughout Colorado and Wyoming, (1) will be extended to hospitals throughout the Region, (Z) produce and distribute videotapes to hospitals in the Region (3) produce and distribute a single concept films, slides and filmstrips to Regional hospitals. -33- COLORADO-WYOMING - IV APPROVED OPERATIONAL PROJECTS (Continued) HOME DIALYSIS TRAINING PROGRAM Objectives: This project is to improve understanding of health personnel and the public in the treatment of kidney disease and of the problems experienced by renal patients, to enhance com- munity involvement in the rehabilitation of patients under- going home dialysis, to provide consultation to community health personnel, to provide highly specialized laboratory services when required, and to develop the capability to provide emergency services for home dialysis patients. Training plans include (1) three-day orientation for 30 physicians and 25 public health nurses; (2) five-day orienta- tion for five physicians; (3) ten-day training for five physi- cians from hospitals planning home dialysis service; (4) two- week training session for seven nurses and for technicians from hospitals planning a service program, three-day training for ten dieticians; (5) one-three day conference of 20 social workers and rehabilitation personnel; (6) one-three day orientation for five clergy, welfare workers, pharma- cists and community leaders; (7) five one-two day conferences for 50 health related and community-oriented individuals; and (8) six-week training for family members of patients. Travel and per them is requested for all these groups. TRAINING AND APPLIED RESEARCH FOR INTENSRVE AND RE- HABILITATRVE RESPIRATORY CARE Objectives: To (1) familiarize physicians and paramedical personnel of the magnitude of the emphysema-chronic bronchitis problem; (2) disseminate knowledge on the latest advances in the treatment of the problem; (3) to promote and assist in the establishment of respiratory care programs in local com- rnunities; (4) obtain greater knowledge on the effectiveness of home oxygen for both hypoxemia and nonhypoxernia individuals and (5) increase the effectiveness of the therapy through the development of improved ventilators and nebuli- zation devices as well as the addition of humidification de- vices to existing ox gen equipment. y -34- COLORADO-WYOMING - V APPROVED OPERATIONAL PROJECTS (Continued) RADIATION THERAPY AND NUCLEAR MEDICINE Objectives: 'Technology Training. To reduce the acute shortage of well- trained radiation therapy and nuclear medicine technologists by establishing Associate Degree two-year training programs in radiation therapy and nuclear medicine technology. The programs will be offered by the Denver Community College in conjunction with nine hospitals in the Denver area: (1) Colorado General, (2) Denver General (3) Fitzsimmons General, (4) Lutheran, (5) Mercy, (6) Presbyterian Medical Center, (7) St. Anthony's, (8) St. Lukels, and (9) General Rose Memorial. It is expected that at least seventy students per year will graduate from the training programs. COLORADO INTERAGENCY COUNCIL ON SMOKING AND HEALTH PROGRAM Objectives: To continue support of an Interagency Council on Smoking and Health. The prime source of funding for the Council (which paid the salary of a coordinator and a secretary) has been through a Special Project Grant from the Public Health Service. This source of funding is no longer available due to budget limitations. The general objectives of this proposal are: (1) coordination of Council member activities per- taining to smoking and health and promotion of more efficient communication between Council agencies; and (3) continuation of efforts on a long-range program aimed at permanent financing of the Council within the State of Colorado. CONTINUING EDUCATION CORE PROGRAM FOR NURSES* Objectives: Based at University of Colorado School of Nursing,would pro- vide integrated training in intensive nursing care. CONTINUING EDUCATION STAFF* Objectives: Develop continuing education staff in Colorado-Wyoming Regional Medical Program to counsel with communities interested in developing local continuing education programs. Staff teams would provide consultation to local hospitals. Development of local consultation teams would also be en- couraged, with Regional Medical Program staff assistance provided to fill gaps in local expertise. *Approved but not funded -35- COLORADO-WYOMING - VI APPROVED OPERATIONAL PROJECTS (Continued) PEDIATRIC CHRONIC PULMONARY DISEASE Objectives: Workshops to acquaint physicians of the Rocky Mountain Region with the facilities of the University of Colorado Medical Center will be held, and a means of communicating new information to those medical groups which do not attend postgraduate lectures will be achieved through this project. On the local level, the project will strive to stimulate physi- cian interest in cardiopulmonary disease, increase the willingness to care for more patients with this disease on the local level, evaluate and improve the home management of cardiopulmonary cases and interest physicians in seeking training in pediatric chest disease. -36- CONNECTICUT - I NAME OF PROGRAM Connecticut Regional Medical Program GEOGRAPHICAL REGION State of Connecticut ESTIMATED POPULATION 3, 017, 000 COORDINATING HEADQUARTERS Connecticut Regional Medical Program 272 George Street New Haven, Connecticut 06510 (Tel.: 203/772-0860) GRANTEE ORGANIZATION Yale University School of Medicine EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACTRVITIES EFFECTIVE STARTING DATE January 1, 1969 OF OPERATIONAL ACT rV IT IES TOTAL FUNDING TO DATE $1, 968, 189 FUNDING FOR CURRENT $1, 548, 257 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Arthur M. Rogers ADVISORY GROUP Scovill Manufacturing Company 99 @ll Street Waterbury, Connecticut 06720 PROGRAM COORDINATOR AND @'Henry T. Clark, Jr., M.D. DIRECTOR STAFF ASSOCIATE DIRECTOR Edward F. Morrissey, M. S. W. EDUCATION SECTION Lester Evans, M. D., Coordinator Eleanor E. McGuire, M.A., Associate Coordinator RESEARCH AND EVALUATION SECTION John Glasgow, Ph. D. Associate Coordinator, HealthEconomics PLANNING SECTION Albert Snoke, M.D. Consultant, Health Service Area Program Assistance OFFICE OF REGIONAL ACTRVITIES David Pearson, M.P. H. Acting Coordinator, Yale-New Haven Medical Center ADMINISTRATIVE ASSISTANT Marcelle McKeon -@Chief Executive Officer -37- CONNECTICUT - 11 ,APPROVED OPERATIONAL PROJECTS CONNECTICUT UTILIZATION AND PATIENT INFORMATION STATISTICAL SYSTEM (CUPISS) Objectives: The development of a program for routine assembly of hospital patient care information to (1) serve as central registry for summaries of patients' institutional medical histories as guide for subsequent treatment, (2) generate indices of institutional performance and effectiveness, (3) provide data base for a two-stage Utilization Review Screening System, (4) provide data for additional planning, (5) serve as a basis for evaluation of institutional operational programs, and (6) serve as a data bank for research in delivery of care. HEALTH SERVICE AREA PLANNING Objectives: This project would provide financial and technical assistance for local long-range planning within each of the ten health service areas of the Region, to delineate each community hospital's relationship to.the other and to strengthen cooperative arrangements among all the institutions involved in continuum of care: general hospitals, special hospitals, extended care facilities and public health nursing and home health programs. SOUTH CENTRAL HEALTH SERVICE AREA CONTINUING CARE PROGRAM Objectives: A patient care demonstration program for a continuum of long- term care will be developed in South Central Health Service Area using the unique resources of the Yale-New Haven Hospital, chronic disease institutions, extended care facilities, rehabi.1- itation centers, nursing homes, boarding homes, home health agencies, and ambulatory services either in the physician's offices or the hospital out-patient departments. It will also serve as a continuing education and consultation resource in continuing care for the entire Region, with special emphasis on assisting other hospitals to develop comparable programs in other health service areas. -38- CONNECTICUT - III APPROVED OPERATIONAL PROJECTS (Continued) PATIENT CARE WORKSHOPS* Objectives: Five two-day workshops on patient care will be held each year in five different settings; acute, general hospital, extended carefacilityand/ornursinghome, home health agency, chronic disease institution and rehabilitation center. The full range of administrative, organizational and professional service re- lationships in the health service area, as well as activities of the health professions, will be studied in the workshops to help determine measures to strengthen cooperative arrange- ments among local providers of care. THIRD FACULTY - COMMUNITY BASED Objectives: Joint appointments are proposed for 24 full-time chiefs of service the first year, inc'reasing to 72 by the fifth year, by selected local hospitals and the medical schools. Goals of the "third faculty" are to improve undergraduate instruc- tion opportunities, intern and residency training, continuing education, patient management, patient care study, local specialized medical services, patient referral services and planning for disadvantaged patients. THIRD FACULTY - UNIVERSITY BASED Objectives: As the second part of the "third faculty" development, it is proposed to augment the clinical faculty at the university medical centers to provide counterparts to the full-time community hospital appointees, and to serve as focus for Regional Medical Programs development within the univer- sities' clinical services. It is expected that the university third faculty will assist in recruting community-based third faculty, and will then assist the communities in their pro- grams to improve education, patient care and health services research. REGIONAL CORONARY CARE TRAINING AND CONSULTATION PROGRAM Objectives: This program consists of two parts: (1) a training program for community physicians at St. Raphael Hospital in New Haven and (2) a Connecticut Regional Medical Program consultation and education program offering: (a)consultationteams to advise hospitals on coronary program development, (b) cooperative educational programs for hospital staffs, and (c) feasibility studies on communications systems between hospitals and ex- ploratory studies of mobile coronary care units. Approved but not funded -39- CONNECTICUT -IV APPROVED OPERATIONAL PROJECTS (Continued) REGIONAL CLINICAL REFERENCE LABORATORY DEVELOPMENT* Objectives: It is proposed to develop a reference laboratory to (1) conduct clinical tests which are too complex and limited volume for any single health care institution; (2) provide 24-hour, 7 days a week analysis and consultation for tests which are not of an emergency nature or necessary for immediate patient care: and (3) serve as a center for continuing education in the labor- atory specialties. CONTINUING EDUCATION OF PHYSICIANS AND DENTISTS Objectives: (1) An agency for continuing education is planned to coordinate planning among the many agencies sponsoring continuing edu- cation and to develop a long range approach that will provide comprehensive continuing education. (2) @dical Information Centers will be established to provide physicians, via tele- phone, withimmediateanswerstotheirquestions;toassemble and distribute study kits for physicians; and to assemble and distribute audiovisual reference materials to hospitals, phy- sicians and organizations. (3) A Regional Television Network for Continuing Education will be developed to connect medical centers with the major hospitals. (4) Refresher fellowships will be provided physicians and dentists in rural areas for 1-4 months of intensive training at Medical Centers. CONTINUING EDUCATION FOR NURSES AND ALLIED HEALTH PRO.FES- SIONS Objectives: (1) An inventory of health profession education programs and facilities, emphasizing qualitative surveillance and assess- ment rather than quantitative data collections will be devel- oped; (2) expert advisory committees will be organized to analyze current practices in the areas of counseling, recruit- ment, licensing, accreditation, etc., to relate educational programing to health care needs; (3) program development funds and technical assistance will be provided to existing institutions for expanded and experimental programs in re- cruitment, career counseling, curriculum design and train- ing; (4) C. R. M. P. plans to aid in planning, organization and development of regional and sub-regional continuing education programs; and, (5) a Health Profession Education Council is proposed to provide technical assistance and coordination in health technology education. Approved-but not funded -40- CONNECTICUT - V APPROVED OPERATIONAL PROJECTS (Continued) DEVELOPING OPTIMUM LIBRARY SERVICES Objectives: (1) Providing the two University Medical Center libraries with additional personnel, machine facilities, and a com- munications linkage to health institutions and practitioners so that medical literature resources and library resources can be made available upon request and with dispatch; and (2) inaugurating extensive field consultation, basic training and technical assistance to help local libraries upgrade serv- ices and facilitate their involvement in a region-wide system of interlibrary borrowing and loan of medical literature. CONTINUING INVENTORY OF HEALTH RESOURCES AND SERVICES Objectives: This is a request primarily to employ a professional to devote full time to assembling, organizing and preparing monographs and reports on demographic, socioeconomic and related characteristics of the Region's population, exist- ing health facilities and specific differences among the ten health service areas. RESEARCH PROGRAM PLANNING Objectives: (1) Providing support for field research activities related to planning and program development; (2) assisting in continued evaluation of operational programs; (3) conducting feasibility studies related to design of long range evaluation. SPECIAL CONSIDERATIONS IN FINANCING HEALTH CARE Objectives: Selected studies will be cooperatively undertaken on the fi- nancing of institutional medical care, principally in the acute, general hospitals. Special attention will be given to items of ,direct and indirect administrative control and expenses pre- viously controlled by physician practices. Analyses of capital funding, cash flow, reimbursement formulae of third-party agents and the rate of self-pay patients will be parts of the study. CORE STAFF Objectives: This project will continue and greatly augment core staff per- sonnel for continued planning and over-all direction of opera- tions of the Connecticut Regional Medical Program. -41- FLORIDA I NAME OF PROGRAM Florida Regional Medical Program GEOGRAPHICAL REGION State of Florida ESTIMATED POPULATION 6, 154, 000 COORDINATING HEADQUARTERS Florida Regional Medical Program 1 Davis Boulevard, Suite 309 Tampa, Florida 33606 (Tel.: 813/?.53-0931) GRANTEE ORGANIZATION Florida Advisory Council, Inc. EFFECTIVE STARTING DATE November 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE March 1, 1969 OF OPERATIONAL GRANT TOTAL FUNDING TO DATE $1, 590,179 FUNDING FOR CURRENT $1,376,251 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Coyle F. Moore, Ph. D. ADVISORY GROUP Florida State University Tallahassee, Florida 32306 (Tel.: 904/599-2525) PROGRAM COORDINATOR *Granville W. Larimore, M.D. STAFF DEPUTY DIRECTOR Robert Ausn-ian, M.D. ASSISTANT DIRECTOR FOR COMMUNI- CATIONS Harold A. Tyler AREA COORDINATORS SOUTH FLORIDA AREA George C. Adie, M. D. Four Ambassadors, Suite 1411 801 South Bayshore Drive Miami, Florida 33131 - 305/350-65?.3) (Tel.. MID-FLORIDA AREA 1 Davis Boulevard, Suite 507 Tampa, Florida 33606 Chief Executive Officer -42- FLORIDA AREA COORDINATORS (Continued) NORTH FLORIDA AREA Lamar Crevasse, M.D. Lakeshore Towers, Suite 808 2306 S. W. 13th Street Gainesville, Florida 32601 Tel.: 904/39Z/3181) -43- FLORIDA - III APPROVED OPERATIONAL PROJECTS A COMMUNITY MULTITEST HEALTH SCREENING CENTER Objectives: Develop a computerized multitest screening facility whichwill serve four major, functions --health screening, education, research, and coordination between public and private health programs in the community. Provide low cost health screen- ing to major sectors of the population of area, both public and private patients, and contribute to continuing education of practicing physicians and training of students in medicine and the health related professions. CORONARY CARE UNIT PROGRAM FOR NORTH FLORIDA Objectives: (1) The institution of coronary care unit facilities in 4 com- munities currently lacking such units; (2) the initiation and continuation of educational programs for local community physicians and nurses who will specialize in the care of acute myocardial infarction; (3) the development of coronary care unit facilities in communities having less than 100 myocardial infarctions per year; and (4) the coordination of other regional programs at community hospitals on the subject of heart dis- ease. REGIONAL COMPUTERIZED EKG PROCESSING CENTER Objectives: Establishment of Center at Medical School to: test and eval- uate hardware and software components in an automated EKG system; further its validation as a diagnostic tool; design and implement a data acquisition system for processing of EKG's transmitted over telephone lines; and evaluate and plan a mass screening program for prevention of heart disease and for accumulation of epidemiological data. POSTGRADUATE INTENSIVE INSERVICE EDUCATION FOR PHYSICIANS Objectives: Brings the physician into the training institution, gives him status as a staff member, responsibility for patient care, and makes him a temporary member of a well organized Datient care team. The program includes adult cardiology, 'pediatric cardiology, and cardiac radiology. -44- FLORIDA - IV APPROVED OPERATIONAL PROJECTS (Continued) COMPUTERIZATION OF CORONARY CARE UNITS (JACKSONVILLE) Objectives: Jacksonville Enter-Hospital Coronary Care Committee has been successful in standardizing all of the equipment put into these units, as well as the care of patients and training of the personnel on the units. Project will expand to include sur- rounding communities providing feed-backs of computerized information concerning coronary care tooutlying communities and will eventually become a statewide project providing in- formation on a larger population in a morestatisticallymean- ingful manner. DIABETES PROPOSAL* Objectives.- (1) Training physicians, nurses, and nutritionists as spe- cialists in diabetes mellitus; (2) form effective group of physicians in the community to improve detection and care programs and to extend their ongoing activities for greater effectiveness; and (3) evaluate objectively the achievements of the program. CARDIOVASCULAR SCREENING PROGRAM IN FOUR RURAL FLORIDA COUNTIES Objectives: For continued support of a long-term plan already approved by the Florida Medical Association, Florida Heart Associa- tion, State Board of Health, and the 4 county health officers and the respective medical societies. To provide the nec- essary skeletal screening teams, the necessary statistical services to allow for adequate evaluation, and the minimum amount of supplies needed for their operation. COMPUTERIZED EKG SCREENING PROGRAM Objectives: To cooperate with the University of Florida in the computer analysis of EKG tracings recorded in cardiovascular screen- ing centers, which will be conducted by county health depart- ments under the supervision of the Florida State Board of Health. Approved but not funded -45- 356-998 0 -69 -4 FLORIDA V APPROVED OPERATIONAL PROJECTS (Continued) PEDIATRIC PULMONARY DISEASE CENTER* Objectives: Coordinate the "patchwork" inpatient and outpatient services currently available throughout the South Florida area. In ad- dition to improved care and follow up of the children under treatment, proposes to train physicians and allied health per- sonnel and will utilize the facilities and staff of the University of Miami - Jackson Memorial )Hospital Complex. SUPERVISION OF PARAMEDICAL PERSONNEL VIA TELEMETRY Objectives: Provide an advanced communications system between rescue and ambulance personnel in the field and medical personnel in the hospital. Systemwouldprovideforthetelemetrytransmis- sion of physiological data (electrocardiogram) and two way voice communication. FLORIDA CORONARY CARE NURSE TRAINING PROGRAM Objectives: The Florida Heart Association plans to provide training courses for coronary care unit nurses in four hospitals. Ap- proximately 150nursesfromallover the statewill be trained in the four-week course. Approved but not funded -46- GEORGIA I NAME OF PROGRAM Georgia Regional Medical Program GEOGRAPHICAL REGION State of Georgia ESTIMATED POPULATION 4, 568, 000 COORDINATING HEADQUARTERS Georgia Regional Medical Program Medical Association of Georgia 938 Peachtree Street, Northeast Atlanta, Georgia 30309 (Tel.: 404/875-0701) GRANTEE ORGANIZATION Medical Association of Georgia EFFECTIVE STARTING DATE January 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE July 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $3, 089, 681 FUNDING FOR CURRENT $2,324,0?-8 YEARIS ACTIVITIES CHAIR@N. REGIONAL ArthurP. Richardson, M.D., ADVISORY GROUP Dean, Emory University School of Medicine Woodruff Memorial Building - Emory Campus Atlanta, Georgia 30322 (Tel.: 404/377-2411 or 522-6116) CHAIRNMN. STEERING COMMIT- J. Willis Hurst, M.D. TEE Department of Medicine Emory University School of Medicine 69 Butler Street, Southeast Atlanta, Georgia 30303 (Tel.: 404/525-0738) PROGRAM COORDINATOR J. W. Chambers, M. D. STAFF PROGRAM DIRECTOR *J. Gordon Barrow, M.D. ASSOCIATE DIRECTOR Robert R. Smith, M.D. DIVISION CF ADMINISTRATION James E. Baker, Director ADMINISTRATIVE ASSISTANT Elsie P. Brown Chief Executive Officer -47- GEORGIA - 11 STAFF (Continued) FISCAL OFFICER George W. Adams, Jr. COMMUNICATIONS AND INFORMATION OFFICER (Mrs.) Anne Roberts (Acting) DIVISION OF PLANNING AND PRO- GRAM DEVELOPMENT Morris M. Bradley, Director CANCER SECTION William B. Wilkins (Acting) CARDIOVASCULAR DISEASES AND STROKE SECTION Morris M. Bradley (Acting) RELATED DISEASES SECTION Harry J. Usher FACILITIES AND SERVICES SECTION James R. Griffith EDUCATION AND TRAINING COOR- DINATOR PROFESSIONAL EDUCA- TION, TRAINING AND HEALTH M"POWER SECTION Harold E. Henninger NURSE AND ALLIED HEALTH PRO- ,FESSIONS COORDINATOR Lucile Dismukes EVALUATION COORDINATOR M. Sue Pritchett ,CHIEF FIELD REPRESENTATIVE 'Nfills Drury, Acting EPIDEMIOLOGY AND BIOSTATISTICS SECTION Warren Gullen, M. D. Richard Pogue, Ph. D. Medical College of Georgia Augusta Georgia 30902 (Tel.: 4@4/724-7111) -48- GEORGIA - III APPROVED OPERATIONAL PROJECTS SHORT-TERM TRAINEESHUPS FOR PHYSICIANS Objectives: Emory University and the Medical College of Georgia will offer postgraduate training programs in the categorical dis- eases of 12 weeks duration, one day a week. These are en- tirely new courses; Emory would offer five of them and MCG would offer four. Travel expenses would be paid to physician trainees. HYPERTENSION-RENAL DISEASE CLINICAL FELLOWSHIP Objectives: A one-year fellowship to develop specialists in diagnostic and therapeutic techniques in the field of hypertension and renal disease will provide financial assistance to practicing phy- sicians. Stipends are provided by RUP. The medical schools provide all teaching personnel to the program. VISITING CONSULTANT PROGRAM TO COMMUNITY HOSPITALS Objectives: Consultants from the medical schools would be provided for continuing education of physicians and allied health profes- sionals in area heart and area cancer facilities which will be developed as a part of the Regional Medical Program. These consultants would also be available for any program of con- tinuing education of physicians and other health professionals. INTERLIBRARY COPYING SERVICE Objectives: The two medical school libraries will provide expanded clear- inghouse services for photocopies and interlibrary loans to participating institutions in the Regional Medical Program. Half the cost of a union list of serials will be supported by the Regional Medical Program. COLUMBUS MEDICAL CENTER - EMORY UNIVERSITY TEACHING AF- FILIATION Objectives: A teaching program at the Medical Center in Columbus will be organized and administered by Emory University. A faculty of qualified local physicians will be appointed and will receive training (12 days each) in current teaching methods. -49- GEORGIA - IV APPROVED OPERATIONAL PROJECTS (Continued) COMMUNICATIONS NETWORK FOR THE REGION Objectives: A medical education television network would be established to include 41 community hospitals. Programs, designed to meet specific health personnel needs, would be prepared by Emory University and the Medical College of Georgia. CANCER VISITING CONSULTANT PROGRAM AND WORKSHOPS Objectives: Through efforts of Area Cancer Directors, teaching consulta- tion sessions will be planned for individual scheduled hospital staff meetings. "Cancer workshops" will provide the oppor- tunity to attend workshops and benefit from various learning experiences in order to keep current with latest developments. IMPROVEMENT AND COORDINATION OF FACILITIES FOR CARDIOVAS- CULAR DIAGNOSTIC SERVICES Objectives: The project will assist in the improvement and coordination of existing facilities currently providing cardiac catheterization, angiocardiography and coronary angiography. A major por- tion of support would be toward strengthening the centers to handle increasing case loads, and to train more medical and paramedical personnel in the field in order that these services can be provided to other hospitals in the Region. CARDIOPULMONARY RESUSCITATION Objectives: The project will determine the need and resources for CPR in Georgia, will develop a cadre of instructors, and will create an organizational structure to permit them to carry on train- ing activities in their respective communities. Financial sup- port will also be provided by the Georgia Heart Association and by the State Department of Public Health. CORONARY INTENSIVE CARE DEVELOPMENT IN SMALL HOSPITALS (FEASIBILITY STUDY) Objectives: The study employs the use of monitoring units in small hos- pitals directly connected to an operative coronary intensive care unit in a medical center. The transmission (by special telephone line) from the small hospital will be monitored by trained personnel twenty-four hours a day. This will enable immediate consultation to the small hospitals. -50- GEORGIA - V APPROVED OPERATIONAL PROJECTS (Continued) STATEWIDE CANCER PROGRAM Objectives: Through a system of Area Cancer Facilities, programs of continuing education, professional workshops, and appropriate consultation will be encouraged. A state registry composed of hospital registries will be service-oriented to allow compar- ative evaluation of cancer therapy. Emphasis will be given to biostatistical support and- to training in biometry. PEDIATRIC CHRONIC PULMONARY DISEASE CENTER Objectives: The respiratory center program of the Department of Pediat- rics of the Medical College of Georgia will be expanded to pro- vide comprehensive regional care teaching and research in chronic respiratory diseases of children. Support would also be extended by the National Cystic Fibrosis Research Founda- tion, the Augusta Area T. B. and Respiratory Association, and other programs sponsored by the United States Public Health Service. TRAINING PROGRAM FOR MEDICAL SPECIALIST ASSISTANTS (CORO- NARY CARE) Objectives: Emory University and Grady Memorial Hospital will continue a two-year training program for a new occupation - Medical Specialist Assistant (Coronary Care). The project was estab- lished originally as a pilot project and, after a year, shows promising results. The new specialty concerns the delivery of special skills to patients undergoing coronary care. The coronary care unit of Grady Hospital is the principal teaching resource. ATLANTA AREAWIDE PLANNING FOR PROGRANZ OF HEART, CANCER, AND STROKE Objectives: This project represents support for the final year of an ap- proved three-year program for area planning. The applicant has been informed that its Community Health Services grant should be assumed in the final year by either R@ or by com- prehensive health planning. The purpose is to plan and imple- ment out-of-hospital services for heart, cancer, and stroke patients in the Atlanta area. -51- GEORGIA - VI APPROVED OPERATIONAL PROJECTS (Continued) COMMUNICATION AND PUBLIC INFORMATION PROGRAM Objectives: As a function of the central administrative staff, attention of interested groups and the public at large will be sought through a newsletter, radio programs, and an audiovisual program for use of public speakers, and a system of press releases. -52- GREATER DELAWARE VALLEY - I NAME OF PROGRAM Greater Delaware Valley Regional Med- ical Program GEOGRAPHICAL REGION Eastern Pennsylvania, the southern part of New Jersey, and the entire State' of Delaware ESTIMATED POPULATION 8, 200, 000 COORDINATING HEADQUARTERS Greater Delaware Valley Regional Med- ical Program Wynnewood House 300 East Lancaster Avenue Wynnewood, Pennsylvania 19096 (Tel.: 215-649-4100) PRANTEE ORGANIZATION University City Science Center EFFECTIVE STARTING DATE April 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE April 1, 1969 OF OPERATIONAL ACT ITIES TOTAL FUNDING TO DATE $4,802,342 FUNDING FOR CURRENT $2,862,484 YEAR'S ACTIVITIES CHAIRMAN, REGIONAL WilliamF. Kellow, M.D. ADVISORY GROUP Dean and Vice President Jefferson Medical College 1025 Walnut Street Philadelphia, Pennsylvania 19107 PROGRAM COORDINATOR *George R. Clammer, M. D. STAFF ASSOCIATE DIRECTOR FOR PROJECTS Earl S. Barker, M.D. ASSISTANT DIRECTOR Roderick G. Happel CHIEF, AREA LIAISON Ward Bentley DIRECTOR OF INFORMATION Pierre C. Fraley DIRECTOR OF PUBLIC RELATIONS C. Allan Lafferty Chief Executive Officer -53- GREATER DELAWARE VALLEY STAFF (Continued) AREA LIAISON OFFICERS Homer B. Glover Edgar Hare, Jr. William E. White Joseph B. Mullin -54- GREATER DELAWARE VALLEY - III APPROVED OPERATIONAL PROJECTS CORONARY CARE TRAINING COURSE AT WILKES-BARRE GENERAL HOSPITAL Objectives: Offers a course in acute coronary care for eight to tennurs- es to be given four times a year. Instruction in pulmonary problems will be included. Workshops for hospitals develop- ing coronary care may also be developed. CORONARY CARE TRAINING COURSE AT READING HOSPITAL Objectives: A four-week course will be given four times a year for the training of nurses in the area of acute coronary care. Staffs of three Reading hospitals will participate in the instruction. GENERAL INTENSIVE CARE COURSES AT ALLENTOWN HOSPITAL Objectives: An 11-week course to be given twice a year will be offered to nurses in the care of. acute medical problems. The course will provide training in intensive care and in the following areas: acute myocardial infarction, acute stroke and head trauma, acute cardio-respiratory disease and acute renal failure. Major goal is to provide a panel of nurses capable of serving any one of these areas. PHILADELPHIA REGIONAL CHRONIC PEDIATRIC PULMONARY DIS- EASE PROGRAM Objectives: Goals include increase of knowledge in pathophysiology of chest diseases, development of acute diagnostic program and satellite clinics, and training of physicians and other health personnel. A uniform history and physical form and a case registry will be developed. RETRAINING PROGRAM FOR WOMEN PHYSICIANS AT WOMANIS MEDI- CAL COLLEGE OF PENNSYLVANIA Objectives: To provide retraining for women physicians who wish to return to the practice of medicine. The Macy foundation has funded planning for the program. -55- HAWAII - I NAME OF PROGRAM Hawaii Regional Medical Program GEOGRAPHICAL REGION State of Hawaii, plus American Samoa, Guam, and the Trust Territory of the Pacific (Micronesia) ESTIMATED POPULATION Trust Territory, 91, 448 Guam, 101, 000 American Samoa, 26, 000 Hawaii, 778, 300 COORDINATING HEADQUARTERS Regional Medical Program of Hawaii Harkness Pavilion 1301 Punchbowl Street Honolulu, Hawaii 96813 (Tel.: 808/531-6525) GRANTEE ORGANIZATION University of Hawaii EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE September 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1, 133, 604 FUNDING FOR CURRENT $903, 301 YEARIS ACTIVITIES CHAIRMAN, REGIONAL WilsonP. Cannon, Jr. ADVISORY GROUP Bank of Hawaii Post Office Box 2900 Honolulu, Hawaii 96802 PROGRAM COORDINATOR *@sato M. Hasegawa, M.D. STAFF CHIEF OF FACULTY STAFF Richard T. A&miya, M.D. CHIEF OF OPERATIONS Omar A. Tunks, M. B. A. CHIEF OF PLANNINGAND OPERATIONS OF AMERICAN SAMOA, GUAM,, AND TRUST TERRITORY Satoru Izutsu, Ph.D. CHIEF OF ALLIED HEALTH SERVICES s.) Rosie K. Chang, R. N., B. S., M. S. *Chief Executive Officer -56- HAWAII - 11 STAFF (Continued) CHIEF OF COOPERATRVE COM- MUNITY HEALTH SERVICES Andrew 1. T. Chang, M. S. W. MEDICAL EDUCATIONIST Richard H. Akiyama, B.A., M.S. ASSOCIATE CHIEF OF RESEARCH SERVICES (Mrs.) Nancy C. Fowler, B. A. MEDICAL REFERENCE LIBRARIAN Clyde J. Winters, M.S. L. S. PUBLIC INFORMATION OFFICER Ted T. Kurrus COMPTROLLER Nornian S. Kuwahara, C. P.A. ADMINISTRATIVE OFFICER s. Grace NL Fujitani ONCOLOGIST John Keenan, M.D. PEDIATRIC PULMONARY PROGRAM CONSULTANT Herbert Nakata, M. D. -57- HAWAII - III APPROVED OPERATIONAL PROJECTS ORGANIZATION AND OPERATION OF CENTRAL REGIONAL MEDICAL PROGRAM - HAWAII Objectives: Staff functions for the Hawaii R@ are divided into two categories: (1) central staff to implement overall program direction, to provide consultation to communities central data collection and evaluation services, and to assist in the development of cooperative arrangements and (2) staff faculty to direct project operations, assist in technical review, teach, draft applications and provide consultation. TRAINING IN REHABILITATION IN CATASTROPHIC DISEASES Objectives: The Rehabilitation Center in Honolulu will collaborate with the Hawaii Regional Medical Program in providing training for medical and paramedical personnel in the execution of planned rehabilitation programs. Formal courses will be held in Honolulu everV three months. Lec- tures and demonstrations will be hefd at already identified auxiliary centers on each of the neighboring islands, at monthly or quarterly intervals. HONOLULU HOME CARE SERVICE Objectives: This project will utilize St. Francis Hospital to provide rehabilitation and palliation for terminal patients through consultation and continuing education by the Honolulu Home Care Service, as well as training on the concepts and administrative aspects of home care. CONTINUING EDUCATION FOR NURSES IN PATIENT SETTINGS Objectives: (a) Development and description of a nurse specialist's role in a general hospital setting, Kusakini Hospital; (b) development of data instruments (check lists, rating scales that measure improved patient care in this setting); (c) translation of new methods and techniques in the care of patients with cardiovascular problems, stroke and cancer of the thorax and of the liver and gastrointestinal tract; (d) improved ability to apply a team nursing approach to meet needs of patients suffering from catastrophic diseases, and to communicate with patients and their families; and, (e) definition of the role of in-service edu- cation to meet needs of nursing department in cooperation with the personnel department. This is a University School of Nursing-Community hospital attempt to bridge the gap between formal and in-service education. -58- @WAII IV APPROVED OPERATIONAL PROJECTS (Continued) CARDIOPULMONARY RESUSCITATION TRAINING Objectives: This is a three year request to train 50, 000 professional and lay persons in cardiopulmonary resuscitation. The program will be based in Queen's @dical Center; nine secondary centers will be established in hospitals to train trainers, and twenty CPR teams will be established in additional affiliated hospitals. The program will be directed by an anaesthesiologist assisted by two cardiologists, four nurses, volunteers and Heart Association staff. The pro- gram will be sponsored by the Hawaii Heart Association which has had a role in coordinating CPRT since 1965. Program objectives include development of a teaching faculty, provision of qualified instructors and operators in every community, and establishment of a retaining program. Outlines for training courses are provided. CORONARY CARE TRAINING PROJECT (Queen's Medical Center) Objectives: A three year program to train physicians and nurses in the organization and delivery of coronary care. It is estimated that 260 physicians and 310 nurses could participate. Initial emphasis would be given programs for nurses followed by training programs designed for physicians. A part-time cardiologist would be retained as training director. The facilities of three participating hospitals would be used including those of the sponsoring institution. Previously used course outlines are used as basis for developing teaching programs. The aims of the proposal include.- training of trainers, training of providers of care, identification of sites for coronary care services, establish methods of evaluation, development of appropriate linkages between CCU training and service units, and develop supportive systems. CORONARY CARE UNIT (Hilo Hospital) Objectives: A one-year program to activate a four bed coronary care unit. Slightly more than half of this support would be for equipment; the balance would be used to sponsor coronary care training for 28 nurses and 8 physicians who will travel from Hilo on the Island of Hawaii to Honolulu on the Island of Oahu. -59- HAWAII - V APPROVED OPERATIONAL PROJECTS (Continued) CORONARY CARE UNIT (Wilcox Memorial Hospital) Objectives: One-year funds are requested to activate a four bed coronary care unit. Slightly less than half of this support would be for equipment; the balance would be used to sponsor coronary care training for 32 nurses and 9 physicians who will travel from the Island of Kauai to Honolulu. REGIONAL PEDIATRIC PULMONARY PROGRAM Objectives: Three years of support is requested for this program which would be based in Kauikeolani Children's Hospital, Honolulu. A program of service, professional training, and research has been presented. Four, additional hospitals will partici- pate initially, and emphasis will be given the early identi- fication and referral of high risk.cases to the program. -60- ILLINOIS - I NAME OF PROGRAM Illinois Regional Medical Program GEOGRAPHICAL REGION State of Illinois ESTIMATED POPULATION 10, 991, 000 COORDINATING HEADQUARTERS Illinois Regional Medical Program, Inc. 122 South Michigan Avenue, Suite 939 Chicago, Illinois 60603 (Tel. : 312/939-7307) GRANTEE ORGANIZATION Illinois Regional Medical Program, Inc. EFFECTIVE STARTING DATE July 1, 1967 OF PLANNING ACTIVITIES TOTAL FUNDING TO DATE $1, 056, 626 FUNDING FOR CURRENT $944, 013 YF-ARIS ACTIVITIES CHAIRMAN, REGIONAL Oglesby Paul, M.D. ADVISORY GROUP Professor of Medicine Northwestern University School of Medicine Passavant Hospital 303 East Superior Street Chicago, Illinois 60611 (Tel.: 312/WH 4-4ZOO) PROGRAM COORDINATOR -@WrightAdams, M.D. STAFF ASSISTANT EXECUTIVE DIRECTOR GeorgeA. Lindsley, M.P. . ASSISTANT EXECUTIVE DIRECTOR BryanLovelace, Jr., M.A. PLANNING ASSOCIATE Robert J. Rom, M.A. Lois H. Binkley, IvL S. Ed. PUBLIC INFORMATION ASSISTANT Marilyn J. V os s, M.S. J. COORDINATOR, CHICAGO MEDICAL SCHOOL Martin E. Bruetn-ian, M.D. *Chief Executive Officer -61- 356-998 0-69-5 ILLINOIS - II STAFF (Continued) COORDINATOR, UNIVERSITY O.F HICAGO PRITZKER SCHOOL OF MEDICINE Ann M. Lawrence, M.D., Ph.D. COORDINATOR, LOYOLA UNIVFR- SITY STRITCH SCHOOL OF MEDICINE Isaac Lewin, M.D. COORDINATOR, UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE Nat E. Smith, NL D. COORDINATOR, NORTHWESTERN UNIVERSITY SCHOOL OF MEDICINE Jacob Suker, M.D. COORDINATOR, CHICAGO COLLEGE OF OSTEOPATHY Paul Vandervort, D. O. SUBREGIONAL COORDINATOR Sheldon S. Waldstein, M. D. North Suburban Association for Health Resources Northbrook, Illinois L. R. Brosi Springfield-Central Illinois Health Care Planning Council Springfield, Illinois BUSINESS MANAGER Joseph J. Gallagher INDIANA - I NAME OF PROGRAM Indiana Regional Medical Program GEOGRAPHICAL REGION State of Indiana ESTIMATED POPULATION 5, 061, 000 COORDINATING HEADQUARTERS Indiana Regional Medical Program Indiana University School of Medicine 1300 West Michigan Street Indianapolis, Indiana 46202 (Tel.: 317/639-8492) GRANTEE ORGANIZATION Indiana University Foundation EFFECTIVE STARTING DATE January 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE January 1, 1969 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $2,366,824 FUNDING FOR CURRENT $1, 644, 429 YEAR'S ACTIVITIES CHAIRMAN, REGIONAL Joseph B. Davis, M.D. ADVISORY GROUP The Davis Clinic 131 North Washington Street Marion, Indiana 46952 PROGRAM COORDINATOR *Robert B. Stonehill, M.D. STAFF DIRECTOR OF PROJECT EVAL- UATION Douglas Talbott, M. D. DIRECTOR OF ADMINISTRATIVE SERVICES Charles R. Brown DIRECTOR OF PROGRAM MAN- AGEMENT Roy A. Hagstrom DIRECTOR OF ALLIED HEALTH SCIENCES ACTIVITIES H. Carl Smith DIRECTOR OF INSTRUCTIONAL MEDIA Robert M. Davis DIRECTOR OF COMMUNITY RELATIONS George F. Leamnson -Chief Executive Officer -63- INDIANA - 11 APPROVED OPERATIONAL PROJECTS OFFICE OF COORDINATOR -- CORE PROGRAM Objectives: This project will continue support of the core planning activ- ities. MULTI-PHASIC HEALTH SCREENING--METROPOLITAN INDIANAPOLTS Objectives: This project is based on a feasiblity study conducted during the planning period. The study provided health screening for 1, 360 persons living in the inner-city. The tests were admin- istered by persons previously unemployed or underemployed who were specially trained for this program. The operational project will screen 30, 000 within three years. The cost is $26. 43 per tested individual. Testing centers will be placed in two geographical areas which are optimally accessible to the residents. REGIONAL STROKE PROGRAM Objectives: This program will answer the need for physical therapy, oc- cupational therapy, and language therapy in aphasia by plac- ing three-man teams, representing each discipline, in five geographical areas to serve the entire Region. These teams will visit hospitals on a weekly or biweekly basis to help avail- able hospital personnel develop treatment programs for pa- tients. Secondly, a three-bed demonstration treatment and training center will be established at the Indiana University Medical Center. Personnel from the entire Region in all medical and paramedical areas will receive training and re- training in this center. Third, educational programs will be developed for the staffs in community hospitals. Finally, neurological consultation will be made available to the var- ious communities in the Region. NETWORK OF CORONARY CARE UNITS Objectives: This project will assist in the establishment of coronary care units or other appropriate monitoring facilities throughout the Region, in conjunction with local medical and lay groups. It will offer physicians training in coronary care in a model demonstration and training coronary care unit located at the Marion County General Hospital, Indianapolis. It will provide professional consultation in operating coronary care units in outlying hospitals. Project personnel will cooperate with other institutions in giving coronary care unit instruction to nurses. -64- INDIANA - III APPROVED OPERATIONAL PROJECTS (Continued) HEALTH MANPOWER RECRUITMENT* Objectives: This is a proposal to expand a statewide health manpower recruitment program by (1) extending local recruitment ef- forts, (2) providing additional staff consultation to guidance personnel and students through in-school recruitment pro- grams, (3) establishing a summer intern program, (4) de' veloping and maintaining a loose-leaf Health Careers Direc- tory as a regional resource, (5) operating a clearing house of information for all approved educational opportunities, and (6) revising, publishing, and distributing gratis the career guidebook entitled OPPORTUNITIES UNLIMITED. This pro- 'ject would utilize a wide range of informational and communi- cations techniques and media. EDUCATION AND PRACTICE CF PROSPECTRVE,MEDICINE* Objectives- This project proposes to extend the cooperative arrange- ments for continuing education in the practice of prospective (preventive) medicine among primary physicians over a wider geographical area and for a larger patient population. It will link Indiana University School of Medicine with the medical staffs in more than a dozen community hospitals. Continuing education for improvement of diagnosis and treat- ment will involve medical and graduate students, practicing physicians, and nurse liprogrammers" as physicians' as- sistants. The Health Hazard Appraisal Program is based upon the patient's risk of death from major specific causes, according to age, sex and race; it keynotes both a prospec- tive and a continuing approach to patient care by the primary physician. The coordinating devices for this program in- clude the clinico-prospective conferences conducted by the Methodist Hospital via the Indiana Higher Education Telecom- munications System, the application of computer technology to the health data bank for information retrieval, the estab- lishment of a health care research unit, and the evaluation of this approach for both the patient and the physician. COMMUNITY HEALTH CENTERS FEASIBILITY STUDY Objectives: Make high quality, continuing medical care accessible to dis- advantaged segment of Indianapolis population. Major thrust will be preventive medicine and health education. Health Centers are a potential provider of the followup services needed to make the Multi-Phasic screening program worth- while. Part of the study will be to investigate the possible use in the health centers of technicians trained in the Multi- Phasic screening program. *Approv@e but not funded -65- INDIANA - rV APPROVED OPERATIONAL PROJECTS (Continued) INDIANA CANCER REGISTRY PROGRAM Objectives: To study feasibility of establishing a regional network of tumor registries to evaluate the cancer experience within the Region; to study techniques whereby such information could be processed to relay to appropriate individuals and agencies in the Region the problems and needs of cancer patients. Can- cer Committees will be established in strategically placed population centers and will form tumor registries for the collection of data about cancer incidence, type, treatment, and survival. Data will be transmitted to the central reg- istry at the Indiana University Medical Center. A STATEWIDE SYSTEM OF CONTINUING NURSING EDUCATION LINKED WITH THE INDIANA REGIONAL MEDICAL PROGRAM PROJECTS* Objectives: Two-year planning activity to establish an organizational framework for planning and handling of operational projects. Existing manpower and facilities will be surveyed to deter- mine needs, establish priorities, and identify existing re- sources that can be used for operational activities. Approved but not funded -66- INTERMOUNTAIN - I NAME OF PROGRAM Intermountain Regional Medical Program GEOGRAPHICAL REGION State of Utah, and portions of Wyoming, Montana, Idaho, and Nevada ESTIMATED POPULATION 2, 184, 000 COORDINATING HEADQUARTERS Intermountain Regional Medical Pro- gram 50 North Medical Drive Salt Lake City, Utah 84112 (Tel..- 801/322-7901) GRANTEE ORGANIZATION University of Utah EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE April 1, 1967 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $7, 302, 716 FUNDING FOR CURRENT $2,620,236 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Sister M. Ann Josephine, C.S.C.,Ph.D. ADVISORY GROUP Administrator Holy Cross Hospital 1045 East First Street South Salt Lake City, Utah 84102 PROGRAM COORDINATOR *C. Hilmon Castle, M.D. Associate Dean, University of Utah College of Medicine STAFF ASSISTANT COORDINATOR FOR OR- GANIZATIONAL AND INSTITUTIONAL RELATIONSHIPS Betty S. Gilson, M.D. ASSISTANT COORDINATOR FOR EDUCA- TION PLANNING AND EVALUATION Mitchell Schorow, M.A. PROGRAM MANAGER Richard F. Haglund DIRECTOR, HOSPITALPROGRAMSAND HEALTH MANPOWER Douglas C. Carpenter, Jr., IVLH.A. Chief Executive Officer -67- INTERMOUNTAIN - 11 STAFF (Continued) CHIEFS, RESOURCE PROFESSIONAL STAFF HEART Frank M. Mowry, M.D. STROKE C. J. Batson, M. D. CANCER Stanley J. Altman, M. D. NURSING Barbara J. Kerr, R. N. CHIEFS, PROJECTS DRVISIONS DIVISION I (HEART DISEASQ Dallas F. Whaley DIVISION 11 (CANCER) Vaughn L. Pulsipher DIVISION III (STRQ"E Arthur B. Anderson DIVISION IV (COMPUTER MONI- TORING) Reed M. Gardner, Ph. D. DIRECTOR, COMMUNICATIONS DIVI- SION Donald W. Ulmer DIRECTOR, ADMINISTRATIVE SERV- ICES DRVISION Ray H. Beckett, Jr. COORDINATOR, POSTGRADUATE MEDICAL EDUCATION PROGRAMS Bruce R. McDaniel -68- INTERMOUNTAIN - III APPROVED OPERATIONAL PROJECTS TRAINING FEEDBACK SEMINAR (CORE - STAFF SEMINAR) Objectives: To conduct workshops for members of the staff, core faculty and Regional Advisory Group of the IR@ to demonstrate techniques for keeping professionals abreast of the latest philosophy of comprehensive health care, continuing educa- tion, patient-care research, learning theory, behavioral sciences, and measurement technology. NETWORK FOR CONTINUING EDUCATION Objectives: To offer continuing educational opportunities to practitioners in their own communities. Provides for establishment of Medical Education Coordinators and hospital-based teaching faculties in many communities; expansion of an existing two- way radio network to provide region wide conferences for physicians, nurses, medical technologists, and hospital per- sonnel; video and audio tape libraries; and loan of video tape equipment to institutions for testing and evaluation of this educational medium. INFORMATION AND COMMUNICATIONS EXCHANGE SERVICE (INTRA- REGIONAL) Objectives: 'l-o establish an information service and communications network which will promote understanding of the Regional Medical Program and gain the interest and support of profes- sional and lay groups and individuals in the region; to promote communication among all elements in the Regional Medical Program; and to solicit and evaluate information feedback to assist in continuing program development. Publishes monthly newsletter and various bulletins, brochures and instructional materials. CARDIOPULMONARY RESUSCITATION TRAINING PROGRAM Objectives: To reduce the mortality from reversible cardiovascular and respiratory failure; to prepare physicians and nurses to ad- minister the latest techniques for cardiopulmonary resuscita- tion; to encourage hospitals to have appropriate modern equip- ment available for patient care and training of health person- nel in its use. -69- INTERMOUNTAIN - IV APPROVED OPERATIONAL PROJECTS (Continued) CARDIAC CARE FOR PHYSICIANS Objectives: To provide physicians with current knowledge and skills necessary for delivery of high.quality coronary care. A "core faculty" of practicing internists and cardiologists has been formed to teach others as a part of this educational ef- fort. Regularly scheduled training courses, equipment fa- miliarization labs, and CCU operation clinics are elements of the project. TRAINING FOR NURSES IN CARDIAC CARE AND CARDIOPULMONARY RESUSCITATION Objectives.- To provide three weeks of concentrated study, followed by one-week refresher courses for nurses who will return to their local communities and develop training programs in coronary care for other nurses. Continuous evaluation and inservice education of nurses working in coronary care units are a part of this project. CLINICAL TRAINEE PROGRAM IN CARDIOLOGY - UNIVERSITY OF UTAH MEDICAL CENTER Objectives: To increase the number of practicing cardiologists and up- grade the ability of general practitioners and internists to treat cardiac problems. The training intensity will be varied according to the needs of the physicians. VISITING CONSULTANTS AND TEACHER PROGRAM FOR SMALL COM- MUNITY HOSPITALS Objectives: To establish clinics to upgrade the level of care available to patients with heart disease who live in remote areas. Visit- ing specialists in cardiovascular diseases assist the local physician in a precise diagnosis of his patients and, in the process, teach him about heart disease. COMPUTER-BASED SYSTEM FOR MONITORING PHYSIOLOGIC DATA ON-LINE FROM REMOTE HOSPITALS Objectives: To carry out a pilot study of the feasibility of processing on a central computer facility a variety of physiological signals generated from patients in remote hospitals and feeding the results of these calculations directly back to stations within these hospitals where the information can be used for diagno- sis and care of that patient. -70- INTERMOUNTAIN - V APPROVED OPERATIONAL PROJECTS (Continued) CANCER TRAINING AND CONTINUING EDUCATION PROGRAM Objectives: To upgrade the level of care available to cancer patients. Coordinates existing teaching programs and develops re- fresher courses for practicing physicians, technicians, and other personnel involved in cancer.care. Physicianteachers, participate in tumor boards and clinics in remote communi- ties, and in two-way radio consultation and presentations. A computerized regional tumor registry is maintained to pro- vide automated data collection, analysis and evaluation of quality of patient care and effectiveness of cancer education programs and to insure timely follow-up of cancer patients. STROKE AND RELATED NEUROLOGIC DISEASE Objectives: 1. To establish visiting consultant and teaching clinics that will bring expert consultation service in stroke and related neurological diseases to local communities and provide continuing education to local nurses and physi- cians; and to collect data about the type of patients seen with these diseases and the problems they present to the practitioner. 2. To establish an information library and telephone consul- tation service to keep the practitioner abreast of knowl- edge about the care of stroke victims; to provide him with advice at the moment he needs it. A 24-hour telephone consultation service and information library service is maintained at the University of Utah Medical Center. 3. To establish an inservice training program in neurology to train practicing physicians in the latest diagnostic and treatment techniques and to inform them of therapy avail- able. Trainees will be accepted for 4 weeks to 1 year. EDUCATIONAL PROGRAM IN RESPIRATORY THERA@Y FOR PHYSICIANS AND NURSES Objectives.- To provide training for physicians and nurses inhow to utilize the special techniques and equipment in respiratory therapy. Five-day seminars and follow-up two-day refresher courses assist participants in learning how to administer therapy and how to teach others what they have learned. -71- INTERMOUNTAIN - VI APPROVED OPERATIONAL PROJECTS (Continued) REGIONAL ENDOCRINE METABOLIC LABORATORY Objectives: To provide service facilities where practicing physicians can obtain laboratory data essential to diagnosis and treatment; to create awareness among physicians of the possible pres- enceofmetabolicandendocrineabnormalities:toderive statis- tical information. Three laboratories haven been established: an immuno-assay laboratory, a chemical laboratory to mea- sure steroid hor nes, and a developmental laboratory to refine techniques. Seminars will be held both inside and out- side of the laboratories. Abnormal findings will be reported to the referring physician by telephone by a physician who is competent to offer consultation and specific educational pro- grams will be designed for each physician using the laboratory determination as the stimulus and point of entry. CORONARY CARE UNITS IN SMALL HOSPITALS Objectives: To assist small hospitals in the region in providing for their coronary patients the capability for monitoring cardiac rhythm and recognizing, and treating optimally, any complications by means of coordinated training programs for physicians and nurses, consultation on design, equipment, procedures, etc. Also, to create a network of cooperating hospitals with spe- cialized coronary care capabilities, so that 900/o of the popula- tion can have access to such care within two hours (50 miles) of onset of symptoms. MODEL DEMONSTRATION ACUTE STROKE CARE AND REHABILITATION UNIT Objectives: To provide a model unit for research, education and demon- stration of exemplary care in cerebrovascular disease. In- formation obtained on stroke patients in this unit will be used to define what is necessary and feasible to provide "optimum" management. CORE ADMINISTRATION, PLANNING, AND EVALUATION PROJECT Objectives: To support administrative and planning functions and provide objective continuous evaluation of the impact of IRNM on the health professionals and quality of patient care, as well as on patients in the Intermountain Region. -72- INTERMOUNTAIN - VII APPROVED OPERATIONAL PROJECTS (Continued) REGIONAL MYOCARDIAL INFARCTION DATA SYSTEM AND STUDY OF CORONARY CARE* Objectives: To establish a uniform regional myocardial infarction data system and to study the effectiveness of coronary care units in reducing death and complications in patients with acute myocardial infarction. Approved but not funded -73- IOWA-1 NAME OF PROGRAM Iowa Regional Medical Program GEOGRAPHICAL REGION State of Iowa ESTIMATED POPULATION 2, 774, 000 COORDINATING HEADQUARTERS Iowa Regional Medical Program 308 Melrose Avenue Iowa City, Iowa 52240 (Tel.: 31@/353-4018) GRANTEE ORGANIZATION University of Iowa College of Medicine EFFECTIVE STARTING DATE December 1, 1966 OF PLANNING ACTRVITIES EFFECTIVE STARTING DATE OF July 1, 1968 OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1, 037, 696 FUNDING FOR CURRENT $486,820 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Harry Weinberg, M.D. ADVISORY GROUP 1333 West Lombard Street Davenport, Iowa 52804 PROGRAM COORDINATOR *Willard A. Krehl, M.D., Ph. D. STAFF ASSISTANT COORDINATOR Charles W. Caldwell DIRECTOR, PROFESSIONAL AND PUBLIC EDUCATION AND INFORMA- TION J. R. (Pat) Gallagher FIELD CONSULTANTS (Miss) Doris Steele William Schaaf Roger Tracy ADMINISTRATIVE ASSISTANT (Mrs.) Mary Henry COMMUNICATIONS ASSISTANT (Mrs.) Joyce Lupan Chief Executive Officer -74- IOWA - II APPROVED OPERATIONAL PROJECTS CORE ADMINISTRATION Objectives: Coordination of all planning and operational activities, data collection, establishment of priorities, evaluation and over- all administration. CENTRAL STROKE EDUCATIONAL PROJECT Objectives: To establish a university-based educational and demonstra- tion facility to improve and expand comprehensive stroke management education through courses given at both the uni- versity and community settings. A COMPREHENSIVE PROGRAM IN STROKE MANAGEMENT Objectives: Stroke teams in three communities will be responsible for educational programs for health personnel concerned with the total management of the stroke patient; consultation to phy- sicians; strengthening arrangements in the community for continuity of care; and supervising nursing rehabilitation services. Long range planning involves expanding to include sixteen subregions covering the entire region. TRAINING PROGRAM IN CARDIOPULMONARY RESUSCITATION Objectives: Medical and related personnel will be trained and retrained in CPR methods. Pilot studies will be made of the effective- ness of training lay personnel to use these techniques. EDUCATION AND TRAINING FOR NURSES AND PHYSICIANS RESPON- SIBLE FOR THE OPERATION OF INTENSIVE CORONARY CARE UNITS Objectives: Two training centers provide four-week intensive courses for nurses; one training center provides 5-day courses for phy- sicians; advisory service to hospitals indevelopmentof ICCUS; data collection; and utilization of University Hospitals and Des Moines hospitals as training centers. -75- IOWA - III APPROVED OPERATIONAL PROJECTS (Continued) COORDINATED OUT-OF-HOSPITAL SERVICES IN POLK COUNTY Objectives: This proposal would support parts of the final year of a three- year program currently funded by PHS grant for community planning and coordination of home health activities. IR@ would be involved in the home care team activity and the in- formation and referral center. Support requested for one year, due to end in September, 1969. CONTINUING CANCER EDUCATIONAL PROGRAM FOR PHYSICIANS Objectives: This project, administered through the Central Tumor Reg- istry at the University of Iowa College of Medicine, is de- signed to offer continuing cancer education to the practicing physician and allied health professionals within the commu- nity hospital setting, utilizing the data collected through the Central Tumor Registry and its cooperating hospitals. Sup- port of these activities is presently provided by a PI-IS com- munity cancer demonstration grant, the National Cancer Institute, the Iowa State Department of Health, the American Cancer Society and the IRNW. IRNW funds have enabled ad- ditional hospitals to participate in the ca ncer program. ECONOMIC STUDIES, DIVISION OF MEDICAL ECONOMICS Objectives: Launched as A Program to Develop a Model Health Informa- tion System in Iowa, this program would be separated from the IRNM with limited funding that will allow for funding to be sought from other sources. This will permit - on an in- terim basis-analysis, interpretation, collation and the pro- per recording for retrieval of information and data amassed by the Division of Medical Economics during the IR@'s planning stage. DIAGNOSIS AND FOLLOW-UP CARE OF CHILDREN WITH HEART DIS- EASE Objectives: Clinics are presently conducted in Iowa for the diagnosis and follow-up of infants and children with heart disease. These clinics care for approximately 3, 700 patients per year. The shortage of pediatric cardiologists threatens the quality of this program. This project is designed to alleviate the cri- tical lack of manpower by training a nurse to assume the role of a pediatric clinical associate and applying electronic hybrid computer screening techniques for the cardiovascular eval- uation and follow-up of children. -76- KANSAS - I NAME OF PROGRAM Kansas Regional Medical Program GEOGRAPHICAL REGION State of Kansas- ESTIMATED POPULATION 2. 293.;.OOO COORDINATING HEADQUARTERS Kansas Regional Medical Program 3909 Eaton Kansas City, Kansas 66103 (Tel.: 913-236-9920) GRANTEE ORGANIZATION University of Kansas Medical Center EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACT-RVITI]ES EFFECTIVE STARTING DATE June 1, 1967 OF OPERATIONAL ACTRVITIES TOTAL FUNDING TO DATE $3,024,144 FUNDING FOR CURRENT $2,042,492 YEARIS ACTIVITIES CHAIRMAN, REGIONAL George A. Wolf, Jr., M.D. ADVISORY GROUP Provost and Dean, School of Medicine University of Kansas Medical Center 39th and Rainbow Boulevard Kansas City, Kansas 66103 (Tel.: 913-236-5252) PROGRAM COORDINATOR *Robert W. Brown, M.D. STAFF ASSOCIATE COORDINATORS INSTITUTIONS AND ADMINISTRA- TION Charles W. Moore POSTGRADUATE EDUCATION Jessie D. Rising, M.D. ASSTSTANT COORDINATORS RELATED HEALTH PROFESSIONS (Nfiss) Loanna E. Biers RESEARCH AND EVALUATION Richard Watts NURSING (Nfiss) Barbee Cassingham Chief Executive Officer -77- 356-998 0-69-6 KANSAS - 11 STAFF (Continued) DIRECTOR, OFFICE FOR LIBRARY SERV ICES Earl Farley DERECTOR, OFFICE FOR COMMUNICA- ;f IONS Gordon Titus DIRECTOR, OFFICE FOR COMPUTER SERVICES Robert T. A&nning, IvL D. -78- KANSAS - III APPROVED OPERATIONAL PROJECTS EDUCATIONAL PROGRA@ - GREAT BEND, KANSAS Objectives: To develop a model educational program in a selected com- munity. A full-time faculty, which will be affiliated with the Kansas Medical Center, will be in residence. Includedamong a comprehensive program are plans for continuing physician and nurse education and clinical traineeships for health-re- lated personnel. Studies will be made of community needs, resources, etc. REACTIVATING NURSES - GREAT BEND, KANSAS Objectives: A program of clinical and didactic training for inactive nurses in Great Bend or within commutingdistance. Eightfour-week sessions are to be offered-annually with emphasis on cancer, heart disease, and stroke. Evaluations will be made six months after each course or session. Traineeships will be made available. CIRCUIT COURSE FOR ACTIVE NURSES - WICHITA, PARSONS, EM- PORIA, CONCORDIA, COLBY, GARDEN CITY, GREAT BEND, AND SABETHA Objectives: A circuit course program using didactic presentations, dem- onstrations, films and panel discussions. These various teaching methods will be used to highlight the changes that have emerged in professional clinical nursing care of pa -- tients suffering f rom cancer, stroke, and heart dis ea s e. The circuit teaching team will visit each of the above cities three times annually to provide one day sessions in each locality. Participants willbeasked for their evaluations.immediately following each presentation. CARDIOVASCULAR NURSE TRAINING Objectives: To develop an in-service training program to prepare nurses with basic physiological knowledge of coronary care, ability to use instruments and equipment in coronary care units, experience in home care, and familiarity with social agencies that can aid in the rehabilitation of patients. -79- KANSAS - iv APPROVED OPERATIONAL PROJECTS (Continued) CARDIOVASCULAR WORK EVALUATION Objectives: To demonstrate the Cardiac Work Evaluation Unit and show its usefulness for the evaluation and rehabilitation of the patient; to develop an effective technique for showing phy- sicians and the community at large the ability of patients to return to work. CONTINUING EDUCATION FOR CARDIAC CARE Objectives: Wesley Hospital, in Wichita, would initiate a training pro- gram for nurses in the following techniques: providing care for heart patients, utilizing self-instructional media, pre- ceptorships, and teaching conferences as well as lectures. The project will also involve St. Francis Hospital, St. Joseph Hospital and Wesley Medical Center, utilizing medical educa- tional faculty from each, as well as a visiting faculty when needed. The program will provide an intensive course for ten days, two hours a day, and repeated every three months, for nursing as well as other paramedical personnel in the cooperating institutions, and subregional community hos- pitals. The evaluation methods will be pre-test and post- testing methods, as well as personality tests. METROPOLITAN KANSAS CITY NURSE RETRAINING PROGRAM Objectives: All metropolitan area hospitals except one in the greater Kansas City area, will participate in a program for nurse reactivation. This is the first interregional project. The proposal represents a coordinated effort of providing an ongoing opportunity for the inactive nurse to become updated and or retrained. The course will last for six weeks and will provide clinical experience in each of the associate hospitals. Six courses will be offered annually. HEALTH DATA BANK Objectives: This project will be concerned with the first phase of the development of a Health Data Bank. It will thoroughly dbcu- ment: (1) the need(s) for the system; (2) benefits; (3) cost in terms of manpower and time to develop the system; (4) type and cost of computer equipment which would be used as a central core to the system; and (5) the funding requirements for the system. -80- KANSAS - V APPROVED OPERATIONAL PROJECTS (Continued) SELF-INSTRUCTIONAL CENTERS Objectives: This proposal requests funds to establish two other health self-instructional centers at small community hospitals along the lines of the Great Bend Project. Its objectives will: (1) reinforce, using established centers for the continuing educa- tion of health professionals, and(Z) provide for the distribu- tion of educational materials of the Kansas Heart Association; the American Cancer Society, Kansas Division, Inc.; the Kansas Tuberculosis and Health Association; and the Univer- sity of Kansas Department of Postgraduate Medical Education. The Department of Postgraduate Medical Education will be responsible for the supervision of the project. PERCEPTUAL MOTOR DYSFUNCTION ASSESSNMNT AND TREATNMNT Objectives: A three-day program would be presented at the Institute of Logopedics, Wichita, for 100 occupational therapists from Kansas and six other states. Two consultants recommended by the Perceptual Motor Dysfunction Committee of ADTA will present the program. Emphasis will be given to methods of assessing perceptual motor dysfunction and the sharing of information as to treatment approaches which have been used successfully by others. The project will be evaluated by the Postgraduate Education Department of the University of Kan- sas Medical Center and by Regional Medical Program staff. PHYSICAL THERAPY WORKSHOP Objectives: A three day workshop for 10-12 registered physical therapists will be held at the University of Kansas Medical Center. The purpose of the workshop will be to provide basic information as to the appropriate instruction of supportive personnel em- ployed by adult care homes or small community hospitals. Selection of trainees will be based in part upon their avail- ability to provide this instruction to supportive personnel in their local communities. One-day review conferences will be conducted for the participating physical therapists a three and nine-month intervals following the workshop. A course outline is presented. Evaluation will be conducted by the Postgraduate Education Department of the Medical Center, the physical therapy staff, and the Regional Medical Program staff. -81- KANSAS - VI APPROVED OPERATIONAL PROJECTS (Continued) THERAPEUTIC NUTRITION Objectives: A twelve-day institute at Kansas State University is planned for therapeutic dietitians which will update their knowledge of current dietetic information. Instructions will include lectures, audio-visual aids, and discussions. Enrollment will be limited to 30 trainees and the course will carry two hours graduate credit. The pyoject will be evaluated by the faculty member presenting the course and by Regional Me- dicalprogram staff. A course outline is provided. CANCER CHEMOTHERAPY SEMINAR Objectives: Two one-day seminars for practicing physicians are planned for presentation at Tope@ and Hays. This pilot proposal is sponsored by the State Medical Society, the State Division of the American Cancer Society, the State chapter of the Ameri- can College of Surgeons, the State Department of Health, and the Department of Postgraduate Medical Education of the School of Medicine. A primary objective is to present cur- rent information regarding clinical chemotherapy of cancer. Enrollment would be limited to 24 physicians. A seminar schedule is presented. Evaluation would be made by Regional Medical Program staff. CORE PROGRAM Objectives: Sixty-one persons are indicated as currently employed full or part-time in the ten offices organized under the program. The offices are designated functionally as those of: (1) the Coordinator, (Z) Administration and Institutions, (3) Con- tinuing Education, (4) Nursing Education, (5) Health Related Professions, (6) Research and Evaluation, (7) Data Proces- sing, (8) Medical Communications, (9) Library Services, and (10) the Wichita Coordinator. -8Z- KANSAS - V II APPROVED OPERATIONAL PROJECTS (Continued) A CONTINUING EDUCATION PROGRAM FOR OCCUPATIONAL THERA- PISTS* Objectives: (1) To increase the occupational therapists' professional value to patients with stroke and post-cardiac disability by training them in this more current and basic treatment method: (2) to bring patient treatment in this area of the coun- try up to the highest current level; (3) to train occupational therapists, not in a particular method but in a concept of treatment which is the foundation for many neuro uscular facilitation techniques; (4) to most effectively present this involved method of treatment, the Rood Technique, through live demonstration and supervised practice in order to teach the correct application and gain an understanding of this mod- ern neurophysiological concept; and, (5) to disseminate this knowledge so that the participants will be able to competently teach other staff the concept and technique. CEREBROVASCULAR AND NEUROLOGICAL NURSE TRAINING* Objectives: To increase: (1) understanding and participation in the multi- disciplinary approach to patient care; (2) understanding of the interrelatedness of patient, family and community; (3) ability to assess and analyze nursing problems peculiar to patients with. cerebrovascular and neurological disease; (4) knowledge and skills necessary to give direct care to patients with cere- brovascular and neurological conditions; (5) skills in pre- ventive measures of complications from prolonged bed rest; and, (6) ability to help patient move from dependence to in- dependence, i. e. activities of daily living. KANSAS MEDICAL LIBRARY SYSTEM* Objectives: Medical library services include: (1) development of a collec- tion of books, journals and other materials pertinent to the biomedical sciences, (2) maintenance of special subject refer- ences, files and indexes, (3) circulation of material by photo- copying, (4) filing and indexing of internal reports, (5) main- tenance of reference services, and (6) compilation of biblio- graphies on biomedical topics. In order to provide adequate medical library services in the state, an organized network provides knowledge of medical library services to health-re- lated personnel; assistance to hospital administrators in build- ing basic medical literature and to medical librarians, a source of material not available at their local level. Approved but not funded -83- KANSAS - VIII APPROVED OPERATIONAL PROJECTS (Continued) FOOD SERVICE PERSONNEL USING THE DIETARY CONSULTANT AP- PROACH* Objectives: (1) To contribute to patient care through improvement of menu planning, food preparation and service, sanitation, and related topics and, (2) to supplement the existing knowledge of non-professional food service personnel concerning menu planning, food preparation and service, sanitation, and re- lated areas. COORDINATED SYSTEM FOR THE CONTINUING EDUCATION OF NM- DICAL AND PARAMEDICAL PERSONNEL* Objectives.- (1) To establish and maintain coordinated efforts of existing in service training programs in Newman and St. Mary Hos- pitals, Emporia, Kansas; (2) to extend these programs to other area hospitals and nursing homes and other community groups concerned with patient care in the areas of heart, cancer, stroke and related diseases; (3) to provide a common community resource for continuing education, consisting of personnel facilities, equipment, and libraries; (4) to stimulate continuing education for medical and paramedical groups in the areas of heart, cancer, stroke and related diseases; and, (5) to improve patient care through consumer education and better trained medical and paramedical personnel. CANCER CARE CONTINUING EDUCATION PROGRAM* Objectives: The program will combine the clinical teaching resources and medical experience of this region with the educational re- sources of the University of Kansas Medical Center. The educational resources of the Kansas Division of the American Cancer Society Wesley Medical Center, St. Francis and St. Joseph hospitals in Wichita will also be used. By properly utilizing and coordinating all of these existing resources, we believe we can develop a very effective cancer care continu- ing education program for nursing and paramedical personnel. *Approved but not funded -84- KANSAS - IX APPROVED OPERATIONAL PROJECTS (Continued) SEMINAR ON BASIC MEDICAL LIBRARIANSHIP* Objectives: To impart the basic skills of medical librarianship to sub- professionals in order to improve medical library services in the state; (2) to improve acquisitions, cataloging, refer- ence services, and inter-library loans; (3) to increase inter- library cooperation; and (4) to indoctrinate the sub-profes- sionals in ways and means of keeping up to date in the art of medical librarianship. A two-day symposium will be held on May 15-16, 1969 at the University of Kansas. KANSAS CITY COUNCIL ON HEALTH CAREERS HEALTH MANPOWER RECRUITMENT PROGRAM* Objectives.- Incooperationwiththestatemedicalsociety, statenursesasso- ciation, high s chool counselors and directors of health prof es - sional schools (1) to create an increase in numbers of student applicants to allied health professional schools; (2) to create an increase in numbers of student health professionals enter- ing schools from families with incomes less than $5, 000; and (3) to develop more effective and efficient methods of health science recruiting. A 7-point program will encompass the following; High school biomedical career programs and as- semblies, counseling, tutoring, academic program, job placement, tours, and testing. SUBREGIONAL OFFICE IN TOPEKA Objectives: This is a request to establish a second subregional office in Topeka similar to the one in Wichita which is functional. The Topeka sub-region is described inthenarrativeandrepresents the third largest grouping in health personnel and facilities in theKansasRegion. TheTopekasubregionalCoordinatorwould work with a local action group in defining health needs and in identifying appropriate programs to meet them, promotion of effective utilization of health resources, and in assisting with the coordination of training or retraining program for health manpower. Approved but not funded -85- LOU15IANA NAME OF PROGRAM Louisiana Regional Medical Program GEOGRAPHICAL REGION State of Louisiana ESTIMATED POPULATION 3. 7z6, ooo COORDIMTING HEADQUARTERS Louisiana Regional Medical Program Claiborne Towers Roof 119 South Claiborne Avenue New Orleans, Louisiana 701 1 2 (Tel.: 504/522-5678) GRANTEE ORGANIZATION Louisiana State Department of Hospitals EFFECTRVE STARTING DATE January 1, 1967 OF PLANNING ACTRVITEES TOTAL FUNDING TO DATE $1,177,840 FUNDING FOR CURRENT $467,550 YEARIS ACTRVITIES CHAERMAN, REGIONAL Charles B. Odom, M.D. ADVISORY GROUP 4500 Magnolia Street New Orleans, Louisiana 70115 PROGRAM DIRECTOR *Joseph A. Sabatier, Jr., NL D. STAFF ADVISORS TO THE DIRECTOR Robert Sappenfield, M. D. School of Medicine, Louisiana State University (New Orleans) Jerome Ryan, M.D. Tulane University School of Medicine (New Orleans) Joseph T. Hamrick, M.D. School of Public Health and Tropical Medicine Tulane University (New Orleans) ASSISTANT DIRECTOR FOR ADMINISTRATION Frank Roberts PLANNING SECTION C. Jerre Lloyd, Acting Chief Beverly Baird *Chief Executive Officer 86- LOUISIANA - II STAFF (Continued) PROJECT DEVELOPMENT AND EVALUATION SECTION Ijaurence J. Baas,, Acting Chief Rafael Sanchez, K D. B. A. Gla s s, M.D. BUSINESS MANAGER Louis J. Edmondson CONSULTANT, PUBLIC RELATIONS AND INFORMATION Joseph Coyle Tulane University School of Medicine (New Orleans) -87- MAINE I NAME OF PROGRAM Maine's Regional Medical Program GEOGRAPHICAL REGION State of Maine ESTIMATED POPULATION 1, 000, 000 COORDINATING HEADQUARTERS Maine's Regional Medical Program 295 Water Street Augusta, Maine 04330 (Tel. : 267/622-7566) GRANTEE ORGANIZATION Medical Care Development, Inc. EFFECTIVE STARTING DATE May 1, 1967, OF PLANNING ACTIVITIES EFFECTRVE STARTING DATE July 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1, 355,455 FUNDING FOR CURRENT $865,ogo YEARIS ACTRVITIES CHAIRMAN, REGIONAL Donald H. Horsman, M.D. ADVISORY GROUP 50 Goff Street Auburn, Maine 04210 (Tel. : 7-07/78.2-8350) PROGRAM COORDMTOR *Manu Chatterj ee, M.D. STAFF ASSISTANT PROGRAM COORDINATOR Niles L. Perkins, M.D. ASSOCIATE COORDINATOR, MAINE CITIES John R. Davy, "D. DIRECTORS ADMINISTRATIVE SERVICES Justin W. Cowger COMMUNITY RELATIONS Jefferson D. Ackor NURSING (Miss) Cora E. Pike, R.N. TELECOMMUNICATIONS AND DATA PROCESSING John A. LaCasse *Chief Executive Officer -88- @INE - n STAFF (Continued) ADMINISTRATIVE ASSLSTANT (Mrs. ) Janet H. Jones RESEARCH ASSISTANT (Miss) Patricia Wallace PROJECT DIRECTORS CORONARY CARE Harold 4 Osher, M.D. PHYSICIANS' CONTINUING EDUCATION Philip G. Good, K D. SMOEING CONTROL Joseph L. Ha enfus REGIONAL HEALTH AGENCY UPPER KENNEBEC VALLEY Burt C. Sheehan GUEST RESIDENT PROGRAM George J. Robertson, M. D. ASSISTANT PROJECT DIRECTOR, CORONARY CARE Joseph @ Edgar, M.D. NURSE TRAINING DIRECTOR, CORONARY CARE- (Miss) eve C. Brady, R.N. CONSULTANTS RESEARCH AND EVALUATION Bhopinder S. Bolaria, Ph. D. STROKE E. Charles Kunkle, K D. REHABILITATION John J. Lorentz, M.D. HEART CANCER Hadley Parrot, K D. -89- I MAINE - III TAFF (Continued) NURSING COMPUTERIZED MEDICAL RECORDS, CORONARY CARE -90- MAINE - IV APPROVED OPERATIONAL PROJIECTS VISITING GUEST RIESIDIENT PROJECT Objectives: To continue and expand a program initiated'by the Bingham Associates Fund which sends senior residents or fellows at Tufts-New England Medical Center to small community hospitals. Thisestablishesalineofcommunicationsbetween the University Hospital Center and the relatively isolated practitioners. KENNEBEC VALLEY REGIONAL HEALTH AGENCY PROGRAM Objectives: This project establishes cooperation between Maine's Regional Medical Program and the Regional Health Agency of Maine's Upper Kennebec Valley in the develop- ment of a regional approach to comprehensive health care and planning for rural area residents. SMOKING CONTROL Objectives: This project is designed to improve the health status of Maine people through an educational and action program directed against "cigarette disease. 11 Basic work has already been done by the Maine Interagency Council on Smoking and the Health Council of Maine. This project involves Maine's Regional Medical Program in these activities and provides a coordinator and other staff assistance, office equipment and supplies, and supplies administrative funds. CORONARY CARE PROGRAM Objectives: This is a comprehensive program designed to bring the latest advances in diagnosis and treatment to patients with acute coronary disease by establishing coronary care units in 20 community hospitals over a five-year period. These hospitals will be linked by remote monitoring methods to referral centers where expert consultation services are available on a 24-hour basis. Included in this program are: (1) planning consultation service; (2) training programs for nurses; (3) training programs for physicians; (4) visiting physician program; (5) paramedical consultation service; (6) operational aids, data collection, and evaluation; (7) hospital cardiopulmonary resuscitation programs; (8) possible mobile coronary care units (future); and, (9) remote monitoring by communications media. -91- MAINE - V APPROVED OPERATIONAL PROJECTS (Continued) PHYSICIANS' CONTINUING EDUCATION PROGRAM Objectives: This project wi 11 establish teaching programs in 20 community hospitals and five groups of small community hospitals. Four programs will be presented annually to the staffs of these hospitals in the areas of heart disease, cancer, stroke, and rehabilitation. CORE PROGRAM Objectives: The major objective of the administrative shift from plan- ning to core will be to connect operational projects to the planning process. Other goals are: (1) provide leadership and assistance in the development and accomplishment of program objectives; (2) maintain regional relevance within individual operational projects; (3) update and redefine operational objectives; and (4) expand the services of the Research and Evaluation Unit at the University of Maine. DIRECTOR OF MEDICAL EDUCATION PROGRAM* Objectives: Proposes a "third faculty" composed of Directors of Medical Education. Expanded and improved opportunities for continuing education of rural area health professionals is the major emphasis of this program. REGIONAL LI]BRARY* Objectives: Expand the existing facilities of the Maine Medical Center Medical Library so that it can more adquately function as a regional medical library. *Approved but not funded -92- MARYLAND - I NAME OF PROGRAM Maryland Regional Medical Program GEOGRAPHICAL REGION State of Maryland, less environs of Washington, D. C. ; includes lower southeastern counties of Delaware, Accomac County (Virginia), and York County (Pennsylvania) ESTIMATED POPULATION 3,754,000 COORDINATING HEADQUARTERS Maryland Regional Medical Program 550 North Broadway Baltimore, Maryland 21ZO5 (Tel. :301/342-7445) GRANTEE ORGANIZATOIN The Johns Hopkins Medical Institutions EFFECTIVE STARTING DATE January 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE March 1, 1969 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $3,204,046 FUNDING FOR CURRENT $2,236,5?.o YEARIS ACTIVITIES CHAIRMAN, REGIONAL M. Shakman Katz ADV OR Y 2609 Talbot Road Baltimore, Maryland 21216 CHAIRMAN, ADMINISTRATIVE William Peeples, M.D. COMMITTEE Commissioner, State Health Department 301 West Preston Street Baltimore, Maryland 21201 PROGRAM COORDINATOR *William S. Spicer, Jr., M.D. STAFF DIRECTOR Abraham M. Lilienfeld, M. D. Epidemiology and Statistical Center ASSOCIATE COORDINATORS Edward S. Stafford, M.D. Johns Hopkins University Perry Stearns, M. D. State Health Department Arlie R. Mansberger, Jr., M.D. University of Maryland -93- *Chief Executive Officer 356-998 0-69- 7 MARYLAND II STAFF (Continued) ASSOCIATE COORDINATORS (Continued) HEALTH PLANNING AND RESEARCH Louis P. Hellman, Sc. D. CONTINUING EDUCATION Bruce E. Strem, Ph., D. EPIDEMIOLOGY AND STATISTICAL CENTER Maureen Henderson# M. B. B. S. ASSISTANT COORDINATORS MEDICAL CARE ADMINISTRATION AND AMBULATORY SERVICES Harle V. Barrett, K D. CONTINUING EDUCATION Eugene J. Linberg, M.D. AUDIOVISUAL DEVELOPMENT J. D. Allred, D. Ed. CONTINUING EDUCATION AND ADMINISTRATION Richard C. Peters BUSINESS MANAGER Richard M. Metzinger SURVEY DIRECTOR, EPIDEMIOLOGY AND STATISTICAL CENTER Jean Galkin, D.P. H. PUBLIC INFORMATION OFFICER Bernard A. Curtis -94- MARYLAND - III APPROVED OPERATIONAL PROJECTS CONTINUING EDUCATIONAL PROGRAM FOR PENINSULA GENERAL HOSP-ITAL Objectives: To meet the need of a sound continuing educational program, funds for 500/o support of a Director of Continuing Education are requested for this 334 bed community hospital located 100 miles from Baltimore on the Eastern Shore. DEVELOPMENT AND EVALUATION OF A COMPREHENSIVE TECHNICAL SCREENING PROGRAM FOR SCHOOL-AGE CHILDREN OF LOW-INCOME FAMILIES Objectives: By utilizing specially trained health technicians, the Community Pediatric Center of the University of Maryland, in cooperation with the Baltimore City Health Der)artment, would develop a comprehensive technical screening pro- cedure for school-age children with a high incidence of un- diagnosed cardiovascular renal and pulmonary diseases. EARLY DETECTION OF CARDIAC AND MALIGNANT DISEASE IN PRE-SCHOOL AND SCHOOL CHILDREN Objectives: The pediatric clinic of Mercy Hospital proposes to establish screening programs and diagnostic centers for children from low-income families living in the inner city of Baltimore, and to other children when local resources are not available. A PROGRAM FOR MASS DETECTION OF HEART DISEASE IN SCHOOL CHILDREN Objectives: In the first year, children of nine schools will be screened by phono-cardioscan team trained by the Community Pediatric Center of the University of Maryland, Approxi- mately 3, 500 children will be surveyed initially, with planned increase in activity up to 20, 000 screenings per year. EARLY DETECTION OF HEART DISEASE IN THE NEWBORN Objectives: A case-finding program for the early detection of congenital heart disease will be established under the auspices of the Johns Hopkins Hospital in six city and four regional cooperating hospitals. -95- MARYLAND rV APPROVED OPERATIONAL PROJECT-S (Continued) CORONARY CARE PROGRAM Objectives: A comprehensive training program in management of acute coronary care units for physicians and nurses will be established in conjunction with the seven bed unit already m operation at the University of Maryland Medical School. CLOSED CHEST CARDIOPULMONARY RESUSCITATION Objectives: The Heart Association of Maryland proposes to establish a cardiopulmonary resuscitation teaching center in each community hospital in the Region to instruct physicians, nurses and select lay personnel in closed chest cardio- pulmonary resuscitation techniques. ACUTE AND CHRONIC STROKE UNITS Objectives: A four-bed acute stroke unit will be established at Johns Hopkins to provide initial diagnosis and intensive care of patients with acute cerebral vascular episodes. ACUTE INTERMEDIATE AND LONG TERM STROKE CARE PROGRAM Objectives: The York Hospital, a 530 bed acute general hospital, would establish a four-bed acute stroke unit, an eighteen bed intermediate care unit, and a three bed special evaluation and post-intermediate care unit for the complete care and rehabilitation of patients with stroke. PROPOSAL ON STROKE - UNRVERSITY OF MARYLAND Objectives: The University of Maryland would expand the services of its functioning out-patient stroke clinic, to establish a four bed acute stroke unit, and augment an existing cooperative arrangement with Montebello State Hospital for care of patients with rehabilitation potential. -96- MARYLAND - V APPROVED OPERATIONAL PROJECTS (Continued) PROPOSED COORDINATED DISCHARGE PLANNING PROGRAM FOR WICOMICO AND SOMERSET COUNTIES Objectives: Through the joint cooperation of the Wicomico County Health Department and the Peninsula General Hospital, a public health nurse will coordinate a planned program of follow-up care for indigent and medically indigent patients discharged from Peninsula General Hospital to home or to chronic disease hospitals or nursing homes. REGIONAL MEDICAL PROGRAM FOR OUTPATIENT STROKES Objectives: The Deer's Head Chronic Disease and Rehabilitation Hospital in cooperation with the Peninsula General Hospital and Wicomico County Health Department will establish an outpatient community rehabilitation clinic for stroke patients. DEMONSTRATION AND TRAINING PROGRAM IN THE REHABILITATION OF STROKE PATIENTS Objectives: By expansion of existing facilities at Sinai Hospital, the Department of Rehabilitation Medicine proposes a comprehensive demonstration program for the management of patients with stroke. CLINICAL CANCER PROGRAM AND REGISTRY* Objectives: Peninsula General Hospital would establish a clinical cancer program registry as outlined by the American College of Surgeons. AN AMBULATORY PROGRAM FOR COMPREHENSIVE PULMONARY SERVICES Objectives: The Maryland General Hospital proposes to establish a model ambulatory pulmonary service unit to demonstrate optimum, comprehensive care for patients with chronic respiratory disease. *Approved but not funded -97- MEMPHIS - I NAME OF PROGRAM Memphis Regional Medical Program GEOGRAPHICAL REGION Western Tennessee, Northern Mississippi, Eastern Arkansas, and portions of Kentucky and Missouri ESTIMATED POPULATION 2, 435, 000 COORDINATING HEADQUARTERS Memphis Regional Medical Program The University of Tennessee Medical Units 62 South Dunlap Memphis, Tennessee 38103 (Tel. : 901/527-8371) GRANTEE ORGANIZATION The University of Tennessee College of Medicine EFFECTIVE STARTING DATE April 1, 1967 ITIES EFFECTIVE STARTING DATE July 1, 1968 OF OP TIONAL A TIVITI]ES TOTAL FUNDING TO DATE $1, 192, 974 FUNDING FOR CURRENT $781, 789 YEA AC ITI]ES CHAIRMAN, REGIONAL Frank M. Norfleet DVISORY GROUP Mid-South Medical Center Council 1331 Union Avenue Memphis, Tennessee 38104 PROGRAM COORDINATOR *James W. Culbertson, M.D. STAFF EPIDEMIOLOGIST - STATISTICIAN Mark Kashgarian, D. CONSULTANT IN COMMUNITY SERVIC S Kathryn Taylor, M. S. S. W. MEDICAL ECONOMIST Lewis N. mis, Ph.D. CONSULTANT IN NURSING SERVICES Ruth H. ryc e, R. N. , M.N. NUR Jean NURSING SPECIALIST IN CANCER Patricia unigan, R- N.. M. *Ch ef Executive Officer -98- MEMPHTS - E STAFF (Continued) INFORMATION OFFICER Clayton Braddock, M. A. ASSOCIATE INFORMATION OFFICER Kenneth L. Johnson, B. J. ASSISTANT INFORMATION OFFICER Fred Rawlinson, B. F. A. PLANNING ADVISOR Joyce H. Harrell, B.A. COMMUNICATIONS OFFICER John Vincent, M. B.A. EDITORIAL OFFICER Betty S. @rk, B. J. ADMINISTRATIVE ASSISTANT FOR OPERATION Ellen P. McDowell CHAIRMAN OF COMMITTEES (University of Tennessee College of Medicine) CENTRAL COMMITTEE AND PLANNING BOARD James W. Pate, M. D. CARDIOVASCULAR Charles E. Kossmann, M.D. CANCER AND COMMUNICATIONS Edward H. Storer, NL D. CEREBROVASCULAR Robert A. Utterback, M. D. COMMUNITY MEDICINE Henry Packer, M.D. DISEASE PREVENTION Dean F. Davies, M.D. AUTOMATION (COMPUTER SERVICES) Glenn Clark, M.D. CONTINUING EDUCATION William North, NL D. RESEARCH Richard Overman, Ph. D. -99- MEMPHIS IH STAFF (Continued) BEHABILTXATIQN Robert Christopher, M.D. ALLI]ED HEALTH PROFESSIONS Blair Erb, M.D. Jackson, Tennessee LEBRARY SCIENCE AND SERVICES Andrew Lasslo, Ph.D. (College of Pharmacy) NURSING Ruth Neil Murry, B.S. N., NL S. (College of Nursing) DENTISTRY Roy M. Smith, D. D. S. (College of Dentistry) PHARMACY Grover Bowles, B. S. Baptist Memorial Hospital Memphis, Tennessee COMMUNITY SERVICES (Chronic Disease Advisory) Richard Block Memphis, Tennessee -100- MEMPHIS - rV APPROVED OPERATIONAL PROJECTS ESTABLISHMENT OF A STROKE CENTER IN THE MEMPHIS REGION Objectives: A "model center" for management of stroke, including a special unit for the intensive care of stroke, would be developed in the University of Tennessee - City of Memphis Medical Center. The Center would be used for development of a training program to provide special nursing skills, dissemination of new information techniques and therapeutic approaches, expansion of physical therapy training facilities, and development of continuing education programs for stroke management. The facility would be availableforcomplexdiagnosticproblems referred fromall medical institutions in the Region. REGIONAL LABORATORY FOR GASTROINTESTINAL MUCOSAL SUCTION BIOPSY Objectives: Project would establish a laboratory for gastrointestinal mucosal suction biopsy at the University of Tennessee. Servicesofthelaboratorywouldbeavailable to allphysicans in the Region. PROGRAM FOR PREVENTION AND IMPROVED TREATMENT OF SKIN CANCER Objectives: Skin cancer is the indigenous cancer of the Memphis Region. Although such cancers can be successfully treated in dermatologists' offices, many patients are poor farm workers who under-utilize medical facilities. The proposal would combine a study for defining the problem with educational activities aimed at the general public, as well as at health professionals. Appropriate laboratory facilities will assure recruitment of a highly qualified clinician-investigator. REGIONAL PROGRAM FOR PERIPHERAL VASCULAR DISEASE Objectives: Renovation and remodeling of space in an out-patient clinic of the University of Tennessee Medical Center will permit establishment of a first class vascular out-patient teaching service and clinic. Approximately 250/o of support would come from sources other than RMP. -101- MEMPH15 - V APPROVED OPERATIONAL PROJECTS (Continued) CORONARY CARE TRAINING UNIT Objectives: A I 2-bed coronary care unit would be installed in the City of Memphis Hospital of the University of Tennessee Medical Center. The unit would be a training and demon- stration "show case" for health professionals from other hospitals in the Region. Training and consultation would be facilitated by a standard -format for coronary care unit data which would be suitable for analysis by computer. The coronary care unit would be affiliated with an existing myocardial infarction center. REGIONAL PROGRAM ON EMPHYSEMA AND COR PULMONALE Objectives: A special out-patient facility for chronic obstructive lung disease will be housed in the City of Memphis Hospital out-patient department.. Pulmonary function studies will make use of data processing facilities and will assist in evaluation of results. STREPTOCOCCAL DISEASE CENTER Objectives: A service laboratory for the Region will be established in the City of Memphis Hospital out-patient clinic. Diagnostic services and epidemiological studies will be available for the entire Region. Objectives are to standardize culture techniques, and to develop epidemio- logical teams. Clinical facilities for referral of rheumatic fever victims would also be provided. REGIONAL ELECTROCARDIOGRAPHIC DIAGNOSTIC CENTER Objectives: The project will provide im-proved service in the recording and processing of electrocardiograms for outlying areas in the Region. Facilities will be centralized to utilize modern technology for rapid recording and processing. A computer program for ECG interpretation will be developed; it will be suitable for smaller computers, which will be more practical economically for smaller hospitals or communities. -102- MEMPHis - VI APPROVED OPERATIONAL PROJECTS (Continued) OBION COUNTY GENERAL HOSPITAL PROJECT Objectives: This General Hospital in Union City, Tennessee, requests support for upgrading certain key facilities in order to increase its potential and capability for handling heart, cancer, and stroke. Facilities concerned are radiographic equipment, radioisotope laboratory facilities, pulmonary function laboratory, and equipment for a coronary care unit. COMBINED ATTACK ON CERTAIN FORMS OF HEART DISEASE, CANCER, AND STROKE Objectives: Two hospitals, Community Methodist, Paragould, Arkansas, and Dunklin County Memorial, Kennett, Missouri, request support for forming a transportation service between the two institutions. The service would avoid duplication of facilities by transporting patients, specimens, educational materials, personnel, blood and blood products, and various documents. A PROPOSAL FOR A CARDIOVASCULAR INTENSIVE CARE UNIT* Objectives: Proposed by the St. Bernard's Hospital, Jonesboro, Arkansas, this project proposes to install and operate monitoring devices with four bedside unit components, and one central nursing station console and to train necessary paramedical personnel by sending them to operational centers in geographic proximity of the hospital. *Approved but not funded -103- METROPOLITAN WASHINGTON, D.C. -I NAME OF PROGRAM Metropolitan Washington, D. C. Regional Medical Program GEOGRAPHICAL REGION District of Columbia and contiguous counties in Maryland (2) and Virginia (2), and the cities of Alexandria, Falls Church, and Fairfax, Virginia ESTIMATED POPI@, TION 2, 160, 000 TING HEADQUARTERS Metropolitan Washington, D. C. Regional Medical Program Medical Society of the District of Columbia 2007 Eye Street, Northwest Washington, D. C. 20006 (Tel.: 202/223-6490) GRANT-Fr. r-iPr--ATTT17 ATION Medical Society of the District of Columbia EFF]Er.TTVr- 'Z'rA T) rING DATE January 1, 1967 v.r 1-@-NNING ACTRVIT S EFFIEC,'TTVr. C-rA ID -ING DATE March 1, 1968 u.r IL).Fh;RATIONAL s TOTAL F $2,229,145 FUNDTWR. rr-ID f-TTnnENT $1, 058,523 ACTIVITIES CHAIIRMA EGIONAL Francis C. Mayle, Jr., M. D. 8218 Wisconsin Avenue Bethesda, Maryland 20014 PROGRAM rnnIDr%rKTA TOR *Arthur E. Wentz, NL D. FF EXECUTRVE OFFICER .LY.LcLiL Aavier MANAG]EX41PW-r A?-,T,& T @eT Freci weamer ASSOCIATE ronT?nMTArrr%ns Otis L. Anderson, M.D. Hospital Council of the National Capital Area, Inc. Martin E. Levy, M.D. D. C. Department of Health Chief Executive Officer -104- METROPOLITAN WASHINGTON, D. C. - H STAFF (Continued) ASSOCIATE COORDINATORS (Continued) W. E. Anderson, M. D. George Washington University Medical Center Maurice E. Odoroff Georgetown University Medical Center Joel W. Novak Howard University Medical Center PROJECT DIRECTORS CANCER John R. Heller, NL D. HEART John F. Stapleton, M.D. STROKE James W. Watts, M. D. -105- I METROPOLITAN WASHINGTON, D. C. - III APPROVED OPERATIONAL PROJECTS THE FREEDMENIS HOSPITAL STROKE STATION FOR THE DIAGNOSIS, TREATMENT, AND INVESTIGATION OF CEREBRAL VASCULAR DISEASE Objectives: To establish a stroke station in which the latest methods for the diagnosis and treatment of cerebral vascular disease will be carried out and taught to medical per- sonnel, students, and paramedical and allied personnel. A team of physicians, social workers, psychologist, occupational therapist, etc. will be involved. CEREBROVASCULAR DISEASE FOLLOW-UP AND SURVEILLANCE SYSTEM OF GEORGETOWN UNIVERSITY Objectives: To establish baseline data in a formal system. Incidence of stroke, effectiveness of care, and results of follow-up efforts will be recorded. A TRAINING PROGRAM FOR CARDIOVASCULAR TECHNICIANS - WASHINGTON HOSPITAL CENTER Objectives: To meet the needs for specially trained paramedical man- power to support physicians and nurses in a highly tech- nical medical and surgical area. AUDIOVISUAL LIBRARY OF OVARIAN NEOPLASMS FOR CONTINUING EDUCATION Objectives: This project will test the value of audiovisual projectors in the community hospitals and medical centers as a means of continuing education. A cassette library dealing with ovarian neoplasms will be developed by Columbia Hospital, Medical Illustrations Department of George Washington University, Armed Forces Institute of Pathology, and Rodel Studios. Distribution will be made to hospitals. -106- METROPOLITAN WASHINGTON, D. C. - IV APPROVED OPERATIONAL PROJECTS (Continued) COMPREHENSIVE CARE OF PATIENTS WITH PULMONARY DISEASE - GEORGETOWN Objectives: This project will establish a continuing teaching program between Georgetown and, initially, 6 community hospitals. Physicians, nurses, cardiopulmonary technologists, chest physical therapists, and inhalation therapists will receive training required for modern diagnostic and treatment services. The training program consists of a "compre- hensive visit" by a Georgetown staff team to the community hospitals to work with professional counterparts; on-site visits of health personnel to Georgetown; the out-patient breathing clinic at Georgetown; the computer pulmonary function program; and two-day seminars. MOBILE CORONARY CARE UNIT - MONTGOMERY COUNTY HEART ASSOCIATION Objectives: This project will establish a mobile coronary care unit primarily to serve Montgomery County, Northwest Washington, D. C. and Metropolitan Prince George's County. The unit will be stationed on a rotating basis at the three hospitals in the area which now have Coronary Care Units. These hospitals will provide trained nurses for the unit; physicians will be provided by the Heart Dis- ease Control Program, HEW; and Cardiovascular techni- cians will be recruited from among Navy and Army corpsmen. HOME TELECASTS OF MEDICAL-SURGICAL CARDIOVASCULAR CONFERENCES Objectives: This is a one-year pilot project to introduce medical tele- vision to the Region's physicians as a source for continuing education. The program to be presented is the weekly medical-surgical conference conducted by Georgetown University's Division of Cardiology. The media is an educational station which can place expensive operating equipment and trained manpower at the disposal of the project. Evaluation mechanisms have been developed by the Director of the Center for Educational Technology, Graduate School of Education, Catholic University of Am erica. -107- METROPOLITAN WASHINGTON, D.C. - V APPROVED OPERATIONAL PROJECTS (Continued) PARAMEDICAL PROFESSIONAL RETRAINING BY VI]DEOTAPE* Objectives: To use videotape to retrain medical technologists who have been out of practice ten years or more. Will be conducted in the Laboratory Service of the Veterans Administration Hospital, with the cooperation of the Pathology Department at George Washington Hospital Center. A HEALTH CAREERS COUNCIL FOR THE NATIONAL CAPITAL AREA* Objectives: A Council will be established to coordinate and amplify existing recruitment efforts within the Region and develop new programs. Through this Council, the Region hopes to make information about health careers and scholarships available to school guidance counselors, health groups, and interested individuals. METROPOLITAN WASHINGTON REGI<)NAL CANCER REGISTRY* Objectives: The D. C. Department of Health cancer registry can be computerized and enlarged to collect complete cancer data for the entire Metropolitan Washington Region, analyze it thoroughly, and report findings to physicians, hospitals, and health departments. METROPOLITAN WASHINGTON AREA PERIPHERAL VASCULAR FACILITY* Objectives: To establish a Central Peripheral Vascular Facility at the George Washington University with independent Peripheral Satellite Clinics at Providence Hospital, D. C. General, D. C. Village, and Fairfax Hospital. CORE PROGRAM Objectives: Aims at assisting the process of regionalization through linking patient care with health research and education by developing programs through the use of 5 Associate Co- ordinators, reaching into the university medical schools and hospitals of the community. The implementation of a program for continuing medical education and the training of paramedical personnel has been structuredby committees representing all hospitals--community, university, and federal-- of the Region and will be one of the core staff Is major objectives for 1969-1970. *Approved but not funded -108- MICHIGAN I NAME OF PROGRAM Michigan Regional Medical Program GEOGRAPHICAL REGION State of Michigan EST@TED POPULATION 8, 739, 000 COORDINATING HEADQUARTERS Michigan Association for Regional Medical Programs Suite 200, 1 1 1 1 Michigan Avenue East Lansing, Michigan 48823 (Tel. : 517/351-0290) GRANTEE ORGANIZATION Michigan Association for Regional Medical Programs EFFECTIVE STARTING DATE June 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE July 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $3, 135, 919 FUNDING FOR CURRENT $1, 841, 470 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Michael Brennan, IvL D. .ADVISORY GR UP Suite 200, 1 1 1 1 Michigan Avenue East Lansing, Michigan 48823 PRESIDENT, MICHIGAN Don Marshall, M.D. ASSOCIATION FOR President, Michigan Association for REGIONAL MEDICAL PROGRAMS Regional Medical Programs Suite 200, 1 1 1 1 Michigan Avenue East Lansing, Michigan 48823 PROGRAM COORD@TOR *Albert E. Heustis, M. D. STAFF ASSOCIATE PROGRAM COORD@TOR Gaetane M. Larocque, Ph. D. ASSISTANT PROGRAM COORDMTOR Harold Poindexter ASSISTANT TO PROGRAM COORDI- NATOR (Mrs.) Ilze V. Koch FIELD REPRESENTATRVES David Eaton- Jerard Riddell *Chief Executive C)fficer -109- 356-998 0-69-8 MICHIGAN - II APPROVED OPERATIONAL PROJECTS CENTRAL PLANNING AND ADMINISTRATIVE STAFF Objectives: Provides guidelines and assistance in development of subregions and districts and is responsible for overall coordination and development of regional cooperative arrangements. COORDINATED DATA COLLECTION AND ANALYSIS; PLANNING FOR AUTOMATION OF MULTIPLE SCREENING Objectives: To provide designated types of data on heart disease, cancer, and stroke to Regional Medical Program participants on a block by block basis. MICHIGAN HEART ASSOCIATION - MODEL CORONARY CARE UNIT CONTINUING EDUCATION CURRICULUMS Objectives: To develop, implement, and evaluate a model teaching package for coronary care unit and intensive care unit personnel. Methods include a two-week course for nurses, continuing education courses for physicians (1-3 days) and a programmed electronic teaching unit model. The project demonstrates the value and effectiveness of cooperative program planning and leads to the development of programmed learning texts for classroom use. MICHIGAN STATE UNIVERSITY PLANNING AND FACILITATING OF- FICE FOR HEART DISEASE, CANCER, STROIKE AND RELATED DISEASES Objectives: Under the college of Human Medicine, the planning office develops cooperative arrangements for certain geographi- cal areas and plans and conducts continuing education programs. Long-range objectives include a preliminary evaluation of health care resources and systems and development of information resources. A local advisory committee assists in establishing these objectives. ESTABLISHMENT OF A CENTER FOR -PHYSICIAN EDUCATION IN HYPERTENSION Objectives: An existing clinic at the Sparrow Hospital is being expanded into a training center for the continuing education of physicians in the management of hypertension. Sparrow Hospital will contribute approximately 300/o of the costs. -110- MICHIGAN - III APPROVED OPERATIONAL PROJECTS (Continued) UNIVERSITY OF MICHIGAN ADMINISTRATIVE SECRETARIAT Objectives: This office within the Department of Postgraduate Medicine of the University of Michigan Medical School functions as a major coordination and implementation point for University efforts in programs related to heart disease, cancer and stroke. Its purpose is to avoid unnecessary duplication of efforts with other University-sponsored programs and to provide core personnel and facilities for carrying out certain specific initial projects. A local advisory committee provides advice and guidance. POSTGRADUATE NURSING EDUCATION - HEART DISEASE, CANCER AND STROKE NURSING Objectives: The University of Michigan School of Nursing proposes to identify continuing education needs of nurses in the categorical diseases, to design and implement short-term programs to meet these needs, to develop teaching aids and to evaluate the effectof teaching programs. Consulta- tion services from the University of Michigan Center for Research in Learning and Teaching and the University of Michigan Center for Research in the Utilization of Scientific Knowledge will be used extensively. DRUG INFORMATION AND THERAPY ANALYSIS AND REPORTING SYSTEM Objectives: The College of Pharmacy and the University Hospital Pharmacy are conducting a pilot drug information and drug therpay analysis and reporting system. The purpose is to reduce time between development of new practices, procedures, and methodologies and their practical appli- cation to patient care in the categorical disease. Computeri- zation of information retrieval is involved. MEDICAL CARE EVALUATION Objectives: A three to five year pilot study to evaluate and attempt to improve delivery of heart, cancer, and stroke care in an urban community. The study team will involve collabora- tion between resources of the University of Michigan and a local self-study team made upof consumers andpurveyors of medical care. MICHIGAN - rV APPROVED OPERATIONAL PROJECTS (Continued) SCHOOL OF DENTISTRY PROGRAM FOR HEART DISEASE, CANCER AND STROKE Objectives: Baseline data requirements for implementation of specific training programs will be developed. Continuing education programs will be developed and will assist practicing dentists to acquire the ability to detect oral cancer and to manage patients whose cancer or cancer treatment affects their oral health. An effort will be made to provide information for practicing physicians oral diagnosis and the importance of early consultation in lesions affecting the oral region. STUDY OF PHYSICIAN ATTITUDES TOWARD CONTINUING MEDICAL EDUCATION Objectives: The degree to which physicians in the Region feel they are able to keep up with the advances in medical knowledge is being surveyed. Physicians who occupy key roles in the dissemination of new information to their colleagues will be identified. The data obtained will be the basis for im- proving the system of continuing education in Michigan. WAYNE STATE UNRVERSITY STAFF FOR REGIONAL MEDICAL PROGRAMS Objectives: A planning group reporting to the Dean of the School of Medicine will be developed to involve all University depart- ments having an interest and capability in relationship to Regional Medical Programs. Staff maintain fiscal records, coordinate efforts in various departments, and provide central office services to expedite planning activities. Preliminary planning efforts involve studies of the needs of allied health groups for educational programs as well as continuing professional education for physicians. ZEIGER/BOTSFORD HOSPITALS PARTICIPATION Objectives: With the organization of a small project staff, these osteopathic hospitals hope to develop and promote effective programs for disseminating knowledge of heart disease, cancer, and stroke management to the osteopathic profes- sion and to other MARMP participants. In conjunction with the Professional Evaluation Service of the American Public Health Association they are developing a device for evaluating skills of practicing osteopathic physicians. -112- MICHIGAN - V APPROVED OPERATIONAL PROJECTS (Continued) SURVEILLANCE OF ELECTRONIC EQUIPMENT IN SPECIAL CARE UNITS* Objectives: Sponsored by Wayne State University, this one-year demon- stration program is concerned with the identification and elimination of potential or actual hazards to the care of patients in special care units in hospitals in which acutely ill patients with heart and other diseases are customarily treated. A survey is being made of all hospitals in the Greater Detroit Metropolitan Area. *Approved but not funded -113- MISSISSI]PPI - I NAME OF PROGRAM Mississippi Regional Medical Program GEOGRAPHICAL REGION State of Mississippi ESTIMATED POPULATION 2, 344, 000 COORDINATING HEADQUARTERS Mississippi Regional Medical Program University of Mississippi Medical Center 2500 North State Street Jackson, Mississippi 39216 (Tel. : 601/362-4411, ext. 2627) GRANTEE ORGANIZATION University of Mississippi Medical Center EFFECTIVE STARTING DATE July 1, 1967 OF PLANNING ACTIVITIES TOTAL FUNDING TO DATE $i, o6o, 505 FUNDING FOR CURRENT $648,607 YEARIS ACTRVITIES CHAIRMAN, REGIONAL Alton B. Cobb, M.D. ADVISORY GROUP 510 Lamar Life Building Jackson, Mississippi 39201 PROGRAM COORDINATOR *Guy D. Campbell, M.D. STAFF HEART AND STROKE COORDINATOR T. D. @mpton, M.D. CANCER COORDINTAOR Guy T. Gillespie, Jr., M.D. CONTINUING EDUCATION COORDI- NATOR William 0. Barnett, NL D. ALLIED HEALTH PROFESSIONS SPECIALIST James B. Moore, Ed. D. ASSISTANT TO THE COORDINATOR Maurice Hill *Chief Executive Officer -114- MISSISSEPPI - 11 STAFF (Continued) ADMINISTRATIVE ASSISTANT FOR OPERATIONS AND FISCAL AFFAIRS Betty Zimmerman COMMUNICATIONS SPECIALIST Maurine Twiss -115- MISSOURI - I NAME OF PROGRAM Missouri Regional Medical Program GEOGRAPHICAL REGION State of Missouri, exclusive of St. Louis ESTIMATED POPULATION 4, 625, 000 COORDINATING HEADQUARTERS Missouri Regional Medical Program 406 Turner Avenue - Lewis Hall University of Missouri Columbia, Missouri 65201 (Tel.: 314/449-2711) GRANTEE ORGANIZATION University of Missouri School of Medicine EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE April 1, 1967 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $13,038,812 FUNDING FOR CURRENT $5, 303, 871 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Nathan J. Stark ADVISORY GROUP Group Vice President, Operations Hallmark Cards', Inc. 25th and McGee Trafficway Kansas City, Missouri 65108 PROGRAM COORDINATOR *Arthur E. Rikli, M.D., M.P. H. STAFF ASSOCIATE COORDINATOR William C. Allen, M.D., M.P. N. DIRECTOR FOR PLANNING George E. Wakerlin, M.D., Ph.D. ASSOCIATE DIRECTORS FOR PLANNING Yeu-Tsu Lee, M.D. Robert S. Cartwright, M. D. DIRECTOR FOR OPERATIONS Warren P. Sights, M.D. *Chief Executive Officer -116- MISSOURI - II APPROVED OPERATIONAL PROJECTS SMITHVILLE COMMUNITY HEALTH SERVICE PROGRAM Objectives: To establish a model community health service program. Programs include: continuing education training programs and lay health education; emergency, intensive, and restorative care facilities; home care and homemaker program; public health, preventive medicine, and school health programs; voluntary health agency coordination; custodial facilities; vocational rehabfl- itation; family counseling; and cancer detection. COMMUNICATION RESEARCH UNIT Objectives: To provide the NMMP public information office with re- search support; to identify public attitudes, opinions, mis- conceptions, etc. about heart disease, cancer, and stroke, and, in turn, to learn motivations for seeking health care; to determine effective methods for communicating with the public and leading them to seek medical care. MULTIPHASIC TESTING OF AN AMBULANT POPULATION Objectives: To establish centers to perform a series of diagnostic laboratory tests which will identify the most useful tests for separating the ill from the healthy population,. either individually or in patterns. Model centers will be established at the University Medical Center and the State Mental Hospital. A third is planned for the Smithville complex. MASS SCREENING - RADIOLOGY Objectives: To improve the accuracy of radiologic diagnosis of heart disease, cancer and stroke; to evaluate the diagnostic efficiency to various electronic communication media; to determine the applicability of ultra-sound and thermography as screening techniques for neoplastic and vascular diseases. Three hospitals will be connected by appropriate electronic communication systems to the Department of Radiology and Medical Center computer at the University. -117- MISSOURI - M APPROVED OPERATIONAL PROJECTS (Continued) AUTOMATED PATIENT HISTORY Objectives: To investigate the feasibility of an automated system that will provide the physician with (1) a case history and (2) a preliminary analysis of complaints prior to the examina- tion. DATA EVALUATION, COMPUTER SIMULATION AND SYSTEMS DESIGN Objectives: To determine: (1) what data from the general public and physicians are needed to allow early detection of heart disease, cancer, and stroke; (2) what mechanisms are needed to produce these data; and (3) how to extract the necessary information from data and present it in the form of a decision or as a basis for a decision. To evaluate and design the most effective systems. The departments of electronic engineering, statistics, and mathematics will cooperate with the medical staff in this project. COMPUTER FACT BANK Objectives: To develop and apply techniques for delivering the latest information on diagnosis and care of patients with stroke and diseases to the local physicians. An IBM electronic data information storage and retrieval system will be de- veloped at the University Medical Center. A depth index will be created which will allow a single word or concept to recall information stored at upper levels of the hierarchy of data. Students will be taught to use the system. It will later be extended to include St. Louis, Smithville, and other communities. OPERATIONS RESEARCH AND SYSTENZ DESIGN Objectives: To develop operating systems to assist in the objectives of the Regional Medical Program. POPULATION STUDY GROUP SURVEY Objectives: To study the factors contributing to the decision of small town and rural families to utilize health services. The principal relationship to be studied is the influence of the availability of care on the decision to use it. The National Health Survey Questionnaire will be used. -118- MISSOURI - IV APPROVED OPERATIONAL PROJECTS (Continued) AUTOMATED HOSPITAL PATIENT SURVEY Objectives: To use the patient discharge data already collected by the Missouri Hospital Association and tabulated on McBee cards for planning and evaluation of health programs under the Regional Medical Program. PROGRAM EVALUATION CENTER Objectives: To identify two communities which have potential for "grass roots" organization for the implementation of com- munity health service programs; to accumulate data about health care, needs, attitudes, etc. in the communities; to initiate the long term process of developing instruments for measuring quality of care and levels of health in terms of an individuals function in his community. The Center, which is a multidisciplinary research unit, will direct this project. BIOENG@ERING Objectives: To provide technical assistance in the evaluation and de- velopment of sensor-transducers for early detection of heart disease, cancer, and stroke. CENTRAL ADMINISTRATION Objectives: To provide for a staff to assist the Advisory Council and its Subcommittees in overviewing, coordinating, reviewing, and evaluating the program and project proposals. AUTOMATED ELECTROCARDIOGRAPHY IN A RURAL AREA Objectives: To provide hospitals and physicians with an automated system of analyzing electrocardiograms; to demonstrate the feasibility of providing physicians with electrocardio- graphic analysis where this service is limited or non- existent; to demonstrate the feasibility of these systems for regional, inter-regional and national use; to develop, test and implement the usage of bioengineering signals to diagnose cardiovascular, neoplastic and related diseases; to develop usage of automated data analysis to screen populations. -119- MISSOURI - V APPROVED OPERATIONAL PROJECTS (Continued) COMPREHENSIVE CARDIOVASCULAR CARE UNITS - SPRINGFIELD, MISSOURI Objectives: To develop a comprehensive care unit for grouping patients with heart or circulatory disease or who have been ad- mitted for other purposes but require close cardiac ob- servation. The program will be conducted where a house staff is non-existent. It is hoped that this grouping of patients relieves the work load for nurses on general medical and surgical wards and improves the quality and efficiency of care. A COMPUTER ASSEMBLED ON-GOING @NUAL OF MISSOURI MEDICAL AND PARAMEDICAL SERVICES - MISSOURI HEALTH COUNCIL Objectives: To establish a directory of the names, services, and addresses of medical and paramedical services in the entire state of Missouri as a reference source. STROKE INTENSIVE CARE UNIT - UNIVERSITY OF MISSOURI MEDICAL SCHOOL AND HOSPITAL Objectives: To demonstrate appropriate advance care techniques for stroke patients and train nurses and other medical person- nel to use these techniques to evaluate the effect of this type of care on the prognosis of the stroke patient. Follow- up studies and care will be assured by a team of physicians, physical therapists, social workers, etc. TRAINING UNIT FOR INTENSIVE CARE OF THE CARDIAC PATIENT UNIVERSITY OF MISSOURI SCHOOL OF MEDICINE TEACHING HOSPITAL Objectives: To train paramedical personnel in appropriate techniques for intensive care of patients with acute myocardial infarction. PROGRAMMED COMPREHENSIVE CARDIOVASCULAR CARE KANSAS CITY GENERAL HOSPITAL Objectives: To develop, demonstrate, and train in new methodologies of cardiovascular care, stressing the continuity of care planning from onset of a cardiovascular crisis through re- covery and rehabilitation. -120- MISSOURI - VI APPROVED OPERATIONAL PROJECTS (Continued) NORTHEAST MISSOURI COOPERATIVE STROKE PILOT PROJECT - K[RESVILLE CLINIC OF OSTEOPATHY AND SURGERY Objectives: To study and demonstrate how physicians, clinics, and hospitals can cooperate to improve stroke detection, care, and rehabilitation in a rural 5-county area. Cooperative arrangements in the subregion are being developed between M. D. Is and D. 0. Is, local hospitals, and community leaders. COOPERATIVE TUMOR REGISTRY AND COMPUTATION SERVICE LLIS FISCHEL CANCER REGISTRY CENTER, COLUMBIA, MISSOURI Objectives: To raise the quality of cancer diagnosis by strengthening and enlarging an automated network of tumor registries in Missouri. Information collected in each established registry would be transmitted to a centrally located com- puter center. -CORE PLANNING ACTIVITIES Objectives: The MRMP planning staff has responsibility for meetings of the MRMP Advisory Council, Project Review Committee, Liaison Committee and Project Directors: working with groups in the Region on initiation and development of pilot project proposals; preparing MRMP operational grant applications; professional and public relations; facilitating inter-regional arrangements; and preparing and up-dating the MRMP plan. Three separate staff units are involved. Central Administration, Program Evaluation Center for developing evaluation methodology, and Kansas City plan- ning at Kansas General Hospital. In past years these activities were funded by Grant # GOZ RM 00009. In addi- tion, consultants in Springfield and Jackson are coordinat- ing planning for those areas. MISSOURI - VII APPROVED OPERATIONAL PROJECTS (Continued) EFFECTIVENESS OF THE "DETAIL MAN" APPROACH IN DISSEMM- TION OF INFORMATION TO PHYSICIANS Objectives: In an attempt to effect a reduction in incidence of rheu- matic heart disease, a "detail man" from the Missouri Heart Association will call on 1, 311 medical and osteo- pathic physicians in general practice, pediatrics, internal medicine and cardiology, outside metropolitan St. Louis and Kansas City, to provide information about, and enlist involvement in the primary and secondary prevention pro- grams of the state Division of Health. Follow-up calls will be made six months later to the first 262 physicians reached (200/o), to check on use and obtain suggestions on the service. A third follow-up is also planned. Evalua- tion will be based on use of either or both the primary pre- vention service (Fluorescent Antibody Technique for identi- fication of beta-hemolytic streptococcus) and the secondary prevention service (registry, follow-up and low cost prophylactic drug distribution). CONTINUING EDUCATION FOR THE HEALTH PROFESSIONS Objectives: It is proposed to establish, over a three-year period, a dedicated telephone communication system for education between the medical center and 100 community locations. Half-hour telelectures followed by a half-hour question, answer and discussion periods are now being tested in ten locations and will be programmed for physicians, nurses, physical therapists, occupational therapists, medical and radiologic technologists, and others. Records and visual materials of the presentations will be made available to the community hospital as permanent library resources. This proposal is part of a long-range plan to expand patient- centered continuing education for the health professions in the Region. COMMUNITY SERVICES FOR HEART DISEASE, CANCER AND STROKE PATIENTS Objectives: This project supports the last year of a three-year project to develop a Kansas City area-wide comprehensive plan for the establishment, extension and coordination of community service for heart disease, cancer, stroke and related dis- eases, and to extend the Information and Referral Service of the Kansas City Regional Health and Welfare Council to persons and families affected by these diseases. Support for the first two years was through a grant from the PHS Division of Chronic Diseases. -122- MISSOURI - VIII APPROVED OPERATIONAL PROJECTS (Continued) MISSOURI CERVICAL CYTOLOGY PROJECT Objectives: This is a project to demonstrate the use of the self-obtained irrigation smear technique in early detection of cervical cancer. Women will be enrolled in the project through an intensive educational campaign utilizing mass media. Evaluationwill be based on the numberof women reached for the first time, the number of positive and suspicious find- ings, follow-up results, and study of the increased number of "Pap smears. 11 ESTABLISHMENT OF SOUTHEAST MISSOURI RADIOISOTOPE CANCER PROGRAM WITH SATELLITE FACILITIES Objectives: Establishes a complete Isotope Laboratory at St. Francis Hospital in Cape Girardeau, to bring to Southeast Missouri, procedures and specialized equipment not now available to aid in cancer diagnosis and therapy and management of cardiovascular diseases. Training for physicians and tech- nical personnel is requested. During the second year, three satellite isotope laboratories will be established in smaller institutions near Cape Girardeau and in the third year, four more. The satellite facilities will be under direct super- vision of St. Francis laboratory which will also be re- sponsible for training the technical personnel. HOMEMAKER - HOME HEALTH AIDE PROJECT - GREEN COUNTY Objectives: Extends a new type of home care service for patients with heart disease, cancer, or stroke. A minimum of 24 indi- viduals would be trained each year to perform both home- maker" functions of cleaning, marketing and child care and "home health aide" functions relating to personal care of patients. Traditionally, these services have been performed by two individuals but a pilot project indicates the functions can be combined. The Visiting Nurses Association would administer the project with assistance from the Missouri University Extension Service, Burge Hospital staff in Springfield, the County Medical Society and others. Fees for service will be collected and proceeds applied to ad- ministration of the service. -123- MISSOURI - IX APPROVED OPERATIONAL PROJECTS (Continued) A SCHOOL HEART SOUND SCREENING PROGRAM, USING THE PHONOCARDIOSCAN, ON A DEMONSTRATION BASIS Objectives: Under sponsorship of Missouri Heart Association, program plans to do heart sound screening, using an analog-digital computer on a demonstration basis in seven cities, as well as in a number of smaller outlying communities, to detect possible previously unsuspected heart diseases in children in these communities and to attempt to compare the per- centage of undetected heart disease in children in the more metropolitan areas as compared to the rural areas of the state. -124- MOUNTAIN STATES - I NAME OF PROGRAM Mountain States Regional Medical Program GEOGRAPHICAL REGION States of Idaho, Montana, Nevada, and Wyoming ESTIMATED POPULATION z,i6o,ooo COORDINATING HEADQUARTERS Mountain States Regional Medical Program 525 West Jefferson Street Boise, Idaho 83702 (Tel. : Z08/342-4666) GRANTEE ORGANIZATION Western Interstate Commission for Higher Education EFFECTRVE STARTING DATE November 1, 1966 OF PLANNING ACTRVITIES EFFECTRVE STARTING DATE March 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $3,679,96Z FUNDING FOR CURRENT $1,583,653 YEARIS ACTRVITIES CHAIRMAN, REGIONAL Charles A. Terhune, M.D. ADVISORY GROUP 1341 Overland Avenue Burley, Idaho 83381 PROGRAM COORDINATOR Kevin P. Bunnell, Ed. D. Associate Director Western Interstate Commission for Higher Education Post Office Drawer "pit Boulder, Colorado 80302 (Tel. : 303/449-3333) STAFF PROGRAM DIRECTOR *Alfred M. Popma, M.D. COORDINATOR FOR OPERATIONAL PROGRAMS John W. Gerdes, Ph.D. STATE DIRECTORS IDAHO David M. Barton, M.D. 310 Idaho Street Boise, Idaho 83702 *Chief Executive Officer -125- 356-998 0-69-9 MOUNTAIN STATES"' H STAFF (Continued) STATE DIRECTORS (Continued) MONTANA Sidney C. Pratt, M.D. Post Office Box 2829 Great Falls, Montana 59401 NEVADA Lorne M. Phillips, M.D. 956 Willow Street Reno, Nevada 89502 WYOMING Claude 0. Grizzle, M.D. 3100 Henderson Drive, Suite 14 Cheyenne, Wyoming 82001 -126- MOUNTAIN STATES - ][II APPROVED OPERATIONAL PROJECTS CORE ADMINISTRATION, ADVANCED PLANNING AND EVALUATION Objectives: Will provide for continued program planning and transition into programs to meet the established needs, both at the state as well as regional levels. The regional office will continue to coordinate programs and plan for their extension, and also link activities in each state with similar efforts in other MS/RMP states and in other Regional Medical Program s. INTENSIVE CORONARY CARE IN SMALL HOSPITALS Objectives: To provide intensive coronary care throughout the Montana, Wyoming, Nevada and Idaho Mountain States. A Center in Missoula, Montana, trains physicians and nurses to staff in- tensive coronary care units. Eventually there will be centers in all states in the Region. DIAGNOSTIC, TREATMENT AND EDUCATIONAL PROGRAM TO IMPROVE CARE OF CANCER PATIENTS Objectives: Will develop a regional cancer diagnostic and treatment resource--well organized, well staffed and well equipped-- and will provide a concurrent, intensive and continuous cancer educational program for medical, dental and para- medical personnel, for patients, their families and the general public. This will be accomplished through develop- ment of the Mountain States Tumor Institutes in Boise, Idaho, as a subsidiary of St. @ke's Hospital in Boise. PROGRAM TO PROVIDE CONTINUING EDUCATION TO ALL HEALTH PROFESSIONAI-S IN MONTANA AND ADJACENT AREAS OF THE MOUNTAIN STATES REGION* Objectives: Will provide (a) intraprofessional continuing education pro- grams; (b) interprofessional continuing education programs; (c) promote interprofessional communication arnong-all health professionals so the multiprofessional approach to patient care can be maximized; and (d) provide an ongoing evaluation system to assess the effectiveness and efficiency of programs that are developed. *Approved but not funded -127- MOUNTAIN STATES - IV APPROVED OPERATIONAL PROJECTS (Continued) WICHE/MOUNTAIN STATES REGIONAL MEDICAL PROGRAM ROCKY MOUNTAIN TUMOR REGISTRY* Objectives: To give direct assistance to the physician who is treating the cancer patient, providing him with actual patient data for as long as a particular case requires it and better comparative planning data. This is a proposal shared by three RMP's--Colorado-Wyoming, Intermountain and WICHE/Mountain States-covering six states: Colorado, Wyoming, Montana, Idaho, Utah, Nevada. *Approved but not funded -128- NASSAU-SUFFOLK NAME OF PROGRAM Nassau-Suffolk Regional Medical Program GEOGRAPHICAL REGION Counties of Nassau and Suffolk (Long Island, New York) ESTIMATED POPULATION 2, 450, 000 COORDINATING HEADQUARTERS Nassau-Suffolk Regional Medical Program, Inc. Health Sciences Center State University of New York Stony Brook, New York 11790 (Tel. : 516/246-7081) GRANTEE ORGANIZATION Nassau-Suffolk Regional Medical Program, Inc. EFFECTIVE STARTING DATE January 1, 1969 OF PLANNING ACTIVITI]ES TOTAL FUNDING TO DATE -$233, ?.56 FUNDING FOR CURRENT $233,256 YEARIS ACTIVITIES CHAIRMAN, REGIONAL SigmundA. Wesolowski, M.D. ADVISORY GROUP Mercy Hospital 1000 North Village Avenue Rockville Centre, New York 11570 SECRETARY, REGIONAL Frank J. Gibson ADVISORY GROUP- Box 344 Aqueboque, New York 11931 PROGRAM COORDINATOR *Glen E. Hastings, M.D. -129- NEBRASKA-SOUTH DAKOTA I NAME OF PROGRAM Nebrask-a-South Dakota Regional Medical Program GEOGRAPHICAL REGION States of Nebraska and South Dakota ESTIMATED POPULATION 2, 0 95, 000 COORDINATING HEADQUARTERS Nebraska-South Dakota Regional Medical Program 1408 Sharp Building Lincoln, Nebraska 68508 (Tel.: 402/432-2825) GRANTEE ORGANIZATION Nebraska State Medical Association EFFECTIEVE STARTING DATE January 1, 1967 OF PLANNING ACTRVITIES TOTAL FUNDING TO DATE $1, 066, 532 FUNDING FOR CURRENT $51 i, zo6 YEARIS ACTRVITIES CHAIRMAN, REGIONAL Robert Quinn, M.D. ADVISORY GROUP President, South Dakota State Medical Association 1320 South Minnesota Avenue Sioux Falls, South Dakota 57105 PROGRAM COORDINATOR *Harold S. Morgan, M. D. STAFF ADMINISTRATRVE ASSISTANT TO COORDINATOR'AND DIRECTOR OF INFORMATION Darrel D. Buettow PROJECT ADMINISTRATOR, OPERATIONS AND EVALUATION FOR CONTINUING EDUCATION George L. Morris, Jr., Ed. D. PROJECT ADMINISTRATOR, CORONARY CARE PROGRAM AND STAFF COORDINATOR FOR HEART DISEASE Deane S. Marcy, M.D. *Chief Executive Officer -130- NEBRASKA-SOUTH DAKOTA - II STAFF (Continued) ASSOCIATE COORDINATOR AND PLANNING DIRECTOR, UNIVERSITY OF NEBRASKA AND STAFF COORDI- NATOR FOR CANCER J. P. Tollman, M. D University of Nebras@a College of Medicine 42nd and Dewey Avenue Omaha, Nebraska 68105 ASSISTANT TO PLANNING DIRECTOR, UNIVERSITY OF NEBRASKA AND STAFF COORDINATOR FOR STROKE Sally A. Chapple PLANNING DIRECTOR, CREIGHTON UNIVERSITY John B. Hermann Creighton University School of Medicine 657 North 27th Street Omaha, Nebraska 68131 .ASSISTANT TO PLANNING DIRECTOR, CREIGHTON UNIVERSITY AND STAFF COORDINATOR FOR CONTINUING EDUCATION Harriet DeLapp ASSOCIATE COORDINATOR - SOUTH DAKOTA AND STAFF COORDINATOR FOR MANPOWER Robert H. Hayes, M.D. Nebraska-South Dakota Regional Medical Program 216 East Clark Vermillion, South Dakota 57069 PLANNING DIRECTOR FOR NURSING Therese Schwab, R. N. Nebraska-South Dakota Regional Medical Program 216 East Clark Vermillion, South Dakota 57069 FISCAL ADMINISTRATOR Kenneth E. Neff Executive Secretary Nebraska State Medical Association 1315 Sharp Building Lincoln, Nebraska 68508 ASSISTANT TO FISCAL ADMINIS- TRATOR William 4 Schellpeper -131- NEW JERSEY - I NAME OF PROGRAM New Jersey Regional Medical Program GEOGRAPHICAL REGION State of New Jersey ESTIMATED POPULATION 7, 093, 000 COORDINATING HEADQUARTERS New Jersey Regional Medical Program 88 Ross Street East Orange, New Jersey 07018 (Tei. : Zol/674-7270) GRANTEE ORGANIZATION New Jersey Joint Committee for Implementation of Public Law 89-239 EFFECTRVE STARTING DATE July 1, 1967 Ul,'.PL,AN EFFECTIVE STARTING DATE April 1, 1969 OF OPERAT TOTAL FUNDING T DATE $1, 400, 108 FUNDING FOR CURRENT $501, 055 YEARIS ACT ITIES CHAIRMAN, REGIONAL Richard J. Gross, M.D. Professor of Medicine and Associate Dean Rutgers Medical School New Brunswick, New Jersey 08903 PROGRAM COORDINATOR *Alvin A. Florin, M.D., M.P. H. STAFF ASSISTANT COORDINATOR James P. Harkness, Ph. D. DEPUTY COORDINATORS PHYSICIAN EDUCATION James A. Rogers, M.D. PROGRAM ACTIVITIES Marvin H. Burton, M. A., M. P. H. COMMUNICATIONS Frederick A. Botting *Ch ef Executive Officer -132- NEW JERSEY - II APPROVED OPERATIONAL PROJECTS NURSE TRAINING IN CORONARY CARE - HACKENSACK HOSPITAL Objectives: To provide three training courses in intensive coronary care for a total of 60 nurses, 20 per each three-week course. Individualized clinical practice is scheduled for the trainees in coronary care units in several hospitals of the region, under the supervision of the core faculty from Hackensack Hospital. A regional advisory group is organized to provide medical consultation and direction as well as nursing and educational consultation for achievement of objectives and evaluation of the program. NURSES TRAINING IN CORONARY CARE - RUTGERS-COOPER HOSPITAL Objectives: To establish a new intensive coronary care training program for nurses in hospitals in the southern region of the state, under the direction of Rutgers University Department of Continuing Education for Nurses. Training courses of four weeks each will be held for 32 nurses, eight per course, at Cooper Hospital in Camden, New Jersey. A cooperative faculty of medical and nursing personnel has been organized under the educational direction of the University and medical direction by Cooper Hospital. CORONARY CARE TRAINING FOR NURSES - NEWARK BETH ISRAEL MEDICAL CENTER Objectives: To provide three 4-week training courses for 60 nurses from hospitals in the most populated regions of the state at Newark Beth Israel Medical Center in Essex County. Upon return to the employing hospital, each nurse-trainee will be visited by a traveling team of physicans and nurses to assist in adapt- ing new knowledge and skills and offer consultation to the coronary care team. A one-day follow-up refresher course will be held for those nurses completing the program. STATEWIDE PROGRAM IN EXTERNAL CARDIOPULMONARY RE- SUSCITATION Objectives: ToprovideAmericanHeartAssociationapprovedtraining in ECPR technique for physicians, dentists, nurses and otheralliedhealthpersonnel, lifeguards, physicaleducation teachers, policeandfirepersonnel, andhigh-riskindustry personnel. Fourtrainingcenterswillbeestablishedin community hospitals throughout the state for the preparation ofmultidisciplinaryteachingteams. Twenty-oneteamswill conduct 42 courses to train 1, 260 persons. -133- NEW JERSEY - III APPROVED OPERATIONAL PROJECTS (Continued) TRAINING PROGRAM IN SELECTIVE CORONARY CINEANGIOGRAPHY Objectives: To provide training for four cardiologists and/or cardio- vascular surgeons in the performance of coronary cineangio- graphy and in the interpretation of cineangiograms and bi- plane views of the coronary arteries. Two courses will be conducted for two physicians at a time. Trainees will be given full hospital privileges and will spend one fall day or two half-days in training each week over a six-month period. In addition, a traveling consultant team will be provided to help any New Jersey Hospital with problems in this field. EVALUATION OF THE STATUS OF IMPLANTED PACEMAKERS Objectives: To develop improved methods for the prediction of implanted pacemaker failure, thereby avoiding emergency replacement. Facilities of the Pacemaker Clinic at the Newark Beth Israel Medical Center Institute will be extended to an esti- mated 750 New Jersey patients with implanted pacemakers. Each patient, referred by his physician, will be examined every two months for evaluation of pacemaker status. Com- puter techniques will be utilized in the evaluation. ESTABLISHMENT OF TUMOR CONFERENCE BOARDS IN NEW JERSEY Objectives: To encourage and assist in the establishment and upgrading of tumor conference boards in community hospitals through- out New Jersey with the purpose of improving the quality of diagnosis and treatment of cancer and strengthening the con- tinuing education of physicians. Traveling tumor conference teams will be drawn from hospitals with outstanding cancer programs to provide the consultation in tumor board organi- zation and operation. In addition to consultation teams, the project will provide audio-visual equipment for participating hospitals, with shared funding; stipends for physicians attend- ing a two-week training course at Memorial Sloan-Kettering Cancer Center; and an annual regional one-day symposium on cancer diagnosis and therapy. -134- NEW JERSEY - rV APPROVED OPERATIONAL PROJECTS (Continued) MEDICAL TAPES BY TELEPHONE Objectives: To provide readily accessible, up-to-date information on diagnosis and treatment of heart disease, cancer, stroke, and related diseases to practicing physicians by establish- ing a library of 4-6 minute, pre-recorded tapes which are transmitted by telephone. The tape library is housed at a physicians' telephone answering service. Most tapes are producedby New Jersey physicians. The subject matter of tapes most frequently requested will be considered in the development of physician continuing education programs. HEMODIALYSIS TRAINING PROGRAM Objectives: To train physicians, nurses and technicians in the skills and procedures of hemodialysis at Newark Beth Israel Medical Center Institute. Intensive training will be provided for six physicians, three per course, to prepare them for directing hemodialysis programs in their own hospitals. Twelve nurses will receive training in nursing procedures in a four- week course, four per course. Twelve technicians will be trained in four-week courses, four students per course. Three-day orientation will be provided for physicians at- tending hemodialysis patients, and five-day orientation on home-care dialysis will be provided to ten visiting nurses. Consultation will be available to trainees concerning es- tablishment of their hemodialysis units in their respective hospitals. An advisory committee will evaluate effective- ness of the training and the need for additional training centers. -135- NEW MEXICO - I NAME OF PROGRAM New Mexico Regional Medical Program GEOGRAPHICAL REGION State of New Mexico ESTIMATED POPULATION 1, oo6, ooo COORDINATING HEADQUARTERS New Mexico Regional Medical Program University of New Mexico Medical School 920 Stanford Drive, Northeast - Building 3-A Albuquerque, New Mexico 87106 (Tel. : 505/277-3434) GRANTEE ORGANIZATION The University of New Mexico EFFECTIVE STARTING DATE October 1, 1966 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE July 1, 1968 OF OPERATIONAL ACTRVITEES TOTAL FUNDING TO DATE $1, 730, 944 FUNDING FOR CURRENT $1, 1'72,160 YEARIS ACTRVITIES CHAIRMAN, REGIONAL Hugh B. Woodward, M.D. ADVISORY GROUP 200 Oak Street, Northeast Albuquerque, New Mexico 87106 PROGRAM COORDINATOR *Reginald H. Fitz, M.D. STAFF ASSISTANTS TO THE DIRECTOR ADMINISTRATION William Weeks HEART Loyal L. Conrad, K D. CANCER Charles R. Key, M.D. STROKE Lauren Welch, M.D. RELATED DISEASE L E. Hendryson, M.D. EDUCATION G. M. Boyden, M. D. (Acting) *Chief Executive Officer -136- NEW MEXICO II STAFF (Continued) EVALUATION AND DESIGN R. 0. Oseasohn, M.D. PROJECT EVALUATION @rvin Chatkoff PARAMEDICAL EDUCATION SPECIALIST (Mrs.) Elizabeth Barnett NURSING EDUCATION SPECIALIST (Miss) Mary C.' Pozorski DIRECTOR OF REGISTRIES (Mrs) Dorothy Brylinski -137- NEW MEXICO III APPROVED OPERATIONAL PROJECTS MODEL CORONARY CARE UNIT Objectives: Training program for practitioners, house staff, and physician assistants, and for communities seeking advice on Coronary Care Units. TRAINING COURSE IN CORONARY CARE UNIT NURSING Objectives: Will provide pertinent training for registered nurses. TRAINING PROGRAM - LABORATORY SCIENCES IN ALLIED HEALTH PROFESSIONS Objectives: Will establish a unified training program in clinical labora- tory science at the University of New Mexico School of Medicine, to improve the laboratory capabilities of medical facilities in the state. STROIKE PROGRAM Objectives.- Will establish a model for comprehensive care and rehabi.1- itation of patients with vascular diseases, including con- tinuing education for medical, paramedical and lay per- sonnel. RELATED DISEASES (EMERGENCY HEALTH SERVICES) Objectives: Will establish an Emergency Medical Services Council to coordinate and develop a system to improve such services. EDUCATIONAL PROGRAMS Objectives: Will attempt to relate medical school resources with local health information needs by means of programs in com- munity hospitals which will reach about 750/o of the region's physicians. HEALTH INFORMATION AND COMMUNICATION Objectives: Will establish a regional Health Science Information Center and Communication Network to provide consultation ser- vices, training programs and literature support to health science libraries in the region. -138- NEW MEXICO IV APPROVED OPERATIONAL PROJECTS (Continued) PEDIATRIC PULMONARY CENTER (LOVELACE CLINIC) Objectives: Will establish a model for providing the region with special diagnostic and therapeutic competence, as well as social services, for the management of children with chronic non- tuberculosis respiratory disease. CORE SUPPORT Objectives: For core administrative and planning staff, equipment, supplies, alterations and renovations for central core activities. CARDIOPULMONARY EVALUATION LABORATORY, ST. VINCENTIS HOSPITAL, SANTA FE, NEW MEXICO Objectives: This would be the sole such laboratory serving northern New- Mexico. The laboratory would be designed to prevent, diagnose, and assist in the rehabilitation of patients with cardiopulmonary disease, referred from private physicians and state health and welfare agencies. -139- NEWYORK METROPOLITAN -I NAME OF PROGRAM New York Metropolitan Regional Medical Program GEOGRAPHICAL REGION New York City and Westchester County, New York ESTIMATED POPULATION 8,940,000 COORDINATING HEADQUARTERS New York Metropolitan Regional Medical Program 2 East 103rd Street New York, New York 10029 (Tel.: 212/427-4100) GRANTEE ORGANIZATION Associated Medical Schools of Greater New York EFFECTRVE STARTING DATE June 1, 1967 OF PLA TOTAL FUNDING TO DATE $2,189,935 FUNDING FOR CURRENT $1,480,826 YEARIS ACTRVITEES CHAIRMAN, REGIONAL J. Frederick Eagle, M.D. ADVISORY GROUP President, Associated Medical Schools of Greater New York 2 East 103rd Street New York, New York 10029 PROGRAM DIRECTOR '-L Jay Brightman, M.D. STAFF ASSISTANT DIRECTORS FOR PROGRAM DEVELOPMENT Bruce D. Bennett FOR ADMINISTRATION Walter H. Gelby SPECIAL ASSISTANT FOR COMMUNICATIONS Frederica Brooks CHIEF OF RESEARCH AND EVALUA- TION Peter M. Marano PROGRAM REPRESENTATIVES Rose Heifetz Margaret Barnett Allen Fite Lucie Benedikt ADMINISTRATIVE ASSISTANT Josephine Kopetzky *Chief Executive Officer -140- .NORTH CAROLINA I NAME OF PROGRAM North Carolina Regional Medical Program GEOGRAPHICAL REGION State of North Carolina EST@TED POPULATION 5, 122, 000 COORDINATING HEADQUARTERS Association for the North Carolina Regional Medical Program 4019 North Roxboro Road Durham, North Carolina 27704 (Tel. : 919/477-0461) GRANTEE ORGANIZATION Duke University EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACTIVITIES EFFECTRVE STARTING DATE March 1, 1968 OF OPERATIONAL ACTrVITi-ES TOTAL FUNDING TO DATE $2, 797, 310 FUNDING FOR CURRENT $1, 799, 654 YEARIS ACTRVITIES CHAIRMAN, REGIONAL George W. Paschal, Jr., M.D. ADVISORY GROUP Past President, Medical Society of State of North Carolina I 1 10 Wake Forest Road Raleigh, North Carolina 27604 PROGRAM COORDINATOR *Marc J. Musser, M.D. STAFF DIRECTOR, RESEARCH AND EVALUA- TION DIVISION Harvey L. Smith, Ph.D. Miller Hall University of North Carolina Chapel Hill, North Carolina 27514 DIRECTOR, CANCER PROGRAM M. Simmons Patterson, M. D. DERECTOR, STROKE PROGRAM B. Lionel Truscott, M. D. C-5 Castle Towers Beech and Grove Park Avenue Winston-Salem, North Carolina 27103 *Chief Executive Officer -141- 356-998 0-69-10 NORTH CAROL@ H STAFF (Continued) DIRECTOR, EDUCATION AND TRAINING PROGRAM William DeMaria, ZvL D. Baker House Duke Medical Center Durham, North Carolina 27706 DIRECTOR, ADMINISTRATRVE SERVICES DIVISION William J. McComb, F. A. C. H. A. DIRECTOR, HOSPITALS DIVISION William W. Lowrance, F. A. C. H. Tk. President, North Carolina Hospital Association DIRECTOR, COMMUNICATIONS AND INFORMATION DRVISION V rginia H. Benton, B.A. ASSOCIATE DERECTORS PROGRAM DEVELOPMENT Lydia S. Holley, M. P. H. 9 R. P. T. EDUCATION AND TRAINING PROGRAM Audrey J. Booth, R.N., M.S. INSTITUTIONAL COORDINATORS E. Harvey Estes, Jr., M.D. Duke University Medical Center Durham, North Carolina 27706 Louis DeS. Shaffner, NL D. Bowman Gray School of Medicine Winston-Salem, North Carol' 27103 Robert @ Smith, M.D. School of Medicine University of North Carolina Chapel Hill, North Carolina 27514 Herman A. Tyroler, NL D. School of Public Health University of North Carolina Chapel Hill, North Carolina 27514 -142- NORTH CAROLINA - III APPROVED OPERATIONAL PROJECTS EDUCATION AND RESEARCH IN COMMUNITY MEDICAL CARE Objectives: To assign responsibility for developing cooperative arrange- ments between hospitals and communities and medical cen- ters to the existing Division of Education and Research in Community Medical Care of the University of North Carolina. Specific projects in both rural and urban areas have been developed through support from other sources than Regional Medical Programs. This RMP project will complement and expand efforts to improve medical care administration, health service planning, and resource development. Regional Medical Programs will support area wide planning, transportation, continuing education through TV, etc. CORONARY CARE TRAINING AND DEVELOPMENT Objectives: To use the project as a medium for developing cooperative arrangements among the various elements in the health care community. Initial and continuing education will be pro- vided to nurses and physicians, consultation will be availa- ble to hospitals in establishing Coronary Care Units and a computer-based system of medical record keeping will be developed. DIABETIC CONSULTATION AND EDUCATIONAL SERVICES Objectives: To establish three medical teams to deliver services throughout the state; to assist in expansion of diabetic con- sultations and teaching clinics; to provide seminars for physicians and teaching sessions for nurses and patients to assist in organization of a state Diabetes Association and local chapters; to test techniques of data collection. DEVELOPMENT OF A CENTRAL CANCER REGISTRY Objectives: To devise a uniform re gion-wide cancer reporting system, integrated with the PAS, the computer-stored data from which can be retrieved to serve a broad range of educa- tional, research, statistical, and other purposes. -143- NORTH CAROLINA - IV APPROVED OPERATIONAL PROJECTS (Continued) MEDICAL LIBRARY EXTENSION SERVICE Objectives: To bring medical library facilities of the three medical schools into the daily work of those engaged in medical practice. Local hospital personnel will be trained to assist medical staff; libraries will be organized into a functional unit for responding to requests for services; a bibliographic request service will be established. CANCER INFORMATION CENTER Objectives: To provide practicing physicians with immediate consulta- tion by telephone and follow-up literature. Each of the three medical schools will be responsible for providing service in its geographic locale. CONTINUING EDUCATION IN INTERNAL MEDICINE Objectives: To bring practicing internists to the Medical Center for a month of up-to-date training in their subspecialities. They will share responsibilities with attending physicians and make ward rounds with students, staff, and together. CONTINUING EDUCATION IN DENTISTRY Objectives: To provide physicians and dentists with the knowledge of mutual concern which will enable them to be more effective members of the health team. Courses will be given at the University of North Carolina and in communities. Studies will be made of facilities needed to provide dental care in hospitals. CONTINUATION EDUCATION FOR PHYSICAL THERAPISTS Objectives: To develop and establish continuing education for physical therapists. Subregions will be delineated where needs and interests will be identified and committees will be organized to arrange local activities. -144- NORTH CAROLINA - V APPROVED OPERATIONAL PROJECTS (Continued) STATE OF FRANKLIN CORONARY CARE DEMONSTRATION PROJECT Objectives: Will attempt to show the feasibility of establishing a network of coronary care units in small hospitals (50 - 154 beds) in the rural Appalachian area of North Carolina. The physician serving as a unit director and the unit nurses will be inten- sively trained. An analytical study of unit effectiveness will be conducted. MOBILE CARDIAC INTENSRVE CARE CAPABILITY IN APPALACHIA (Feasibility Study) Objectives: To evaluate the impact of Intensive Coronary Care ambu- lances on immediate survival in acute myocardial infarction. Two ambulances will be specially equipped and Rescue Squad drivers will be appropriately trained. Eight physi- cians will provide voluntary assistance. CLOSED CHEST CARDIOPULMONARY RESUSCITATION UNIT Objectives: The project is co-sponsored by the North Carolina Heart Association, which will assign staff members. It is pro- posed to,initiate a Regional Cardiopulmonary Resuscitation Program to make this technique known and available through- out the Region. A survey will establish the present state of training and the need for further training, A regional train- ing facility will be developed and the appointment of local CPR hospital coordinators will be encouraged. HEART CONSULTATION AND EDUCATION PROGRAM Objectives: In order to bring latest techniques and research findings to the developing network of coronary care units, a monthly consultation-education clinic will be initiated at the Memorial Mission Hospital in Asheville. The project rep- resents a cooperative arrangement between the hospital and the Bowman Gray School of Medicine. It will provide a training base for the ItState of Franklin" Coronary Care Unit project, funded in the initial operational award. -145- NORTH CAROLINA - VI APPROVED OPERATIONAL PROJECTS (Continued) COMPREHENSIVE STROKE PROGRAM Objectives: Community development of comprehensive stroke programs will be encouraged through a central coordinating unit at Bowman Gray School of Medicine. Activities will be: publication of guidelines for community stroke programs, arranging educational activities such as training programs for nurses, conducting an annual stroke workshop, and developing a family-patient education unit. The latter is a demonstration project to show the usefulness of modern teaching devices in helping patients and their families learn to cope with the long-term effects of stroke disability. HYPERTENSION Objectives: To explore the means of making available the best of modern diagnostic and therapeutic measures to the patients with hypertension in the Region. ADMINISTRATION, RESEARCH, AND EVALUATION Objectives: To provide for a staff for overviewing, coordinating, re- viewing and evaluating the program. NORTH CAROLINA TUMOR TISSUE REGISTRY* Objectives: The Moses H. Cone Memorial Hospital, Greensboro, North Carolina, proposes to establish a tumor tissue registry, directly tied to the North Carolina Regional Medical Program Central registry. BOWMAN GRAY CORONARY CARE DEMONSTRATION UNIT Objectives: To establish a model unit in a medical center setting to augment existing teaching facilities for training physicians, nurses and other personnel in coronary care unit procedures. This teaching-demonstration unit will provide a resource in consultation capability to assist in the development of coronary care units and continuing education in small com- munities and remote hospitals cooperating with the Bowman Gray School of Medicine for these purposes. *Approved but not funded -146- NORTH CAROLINA - VU APPROVED OPERATIONAL PROJECTS (Continued) TROPHOBLASTIC CANCER PROJECT* Objectives: To enable the development of a radioimmunoassay for human chorionic gonadotropin (HCG) in the Southeastern Regional Center for Gestational Trophoblastic Neoplasms located at Duke University and which serves primarily in addition to North Carolina, the states of Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, South Carolina, Tennessee, Virginia and West Virginia. *Approved but not funded -147- NORTH DAKOTA - I NAME OF PROGRAM North Dakota Regional Medical Program GEOGRAPHICAL REGION State of North Dakota ESTE"TED POPULATION 627, 000 COORDINATING HEADQUARTERS North Dakota Regional Medical Program University of North Dakota 1600 University Avenue Grand Forks, North Dakota 58201 (Tel.: 701/77Z-5961) GRANTEE ORGANIZATION North Dakota Medical Research Founda- tion EFFECTIVE STARTING DATE July 1, 1967 OF PLANNING GRANT TOTAL FUNDING TO DATE $z67,777 FUNDING FOR CURRENT $192, 96o YEARIS ACTRVITIES CHAIRMAN, REGIONAL Lee A. Christoferson, M.D. ADVISORY GROUP The Neuropsychiatric Jnstitute Post Office Box 32 Fargo, North Dakota 581OZ PROGRAM COORDINATOR Theodore H. Harwood, M. D. Dean, School of Medicine University of North Dakota Grand Forks, North Dakota 58201 STAFF PROGRAM DIRECTOR *Willard A. Wright, M. D. ASSISTANT PROGRAM DIRECTORS CONTINUING EDUCATION ALLIED HEALTH PERSONNEL (Mrs. ) Lorraine Parker CONTINUING EDUCATION FOR PHYSICIANS J. 1. Pennington PLANS AND PROGRAMS John A. Grim COMPUTER SERVICES Conrad Dietz *Chief Executive Officer -148- NORTHEAST OHIO NAME OF PROGRAM Northeast Ohio Regional Medical Program GEOGRAPHICAL REGION 12 Counties in Northeast Ohio ESTIMATED POPULATION 4,170,000 COORDINATING HEADQUARTERS Northeast Ohio Regional Medical Program 10205 Carnegie Avenue Cleveland, Ohio 44106 (Tel. : 216/368-4626) GRANTEE ORGANIZATION Northeast Ohio Regional Medical Program, Inc. EFFECTIVE STARTING DATE January 1, 1968 OF PLANNING ACTRVITIES TOTAL FUNDING TO DATE $285,783 ,FUNDING FOR CURRENT $285,783 YEARIS ACTIVITIES CHAERMAN, REGIONAL Charles L. Hudson, M.D. kDVISORY GROUP The Cleveland Clinic 2020 East Ninety-third Street Cleveland, Ohio 44106 CHAIRMAN, BOARD OF Frederick C. Robbins, M. D. TRUSTEES Dean, School of Medicine Case Western Reserve University 2107 Adelbert Road Cleveland, Ohio 44106 PROGRAM COORDINATOR- *Barry Decker, M. D. STAFF ASSISTANT DIRECTORS (Miss) Mary Lou Harrison Hiram H. Nickerson (Mrs.) Mary P. Wheeler (Mrs.) Martha E. McCrary DIRECTOR OF EDUCATION Eugene B. Johnson DIRECTOR OF RESEARCH AND EVALUATION James T. Suter *Chief Executive Officer -149- NORTHEAST OHIO - II STAFF (Continued) DIRECTOR OF ADMINISTRATION AND COMMUNICATIONS Richard C. Meloy DIRECTOR OF PUBLIC EDUCATION Lowell Bernard -150- NORTHERN NEW ENGLAND - I NAME OF PROGRAM Northern New England Regional Medical Program GEOGRAPHICAL REGION Vermont and three counties in North- eastern New York EST@TED POPULATION 425, 000 COORDINATING HEADQUARTERS Northern New England Regional Medical Program University of Vermont College of Medicine 25 Colchester Avenue Burlington, Vermont 05401 (Tel. : 802/864-4511, ext. 777) GRANTEE ORGANIZATION University of Vermont College of Medicine EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE May 1, 1969 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $2,343,090 FUNDING FOR CURRENT $972,053 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Edward C. Andrews, M.D. ADVISORY GROUP Dean, College of Medicine University of Vermont Given Building Burlington, Vermont 05401 PROGRAM DIRECTOR *John E. Wennberg, M.D. ASSISTANT TO DIRECTOR Helen Brink PROJECT MANAGER William Wrighton PROJECT MANAGER Caryl Stewart BUSINESS MANAGER, PROJECT MANAGER Darwin G. Merrill PROJECT MANAGER, -PROGRESSIVE CORONARY CARE David Wagner *Chief Executive Officer -151- NORTHERN NEW ENGLAND - II STAFF (Continued) PROJECT ENGINEER Peter Watts COORDINATOR, CONNECTICUT VALLEY HEALTH COMPACT Eigil deneergaard COORDINATOR, PLANNING AND EVALUATION Jeanette Forsyth, Ph. D. INSTRUCTOR,, CORONARY CARE UNIT Marjorie Porter CARDIOLOGIST Otto Brusis, M.D. COMPUTER PROGRAMMER John Senning MATHEMATICIAN David Odle TECHNOLOGIST Karen Provost ASSISTANT DEAN FOR REGIONAL MEDICAL AFFAIRS John Mazuzan, M.D. Assistant Professo'r of Anesthesiology University of Vermont College of Medicine ASSISTANT TO DEAN FOR REGIONAL MEDICAL AFFAIRS R. Rolf Struthers, M.D. PROFESSOR, COMMUNITY MEDICINE Julian Waller, K D. University of Vermont College of Medicine CONSULTANT, OPS RESEARCH Robert Dunn CONSULTANT, BIOSTATISTICIAN Alan Gittelsohn -152- NORTHERN NEW ENGLAND - III APPROVED OPERATIONAL PROJECTS SUPPORT OF REGIONAL MEDICAL PROGRAM OFFICE Objectives: Project development, technical project support, general pro- gram support, and program review and management will be the responsibility of the Regional Medical Program staff. PROGRESSRVE CORONARY CARE Objectives: Proposes to establish a system of coronary care units which contains certain innovations related to the exigencies of rural medical care. Project implementation will essentially complete the process of regionalization for treatment of this disease during the acute phase. The immediate project goal is to reduce in-hospital mortality from acute myocardial in- farction by one third. CONTINUING EDUCATION FOR HEALTH PROFESSIONALS Objectives: Proposes to establish a regional system of Educational Coordinators in community hospitals to establish and main- tain direct liaison with the communities for educational pro- grams. The overall objectives: motivate health pro- fessionalstowardself-development, encouragecommunicati6ns and cooperation to improve coordination of educational pro- grams, improve the effectiveness of programs, and increase recruitment of health care personnel. -153- NORTHLANDS-I NAME OF PROGRAM Northlands Regional Medical Program GEOGRAPHICAL REGION State of Minnesota ESTIMATED POPULATION 3, 647, 000 COORDINATING HEADQUARTERS Northlands Regional Medical Program, Inc. Fifth Floor - Farm Credit Banks Building 375 Jackson Street St. Paul, Minnesota 55101 (Tel. : 612/224-4771) GRANTEE ORGANIZATION Northlands Regional Medical Program, Inc. EFFECTRVE STARTING DATE January 1, 1967 OF PLANNING ACTRVITIES EFFECTRVE STARTING DATE March 1, 1969 OF OPERATIONAL ACTIVITITES TOTAL FUNDING TO DATE $2,032,702 FUNDING FOR CURRENT $1, 209, 910 YEARIS ACTRVITEES CHAIRMAN, REGIONAL The Honorable Stephen L. Maxwell ADVISORY GROUP Judge of the District Court 1521 Court House St. Paul, Minnesota 551OZ PROGRAM DIRECTOR *Winston R. Miller, M.D. STAFF ASSOCIATE DIRECTOR Robert J. Wilkins, M. H. A. ASSOCIATE DIRECTOR FOR UNIVERSITY OF MINNESOTA CORE ASSOCIATE DIRECTOR FOR MAYO FOUNDATION CORE J. Minott Stickney, M. D. COORDINATOR OF CANCER PROGRAMS LeRoy G. Berglund, B.A. REHABILITATION COORDINATOR (Miss) Marlene J. Deschler, M. P. H. *Chief Executive Officer .154- NORTHLANDS - II STAFF (Continued) COORDENATOR OF HEART AND STROKE PROGRAMS Lawrence B. Stadler, M.A. COORDINATOR OF EDUCATIONAL PROGRAMS (Mrs.) Edith Leyasmeyer, Ph.D. COMMUNICATIONS OFFICER LIAISON LIBRARIAN OFFICER (Miss) Mary Jane Ryan, Ph.D. LIAISON NURSING OFFICER (Miss) Joyce K Schowalter, R.N., M. N. A., M. Ed. RESEARCH ASSOCIATE IN SOCIOLOGY (Mrs.) Lynda F. Cole, M.A. -155- NORTHLANDS - III APPROVED OPERATIONAL PROJECTS CORE PROPOSAL Objectives: The Region requests support for the central organization and for staff components at the University of Minnesota., Mayo Foundation, and American Rehabilitation Foundation. The core staff is administered by a Core Council of the Director and three Associate Directors. MULTIDISCIPLINARY IMPROVEMENT IN MEDICAL CARE OF MYO- CARDIAL INFARCTION - MINNESOTA HEART ASSOCIATION Objectives: This project will provide practical training courses and consultative service for physicians, nurses, and medical directors of Intensive Coronary Care Units. A data collec- tion, analysis and repository system will be developed. Area seminars will be conducted. POSTGRADUATE EDUCATION IN PEDIATRIC CARDIOLOGY - UNIVER- SITY OF MINNESOTA Objectives: The purpose of this project is to increase the knowledge and skills of practicing physicians in pediatric cardiology. Planned in three stages: I - Planning, trial postgraduate seminars and analysis of results; II - Locally oriented, Northlands Regional Medical Program catalyzed post- graduate programs will be developed in the geographic areas served by the State Crippled Childrens Cardiac Clinics; and, III - Locally oriented, locally catalyzed, self-sustaining programs will fulfill the ultimate goal of this project. DIABETES REGIONAL CENTER-DIABETES DETECTION AND EDUCATION CENTER Objectives: To plan, instigate, and develop new programs through the Center aimed at improving the care of patients with diabetes in community hospitals. The program has these phases: 1. Evaluation of existing facilities, personnel and programs; 2. Education courses at the Center; 3. Development of materials and techniques; 4. Implementation of in-service educational programs; and, 5. Re-evaluation. -156- NORTHLANDS-IV APPROVED OPERATIONAL PROJECTS (Continued) SERVICE-ORIENTED CANCER REGISTRY* Objectives: To develop a service-oriented cancer registry in a successive series of phases. 1. Emphasis on service orientation in- cluding optimal utilization of feedback materials..' 2. inclusion of all identified or identifiable patients with neoplastic dis- ease residing within the Northlands Region; and 3. Follow- up, integrated with activities of physicians responsible for care of patients, as well as inclusive of all patients whose cases have been registered. IMPROVING STROKE REHABILITATION THROUGH A REGIONAL PRO- GRAM OF CONTINUING EDUCATION - AMERICAN REHABILITATION FOUNDATION Objectives: To improve rehabilitation of stroke patients through augment- ing the supply of trained health professionals and concerned community members. The objective will be attained through short courses for nurses, social workers, clergymen, and families of stroke patients, presented over a period of three years. TELEPHONE DIAL ACCESS MEDICAL LIBRARY Objectives: This project is a cooperative effort with the Wisconsin Regional Medical Program. It will expand the Dial Access Medical Library being supported by Regional Medical Programs in Wisconsin and make itavailabletoallph y@icians in the Northlands Region by toll-free telephone transmission. The Northlands Regional Medical Program will produce tapes for the library which cover topics recommended by com- mittees in Northlands. POSTGRADUATE EDUCATION IN DISEASES OF CARDIOVASCULAR AND NERVOUS SYSTEMS AND NEOPLASTIC DISEASE IN CHILDHOOD* Objectives: This program is designed to provide postgraduate education to physicians of the State of Minnesota and adjacent regions in cardiovascular, neurologic, and neoplastic diseases of children. The physicians will attend one session per month for a period of four months. *Approved but not funded, -157- 356-998 0-69-11 NORTHLANDS - V APPROVED OPERATIONAL PROJECTS (Continued) PILOT PROGRAMOFREGIONALPOSTGRADUATEMEDICALEDUCATION* Objectives: This program has been designed to provide one to three months of residency type training to general practitioners internists, and surgeons. Training is available -m neurology, physical medicine, oncology, hematology, gastroenterology, surgery, and cardiovascular diseases. A COLLABORATIVE BASIC REGIONAL INFORMATION NETWORK FOR EDUCATION AND CLINICAL EVALUATION APPLIED TO CORONARY ARTERY DISEASE - MAYO CLINIC AND MAYO FOUNDATION* Objectives: By the use of a digital computer, a system is to be provided to the clinician by which he may compare numerous para- meters of a patient with myocardial infarction with para- meters of a large number of patients in the same classifi- cation. The program will enable the isolated hospital or a physician in a peripheral area to function as an extension of a complex medical center. *Approved but not funded -158- NORTHWESTERN OHIO - I NAME OF PROGRAM Northwestern Ohio Regional Medical Program GEOGRAPHICAL REGION 20 Counties in Northwestern Ohio EST@TED POPULATION 1,36o, ooo COORDINATING HEADQUARTERS Northwestern Ohio Regional Medical Program 2313 Madison Avenue Toledo, Ohio 43624 (Tel. : 419/248-6201) GRANTEE ORGANIZATION Medical College of Ohio at Toledo EFFECTIVE STARTING DATE January 1, 1968 OF PLANNING ACTIVITI]ES TOTAL FUNDING TO DATE $482, 107 FUNDING FOR CURRENT $310, 397 YEARIS ACTIVITI]ES CHAERMAN, REGIONAL William T. Collins, M.D. ADVISORY GROUP 2313 Madison Avenue Toledo, Ohio 43624 PROGRAM COORDINATOR *C. Robert Tittle, Jr., M.D. STAFF ASSISTANT PROGRAM COORDINATORS Donald A. Grubb Daniel J. Hanson, M.D. Anthony M. lannone, M. D. Don C. Nouse M.D. Herman W. R@as, M.D. PUBLIC HEALTH SPECIALIST James Pullella NURSE RESEARCH AND LECTURE ASSOCIATE Loalouise Geiger SYSTENO/COMMUNICATION-S SPECIAL- IST James B. Felkey *Chief Executive Officer -159- OHIO STATE - I NAME OF PROGRAM Ohio State Regional Medical Program GEOGRAPHICAL REGION Central and southern two-thirds of Ohio (61 counties, excluding Metropol- itan Cincinnati area) ESTDAATED POPULATION 4, 68o, ooo COORDINATING HEADQUARTERS Ohio State Regional Medical Program 1480 West Lane Avenue Columbus, Ohio 43221 (Tel.: 614/293-5995 GRANTEE ORGANIZATION The Ohio State University College of Medicine EFFECTIVE STARTING DATE April 1, 1967 OF PLANNING ACTRVITEES EFFECTRVE STARTING DATE May 1. 1969 OF OPERATIONAL ACTrvifi-Es TOTAL FUNDING TO DATE $1,408,311 FUNDING FOR CURRENT $1,254,775 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Richard L. Meiling, M.D. ADVISORY GROUP Dean, College of Medicine The Ohio State University 410 West Tenth Avenue Columbus, Ohio 43210 PROGRAM COORDMTOR *Neil C. Andrews, b& D. STAFF ASSOCIATE COORDINATOR Charles IL White, Ph.D. DIRECTOR OF FIELD RELATIONS Braxton E. Tewart ASSISTANT DIRECTOR, FIELD RELATIONS Gerald D. Fry DIRECTOR OF PUBLIC INFORMATION Robert C. Ringe EDITORIAL ASSISTANT Mary Margaret Patterson ADMINISTRATIVE ASSISTANT Leona J. Short *Chief Executive Officer -i6o- OHIO STATE - H APPROVED OPERATIONAL PROJECTS CORONARY CARE UNIT EDUCATION Objectives: This is a training prcigram for practicing nurses, nurse- educators, and physicians. It is a cooperative effort between the Central Ohio Heart Association and the Ohio State University College of Medicine. Hospitals in 10 cities will serve as the "core" of each surrounding geographical area. Two nurses will be selected from each core hospital for intensive training in Columbus as nurse educators. Semi- nars for physicians will be held in core hospitals. There will be two programs for training practicing nurses. A full- time, two-week course will be given in Columbus; courses will be offered in the core hospitals one evening per week in two-hour periods for a total time of 33 weeks. If course space is available, applicants will be accepted for the program in College from outside the area of the Central Ohio Heart Association. (The COHA covers 47 of the 61 counties within the Ohio State Regional Medical Program. Audiovisual equipment and supplies are requested in order to investigate the types of aids needed by the core hospitals to insure adequate presentation of professional materials. A REHABILITATION TRAINING PROJECT FOR HEALTH PROFES- SIONALS (LICKING COUNTY MEMORIAL HOSPITAL) Objectives: A model stroke rehabilitation unit will be developed in phases, which consist of placing completed stroke patients on a single unit; acquiring aid-to-daily living equipment; and organizing an occupational therapy unit. A beginning faculty will.be designed from among existing personnel at the hos- pital and additional faculty will be recruited in order to expand educational activities into homes, nursing homes, and continuing education programs. The project director, assisted by consultants in medical education, will develop instruments for evaluation. The types of measures to be developed are discussed in the application. One goal of this project is to develop a body of educational materials and training experiences. CAREERS IN HEALTH SCIENCE PROGRAM Objectives: This project is designed to stimulate interest among high school students in health science careers. It will be di- rected by volunteers and existing staff of the Ohio Academy of Sciences. The Academy previously has engaged in a number of recruitment activities which can be modified to the health sciences. -161- OHIO VALLEY - I NAME OF PROGRAM Ohio Valley Regional Medical Program GEOGRAPHICAL REGION Greater part of Kentucky, Southwest Ohio, and contiguous parts of Indiana and West Virginia ESTIMATED POPULATION 6, 000, 000 COORDINATING HEADQUARTERS Ohio Valley Regional Medical Program 1718 Alexandria Drive Post Office Box 4025 Lexington, Kentucky 40504 (Tel. : 606/278-6071) GRANTEE ORGANIZATION University of Kentucky Research Foundation EFFECTIVE STARTING DATE January 1, 1967 OF PLANNIN ACTIVITIES EFFECTIVE STARTING DATE January 1, 1969 OF OPERATIO@L ACTIVITIES TOTAL FUNDING TO DATE $1, 390, 464 FUNDING FOR CURRENT $935, 317 YEARIS A CHAIRMAN, REGIONAL Mrs. Rexford S. Blazer, Jr. 2711 Seminole Avenue Ashland, Kentucky 41101 PROGRAM DIRECTOR 'William H. McBeath, M.D. STAFF ASSOCIATE DIRECTORS RESEARCH AND EVALUATION Donald K I-'reeborn, Ph. D. PROGRAM DEVELOPMENT Laurel True, M. P. H. ADMINISTRATIVE OFFICER T. R. Newman, Jr. INFORMATION OFFICER Quentin D. Al en *Chief Executive Officer -16z- OHIO VALLEY - II APPROVED OPERATIONAL PROJECTS CORE STAFF AND UNIVERSITY COORDINATORS Objectives: Support is requested for a core staff in Lexington with general administrative planning and coordinating functions. Coordinating staffs at the three medical schools would also be supported. The functions of these groups include gener- al university coordination, as well as personnel contribut- ing to the operational projects. COMMUNITY HOSPITAL STAFF DEVELOPMENT Objectives: Support is requested for seven Directors of Continuing Professional Education to serve eight hospitals committed to Ohio Valley Regional Medical Program objectives. The seven Directors of Medical Education serving either full- time or part-time, represent an effort equal to 5. 7 "I- time directors. The primary function of the director is to develop and coordinate an organized, hospital-based pro- gram of continuing education. The outcome of these educa- tional efforts will be evaluated in terms of their effect upon needs. REGIONAL MEDICAL TELEVISION Objectives: Support is requested for the first steps toward long range goals established in preliminary planning to develop inter-connections between the three University medical television functions. Partial support is also projected for the cost of tapes, production materials and distribution. LIBRARY EXTENSION SERVICES Objectives: This project proposes to provide a strong library support function in the eight demonstration hospitals for which educational activities are to be developed in this opera- tional application. -163- OHIO VALLEY - III APPROVED OPERATIONAL PROJECTS (Continued) UNIVERSITY CONTINUING EDUCATION RESOURCES Objectives: This project proposes to augment the continuing education resources of the three medical centers, described as not staffed, equipped or supported so as to respond effectively to needs in the life-time learning of health professionals. Also, that the medical center resources must be made more accessible to the cooperating community hospitals by means of staff specifically devoted to mobilizing these resources in response to specific local needs. DRUG INFORMATION SERVICES Objectives: The proposal describes a plan to extend University-based drug information center services to selected community hospitals. Center staff will conduct a local, organized, informational and educational orientation for medical, nursing, and pharmacy staff of participating hospitals to the use of drug information services. The proposal also includes a plan to develop a collaborative training program for "drug information specialists" to beprepared for employment in regional hospitals. *Approved but not funded -i64- OKLAHOMA - I NAME OF PROGRAM Oklahoma Regional Medical Program GEOGRAPHICAL REGION State of Oklahoma ESTIM&TED POPULATION 2. 520, 000 COORDINATING HEADQUARTERS Oklahoma Regional Medical Program University of Oklahoma Medical Center 800 Northeast Thirteenth Street Oklahoma City, Oklahoma 73104 (Tel.: 405/232-8561) GRANTEE ORGANIZATION Medical Center Research and Develop- ment Office of the University of Oklahoma Foundation, Inc. EFFECTIVE STARTING DATE September 1, 1966 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE May 1. 1969 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1, 818, 000 FUNDING FOR CURRENT $1, 255, 244 YEARIS ACTRVITIES CHAIRMAN, REGIONAL James L. Dennis, M.D. ADVISORY GROUP Vice President and Dean University of Oklahoma Medical Center 800 Northeast Thirteenth Street Oklahoma City, Oklahoma 73104 DIRECTOR *Dale Groom, M.D. STAFF (ASSISTANT) COORDINATORS CARDIOVASCULAR ACTRVITIES L. Lee Conrad, M.D. RADIOLOGY, BREAST CANCER AND MAMMOGRAPHY PROGRAMS Eugene Durso, M.D. HEALTH CAREER RECRUITMENT PROGRAMS Kenneth C. Hager EDUCATION PROGRAMS FOR HEALTH RELATED PROFESSIONS Harry J. Parker, Ph.D. *Chief Executive Officer -165- OKLAHOMA STAFF (Continued) (ASSISTANT) COORDINATORS (Continue@d LIBRARY AND INFORMATION SERVICES Patricia A. Smith, M. L. S. NURSING ACTIVITIES Donna Barlow, R.N. CONTINUING EDUCATION. HEftl,'I'ki RE;LATED Pl; John M. White COMMUNICATIONS'K.4EDIA -Roger Wolfe ASSISTANT. HEALTH DATA AND PI Nor an E. Goodwin CHIEF, PROGRAMS EVALUATION AND REI David W. Pearson, Ph.D. PROGRAM MANAGER Neal H. rdin, Jr. ASSISTANT FOR ADMINISTRATIVE SERVICES AND COMMUNICATIONS Erwina B. Cornelison -166- OKI.AHO@ - III APPROVED OPERATIONAL PROJECTS CORE SUPPORT Objectives: This project will support core staff and central administra- tive expenses. A higher level of support is requested than is presently funded under the planning grant. The first year request is for funds in addition to the current planning grant, and the request for future years will be total funding since the planning grant will expire after this year. A CORONARY CARE PROGRAM FOR OKLAHOMA Objectives: To develop a network for monitoring acutely ill cardiac patients and for promoting continuing education with respect to the management of these patients. The plan seeks to create acute coronary care beds in hospitals financially un- able to develop complete coronary care units. The program calls for the development of "central monitoring units" (CMUS) in larger, usually urban hospitals. The CMUs will serve as coronary care units, but will also monitor electro- cardiographic tracings relayed continuously by telephone lines from patients in smaller hospital "remote stations" (RS). Training programs for physicians, nurses, and allied health personnel are included. A REGIONAL EMPHYSEMA PROGRAM FOR OKIAHOMA Objectives: A teaching and demonstration unit to be established at the University of Oklahoma Medical Center would serve as a regional emphysema unit. It would be available as a con- sultative and educational resource to community hospitals in the Region. Initially, hospitals in Oklahoma City, Muskogee, Stillwater, Tulsa and Clinton would cooperate in the University of Oklahoma Medical Center Program. The goal of the project, to improve the care of patients with emphysema at the community level, would be achieved by recruiting and training personnel; developing continuing education programs; evaluating equipment and services; establishing more effective collaborative group relationships; improving and expanding screening activities and establish- ing evaluative mechanisms. -167- OKLAHOMA - IV APPROVED OPERATIONAL PROJECTS (Continued) CONTINUING EDUCATION PROGRAM FOR THE ENID AREA Objectives: A prototype "medical education center" would be established. Ten surrounding counties with eight participating hospitals would be included. Continuing education modalities would include video tape, audio tape, library resources, self- instructional materials, films, conference-type telephone communications, and short courses. A small core staff operating primarily out of one hospital would coordinate and evaluate the-program. The project seeks to demonstrate the feasibility of a subregional "medical education center, and hopes to stimulate the development of a network of similar subregional centers. A CANCER CONTROL PROGRAM FOR THE TULSA AREA Objectives: The first part seeks to evaluate the prevalence and character of cancer among roughly 50, 000 people in a poverty area of Tulsa. A second part seeks to develop a computerized tumor registry combining data from three major Tulsa hospitals. A third part proposes to integrate the continuing education activities of three major Tulsa, hospitals in the field of cancer. A fourth part seeks to increase communi- cations in the field of cancer between physicians in Tulsa and those in a sparsely populated county to the south of Tulsa. The fifth. part would survey the quality and quantity of rehabilitation services for cancer in Tulsa and in four representative smaller communities. A REGIONAL PROGRAM TO IMPROVE LI]BRARY AND INFORMATION SERVICES Objectives: Oklahoma Regional Medical Program, primarily through the University of Oklahoma Medical Center Library, seeks to improve library information services by increasing the scope of services, increasing the speed of delivery, and improving the relevance of the information retrieved. Three model programs, involving five hospitals in Oklahoma City, Tulsa, and Enid are proposed. Like those proposed for the regional unit, devices to speed references to various health professionals would be instituted in these hospitals. The program would promote knowledge of the improved library facilities among the medical community. -168- OKLAHOMA V APPROVED.OPERATIONAL PROJECTS (Continued) A REGIONAL PROGRAM TO PROMOTE EARLY DIAGNOSIS OF BREAST CANCER WITH SPECIAL EMPHASIS ON MAMMOGRAPHY Objectives: A Regional Mammography Unit would be established at the University Medical Center, under the supervision of a physician trained specially in gynecology and radiology. Oklahoma Regional Medical Program would work with the Oklahoma Division of the American Cancer Society. Mass mammography screening would be initiated in cooperation with the Oklahoma State Health Department. Provision for including Zerography and Thermography in future years is included. A REGIONAL PROGRAM IN NUTRITION AND DIABETES FOR OKLAHOMA Objectives: This program seeks to improve the care of diabetic patients at the community level, and to improve nutritional services in hospitals and nursing homes throughout Oklahoma. The program would help support an ongoing diabetes demonstra- tion clinic at the University Hospital which would deve op t e teaching -materials and manpower to extend improved care for diabetic patients throughout the Region. The program would organize workshops, seminars, and consultation ser- vices to physicians, nurses and dieticians, and would also seek to improve community education. The program would coordinate continuing education and public education with mass screening procedures performed by the State Health- Department. REGIONAL UROLOGY PROGRAM WITH INITIAL EMPHASIS ON CANCER OF THE PROSTATE Objectives: The program would create a consortium of urologists, each of whom would coordinate project activities within his own subregion. Thirteen subregions are identified. Initially, the program would appraise local facilities, resources, man- power and medical practices as they relate to the diagnosis and treatment of cancer of the prostate. The program would analyze hospital records and tumor registries, with follow- up on all new cases, and would identify the local needs for continuing education. This program would interdigitate with other proposed programs, such as the Tulsa poverty area program. -169- OREGON-I NAME OF PROGRAM Oregon Regional Medical Program GEOGRAPHICAL REGION State of Oregon EST@TED POPULATION 2, 050, 900 COORDINATING HEADQUARTERS Oregon Regional Medical Program University of Oregon Medical School 3181 S. W. Sam Jackson Park Road Portland, Oregon 97201 (Tel. : 503/228-9181, ext. 603) GRANTEE ORGANIZATION University of Oregon Medical School EFFECTIVE STARTING DATE April 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE April 1, 1968 OF OPERATIONAL.ACTIVITIES TOTAL FUNDING TO DATE $i, 639, 027 FUNDING FOR CURRENT $728,389 YEARIS A CHAIRMAN, REGIONAL HermanA. Dickel, M.D. ADVISORY GROUP 511 S. W. Tenth Avenue, #1308 Portland, Oregon 97205 PROGRAM COORDINATOR *Edward L. Goldblatt, M. D. STAFF COORDINATORS FOR INFORMATION AND COMMU- NICATIONS (Mrs.) Dale Caldwell FOR PROGRAM ADMINISTRATION Jerry 0. Elder FOR PROJECT DEVELOPMENT AND COMMUNITY ORGANIZATION Delbert NL Kole, M.D. FOR NURSING AND ALLIED HEALTH (Miss) Susan Rich, R.N. *Chief Executive Officer -170- OREGON - ]:I APPROVED OPERATIONAL PROJECTS HEART,, CANCER, STROKE CIRCUIT POSTGRADUATE PROGRAM Objectives: To expand the existing University of Oregon Medical School circuit program so that courses can be made available to all physicians and allied health personnel three times a year at 18 locations in Oregon, Idaho, and Montana. Circuits presented by faculty members, and by one faculty member and video tapes will be tried and compared. EARLY DIAGNOSIS AND THERAPY OF CEREBROVASCULAR DISEASE Objectives: In addition to the usual careful history, examination and laboratory tests, measurements of the circulation time of the brain and of factors known to interfere with the circula- tion will be determined in an effort to arrive at a diagnosis as early as possible. Patients will then be placed on a low- fat diet, and others followed as controls. Facilities, per- sonnel, and patient resources will be available at the University of Oregon Medical School and Good Samaritan Hospital. SURGICAL TREATMENT OF VASCULAR LESIONS AND CEREBRAL COMPLICATIONS OF CEREBROVASCULAR DISEASE Objectives: This project will be conducted jointly with Project #I, uti- lizing the same clinic and study facilities. Early cases will be screened for operable lesions of the neck and arteries and a study made of the effectiveness of surgery on longevity and neurological status. DIAGNOSIS AND TREATMENT OF CEREBROVASCULAR DISEASE AND THE INFLUENCE OF A STROKE CLINIC ON STROKE CARE Objectives: The purpose of this project will be to study the natural his- tory of disease; to establish a demonstration clinic which will apply model current methods of therapy in order to determine ff the presence of such a clinic in a community hospital will improve stroke-patient care; and to disseminate pertinent information to medical and paramedical personnel concerned in the care of stroke patients. -171- OREGON-IH APPROVED OPERATIONAL PROJECTS (Continued) A STROKE CONTINUING EDUCATION PROGRAM PLANNED BY COMMUNITY PHYSICIANS: AN EVALUATION OF EFFECTIVENESS Objectives: This project will assess the quality of stroke care available in four selected sample communities and will institute con- tinuing education programs in these communities to deter- mine the effectiveness of traditional continuing education programs as compared to the "process model" type of edu- cational programs. CORONARY CARE TRAINING - SALEM MEMORIAL HOSPITAL Objectives: This project will provide a series of three-week training programs for nurses to learn the fundamentals of coronary care nursing. The courses will be reinforced with follow- up sessions and evaluation in the hospitals of nurse partici- pant s. CORONARY CARE TRAINING - SACRED HEART GENERAL HOSPITAL Objectives: This project will establish a continuing series of three-week programs to train nurses in current techniques of caring for patients with acute myocardial infarctions. Courses will be reinforced by follow-up sessions and evaluation in hospitals of participants. CENTRAL OREGON HEART, CANCER, AND STROKE PILOT PROJECT Objectives: This project is a cooperative arrangement among four small community hospitals in a -geographically isolated area of central Oregon. Initially, the Central Oregon group will explore methods through which cooperative use of resources can favorably influence patient care. The present project has two parts: First, support for a Nursing In-Service Education Coordinator, who will be shared by the areals four hospitals, to develop and coordinate programs that will up-grade nursing practice. Second, to provide physicians with rapid electrocardiogram consultation via a telephone relay system. -172- OREGON - IV APPROVED OPERATIONAL PROJECTS (Continued) CORONARY CARE TEACHING AIDS Obj ectives: This project would create alibrary of electrocardio raphic 9 tapes. The tapes will be accompanied by continual voice interpretation of the arrhythmias as they occur on the oscilloscope. These tapes would be used for the training of coronary care medical and paramedical personnel and would be available without charge to any health institution or agency within the Region. GUIDING ADULT PATIENTS WITH APHASIA Objectives: This project will provide an eight-day instructional and clinical course to increase the ability of health professionals to handle the patient whose communication. skills have been impaired following a stroke. Personnel and facilities in Oregon are not adequate to aid these patients. This project would pool the resources of physicians and allied health workers who work with stroke patients so that this important phase of rehabilitation will not be overlooked. Five training courses will be given each year, with fifteen students per course. EDUCATIONAL OPPORTUNITIES FOR THE OREGON REGIONAL PHYSICIAN IN THE DIAGNOSIS AND THERAPY OF CANCER* Objectives: This project will provide a training program at the Univer- sity of Oregon Medical School with the aim of improving treatment of cancer patients by practitioners in the Region. Eight training courses, lasting four weeks each, will be given per year. Initially, one physician will be accepted for each session. The curriculum will be modified to the individ- uals' special interests, but will include clinics and con- ferences which are part of the regular activity of the Medical School. SOUTHERN OREGON DIABETIC INSTRUCTION AND EVALUATION* Objectives: Provide instruction for diabetic patients, responsible relatives, and medical personnel. Courses will vary ac- cording to the groups. Instructors will be health personnel available in the community. *Approved but not. funded -173- 356-998 0-69-12 PUERTO RICO - I NAME OF PROGRAM Puerto Rico Regional Medical Program GEOGRAPHICAL REGION Puerto Rico ESTIMATED POPULATION 2, 723, 000 COORDINATING HEADQUARTERS Puerto Rico Regional Medical Program Post Office Box M. R. Caparra Heights Station, Puerto Rico 00922 (Tel. : 809/765-2272) GRANTEE ORGANIZATION University of Puerto Rico Medical Sciences Campus EFFECTRVE STARTING DATE June 1, 1968 OF PLANNING ACTRVITIES TOTAL FUNDING TO DATE $238,327 FUNDING FOR CURRENT $238,327 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Jose"D. Sffontes, M.D. ADVISORY GROUP Dean, University of Puerto Rico School of Medicine San Juan, Puerto Rico 00905 PROGRAM COORDINATOR *Adan Nigaglioni, M.D. Chancellor, Medical Sciences Campus University of Puerto Rico STAFF ASSOCIATE COORDINATOR Cristino Col6n, M. D. ASSISTANT COORDINATOR FOR HEALTH SERVICES Merlin Lugo, M.D. HEAD, SECTION OF BIOSTATISTICS (Mrs.) Carmen Allende SOCIAL SCIENTIST Ra&l Munoz HOSPITAL ADMINISTRATOR Ram6n Rivera CONSULTANT IN CONTINUING EDUCATION JosT Chaves Estrada, NL D. -174- *Qhief Executive Officer PUERTO RICO - II STAFF (Continued) HEALTH EDUCATOR (Mss) Elba Roman ADMINBTRATOR Orlando Nieves -175- ROCHESTER - I NAME OF PROGRAM Rochester Regional Medical Program GEOGRAPHICAL REGION Rochester, New York and 10 surround- ing counties EST@TED POPULATION 1, 300, 000 COORDINATING HEADQUARTERS Rochester Regional Medical Program University of Rochester Medical Center 260 Crittenden Boulevard Rochester, New York 14620 (Tel. : 716/275-4861) GRANTEE ORGANIZATION University of Rochester School of Medicine and Dentistry EFFECTIVE STARTING DATE October 1, 1966 OF PLANNING ACTRVITIES EFFECTIVE STARTING DATE March 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1, 995, 859 FUNDING FOR CURRENT $697,670 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Frank Hamlin ADVISORY GROUP Papec Machine Company Shortsville, New York 14548 PROGRAM COORDINATOR *Ralph C. Parker, Jr., M.D. STAFF DIRECTORS MULTI]PHASIC SCREENING PROJECT Barbara Bates, M. D. HEART DISEASE PROGRAM Thomas E. Cardillo, M. D. CANCER PROGRAM Thomas C. Hall, M.D. STROKE PROGRAM Gaetano F. Molinari, M. D. NURSING COORDINATOR (Miss) Edith Olson, R. N. SPECIALIST INCARDIOVASCULAR NURSING (Mrs.) Nancy Clark, R.N. *Chief Executive Officer -176- ROCHESTER STAFF (Continued) CLINICAL SPECIALISTS STROKE NURSING (@ss)Janet Long, R. N. CARDIOVASCULAR NURSING (Miss) Rose Pinneo, R.N. ]PROJECT DIRECTORS COAGULATION LABORATORY Robert Breckenridge, @D. RENAL DISEASE Richard B. Freeman, NL D. -177- ROCHESTER - III APPROVED OPERATIONAL PROJECTS SUPPORT OF RECONSTRUCTION AND EQUIPPING OF FACILITIES FOR USE AS A LEARNING CENTER FOR PROJECTED TRAINING PROGRAMS RELATED TO HEART DISEASE, CANCER, AND STROKE - HELEN WOOD HALL Objectives: To renovate space for training nurses and physicians to use coronary care units, and other continuing education program s that might be developed. Self-instructional equipment, resuscitation models, furniture, etc. would be purchased. POSTGRADUATE TRAINING PROGRAM FOR PHYSICIANS Objectives: To provide continuing education for physicians in the latest techniques and equipment for preventing and treating cardiac patients. In-service training, short-term graduate courses circuit consultation, conferences, etc. will be supported. REGISTRY OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION Objectives: To analyze the informa'tion listed on a standard from re- garding persons admitted to hospitals with acute myocardial infarction. This data will be discussed during training pro- grams and used in evaluating other projects. IBM computer time will be rented. ESTABLISHMENT AND SUPPORT OF A REGIONAL LABORATORY FOR THE EDUCATION AND TRAINING IN THE CARE OF PATIENTS WITH THROMBOTIC AND HEMORRHAGIC DISORDERS - ROCHESTER GENERAL HOSPITAL Objectives: To establish a center where physicians and technicians will receive training and a well-qualified consultancy staff will be available. -178- ROCHESTER - IV APPROVED OPERATIONAL PROJECTS (Continued) INTENSRVE COURSES IN CORONARY CARE NURSING FOR PROFES- SIONAL NURSES Objectives: This project will provide training courses for nurses in the management of coronary care units. Four intensive courses of four weeks duration each will be offered annually. These courses will be conducted at the University of Rochester Medical Center by the Department of Nursing. Nurses will be trained both to staff CCU's as well as develop training programs in CCU's within the region. Instruction will include didactic content, laboratory demonstrations and practice, and clinical experience. EARLY DISEASE DETECTION Objectives: To provide multiphasic screening for selected populations throughout the region. Initial efforts would be implemented at Strong Memorial Hospital and be based in the Outpatient Clinic on a pilot or demonstration basis. The applicant outlines the service, educational, and research and evalua- tion objectives of this proposal. A methodology for imple- mentation is also presented. It is estimated that 5, 000 patients will be screened during the first year. CONTINUING EDUCATION PROGRAM IN CEREBROVASCULAR DISEASE FOR PHYSICIANS IN THE ROCHESTER AREA Objectives: To provide six or more different educational opportunities for practicing physicians in the pathophysiology, symtoma- tology, physical and laboratory diagnosis, complications, management, rehabilitation and prevention of the common types of cerebrovascular and related diseases. A curricu- lum is presented for what is described as in-service train- ing -to be available at Strong Memorial Hospital. In addition, continuing education programs, consultation services, special lectures, and conferences or workshops would be inaugurated in peripheral hospitals. -179- ROCHESTER -V APPROVED OPERATIONAL PROJECTS (Continued) REGIONAL CLEARINGHOUSE ON CANCER Objectives: The purposes of this project include the development of a variety of methods for gathering data about cancer, the continuous identification of unm'et needs, and the establish- ment of different communicative media for the dissemina- tion of cancer information to health care personnel and other appropriate groups. The data to be gathered will include a broad spectrum of medical, consultative, educational, social service' community resources and like information. The Clearinghouse would be administered by the Regional Medical Program with professional staff services provided by the Medical Center. STATISTICAL AND EVALUATION UNIT Objectives: The purposes of this project would be to gather and analyze health data for use in program planning, assist in the evaluation of the regional medical program in improving medical care, and consult with individual projects in the design of evaluation protocols. The project would be ad- ministered by the regional medical program and staff would be professional supervised through the Department of Pre- ventive Medicine and Community Health. TELEPHONE ELECTROCARDIOGRAPH CONSULTATION* Objectives: Would provide for long distance transmission of electro- cardiographs. DECENTRALIZED REGIONAL CANCER EDUCATION* Objectives: Would support oncology programs in affiliated teaching hos- pitals. Physician and nursing personnel would be provided to develop activities in tumor boards, teaching clinics, consultation services, and the like. DEVELOPMENT OF A STROKE TEAM* Objectives: Stroke teams would be established at Strong Memorial Hospital and at Monroe Community Hospital to provide for continuity of care from the acute phase through rehabili- tatioix. pproved but not funded -180- ROCHESTER - VI APPROVED OPERATIONAL PROJECTS (Continued) NEUROLOGIC AND REHABILITATION NURSING* Objectives: Partially decentralized program would be established at a hospital in Elmira which would include bedside teaching opportunities in other community hospitals. Short-term courses, circuit courses, clinical conferences, and other educational programs are planned. PHYSICIAN TRAINING IN CHRONIC RENAL DISEASE* Objectives: Monthly, three-day tutorial programs (for one physician each) would be made available to primary physicians. Information about chronic renal disease, conservative therapy, dialysis, and transplantation would be given. CHRONIC RENAL DISEASE NURSING* Objectives: Two one-week courses in transplantation, and two two-week courses in dialysis will be offered annually. In addition, circuit courses, conference days, and consultation services are planned. A PROGRAM FOR PATIENTS WITH DIABETES MELLITUS* Objectives: Program of patient education, professional education, and periodic medical evaluation of patients to assess diabetic control would be initiated. *Approved but not funded -181- SOUTH CAROLINA - I NAME OF PROGRAM South Carolina Regional Medical Program GEOGRAPHICAL REGION State of South Carolina EST@TED POPULATION 2,664,000 COORDINATING HEADQUARTERS South Carolina Regional Medical Pro- gram Medical College of South Carolina 80 Barre Street Charleston, South Carolina 29401 (Tel. : 803/723-2771) GRANTEE ORGANIZATION Medical College of South Carolina EFFECTRVE STARTING DATE January 1, 1967 OF PLANNING ACTRVITIES EFFECTRVE STARTING DATE August 1, 1968 OF OPERATIONAL ACTRVITIES TOTAL FUNDING TO DATE $1,923,942 FUNDING FOR CURRENT $1,490,849 YEARIS ACTRVITIES CHAIRMAN, REGIONAL William M. McCord, M.D., Ph.D. ADVISORY GROUP President Medical College of South Carolina 80 Barre Street Charleston, South Carolina ?.9401 PROGRAM COORD@TOR *Vince Moseley, M.D. STAFF ASSOCIATE COORDINATORS FOR HEART DISEASE AND STROKE Charles P. Summerall, M.D. EXECUTRVE ASSOCIATE COORDI- NATOR i iam J. Warlick FOR CONTINUING EDUCATION AND COMMUNICATION Charles D. Kimsey DIRECTOR OF FIELD OPERATIONS C. W. Bowman DIRECTOR OF PROFESSIONAL REI,ATIONS J. Walker Coleman *Chief Executive Officer -182- SOUTH CAROLINA STAFF (Continued) PROJECT ADMINISTRATOR FOR ANC@A H rry E. Shaw DIRECTOR OF COMMUNICATIONS Bettye Anne Langdoc PROGRAM REPRESENTATRVES Blanche Urey Patricia NL Westrick Howard Surface Roger McCants STAFF ASSISTANTS Janet G. Gresh Barbara Ann Auld CHIEF ACCOUNTING CLERK Sylvia A. Burke -183- SOUTH CAROLINA - III APPROVED OPERATIONAL PROJECTS YORK GENERAL HOSPITAL CORONARY CARE UNIT Objectives: Through a new coronary care unit, to improve the care of patients with coronary artery disease, provide a mode of continuing education for physicians and nurses in York and surrounding counties. Also to evaluate the feasibility of using the coronary care unit as a referral center by smaller hospitals in the area. Sponsor: York General Hospital, Rock Hill. GREENVILLE CORONARY CARE UNIT Objectives: To establish a coronary care training program in a large hospital system which supports a major population center and subregion of the state. Sponsor: Greenville General Hospital System, Greenville. SPARTANBURG GENERAL HOSPITAL CORONARY CARE UNIT Objectives: To improve patient care, to provide continuing education for medical and nursing staffs, and to provide a broader scope of education and experience for student nurses and house staff. Sponsor: Spartanburg General Hospital, Spartanburg. ANDERSON CORONARY CARE UNIT Objectives: To improve patient care in an acute coronary care unit, through a continuing education program for the medical and nursing staff of Anderson Memorial Hospital and smaller community hospitals in the area. Sponsor: Anderson Memorial Hospital. CORONARY CARE UNIT TRAINING Objectives: To establish in South Carolina a series of training courses designed specifically to prepare nurses to function in coronary care units so that the rapidly expanding number of such units will be adequately staffed and able to offer ever improving patient care. Sponsor: University of South Carolina. -184- SOUTH CAROLINA - rV APPROVED OPERATIONAL PROJECTS (Continued) SPARTANBURG GENERAL HOSPITAL HEART CLINIC Objectives: To improve the medical care of patients with heart disease in the counties of Spartanburg, Cherokee, and Union 'm the Piedmont sub-region of South Carolina, and to accelerate the dissemination of cardiovascular information to the physicians of the three counties involved. Sponsor: Spartanburg General Hospital, Spartanburg. FLORENCE COOPERATIVE HEART CLINIC PROGRAM Objectives: To expand the role of a community hospital heart clinic and strengthen the relationship of the local program to the heart program at the Medical College of South Carolina. Sponsor: South Carolina State Board of Health. CARDIOPULMONARY RESUSCITATION TRAINING Objectives: To instruct physicians and allied medical personnel in cardiopulmonary resuscitation procedures through hospital- based training programs in each county in South Carolina. Sponsor: South Carolina Heart Association, Columbia. CERVICAL CANCER SCREENING Objectives: Will demonstrate the feasibility and benefit of routine Papanicolaou ("pap") smears; stimulate wider use of the test; indicate the vital need for a school for training cytotechnologists; prove the practicability of screening for cervical cancer; initiate a public health program in South Carolina designed to save the lives of females who are in the prime of life, and to unffy the efforts of health, welfare, medical and other community agencies in seeking a solution to a common problem. Sponsor: South Carolina State Board of Health, Columbia. COOPERATIVE PROGRAM ON CARCINOMA OF THE CERVICK Objectives: Development of a cooperative regional program for the improved screening, diagnosis, therapy and management of patients with carcinoma of the cervix. Sponsor: Medical College of South Carolina. -185- SOUTH CAROLINA - V .APPROVED OPERATIONAL PROJECTS (Continued) PEDIATRIC CANCER EDUCATION AND SERVICE PROGRAM Objectives: To establish a post-graduate education program that will bring new information in pediatric cancer diagnosis and therapy to the physicians of the state; to form a state-wide "tumor board" that will encourage co-operation between cancer clinics and the Medical College of South Carolina and provide a two-way learning or consultation service for cancer patients; disseminate consultant advice directed towards more uniform care for pediatric patients. Sponsor: Medical College of South Carolina, Charleston. DEMONSTRATION PROJECT FOR THE DETECTION OF CANCER OF THE GASTROINTESTINAL TRACT Objectives: To demonstrate to the physician the value of coordinated diagnostic procedures through presentations to medical groups and through clinical demonstration to the individual physician; also, to serve as a pilot program for technician training, to establish an orientation center for other cancer detection projects and to offer a community education pro- gram through cooperative arrangements with local health societies and agencies. Sponsor: Columbia Hospital of Richland County. GREENVILLE'COBALT THERAPY PROGRAM Objectives: To improve cancer therapy for the population in the north- western area of South Carolina and to increase the education potential for radiology residency and radiologic technician programs in the 849 bed Greenville General Hospital System. Sponsor: Greenville General Hospital System, Greenville. ACUTE STROKE DEMONSTRATION PROJECT Objectives: To establish in the central region of South Carolina a hospi- tal-based acute stroke service for the purpose of offering a comprehensive medical program for the management of acute stroke patients, keeping physicians abreast of current diag- nostic and management techniques, training interns and res- idents, establishing teaching programs for related para- medical personnel, soliciting involvement and support of the public, and, ultimately, demonstrating to this and other areas of the state the value and feasibility of a coordinated team approach to stroke management. Sponsor: Columbia Hospi- tal of Richland County. -186- SOUTH CAROLINA - VI APPROVED OPERATIONAL PROJECTS (Continued) STROKE REHABILITATION PROJECT Objectives: The gradual conversion of an existing health facility into a facility for the extended care and rehabilitation of stroke patients in the central region of South Carolina with the related objective of demonstrating the feasibility and ad- vantages of such an undertaking to other areas of the state. Sponsor: Columbia Hospital of Richland County. CHRONIC HEMODIALYSIS DEMONSTRATION UNIT Objectives: Initial support for organization of a hemodialysis Medical College of South Carolina to treat uremic patients, offer training for medical and paramedical personnel, and act as both a pilot and demonstration project that will culmi- nate in the development of such centers on a regionwide basis. Sponsor: Medical College of South Carolina. HEALTH, EDUCATION AND RECRUITMENT PROJECT Objectives: To expand and refine information on the availability and need for educational programs and to assist hospitals and the health industry in the recruitment of trainees and the development of educational programs. Sponsor: South Carolina Hospital Association, Columbia. -187- SUSQUEHANNA VALLEY NAME OF PROGRAM Susquehanna Valley Regional Medical Program GEOGRAPHICAL REGION Z7 counties in Central Pennsylvania ESTIMATED POPULATION 2, 140, 000 COORDINATING HEADQUARTERS Susquehanna Valley Regional Medical Program 3806 Market Street Post Office Box 541 Camp Hill, Pennsylvania 17011 (Tel. : 717/761-3Z52) GRANTEE ORGANIZATION Pennsylvania Medical Society EFFECTIVE STARTING DATE June 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE April 1, 1969 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $984, 216 FUNDING FOR CURRENT $616, 075 YEARIS ACTIVITIES CI-IAIRMAN, REGIONAL Raymond C. Grandon, M.D. ADVISORY GROUP Secretary Dauphin County Medical Society 131 State Street Harrisburg, Pennsylvania 17101 PROGRAM COORDINATOR *Richard B. McKenzie STAFF FIELD SERVICES Herbert J. Toy, Jr. RESEARCH AND APPLICATION ACTIVITIES Robert A. Ranberg COMMUNICATIONS Robert M. Fisher SYSTEMS ANALYSIS Martin Ferrante -188- *Chief Executive Officer SUSQUEHANNA VALLEY STAFF (Continued) AREA REPRESENTATIVES John Hoffmann James Smith Frank Williams Richard Wright STATISTICIAN Thomas Boone -189- 356-998 0-69-13 SUSQUEHANNA VALLEY - III APPROVED OPERATIONAL PROJECTS EVANGIELICAL COMMUNITY HOSPITAL CORONARY CARE UNIT Objectives: A four-bed unit is planned. Six nurses from the Lewisburg Hospital will receive subsidized training at the Geisinger Medical Center. SUNBURY COMMUNITY HOSPITAL CORONARY CARE UNIT Objectives: This proposal will provide a three-bed coronary care unit, including equipment and renovations, and one month's training in coronary care at the Geisinger Medical Center for six nurses. SHAMOKIN STATE GENERAL HOSPITAL CORONARY CARE UNIT Objectives: A three-bed unit is planned. Four nurses will be trained at the C;eisinger Medical Center. A. C. MILLIKEN HOSPITAL (GOOD SAMARITAN) CORONARY CARE UNIT Objectives: Nine nurses will be trained in coronary care at the Reading General Hospital in order to staff the four-bed unit in this proposal. MEMORIAL HOSPITAL OF BEDFORD COUNTY CORONARY CARE UNIT Objectives: This hospital seeks funds to establish a four-bed unit and to train six nurses at Altoona Hospital. CORONARY CARE UNIT NURSES TRAINING PROGRAM AT THE GEISINGER MEDICAL CENTER Objectives: Coronary Care Unit at this institution is presently the only established unit within an eight county area. Several neighboring community hospitals are establishing or plan- ning to establish coronary care units. These institutions need a conveniently located nurses' coronary care train- ing program to provide facilities for training to their nursing staff. Support is requested to train 20 students in a one-month course. -190- SUSQUEHANNA VALLEY - rV APPROVED OPERATIONAL PROJECTS (Continued) STROKE CARE UNIT - MERCY HOSPITAL, ALTOONA Objectives: Stroke Unit will be established in the Appalachian-Highland sub-area to serve as a consultation and training resource for practicing physicians, nurses, physiotherapists and other personnel involved in caring for stroke patients. A stroke advisory committee will be organized to oversee the project. HOME HEALTH CARE PROJECT Objectives: Susquehanna Valley Home Health Services, Inc., -will pro- vide training and home health services for the counties of Snyder, Union and part of Northumberland which do not now have service. REGIONAL MEDICAL PROGRAM INFORMATION SERVICE Objectives: To develop and maintain a medical library service -for practicing physicians and hospitals. -191- TENNESSEE MID-SOUTH - I NAME. OF PROGRAM Tennessee Mid-South Regional Medical Program GEOGRAPHICAL REGION Tennessee and Southwestern Kentucky ESTMIATED POPULATION 2,750,000 COORDINATING HEADQUARTERS Tennessee Mid-South Regional Medical Program I 1 00 Baker Building 1 10 Twenty-first Avenue, South Nashville, Tennessee 37203 (Tel. : 615/244-2960) GRANTEE ORGANIZATION Vanderbilt University EFFECTRVE STARTING DATE July 1, 1966 OF PLANNING ACTRVITI]ES EFFECTRVE STARTING DATE February 1, 1968 OF OPERATIONAL ACTRVITIES TOTAL FUNDING TO DATE $5,333,285 FUNDING FOR CURRENT $2,777,149 YEARIS ACTIVITI]ES CHAERMAN, REGIONAL Thomas P. Kennedy, Jr. ADVISORY GROUP Post Office Box 449 Nashville, Tennessee 37202 PROGRAM COORDINATOR *Robert M. Metcalfe (Acting) *Paul Teschan, M. D. (Effective August 1, 1969) STAFF ASSISTANT DIRECTOR FOR ADMINISTRATION William Yates (Acting) SECTION HEADS ALLI]ED HEALTH SERVICES Richard 0. Cannon, M.D. HOSPITALS Hugh Vickerstaff SOCIOLOGICAL STUDIES William A. Rushing, -Ph.D. EPIDEMIOLOGY Ruth Hagstrom, M. D. *Chief Executive Officer -192- TENNESSEE M]ID-SOUTH - II STAFF (Continued) NURSING (Mrs.) Millie S. Sprofkin (Acting) COMMUNITY HEALTH Leslie A. Falk, M.D. INFORMATION OFFICER Ernest Conner -193- TENNESSEE MID-SOUTH - III APPROVED OPERATIONAL PROJECTS CONTINUING MEDICAL EDUCATION FOR PHYSICIANS MERARRY MEDICAL COLLEGE Objectives: To provide refresher courses for practicing minority group physicians in methods of diagnosing and treating heart dis- ease, cancer and stroke. To provide postgraduate educa- tion through the use of rnore-effective means of audiovisual education. To develop methods to insure the phyi3ician's participation in the program. CONTINUING EDUCATION PROGRAM - VANDERBILT UNIVERSITY SCHOOL OF MEDICINE Objectives: To improve the opportunities of physicians in the Region for continuing education and developing skills in caring for patients with heart disease, cancer, stroke &-nd related diseases throughout this region. HOPKINSVILLE EDUCATION CENTER - JENNIE STUART MEMORIAL HOSPITAL, HOPKINSVILLE, KENTUCKY Objectives: To improve and develop opportunities for continuing educa- tion for physicians in Hopkinsville, Kentucky and its sur- rounding communities. CHATTANOOGA EDUCATION CENTER - BARONESS ERLANGER HOSPITAL, CHATTANOOGA Objectives: To improve the opportunity for physician education for residents and practicing physicians in Chattanooga and its surrounding communities. SPECIAL TRAINING FOR PRACTICING RADIOLOGISTS-VANDERBILT UNIVERSITY SCHOOL OF MEDICINE Objectives: To provide the opportunity for practicing radiologists in this region to improve their knowledge and skills in the newer techniques of diagnostic and therapeutic radiology. CARDIAC NURSE TRAINING PROGRAM - MID-STATE BAPTIST HOSPITAL, NASHVILLE Objectives: To provide a training program for coronary care unit nurses--approximately 30 nurses, three times a year. -194- TENNESSEE MID-SOUTH - IV APPROVED OPERATIONAL PROJECTS (Continued) SCHOOL OF X-RAY TECHNOLOGY - M.EHARRY MEDICAL COLLEGE Objectives: To establish a School of X-Ray Technology at Meharry Medical College. X-RAY TECHNOLOGIST TRAINING PROGRAM - VANDERBILT UNIVERSITY SCHOOL OF MEDICINE Objectives: To plan, implement, and evaluate an expanded radiology technologist training program at Vanderbilt University in cooperation with community hospitals. NUCLEAR MEDICINE TRAINING PROGRAM - VANDERBILT UNRVER- SITY SCHOOL OF MEDICINE Objectives: To provide a training program in techniques of Nuclear Medicine for physicians and technicians of the Region. EXPANSION OF SCHOOL OF MEDICAL TECHNOLOGY - ERLANGER HOSPITAL, CHATTANOOGA Objectives: To expand the School of Medical Technology at Erlanger Hospital and develop a school for certified laboratory assistants. VANDERBILT UNIVERSITY CORONARY CARE UNIT - VANDERBILT UNIVERSITY SCHOOL OF MEDICINE Objectives: To aid in the establishment of coronary care units distant to metropolitan communities. Vanderbilt will serve as an information source and important hub in a coronary care network. Advice will be provided through direct telephone communications with four other units and, indirectly, through its faculty, with all participating units. FRANKLIN CORONARY CARE UNIT - WILLIAMSON COUNTY HOSPITAL Objectives: To establish a two-bed acute coronary care unit in a 100- bed hospital located 30 miles from a relating major medical center and to evaluate its feasibility in such an environment. -195- TENNESSEE MM-SOUTH - V APPROVED OPERATIONAL PROJECTS (Continued) HOPKINSVILLE, KENTUCKY, CORONARY CARE UNIT - JENNIE STUART MEMORIAL HOSPITAL Objectives: To establish a four-bed coronary care unit communicating with a medical school hospital and staffed with well-trained nurses and informed physicians, and to establish the capa- bility for providing training for nurses and continuing educa- tion for physicians in Hopkinsville and surrounding smaller hospitals in the management of patients with acute myo- cardial infarction. CLAR@VILLE CORONARY CARE UNIT - CLARKSVILLE MEMORIAL HOSPITAL Objectives: To expand facilities and improve the quality of care in the acute coronary care unit at the Clarksville Memorial Hospital with electronic communication to Vanderbilt University. NASHVILLE GENERAL CORONARY CARE UNIT - NASHVILLE METROPOLITAN GENERAL HOSPITAL Objectives: To improve the care of the indigent population of Metropoli- tan Nashville by expanding and improving the facilities for acute coronary care in the Nashville General Hospital and to participate in the training program for nurses in coro- nary care units distant to the metropolitan community. MEHARRY MEDICAL COLLEGE CORONARY CARE UNIT - MEHARRY MEDICAL COLLEGE, NASHVILLE Objectives: To improve care of patients with myocardial infarction at Hubbard Hospital and throughout the region through the influence on training programs for medical students, house officers and nurses who receive their training at Hubbard's Hospital. To develop the potential for providing the com- munications and training programs necessary to aid in the establishment of coronary care units in smaller community hospitals in this part of the region. (two beds) -196- TENNESSEE MM-SOUTH - VI APPROVED OPERATIONAL PROJECTS (Continued) MURRAY CORONARY CARE UNIT - MURRAY-CALLOWAY COUNTY HOSPITAL Objectives: To improve patient care, to provide continuing education for medical and nursing staffs, to develop methods of communication with other institutions and to provide a broader scope of education and experience for student nurses in a local school of nursing. (two beds) CHATTANOOGA CORONARY CARE UNIT - BARONESS ERLANGER HOSPITAL Objectives: To develop the necessary nurse training staff and cadre of physicians concerned with acute coronary care to allow this 700-bed teaching hospital to aid in the establishment of coronary care units in smaller hospitals neighboring Chattanooga, Tennessee. BAPTIST HOSPITAL CORONARY CARE UNIT - MIID-STATE BAPTIST HOSPITAL, NASHVILLE Objectives: To expand the existing coronary care unit at Baptist Hospital in order to meet patient care demands, provide necessary personnel and facilities for the training program for coronary care unit nurses, and aid in the establishment of on-line communication with coronary care units at Tullahoma and Crossville, Tennessee. (four beds) CROSSVILLE CORONARY CARE UNIT - UPLANDS CUMBERLAND MEDICAL CENTER Objectives: To establish a two-bed coronary care unit in the 110-bed Uplands Cumberland Medical Center to serve a large rural population in east-central Tennessee. To determine the medical, financial and sociological feasibility of operating acute coronary care units in rural areas of the region in cooperation with a Metropolitan Medical Center that is not formally affiliated with a medical school (Mid-State Baptist). -197- TENNESSEE MID-SOUTH - V.U APPROVED OPERATIONAL PROJECTS (Continued) TULLAHOMA CORONARY CARE UNIT - HARTON MEMORIAL HOSPI- TAL Objectives: To establish a two-bed coronary care unit at the 100-bed Harton Memorial Hospital in Tullahoma and relate its personnel training and operation to the demonstration unit at Mid-State Baptist Hospital in Nashville. MEHARRY SUPER-VOLTAGE THERAPY PROGRAM Objectives: To improve cancer therapy for a large indigent population and increase the education potential for undergraduate and graduate radiology programs at Meharry Medical College. (Includes assistance in acquisition of cobalt high energy source.) HEALTH EVALUATION STUDIES ONA DEFINED POPULATIONGROUP MULTI]PHASIC SCREENING CENTER AT MEHARRY MEDICAL COLLEGE Objectives: To establish a multiphasic screening laboratory with an Office of Economic Opportunity sponsored Community Health Center and to evaluate its effectiveness on screening and treatment of heart, cancer, and stroke, on a defined inner-city population group. PATIENT CARE MODEL - VANDERBILT UNIVERSITY HOSPITAL, ST. THOMAS HOSPITAL, MID-STATE BAPTIST HOSPITAL, NASHVILLE Objectives: To test, refine and implement a model designed to improve the efficiency and the quality of patient care. Nurses will perform only clinical tasks, and administrative functions will be handled by persons called stewardesses. Patient units will consist of approximately 5 clinical units, 25 patients, 5 nurses, 5 stewardesses, and physicians. Trained nurse specialists must be among the nurse group to counsel other nurses. The underlying concept is of a cohesive group which will have the capability for maximum effectiveness in patient care. -198- TENNESSEE MU)-SOUTH - VIIII APPROVED OPERATIONAL PROJECTS (Continued) A MEDICAL-SURGICAL NURSE SPECIALIST GRADUATE EDUCATION PROGRAM TO IMPROVE NURSING CARE OF PATIENTS WITH HEART DISEASE, CANCER AND STROKE - VANDERBILT Objectives: The purpose of this project is to develop medical-surgical nurse specialists in order to improve the nursing care of heart, cancer, and stroke patients. CORE PROGRAM Objectives: To support administrative and planning function. CONTINUING EDUCATION PROGRAM IN INTENSIVE CARE NURSING FOR REGISTERED NURSES AND TECHNICIANS - EAST TENNESSEE* Objectives: To provide formal education and clinical experience for nursing service personnel of patients with cancer, heart disease, stroke and related diseases requiring maximum or intensive nursing care; and to prepare nursing personnel to staff Intensive Care Units in community hospitals. CARDIAC SCREENING OF SCHOOL CHILDREN - SOUTHEASTERN TENNESSEE* Objectives,. Proposes that the Chattanooga Area Heart Association study the effectiveness of a program for the mass screening of school children, many from underprivileged rural communities, for heart defects by use of the @hono- Cardio-Scan, an electronic screening instrument. A DEMONSTRATION PROJECT IN SPEECH THERAPY AT A COMMUNITY HOSPITAL* Objectives: Nashville Memorial Hospital proposes a pilot feasibility project: (1) to primarily demonstrate the financial% and functional practicality of providing a speech rehabili- tation center for aphasics and laryngectomees in a community hospital; (2) to provide this comprehensive rehabilitation center in a side area of Nashville which presently does not have close access to both speech and physical therapy at one location; (3) to provide a source of training and education through observation and partici- pation for students and nurses. *Approved but not funded -199- TENNESSEE MID-S<)UTH - I:K APPROVED OPERATIONAL P-ROJECTS (Contin@) HEALTH COMMUNICATION SYSTEM - SOUTHWESTERN KENT-UCIKY AREA* Objectives: Four community hospitals will establish an inter- institutional communication system with Jennie Stuart Memorial Hospital in Hopkinsville -as the area hospital center, and with Vanderbilt Uiaiversity Medical School as the Regional center. *Approved but not funded -zoo- TEXAS - I NAME OF REGION Texas Regional Medical Program GEOGRAPHICAL REGION State of Texas ESTIMATED POPULATION Regional Medical Program of Texas Post Office Box Q, University Station 2608 Whitis Austin, Texas 7871@Z -1 2/471-181 1)' (Tel 5 GRANTEE ORGANIZATION The University of Texas System EFFECTIVE STARTING DATE July 1, 1966 OF PLANNING ACTRVITIES EFFECTIVE STARTING DATE July 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $3, 928, 194 FUNDING FOR CURRENT VI, 943, 569 YEARIS ACTRVITIES CHAIRMAN, REGIONAL Nicholas C. Hightower, M.D. ADVISOR'Y GROUP Scott and White Clinic Temple, Texas 76501 PROGRAM COORD@,T4)R *Charles B. McCall, -M.D. STAFF ASSOCIATE COORDMTOR Stanley Burnham, Ed. D. DIRECTOR OF HEALTH CARE DEMONSTRATIONS Jimmie C. Hocker DERECTOR OF ADMINISTRATIVE SERVICES (Mrs. Louise Miller *Chief Executive'Officer -201- TEXAS - II APPROVED OPERATIONAL PROJECTS MEDICAL GENETICS Objectives: This is a project to increase understanding by general practitioners of the important role that genetic factors may play in certain cancers and the relation of applying genetic knowledge of early cancer detection. Lectures, presentations of exhibits at county medical societies, referrals of patients to the M. D. Anderson Genetic Clinic, and field consultation and examination trips by medical genetics teams to community locales are procedures planned. The M.D. Anderson Hospital has been providing limited service in this area. Funds are requested for adding a medical social worker to the team, secretarial service, travel (12 team field visits a year) and exhibits. ESTABLISHMENT OF AN EAST TEXAS HOSPITAL TEACHING CHAIN Objectives: The Division of Continuing Education of the University of Texas Graduate School of Biomedical Sciences proposes to assist the staffs of seven Catholic hospitals in the East Texas area in strengthening their medical educational programs in heart dis- ease, cancer, stroke, etc. Four two-hour teaching sessions in cancer and cardiology will be held annually in each hospital. Teams of two physicians from each hospital will be provided an opportunity twice a year to visit Houston and observe the man- agement of referred patients or specific institutional programs, or receive special tutoring in some phase of patient manage- ment. Two annual two-day courses, one on cancer and one on cardiology w4l be held at the St. Joseph's Hospital in Houston for physicians in practice. The Division of Continuing Educa- tion will coordinate the training sessions and develop suitable educational materials. HELPING HOSPITALS ORGANIZE AND STRENGTHEN INHALATION THERAPY PATIENT CARE PROGRAMS Objectives: To develop or improve inhalation therapy programs in communi- ty hospitals for the care of patients with cardiorespiratory dis- eases, Four 2-day inhalation therapy institutes will be held in different geographic areas, to acquaint approximately 200 ad- ministrators, nursing directors and potential inhalation therapy employees with the principles, organization and clinical appli- cation of an organized inhalation therapy program. Then a con- centrated 1 -month clinical experience will be provided for two employees selected by each of the hospitals in that particular area, interested and able to develop a program. Forty students will receive the 1-month training, ten per session. Three months after the clinical experience, visits will be made to the hospitals to plan any follow-up education and training that is indicated. -202- TEXAS - III APPROVED OPERATIONAL PROJECTS (Continued) REGIONAL CONSULTATION IN RADIOTHERAPY Objectives: To raise the level of radiotherapeutic treatment in Texas by strengthening the consultation ties between practical radiolo- gists and M. D. Anderson Hospital radiation therapists and by making available Anderson' s highly specialized equipment and gamma ray sources to selected closely affiliated hospitals; and to advance knowledge of the most efficient and progres- sive treatments for cancer sites, through development of uniform treatment data and pooling of data from cancer pa- tients throughout Texas. REGIONAL PROFESSIONAL CONSULTATION SERVICE IN MEDICAL PHYSICS Objectives: Aims to improve the quality of medical physics in Texas which is required for quality radiotherapy. The program consists of two phases: (1) the extension of full services and responsibility by M. D. Anderson to the Houston hospitals aff iliated for clinical service will be accomplished by station- ing physicists at the collaborating institutions and central- izing computing by graphical transmission of data via tele- phone lines; (4) providing consultation in physics at com- munity hospitals and physicians' offices relating to radio- therapy, nuclear medicine and diagnostic radiology together with a system for mailing radiation dosimeter readings for verifying machine output. It is planned to organize a Texas Regional Medical Physics Unit. SURVEY OF CANCER INCIDENCE AND RESOURCES IN TEXAS Objectives: Will continue a planning survey in which every known case of cancer in rexas from 1944 to 1966 will be abstracted by name and address of patient, name of physician will be checked for fact and date of death, and will be taped for com- puter handling, and for figuring trends, adjusted incidence and survival rates, by site, by region and by three ethnic groups. A mechanism will be established for notifying, with minimal delay, each physician of developments in the re- searchandclinicallaboratorieswiththenames andaddresses of his living patients who might be benefitted. . Hospitals, clinics, laboratories, dermatologists' offices and group practices are surveyed for the basic data. To date, three of the 21 Hill Burton Hospital regions in Texas have been completed, surveyed and two are partially completed. -203- TEXAS - IV APPROVED OPERATIONAL PROJECTS (Continued) STATIE-WEDE CANCER REGISTRY SYSTEM Objectives: A central repository and origin of'dissemination for a pre- determined amount''and type of cancer patient information is to be established at the School of Public Health, which is being developedinhoustonas part of the Universityof Texas. Registry systems already operative in the Texas State De- partment of Health, the M. D. Anderson Hospital and other smaller units will be channeled into the central respository system. Additionalhospitalsandotherhealthdatacollection stations will be encouraged to participate on a voluntary basis. Forty-six cancer registries now exist in Texas. STROKE DEMONSTRATION UNIT FOR PROGRESSIVE PATIENT CARE* Objectives: To establish and staff an intensive stroke demonstration unit at Presbyterian Hospital, Dallas, under the supervision of the University of Texas Southwestern Medical School, has been funded under an earmarked supplement to the planning grant. The unit will serve the metropolitan area of Dallas and Tarrent Counties, Hillsboro and Kilgore. Specialized training programs will be developed and new methods of communication with the practicing physicians will be explored. AREA-WME TOTAL RESPIRATORY CARE Objectives: This is a project under direction of Baylor University to render total respiratory care in an area of 12 counties, uti- lizing the organizational structure of the San Jacinto Tuber- culosis and Respiratory Disease Association and a State Health Department Region. Public and professional educa- tion, area-wide screening for tuberculosis and respiratory network of respiratory care facilities are parts of the ap- proach to total care. Model programs of respiratory care will be assisted to serve as teaching and training centers. The first center to be assisted will be the Jefferson Davis Hospital which serves an urban indigent population basis in Houston. The VA Hospital and the Methodist Hospital will also be utilized to provide a broad base for education, train- ing, and patient care. *Approved but not funded -.204- TEXAS - V APPROVED OPERATIONAL PROJECTS (Continued) REGIONAL REHABILITATION PROGRAM - PART A: BAYLOR UNIVERSITY Objectives: Baylor has selected the community of Wharton, which has two hospitals, the Caney Valley Memorial Hospital, and the Gulf Coast Medical Center, which need rehabilitation serv- ices for their patients. This project will develop a shared core rehabilitation staff for both hospitals and a program for home health care. REGIONAL REHABILITATION PROGRAM - PART B: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO Objectives: The San Antonio Medical School will work in the New Braunfels Community which has a new rehabilitation center under construction adjacent to a home for the aged. The Schoolwillprovideprofessionalguidanceinthe initiationand development of a rehabilitation program for the community. REGIONAL REHABILITATION PROGRAM - PART C: UNIVERSITY OF TEXAS SCHOOL OF MEDICINE AT DALLAS Objectives: The Dallas School of Medicine will assist the community of Kilgore which has an on-going East Texas Rehabilitation Center interested in refining and improving rehabilitation techniques. An addition, the School of Medicine will assist the Caruth Rehabilitation Center in Dallas in training home rehabilitation aides and in establishing a program to assess and evaluate the potential and capacity of the stroke patient for vocational endeavor. CARDIAC WORK EVALUATION FOR REHABILITATION Objectives: As another phase in the development of a comprehensive rehabilitation program in Texas, an existing cardiac work evaluation unit supported by the Heart Association will be moved to the Baylor University College of Medicine. The professional staff will be expanded to serve more patients from the Houston area and to provide training to medical students, physicians, social workers, vocational counselors and rehabilitation teams from other hospitals. The unit will also send its team to Wharton, Texas to serve patients in that area. The mobile unit experience will be utilized to establish a prototype for other institutions collaborating in the Texas rehabilitation program. -ZO5- TEXAS - VI APPROVED OPERATIONAL PROJIECTS (Continued) ERADICATION OF CERVICAL CANCER IN SOUTH TEXAS Objectives: To extend and improve a mass cytologic screening program developed inbexar Countyto other areas aroundsan Antonio; to develop a school of cytotechnology and support training of cytotechnologists; to provide training in exfoliative cytology for pathologists and colposcopy training,for gynecologists; to expand the central screening laboratory and reference laboratory to the Bexar County Hospital District; and to de- sign an information system for automatic data processing. A screening program for indigent women has been supported by a PHS community cancer demonstration grant since 196Z. Information is being gathered regarding nature and level of present support. The goal is to include 7001o of the women in a routine screening system and eventually to create a self- supporting, self-perpetuating detection -,and follow-up system. CORE STAFF FOR COORDINATION OF PLANNING OPERATIONS AND FISCAL MANAGEMENT Objectives: The core staff of the Texas RMP will be greatly augmented in line with RAG recommendations. In addition to the pro- gram coordinator, positions are requested to coordinate public relations, evaluation, manpower training, health data systems and hospital liaison. PLANNING FOR SOUTHWEST TEXAS AREA Objectives: To continue a third year of planning RMP activities in South Texas, with headquarters at the New University of Texas Medical Ichool at San Antonio. This group is utilizing con- sultants and faculty from College of Business Administration at Austin in developing a systematic approach to planning. PPBS (Planned Programming Budgeting System) has been utilized to develop the Rehabilitation Part B proposal and the Cervical Cancer proposal. -zo6- TEXAS VII APPROVED OPERATIONAL PROJECTS (Continued) PLANNING FOR DALLAS AREA Objectives: The University of Texas Southwestern Medical School at Dallas is headquarters for planning in this -area of Texas. Plaianing to-date has involved studies of health manpower, hospital facilities, a stroke demonstration and regional re- habUitation services, and public and professional informa- tion., The Stroke Demonstration Unit For Progressive Patient Care, funded under the earmarked category, and Part C of the Regional Rehabilitation Program, have been developed out of this planning office. PLANNING FOR GALVESTON AREA Objectives: The University of Texas Medical Branch at Galveston is the headquarters for planning in that areai To date this group has been instrumental in coordinating the development basic degree curricula within a School of Allied Health Sciences, which is nearing final approval status,'and in planning the establishment of a coronary care demonstration unit and a stroke demonstration unit. PLANNING DENTAL ACTIVITIES IN TEXAS REGIONAL MEDICAL PROGRAM Objectives: Planning to date has centered on building cooperative ar- rangements among the various dental educational and pa- tient care institutions, expending maxi-Ilo facial prosthetic service within the Region, and developing an effective com- munication modality for dentists, particularly those prac- ticing in isolated areas. PLANNING - THE UNIVERSITY OF TEXAS GRADUATE SCHOOL OF BIOMEDICAL SCIENCES AT HOUSTON DIVISION OF CONTINUING EDUCATION Objectives: This group has been coordinating planning for the regiona- lization of a broadbased, multimedia communications system for Texas to provide all program units with assistance in consultation, production and distribution. The establish- ment of an East Texas Hospital Teaching Chain is an operational proposal developed by this group. -207- TEXAS - VIII APPROVED OPERATIONAL PROJECTS (Continued) PLANNING OF REGIONAL CANCER PROGRAM Objectives: The University of Texas IvL D. Anderson Hospital and Tumor Institute at Houston is the headquarters for this planning effort. Several of the activities formerly included in plan- ning are now operational projects. Additional planning is .needed during this transition stage and funds requested are primarily to support a planning coordinator and secretar- ial support. PLANNING FOR A SCIENCE FIELD STATION Objectives: The University of Texas M. D. Anderson Hospital and Tumor Institute is headquarters for planning the Buescher Science Park, a Z, 000 acre plot of land in central Texas which will be developed for a number of educational, rec- reational, and experimental projects. Funds are requested for architectural and advisory consultation to develop a master plan for development of meeting facilities, field re- search areas, and animal breeding and raising facilities. Planning funds have been requested for this study. PLANNING 13-AYLOR UNIVERSITY COLLEGE OF MEDICINE Objectives: This is a request for continued support of planning activi- ties centered at Baylor University related to (1) feasibility study of the establishment of television and data communi- cations systems between perimeter hospitals and Texas Medical Center, (2) postgraduate medical education, (3) extension of regional rehabilitation program, (4) develop- ment of a model neighborhood health center in Houston. Planning to date has resulted in the operational proposal for Area-Wide Total Respiratory Care, Part A of the Regional Rehabilitation Program, and the operational pro- posal for Cardiac Work Evaluation For Rehabilitation. -208- TEXAS - IX APPROVED OPERATIONAL PROJECTS (Continued) PLANNING FOR ALLIED HEALTH TRAINING Objectives: . The Methodist Hospital has been headquarters for planning allied health training activities, involving Baylor Universi- ty, South Texas Junior College and 21 hospitals and organi- zations. The operational proposal for Inhalation Therapy Training is an outgrowth of planning by this group. In addition, assistance has been provided to develop curricula, clinical affiliation and faculty for the Division of Allied Health Science at South Texas JuniorCollege. Other plan- ning activities have been focused on continuing education needs and resources and cardiovascular and neurological nurse specialist training. DISSEMINATION OF CANCER LITERATURE* Objectives: Would expand and extend to all accredited hospitals in the region, a weekly bibliography of articles on Neoplasia culled from journals received in the M. D. Anderson Library the previous week. The service is now distributed to the Hospital staff and to any physician or library request- ing it. Full texts of any report cited in the bibliography will be mailed within 24 hours after the request is received. COMMUNICATION STUDY* Objectives: Request for two-year funds to continue a communication study by the Department of Medical Communications, M. D. Anderson Hospital, which began in April 1967 with planning grant funds: microwave communications between the Ander- son Hospital and the Medical Branch in Galveston, and radio- therapy consultation through TV are operational proposals growing out of the study thus far. *Approved but not funded -209- TRI-STATE - I NAME OF PROGRAM Tri-State Regional Medical Program GEOGRAPHICAL REGION States of Massachusetts, New Hampshire and Rhode Island ESTIMATED POPULATION 7, 085, 000 COORDM&TING HEADQUARTERS Tri-State Regional Medical Program Medical Care and Education Foundation, Inc. Two Center Plaza, Room 400 Boston, Massachusetts 02108 (Tel. : 617/742-7280) GRANTEE ORGANIZATION Medical Care and Education Foundation, Inc. EFFECTRVE STARTING DATE December 1, 1967 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE February 1, 1969 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $2,410,686 FUNDING FOR CURRENT $1,386,781 YEARIS ACTRVITIES CHAIRMAN, REGIONAL William B. Reid ADVISORY GROUP Executive Director New Hampshire Heart Association 54 South State Street Concord, New Hampshire 03301 PROGRAM COORDINATOR *Leona Baumgartner, M. D. STAFF ASSOCIATE DIRECTORS FOR ADMINISTRATION Alfred F. Popoli FOR DATA COLLECTION C5sler Peterson, M. D. ASSISTANT DIRECTORS FOR DATA COLLECTION Benedict J. Duffy, Jr., M.D. John Pearson, M.D. FOR COMMUNICATIONS Greer Williams *Chief Exec-utive Officer -210- TRI-STATE - III STAFF (Continued) ASSISTANT TO EXECUTRVE DIRECTOR Adam Yarmolinsky STATE COORDINATORS MASSACHUSETTS Rolf Lium, M.D. NEW HAMPSHIRE Cornelia Walker, M. D. 15 Pleasant Street Concord, New Hampshire 03301 RHODEISLAND Henry S. M. Uhl, M.D. Brown University Program of Medical Science Providence, Rhode Island 02912 UNRVERSITY COORDINATORS BROWN UNIVERSITY PROGRAM OF MEDICAL SCIENCE Henry S. M. Uhl, M.D. BOSTON UNIVERSITY SCHOOL OF MEDICINE Thomas R. Dawber, K D. DARTMOUTH MEDICAL SCHOOL Dean Seibert, M.D. TUFTS UNIVERSITY SCHOOL OF MEDICINE John M. Tyler, K D. COORDINATOR FOR EVALUATIONS Harold W. Keairnes, M. D. SPECIAL PROJECTS COORDINATOR (Miss) Claire Farrisey COMMUNICATIONS AND CONFERENCE SECRETARY (Miss) Catherine Toll TRI-STATE - III APPROVED OPERATIONAL PROJECTS PROGRAM OF CONTINUING EDUCATION FOR QUALI]FIED PHYSICAL THERAPISTS* Objectives: To provide an opportunity for graduate physical therapists to increase their knowledge and understanding of the more recent advances in their specialty in the treatment of heart disease, cancer, stroke and related diseases. The Boston University Sargent College of Allied Health Professions and Boston-Bouve College of Northeastern University propose a two year coopera- tion program. Simmons College (no funds requested) will par- ticipate in the operational phase of the proposed courses. A series of evening and summer courses is planned both within and outside the Greater Boston area. EXPANSION AND CONSOLIDATION OF CORONARY CARE TRAINING FOR THE NORTHERN PORTION OF THE TRI-STATE REGION TO PROVIDE STATE-WIDE SERVICE Objectives: To expand the Coronary Care Training Unit at the Mary Hitchcock Hospital, Hanover, New Hampshire, to help meet the unmet need for the training of personnel, to provide leader- ship and guidance to other local programs and to explore new methods of training at the community level. ESTABLISHMENT OF A COMPREHENSIVE INTER-UNIVERSITY CARDIO- VASCULAR PROGRAM IN THE DEPARTMENT OF HEALTH AND HOSPITALS IN THE CITY OF BOSTON Objectives: To establish a clinical-cardiovascular program to provide com- prehensive in- and out-patient care for indigent patients with heart disease in the primary service area, to make this level of care available to patients referred by physicians throughout the Region, and to insure continuity of medical care and follow- up in Boston City Hospital. COMPREHENSIVE REGIONAL MEDICAL PROGRAM IN CANCER Objectives: Proposed by Boston University Medical Center, project envi- sion,s two goals in its operational approach: (1) Resources of the Boston University Medical College and 7 hospitals will be utilized to create a teaching, training and patient care atmo- sphere; (2) Provision of a geographically distinct and identifi- able cancer unit at the University Hospital. *Approved but not funded -212- VIRGINIA - I NAME OF PROGRAM Virginia Regional Medical Program GEOGRAPHICAL REGION State of Virginia ESTIMATED POPULATION 4, 595, 000 COORDINATING HEADQUARTERS Virginia Regional Medical Program 700 Building - Suite 1025 700 East Main Street Richmond, Virginia 23219 (Tel. : 703/644-1907) GRANTEE ORGANIZATION Medical College of Virginia, Health Sciences Division, Virginia Common- wealth University EFFECTIVE STARTING DATE January 1, 1967 OF PLANNING ACTIVITI]ES TOTAL FUNDING TO DATE $1,052,400 FUNDING FOR CURRENT $506,946 YEARIS ACTRVITIES CHAIRMAN, REGIONAL A&ck 1. Shanholtz, M.D. ADVISORY GROUP State Commissioner of Health State Department of Health James Madison Building Richmond, Virginia 23219 PROGRAM COORDINATOR *Eugene R. Perez, M.D. STAFF DEPUTY DIRECTOR David K Pechmann COMMUNICATIONS AND PUBLIC INFORMATION OFFICER (Mrs.) Ann S. Cann NURSE OFFICER (Mrs.) Faye @ Peters, R.N. PROJECTS DEVELOPMENT OFFICER Clark 0. Martin ALLIED HEALTH OFFICER (Miss) Mary E. Campbell SURVEY OFFICER (Mrs.) @rga.ret,W. Proctor *Chief Executive Officer -Zl3- 3N-998 0-69-14 VIRGINIA - II STAFF (Continued) COMMUNITY LIAISON OFFICERS Frederick @ Beamer, Jr. (Mrs.) Wilma W. Schmidt HEART DIVISION OFFICER Thomas S. Edwards, M.D. CANCER DIVISION OFFICER Carrington Williams, r., M. D. STROKIE DIVISION OFFICER David W. Scott, Jr. D. MEDICAL SCHOOL REPRESENTATRVES MEDICAL COLLEGE OF VIRGINIA$, RICHMO@D M. PinsoiFNeal, Jr., M. D. UNIVERSITY OF VIRGINIA, CHARLOTTESVIL,LE William B. Hunt, Jr., M.D. -214- WASHINGTON - ALASKA - I NAME OF PROGRAM Washington-Alaska Regional Medical Program GEOGRAPHICAL REGION States of Washington and Alaska EST@TED POPULATION 3,552,000 COORDMTING HEADQUARTERS Washington/Alaska Regional Medical Program 500 "Ull District Building 1107 Northeast Forty-fifth Street Seattle, Washington 98105 (Tel. : 206/543-8540) GRANTEE ORGANIZATION University of Washington EFFECTIVE STARTING DATE September 1, 1966 OF PLANNING ACTRVITIES EFFECTRVE STARTING DATE February 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $2,864,516 FUNDING FOR CURRENT $1,449,938 YEARIS ACTIVITEES CHA'ERMAN, REGIONAL Donal R. Sparkman, M.D. ADVISORY GROUP PROGRAM COORDMTOR *Donal R. Sparkman, M. D. STAFF ASSOCIATE DIRECTORS CONTINUING EDUCATION Robert C. Davidson, M. D. PROGRAM PLANNING AND DEVELOPMENT Tasker & Robinette PROGRAM ADMINISTRATION AND SUPPORT William R. Thompson ASSISTANT DIRECTORS FINANCE Lee D. Carey DATA AND INFORMATION Edward Freedman *Chie Executive Officer -215- WASHINGTON - ALASKA - II STAFF (Continued) EVALUATION Richard A. Gilberts, Ed. D. CONTINUING EDUCATION Production and Wormation Marion H. Johnson Distribution and Fipld Coordina- tion Richard R. Reimer RESEARCH AND DEVELOPMENT Lawrence J. Sharp, Ph. D. CONTINUING NURSING EDUCATION Louise Shores, R. N. PLANNING OFFICERS HEART Stephen R. Yarnall, M. D. CANCER AND STROKE Ann Carter, K D. AREA COORDINATORS EASTERN WASHINGTON Larry Belmont 1130 Old National Bank Building West 422 Riverside Avenue Spokane, Washington 99201 (Tel. : 509/TE8-8553) SOUTHEASTERN ALASKA Jack & Lesh, M.D. Gustavius, Alaska 99826 CENTRAL-SOUTHCENTRAL ALASKA *John Aase, M.D. Room 200 519 Eighth Avenue Anchorage, Alaska 99501 (Tel. : 907/277-6891) *Effective September 1, 1969 -zl6- WASHINGTON-ALASKA - III APPROVED OPERATIONAL PROJECTS CENTRAL WASHINGTON Objectives: To improve communication between the Seattle academic complex and Yakima and from Yakima to its surrounding communities; to promote an exchange of teachers and prac- titioners; to provide audio-visual instruction from Seattle; to connect internists in Central Washington to Yakima cardiologists via EKG telephone hot-line. SOUTHEASTERN ALASKA PROJECT Objectives: To improve communication between the Seattle academic complex and Southeastern Alaska, particularly with respect to consultations and postgraduate education and training of medical and paramedical personnel. Radio, telephone, television, individual cartridge-load film viewers, visits to Seattle, etc. POSTGRADUATE PRECEPTORSHIPS FOR PHYSICIANS Objectives: To provide the opportunity for practicing physicians to re- turn to major medical centers for one week periods or more of continuing education. TWO-WAY RADIO CONFERENCE WITH SLIDE PRESENTATION (Rad- Tel-Con) Objectives: To prepare and broadcast via two-way radio-telephone slide conferences pilot programs of heart, cancer and stroke topics with a two-way discussion to as many physicians and hospital staffs in the Pacific Northwest as is feasible. To determine subjective and objective evidence of consumer reaction. To explore potential for continuing network series with local and remote origins. INFORMATION AND EDUCATION RESOURCE SUPPORT UNIT Objectives: To ive medical communities skilled assistance which will 9 help them identify their educational needs and develop pro- grams to meet them; to establish a central production unit .for audio-visual materials, and printed information for WARMP projects; to create a distribution system for this information which can penetrate the vast reaches of the Region. Radio, television, telephone, videotape, films, art- work, advisory committees, etc. will be used. -217- WA.SKINGTON-ALASKA IV APPROVED OPERATION&L PROJECTS (Conti"ed) CORONARY CARE UNIT COORDINATION Objectives: To coordinate a number of CCU-related projects, and to initiate cooperative projects directed at improving CCU operations and training programs. Particular attention is given in the first year to development of 'Irnockup" coro- nary care unit to be used in nurse and physician educational programs. Audio-visual self-instruction materials will be produced and evaluated. CONTINUING EDUCATION AND ON THE JOB TRAINING OF LABORA- TORY PERSONNEL Objectives: To establish a training, supervision and continuing educa- tion program for medical, laboratory technicians. CARDIO-PULMONARY TECHNICIAN TRAINING PROGRAM - SPOKANE COMMUNITY COLLEGE Objectives: To develop a formal educational program to train cardio- pulmonary technicians. ALASKA MEDICAL LIBRARY Objectives: To develop a community medical library at the Alaska Na- tive Medical Center, Anchorage, Alaska. ANCHORAGE CANCER PROGRAM Objectives: To improve the treatment of cancer in Alaska by providing a super-voltage radiation therapy unit. Accumulating data, clinical conferences, and stimulating interest in establish- ing cancer registries will be included. PATTERNS OF HEALTH CARE OF CHILDREN WITH CANCER Objectives: To carry out a detailed study of cases of childhood cancer in Washington and Alaska. Data will be collected via physician interviews of physicians and recorded on IBM cards for analysis. -218- WASHINGTON-ALASKA - V APPROVED OPERATIONAL PROJECTS (Continued) RADIATION PHYSICIST CONSULTANT TO RADIOLOGISTS IN THE WASHINGTON-ALASKA REGION Objectives: To provide a radiation physicist consultant whose ability will improve the use of existing facilities and will enhance post- graduate education for radiology residents and paramedical trainees outside the university system. COMPUTER-AIDED INSTRUCTION IN HEART DISEASE, CANCER, STROEE AND RELATED DISEASES(CAI) Objectives: To develop and evaluate CAI as a complementary and supple- mentary method of education of physicians, nurses and allied health personnel. To acquaint physicians, nurses and others with the use of computer terminals with inter- action between the user and the computer. CYSTIC FIBROSIS: EARLY DETECTION AND IMPROVED PATIENT CARE Objectives: A one-year feasibility study in a new method of detection of patients with cystic fibrosis. It is based at the Children's Orthopedic Hospital and Medical Center in Seattle. The objective is to study the feasibility of mass screening for cystic fibrosis using neutron activation of toenails. The center has experimented with this technique of bombarding toenails with neutrons, and feel that they are able to detect the electrolyte abnormalities in the toenails peculiar to cystic fibrosis. LABORATORY EVALUATION OF RENAL AND ADRENAL HYPER- TENSION* Obj ectives: This proposal would offer a new laboratory test for renin and aldosterone in the region that previously has been difficult to obtain. The tests would be made available on a region-wide basis and evaluated by a hypertension study group which also advises the Regional Medical Program concerning this disease process. The physicians in the region will receive periodic information about the labora- tory diagnosis of hypertension as well as the latest informa- tion about other aspects of renal and adrenal hypertension. *Approved but not funded -219- WASHINGTON-ALASKA - VI APPROVED OPERATIONAL PROJECTS (Continued) COOPERATIVE PROGRAM FOR STROIKE EDUCATION AND PERSONNEL DEVELOPMENT* Objectives: Provides for the development of new personnel and for pro- grams of Post-graduate Education using neurologists, physiatrists and ancillary medical personnel to provide a needed continuing education out-reach to selected com- munities of the Washington/Alaska Region. STROKE REHABILITATION NURSING PROGRAM* Objectives: This proposal would expand a training program in stroke rehabilitation nursing initiated in September, 1967, by the Washington State Heart Association at Good Samaritan Hospital in Puyallup, Washington, a 154 bed general hos- pital, and only comprehensive rehabilitation center outside of University-affiliated hospitals. The present program of five two-week courses a year would be expanded to six courses per year, training 50 plus nurses as teachers, hir- ing of one additional instructor, and would provide follow- up by course instructors to the home hospitals of the train- ees. The total budget for the project is shared with the Washington State Heart Association. This project with. the other three stroke related proposals, will be included under the surveillance of a Washington/Ala@ Regional Medical Program Stroke Coordinators Office to structure relationships and future developments in the regional stroke pl@ DENTISTRY CIRCUIT COURSES IN ORAL CANCER* Objectives: One year of support is requested for ten circuit courses for dentists in the detection of oral cancer. The project will be co-sponsored by the University of Washington School of Dentistry and the Washington/Alaska Regional Medical Program. Evaluation will include an assessment of the impact of tl%ese courses on screening for oral cancer. pproved but not funded -220- WEST VIRGINIA - I NAME OF PROGRAM WestVirginiaRegional MedicalProgram GEOGRAPHICAL REGION State of West Virginia ESTIMATED POPULATION 1, 802, 000 COORDINATING HEADQUARTERS West Virginia Regional Medical Program Room 2237, University Hospital West Virginia University Medical Center Morgantown, West Virginia 26506 (Tel. : 304/293-2601) GRANTEE ORGANIZATION West Virginia University Board of Governors EFFECTIVE STARTING DATE January 1, 1967 OF PLANNING ACTRV!.I,Izs TOTAL FUNDING TO DATE $658,773 FUNDING FOR CURRENT $378,045 YEARIS ACTIVITIES CHAIRMAN, REGIONAL Clark & Sleeth, M.D. ADVISORY GROUP Dean, School of Medicine West Virginia University Medical Center Morgantown, West Virginia ?.6506 PROGRAM COORDINATOR *Charles D. Holland (Acting) STAFF @ORMATION OFFICER James R. Young BEHAVIORAL SCIENTIST David S. Hall, Ph.D. BIOSTATISTICIAN Joseph Costello ADMINISTRATIVE ASSISTANT (Mrs.) Phyllis J. Popovich *Chief Executive Officer -zzi_ WESTERN NEW YORK - I NAME OF PROGRAM Western New York Regional Medical Program GEOGRAPHICAL REGION 7 Western New York counties and Erie County in Pennsylvania EST@TED POPULATION 1, 940, 000 COORDINATING HEADQUARTERS Western New York Regional Medical Program 2929 Main Street Buffalo, New York 14214 (Tel. : 716/835-0728) GRANTEE ORGANIZATION Research Foundation of the State University of New York EFFECTIVE STARTING DATE December 1, 1966 OF PLANNING ACTIVITIES EFFECTIVE STARTING DATE March 1, 1968 OF OPERATIONAL ACTIVITIES TOTAL FUNDING TO DATE $1, 877, 838 FUNDING FOR CURRENT $955,685 YEARIS ACTIVITI]ES CHAIRMAN, REGIONAL Herbert E. Joyce, M.D. ADVISORY CIROUP 3435 Bailey Avenue Buffalo, New York 14215 (Tel. : 716/833-4431) PROGRAM DIRECTOR *John R. F. Ingall, M.D. STAFF ASSOCIATE DIRECTOR Jerome 1. Tokars, hC D. ADMINISTRATIVE ASSOCIATE Spero Moutsatsos ADMINISTRATRVE ASSOCIATE FOR BUSINESS AND PERSONNEL (Mrs.) Marion Sumner DERECTOR, NURSING AFFAIRS Patricia Shine, R. N. DIRECTOR OF COMMUNICATIONS Anthony Zerbo, Jr. RESEARCH ASSISTANT Elsa Kellberg *Chief Executive Officer 222 WESTERN NEW YORK - II STAFF (Continued) ADMINISTRATIVE ASSISTANT Sohn Winston PROJECT DIRECTORS CORONARY CARE PROGRAM (Mrs.) Betty Lawson, R.N. TELEPHONE LECTURE NETWORK Joseph Reynolds -ZZ3- WESTERN NEW YORK - III APPROVED OPERATIONAL PROJECTS TELEPHONE LECTURE NETWORK Objectives: A two-way telephone communication network would link hospitals of Western New York and Erie ounty, Pennsyl- vania to the Continuing Education Departments of the State University of New York at Buffalo and the Roswell Park Memorial Institute. Equipment would be leased from the New York Telephone Company. The network could serve several purposes, such as continuing education for physicians, nurses, and the health-related professions, public education, administrative communication, consulta- tion with experts, and contacts among blood banks. CORONARY CARE PROGRAM Objectives: The proposed coronary care program would test a training technique for providing qualified nurses who will be re- quired to staff developing coronary care units in the Region. Approximately 80 nurses (4 groups of 20).have been selected from all parts of the Region for a combined academic and clinical course. Additional nurses will be trained. In addition, physicians would receive a condensed course to include that given to the nurse plus an opportunity to study physical, legal and administrative requirements of coronary care units. CHRONIC RESPIRATORY DISEASE PROGRAM Objectives: Funds are requested to develop a model regional compre- hensive pulmonary care program. A nine point program is presented, including correlated educational activities for physicians, nurses, and allied health personnel. Other selected program aspects are: early case finding, out- patient and in-patient care, rehabilitation services, inten- sive care for acutely ill patients, and extended care services. Maximum use would be made of existing service, teaching and research resources. Four major hospitals will participate in this cooperative program. A site-team which can be any combinations of chest physicians, respiratory nurse specialist, and/or a blood gas technician will be available to all hospitals in the region upon request. This will act as support consultation for problems of diagnosis, management, in-service education, staff conferences, or whichever will serve the local purposes. -224- WESTERN NEW YORK - IV APPROVED OPERATIONAL PROJECTS (Continued) IMMUNOFLUORESCENCE SERVICE AND TRAINING* Objectives: This proposal would make available immunofluorescent anti- body tests for diagnostic purposes on a regional basis. Physicians in the region would be given information on the applicability of these tests. A teaching program for pathol- ogists and laboratory personnel from regional hospitals would be offered so as to decentralize routine tests away from the host facility. PILOT STUDY PROGRAM IN NUCLEAR MEDICINE Objectives: This is a pilot or feasibility study of cost-effectiveness and patient service aspects of a nuclear medicine unit in a small community hospital. Funds are requested to equip such a program... Program objectives include provision of diag- nostic services, educational programs for practitioners as to the potential of this procedure, and the development of a training program for isotope technicians. A TEST OF TWO CONTINUING MEDICAL EDUCATION TECHNIQUES* Objectives: The. purpose of this proposal is "to define a research strategy which will measure the effectiveness of the central tape library and the medical juke box as teaching and con- sultation tools for physicians and subsequently for para- medical personnel... This study will evaluate the educa- tional advantages and cost-effectiveness of: (a) central tape medical library, (b) juke box medical recording, and (c) central tape versus juke box. DIALYSIS AND KIDNEY PROGRAM* Objectives: Funds are requested to improve the level of care of patients with acute and chronic renal disesae. Four hospitals in Western New York and one in Pennsylvania would partici- pate and thereby expand the number of beds available for the treatment of renal disease patients. Activitiesaimedtoward the prevention of renal disease include appropriate screen- ing procedures and educational programs for physicians, nurses, and technicians. *Approved but not funded -225- WESTERN NEW YORJK - V; APPROVED OPERATIONAL PR,04F.CTS (Contz'nued) CORE PLANNING AND ADMINISTRATION Objectives: To continue and complete certain surveys, communication and community involvement activities already inaugurated or planned; and to support professional core staff dur' the next mg program period. WESTERN PENNSYLVANIA - I NAME OF PROGRAM Western Pennsylvania Regional Medical Program GEOGRAPHICAL REGION Pittsburgh.. Pennsylvania and 28 sur- rounding counties (Western Pennsylvania.) EST@TED POPULATION 41 200, 000 COORDINATING HEADQUARTERS Western Pennsylvania Regional Medical Program 508 Flannery Building 3530 Forbes Avenue Pittsburgh, Pennsylvania 15213 (Tel. : 412/621-1006) GRANTEE ORGANIZATION University Health Center of Pittsburgh EFFECTRVE STARTING DATE January 1, 1967 OF PLANNING ACTIVITIES TOTAL FUNDING TO DATE $573,125 FUNDING FOR CURRENT $445,392 YEARIS ACTIVITIES CHAIRMAN, REGIONAL James A. Rock, M.D. ADVISORY GROUP Lee Hospital 320 Main Street Johnstown, Pennsylvania 15901 PROGRAM COORDINATOR F. S. Cheever, M. D. Vice Chancellor for Health Professions University of Pittsburgh M-240 Scaff e Hall Pittsburgh, Pennsylvania 15Zl3 (Tel. : 412/621-3500, ext. 320) STAFF PROGRAM DIRECTOR *Robert R. Carpenter, M. D. ASSOCIATE DIRECTORS MEDICAL LIAISON E. Wayne Martz, M.D. COMMUNITY INVOLVEMENT Howard E. Hough ASSISTANT DIRECTORS EVALUATION David E. Reed, M.D. *Chief Executive Officer -227- WESTERN PENNSYLVANIA It STAFF (Continued) PROFESSIONAL AND PUBILIC RELATMM Gir@m W. Wtird FISCAL AFIP s MSING !*MN Goldbets. Ph. D. AREA LtAlSOt4 REPRESENTAT@U P&ML J. M&rtija RESEARCH ASSOCIATIC Manuel @toi ADMINISTRATIVIC ASSLSTANT Ltri. E]Iin R.- maione -228- WISCONSIN - I NAME OF@ PtkOGRAM Wiscon @ Regional Medical Program GEOGRAPHICAL REGION State of Wisconsin ESTD4ATED POPULATTON 40221,000 fOORDINATWi IMADQUARTERS Wisconsin Regional Medical Program, I 10 East Wisconsin Avenue Milwaukee, Wisconsin 53202 (TeL : 414/272-3636) GRANTEE ORGANIZATION Wisconsin Regional Medical Program, Inc. EFFECTIVE STARTING DATE September 1, 1966 OY PLA Amrrms- EFFECTIVE STARTING DATE September 1, 1967 OF OPERATIO@R, ACTRVITIE.S TOTAL FUNDIKG TO DATE $1, 870, 218 FUNDRLG FOR CLJRRENT $1, 023, 504 T_ YEAR IS AC IVITMS CHAIRMAN REGIONAL Rodney Lee Young 4 - @]§ORY GRO@ County Judge County Court Chambers Rusk County Ladysmith, Wisconsin 54848 PRESIDENT, WISCONSIN T. A. Duckworth REGIONAL MEDICAL PROGRAM Senior Vice President - Secretary INC. Employers Insurance of Wausau Wausau, Wisconsin 54401 PROGRAM COORDINATOR *John S. Hirschboeck, M. D. STAFF ASSISTANT COORDINATOR (PROGRAM) J. D. Kabler, M.D. University of Wisconsin Madison, Wisconsin DIRECTOR OF PUBLIC INFORMATION Peter A. Kirsch NURSING COORDINATOR (Mrs.) Norma M. Lang, R. N. EVALUATIONS COORDINATOR Charles W. Lemke University of Wisconsin Madison, Wisconsin *Chief Executive Officer -229- WL'5CONSIN - II STAFF (Continued) ASSISTANT PROGRAM COORD@TOR Peter J. Sheldon PLANNING COORDMTOR Paul C. Nutt CONTINUING EDUCATION COORDMTOR William J. Sheeley ASSOCIATE COORDINATOR James H. Sullivan -Z30- WTSCONSIN - IU APPROVED OPERATIONAL PROJECTS CORE PROGRAM Objectives: Funds requested would support the core planning and basic operations over the next five years. Approximately 75,lo of the budget is for personnel. These funds would permit continued program growth and development, support the@planning of new and the monitoring of approved operational activities, and allow for the expansion and strengthening of regional as well as extraregional cooperative arrangements. STUDY PROGRAM FOR UTERINE CANCER THERAPY AND EVALUATION Objectives: To develop a Study Program for Uterine Cancer Therapy and Evaluation which will have as its primary objective improve- meat in the quality of uterine cancer therapy in the region by the introduction of new techniques for review and evaluation of current therapy and long-term results. Includes physician education. A PILOT DEMONSTRATION PROGRAM FOR PULMONARY THROMBOEM- BOLISM - MARSHFIELD CLINIC Objectives: To demonstrate a comprehensive program which will encom- pass diagnostic, preventive, therapeutic and rehabilitation procedures for patients, postgraduate education, a rapid transportation system for patients from Northern sections of the state, cooperation between the Clinic and other hospitals and medical schools in the region, collaborative research be- tween the Center and the medical schools in basic research in blood coagulation and thromboembolism, and evaluation of the capability of Marshfield-Wausau to function as a subregional medical center of the WRMP. CANCER CHEMOTHERAPY FOR ADULTS Objectives: This will be a three-year cooperative program. It is proposed to build a collaborative chemotherapy service program, upon the resources of an established university medical center Division of Clinical Oncology, and the experience of practicing chemotherapists located in different parts of the Region would form the initial group of principal collaborators. An overall objective is to favorably influence morbidity and mortality rates for cancer, and a number of activities will be initiated to achieve this. Cooperative activities will be developed with the Cancer Committee of the State Medical Society, division of the American Cancer Society,VeteransAdministrationHospitals, and the Milwaukee CountyHospital. It is estimated thatabout 10, 000 new cancer patients might benefit from this project annually. -231- WISCONSIN - IV APPROVED OPERATIONAL PROJECTS (Continued) POSTGRADUATE EDUCATION FOR HEALTH PROFESSIONS Objectives: A self-supporting program would acquaint practicing physicians with research and other programs in heart dis- ease, cancer, and stroke. The following proposals are planned: (1) single concept filrns.- (2) dial access tapes for physicians; (3) dial access tapes for nurses; (4) the develop- ment of from five to, ten continuing education centers to be located throughout the Region. INTERRELATED PROGRAMS IN RADIOLOGY AND NUCLEAR MEDICINE* Objectives: A combined program in radiology and nuclear medicine which would (1) coordinate radiotherapy programs. (2) pro- vide specialized consultation services, and (3) establish training programs for physicians and technologists. This program is established to promote the availability of im- proved medical care for the patient population involved through through the cooperative and efficient utilization of existing resources. THE PREVENTION,. DIAGNOSIS, AND TREATMENT OF CARDIO- VASCULAR DISEASE* Objectives: (1) a program which would increase regional capability in -coronary angiography; and (2) a proposal which would focus on improving service training and consultation in pedi- atric cardiology and would be directed by Marshfield Clinic. CANCER CHEMOTHERAPY PROGRAM FOR THE METROPOLITAN MILWAUKEE AREA Objectives: This program would complement a previously awarded cancer chemotherapy program for adults, and would focus on Southeastern Wisconsin, including metropolitan Milwaukee. This project would make available to larger patient groups the results of clinical studies in chemotherapy Marquette School of Medicine, St. Mary's Hospital, St. Joseph's Hospital as well as a number of other hospitals and agencies participating. Efforts would be made to co- ordinate chemotherapy provided by physicians and to dis- seminate information through organized teaching programs. Study protocols a s well as diff erent types of training pro - grams for physic ians and nurses are outlined. *Approved but not funded -232- WISCONSIN - V APPROVED OPERATIONAL PROJECTS (Continued) TISSUE TYPING PROGRAM Objectives: Support is requested to develop a regional resource for tissue typing and compatibility testing of tissue trans- plantation. This resource would provide a means to im- plement new techniques as they are developed, as well as provide a program from which to train physicians and technicians in recent advances in this field. The project would be based at the Milwaukee Blood Center which has served Southeastern Wisconsin for twenty years. UTERINE CYTOLOGY SCREENING PROJECT* Objectives: This project is co-sponsored by the University of Wisconsin, Marshfield Clinic, Division of Health of the Wisconsin Department of Health and Social Services, and the Milwaukee Health Department. It seeks to demonstrate the validity of cell-sizing by use of the Coulter Counter, using standardized criteria for interpretation, as a pre- screening procedure for cervical cancer. The study population would have Pap smears performed at the same time specimens are obtained for the size distribution analysis. AN OPERATIONAL PROGRAM FOR NURSE TRAINING Objectives: This project is jointly sponsored by the- University of Wisconsin and Marquette University. Part One provides for the preparation of inactive nurses returning to practice. Part Two is a continuing education program for nurses on the treatment of the patient in shock. *Approved but not funded -Z33- 0238 INDEX The INDEX is a first attempt at identifying by type of activity and dis- ease all the approved operational projects of Regional Medical Programs described in this Directory. The listings made are by no means com- prehensive or specific, but refer to the apparent primary focus of the projects, as interpreted by the Division of Regional Medical Programs' Office of Health Data on the basis of information available to them. The INDEX is divided into two parts. Listings are made by Type of Activity including.... * Continuing Education and Training * Demonstration of Patient Care * Research and Development * Planning, Coordination and Evaluation and by Disease Orientation including.... * Heart Disease * Cancer * Stroke * Related Disease * Multicategorical NOTES: -Each of the projects listed under Disease Orientation is further subdivided according to the Type of Activity. References are made in encyclopedic style with a page number followed by a letter of the alphabet which indicates where the description is located on the reference page... first (a), second (b), third (c), fourth (d), or fifth (e). "Planning, Coordination and Evaluation" includes core support and feasibility and planning studies when they are funded through the operational grant. -234- APPROVED OPERATIONAL PROJECTS INDEXED BY TYPE OF ACTIVITY CONTINUING EDUCATION AND TRAINING 4a, 4b, 4c, 7a, 7b, 7c, 8a, 13b, 13c, 13d, 14a, 14b, 14c, 15a, 15b, 15c, 16a, Zla, 21b, Zlc, Zld, 22a, 22b, 22c, 2 3b, 23c, 24b, 24c, 28a, 28c, 28d, 29a, 29b, 29c, 29d, 30a, 33c, 34a, 34b, 35a, 35b, 35c, 35d, 39a, 39b, 39c, 39d, 40b, 40c, 41a, 44b, 44d, 45b, 46b, 46c, 49a, 49b, 49c, 49d, 49e, 50a, 50b, 50d, 51a, 51c, 55a, 55b, 55c, 55e, 58b, 58c, 58d, 59a, 59b, 59c, 60a, 60b, 65a, 65b, 66b, 69b, 69d, 70a, 70b, 70c, 71b, 71c, 72b, 75d, 75e, 76b, 76d, 79a, 79b, 79c, 79d, 80b, 80c, 81a, 81b, 81c, 82a, 82b, 83a, 83b, 83c, 84a, 84b, 84c, 85a, 85b, gla, 91c, 91d, 92a, 95a, 95c, 95e, 96a, 101d, 102a, 103c, 106c, 106d, 107a, 107b, 107c, 108a, 108b, 108d, 110c, 110e, lllb, 112a, 117b, 118c, 120d, 121a, 122a, 122b, 122c, 123c, 127b, 127d, 133a, 133b, 133c, 133d, 134a, 134c, 135a, 135b, 138a, 138b, 138c, 138d, 138e, 138f, 143b, 143c, 144a, 144b, 144c, 144d, 144e, 145b, 145c, 145d, 146a, 146d, 153c, 156b, 156c, 157a, 157b, 157c, 161a, 161b, 161c, 163b, 163d, 164a, 164b, 167c, 168a, 168c, 169b, 169c, 171a, 172b, 172c, 172d, 173a, 173c, 178b, 178d, 179a, 179c, 180d, 181a, 181b, 181c, 181d, 184b, 184c, 184e, 185c, 186a, 190a, 190f, 191c, 194a, 194b, 194c 194d, 194e, 194f, 195a, 195b, 195c, 195d,.196a, 196d, 197a, 197b, 198a, 198b, Igga, 199c, 200a, Z02a, 202b, 202c, 203a, 203b, 209a, 209b, 209c, 212a, 212b, 212d, 217a, Z17b, 217c, 217d, 217e, 218a, 218b, 218c, 218d, 219a, 219d, 220a, 220b, 220c, 224a, 224b, 225a, 225c, 232a, 232c, 233a, 233c DEMONSTRATION OF PATIENT CARE 4d, 8b, 8c, 8d, 8e, ga, 22d, 23a, 24a, 24d, 28b, 33b, 38c, 40a, 45c, 50c, 50e, 51b, 55d, 64b, 64c, 65c, 70d, 70e, 71a, 72a, 72c, 75b, 75c, 95b, 95d, 96b, 96c, 96d, 96e, 97a, 97b, 97c, 97e, 101a, 101b, 101c, 102b, 102c, 102d, 103b, 106a, 106b, 107a6, 107b, 113a, 117a, 117c, 117d, 119a, 120a, 120c, 120e, 121b, 123b, 124a, 127c, 128a, 134b, 139a, 139c, 145a, 153a, 156d, 167b, 168b, 169a, 171b, 171c, 171d, 172a, 173b, 178c, 179b, 180c, 180e, 184a, 184d, 185a, 185b, 185d, 185e, 186b, 186c, 186d, 187a, 187b, 190b, 190c, 190d, 190e, 191a, 191b, 195e, 195f, 196b, 196c, 197c, 197d, 199d, 204b, 204c, 205a, 205b, 205c, 205d, 206a, 212c, 218e, 219c, 224c, 225d, 231b, 231c, 231d, 232b, 232d, 233b RESEARCH AND DEVELOPMENT 38a, 41d, 44a, 44c, 45a, 45d, 46a, 64d, 66a, 73a, 80a, 80d, 91b, 92d, 97d, 110b, lllc, Illd, 112b, 118a, 118b, 119b, 119c, 119e, 123a, 143a, 143d, 163c, 180a, 198d, 203c, 204a, 208c, Z18f, 219b, 225b -235- PLANNING, COORDINATION AND EVAWATION 9b, 13a, 23d, 29e, 33a, 38b, 41b, 41c, 41e, 51d, 52a, 58a, 64a, 69a, 69c, 7?d, 75a, 76c, 82c, 85c, 92b, 92c, 103a, 108e, 110a, 110d, llla, llzc, 112d, 118d, 118e, 119d, 120b, 121c, 127a, 138g, 146c, 153a, 156a, 163a, 167a, 173d, 178a, 180b, lggb, 206b, 206c, 207a, 207b, 207c, 207d, 208a, 208b, 226a, 231a -236- APPROVED OPERATIONAL PROJECTS INDEXED BY DISEASE ORIENTATION HEART DISEASE Continuing Education and Training 4c, 13b, 13c, 13d, Zla, Zlc, 22b , 1, 22c, 24b, 29a, 40a, 44b, 44d, 46c, 49c, 504, Slc, SSa, 55b, Sft, 59bp 59c, 60a, 69d, 70a, 70b, 70c, 72b, 75d, 75e, 76d, 79d, 80b'914, 95c, 95e, 96a, 101d,@ lOza, 103c, 106c, 107b, 107c, 108d, Ilee, 120d, 122a, 127b, 133a, 133'b,, 133c, 133d, 134a, 138a, 138b, 143b, 145b, 145c' 145d, 156b, 156c, 161a, 172b, 172c, 173a, 178b, 17$d, 179a, 184b: 184c, 184e, IgSc, 190a, 190f, 194f, 196a, 196d, 19Ta, 197b, 198a, ZOZC, Z 1 2b, 2 17a, 218&, 218c, 224b, 232c, Z33a Demonstration of Patient Care 8b, 8c, 8d, 8e, 45c, 50c, 50e, 70d, 70c, 7Za, 95d, 96b, IOZC, 102d, 113a, 120a, 120e, IZ4a, 134b, 139c, 145a, 146b, 153b, 167b, 178c, 180c, 184a, 184d, 185a, 185b, 190b, 19*c, 190d, 190e, 195a, 195f, 196b, 196c, 197c, 197d, 199d, Z05d, Zl?-c Research and Development 44c, 45a, 45d, 64d, 73a, 80a, 119e CANCER Continuing Education and Training 14a, 14b, 15b, 15c, 23b, Z8c, 29c, 35a, 50b, 51a, 58c, 76b, SZb, 84c, 106d, lIZa, 134c, 144b, 146d, 157a, 169c, 173c, 180d, 186&, 194e, 195a, 195b, 195c, 198b, 202a, ZOZB, Z03a, 203b, 209b, Z09c, Z12d, 219a, 2ZOa Demonstration of Patient Care 4d, 9a, 33b, 71a, 101c, 121b, IZ3b, IZ7c, IZ8a, 168b, 169a, 185d, 185e, 186b. 186c, 206a, 218e, Z31b, Z31d, 232b, Z32d, Z33b Research and Development 66a, 97d, 123a, 143d, 180a, 203c, 204a, Zlgf, ZZSB Planning, Coordination and Evaluation 108c, 208a -237- STROKE Continuing Education and Training 71b, 81b, 81c, 83a, 83b, 118c, 121a, 138d, 144e, 146a, 157b, 161b, 179c, 181a, 220a, 220b Demonstration of Patient Care 24d, 28b, 64c, 72c, 75b, 75c, 96c, 96d, 96e, 97b, 97c, 101a, 106a, 106b, 107a, 107b, 120c, 171b, 171c, 171d, 172a, 173b, 180e, 186d, 187a, 191a, 199e, 204b, 205c RELATED DISEASES Continuing Education and Training 23c, 29b, 34a, 34b, 45b, 49b, 60b, 107a, 110e, 135b, 143c, 167c, 169b, 181b, 181c, 181d, 219d Demonstration of Patient Care 22d, 23a, 51b, 55d, 97e, 102b, 156d, 187b, 204c, 219c, 224c, 225d, 231c Research and Development 46a Planning, Coordination and Evaluation 173d MULTI-CATEGORICAL Continuing Education and Training 4a, 4b, 7a, 7b, 7c, 7d, 8a, 14c, 15a, 16a, Zlb, Zld, 22a, 24c, 28a, 28d, 29d, 30a, 33c, 35b, 35c, 35d, 39a, 39b, 39c, 40b, 40c, 41a, 46b, 49a, 49d, 49e, 50a, 55c, 55e, 58b, 58d, 65a, 65b, 66b, 69b, 79a, 79b, 79c, 80c, 81a, 82a, 83c, 84a, 84b, 85a, 85b, 91a, 91c, 95a, 108a, lllb, 117b, 122b, 122c, 123c, 127d, 135a, 138c, 138e, 138f, 144a, 144c, 144d, 153c, 157c, 161c, 163b, 163d, 164a, 164b, 168a, 168c, 171a, 172d, 187c, 191c, 194a, 194b, 194c, 194d, 195d, 199a, 199c, 200a, 212a, 217b, 217c, 217d, 217e, 218b, 218d, 224a, 225a, 225c, 232a, 233c Demonstration of Patient Care 24a, 38c, 40a, 64b, 65c, 95b, 103b, 117a, 117c, 117d, llga, 179b, 191b, 205a, 205b -:238- Research and Development 44a, 91b, 9Zd. llllc, Illd, I 12b, 118a, 118b, 119c, 143a, 198c, 1984, 219b PlAnning, Coordination and tmluatiois 51d, 76a, 92c, 103a, 112d -239- U.S. GOVSRNMENT PRINTING OFFICE: 1969 0-336-994