Igo El B. ADAMS DISTRICT 7 - SEATTLE WASHINGTON-ALASKA REGIONAL MEDICAL PROGRAM The Washington-Alaska Regional Medical Program under the leadership of Dr. Donal'R. Sparkman, Program Coordinator, and an advisory group of thirty members has completed its first year of planning and embarked upon its initial operational program. Current awards for both continued planning and initial operations total $1,656,151. It is one of the eight Regional Medical Programs which has reached the operational staae. Continuing education for physicians and the tra3'-nlng of allied health personnel figure importantly in its operational program. Several projects are aimed specifically at enhancing the health resources of Alaska. More detail on the program can be found in the attached summary. The University of Washington School of Medicine, located in Seattle, is the coordinating headquarters of the Washington-Alaska Regional Medical Program March 1968 B. ADAMS DISTRICT 7 - SEATTLE WASHINGTON-ALASKA REGIONAL MEDICAL PROGRAM REGION: States of Washington and Alaska COORDINATING HEADQUARTERS: University of Washington School of Medicine STARTING DATE: September 1, 1966 FUNDING: Current Award: $1,656,151 Projected Next Year: $2,387,587 OPERATIONAL STATUS: Now pending. See project descriptions below. PROGRAM COORDINATOR: Dr. Donal R. Sparkman Associate Professor, School of Medicine University of Washington ADVISORY GROUP: 1. Chairman: Dr. Donal R. Sparkman 2. Membership 30 (attached) Practicing MD's 11, Medical Center 4, Hospital Administrators 2, Voluntary Health Agencies 3, Public Health Officials 2, Other Public Officials 1, Allied Health Personnel 2. Public 5. Organization and Staffing During the past year, several top staff members were recruited to assist Dr. Donal Sparkman, who has been the program's director since its inception. The key staff personnel now include Mr. Tasker Robinette, Director of Health Care Services, Mr. Bill Thompson, Director of Project Administration, Mr. Jack Kornfeld, Director of Data Analysis, Mrs. Marion Johnson, Director of Communications, Dr. Stephen Yarnall, Director of Project Development, and Mr. Lawrence Sharp, Sociology Consultant. In addition, several project directors for the operational projects have been recruited through the University. The Washington-Alaska Regional Medical Program core staff personnel has been instrumental in the planning activities of the region, and in formulating policies by which the program will operate. Subregional Development The Alaska And Spokane areas have been operating as subregions in relation to the core staff in Seattle. Plans to further implement the subregions concept are presently being considered. Washington-Alaska RNP -2- Regional Advisory Group An active Regional Advisory Group has most recently reviewed and approved. the operational grant proposal, which was subsequently awarded. In addition, this 30 member group has made several recommendations concerning program goals, and has appointed an Executive Committee to be responsible for major Regional Medical Program interim decisions. The Group also recommended that categorical subcommittees be established, and they are presently very active in reviewing and proposing specific projects. Planning Activities The major thrust of Washington-Alaska's Regional Medical Program planning has been in the areas of data collection and feasibility studies, with the core staff providing the major inputs into this planning. A Planning Committee and a Consulting Committee have also been formed to aid in the overall Planning process. In the specific areas mentioned above, the following are representative of some of the efforts made to date: (1) Data Studies: (a) patient origin (b) heart registry (c) stroke facilities (d) nursing manpower (2) Feasibility Studies: Health resources study--to test the feasibility of providing emergency health care services without a doctor. Operational Activities The following are summaries of the Washington-Alaska Regional Medical Program operational projects, which were recently funded: (1) Central Washington Project Several methods of bringing the medical resources of Seattle closer to Central Washington have been proposed. First physicians from the University of Washington will hold conferences'and seminars at various hospitals in Yakima (Central Washington). The doctors from Yakima will then act as consultants for the smaller community hospitals in the area. Second educational television programs conducted by faculty at the University of Washington will be broadcast to Yakima where physicians will summarize the content for Washington-Alaska RNP -3- Operational Activities (1) Central Washington Project cont'd. .outlying practitioners. Thirty-five community hospitals will be connected by an EKG hotline that will-permit quick analysis by trained technicians. (2) Southeastern Alaska Project To alleviate Southeastern Alaskan physicians problems of isolation, several long-range communication methods will be used to bring information to the practitioner. As in the Central Washington project consultants from Seattle telelectrures EKG hotlines, and library support will be tested. (3) Postgraduate Preceptorships for Physicians--University of Washington School of Medicine This project provides the opportunity for isolated practitioners to come to Seattle for d week or more to study coronary care under the guidance of a preceptor. Stipends for the preceptees will be provided, as will physicians to cover their practice while they are in Seattle. This program will serve as a pilot project to test the feasibility of the preceptor approach to continuing education in other areas. (4) Two Way Radio Telephone Conferences on Continuing Health Sciences Education (RAD TEL-CON)--University of Washington Six radio programs on topics selected by a panel of physicians will be broadcast to twenty hospitals in Washington, each of which will be provided with slides to accompany the presentation. A two way radio hook-up between the instructor and the hospitals will offer physicians in the audience an opportunity to ask questions. (5) Information and Education Resource Support Unit The support unit is a central clearing house for Washington- Alaska Regional Medical Program educational programs. It will produce educational informational and promotional literature films and programs, as well as coordinate audiovisual projects such as those mentioned in 1, 2, and 4. The central coordinat- ing unit is especially important to Washington-Alaska Regional Medical Program because so many of its projects are individual programmed learning units aimed at each practitioner's unique needs. A central support unit can send each individual the precise learning unit he requests. Washington-Alaska RNP -4- operational Activities cont'd. (6) Coronary Care Unit Coordinator The CCU Coordinating Committee will distribute new information on patient care in coronary units. The committee will also write a syllabus for a course in coronary care unit work, and set standards for the many nurses and physicians training courses in this area. (7) Continuing Education and On-The-Job Training of Laboratory Personnel Five designated local training centers will list laboratory procedures that should be available in their communities and send the list to the University of Washington. The University of Washington will make the list available to smaller community labs, which will then designate in which procedure training courses they would like to place a trainee. University of Washington will arrange for one of the five training centers to run a course for the trainee. (8) Cardiac-Pulmonary Technician Training Program This project will develop a program for training cardiopulmonary technicians to take over non-critical functions in coronary care units and free physicians for other duties. Four major hospitals and the Spokane Community College will cooperate in conducting the program. (9) Alaska Medical LibraEZ Since Alaska has no medical library the Washington-Alaska Regional Medical Program proposes to establish one in Anchorage the State's population center. Cooperative arrangements with other libraries will be established. (10) Anchorage Cancer Program In 1966, 102 cancer patients in Alaska required super-voltage therapy treatment but there was no equipment for it in the State. Some local money has been raised the rest is being applied for in this grant. The facility will be located in Anchorage. (11) Children with Cancer This is a study to determine the impact of different methods of caring for childhood cancer. Specifically, children treated in their loc al community and at a major center will be compared as to Washington-Alaska RMP -5- Operational Activities (11) Children with Cancer cont'd. (1) their physicians' feelings about the treatment (2) why or why not the children were treated at a center (3) socioeconomic impact on their families and (4) availability of adequate equipment. (12) Radiological Physics Program The Washington-Alaska Regional Medical Program wants to hire a radiological physicist as a consultant for smaller hospitals to aid in dosimetry and other problems of radiotherapy. Provisions will also be made for equipment calibration. (13) Computer Aided Instruction in Heart Disease, Cancer, Stroke and Related Diseases A group of nurses studying electrocardiographic diagnosis of arrhythmias will lie given supplemental computer aided instruction.. Another group will not. The results of the comparative studies will be used to determine the effectiveness of computer aided 10 instruction for teaching medical techniques. The participants will also become familiar with using computer terminals which are becomin more important in medical work. 9 Relationship to Comprehensive Health Program The Washington-Alaska Regional Medical Program has planned to'. set up a number of community planning bodies, which it is anticipated will tie-in with the comprehensive area-wide health planning under this program. March 1068 ADVISORY COMMITTEE FOR PLANNING FOR REGIONAL MEDICAL PROGRAMS IN WASHTNGTON AND ALASKA Chairmen Donal R. Sparkman, M.D. Chairman, Regional Advisory Group Associate Professor School of Medicine University of Washington Seattle, Washington Henry I. Akiyama, M.D. Chairman, Southeastern Alaska WARMP group Juneau, Alaska Advisory Committ'ee Members John Bigelow Executive Director Washington State Hospital Association Seattle, Washington Amos P. Bratrudel M.D. Chairman, Continuing Education Committee Washington Academy Omak, Washington Thomas Carlile, M.D. Past President, American Cancer Society Seattle, Washington H. P. Dygert, M.D. Member Board of Trustees Washington State Medical Association Vancouver, Washington John W. Finley, M.D. Director, Tumor Registry and Clinic King County and Providence Hospitals Seattle, Washington George Grimes Past President, Alaska Division, Cancer Society Anchorage, Alaska Lucius D. Hill, M.D. President, Washington State Medical Association Seattle, Washington 2 John R. Hogness, M.D. (Ex Officio), Dean, School of Medicine University of Washington Seattle, Washington Ralph Huey, D.D.S. Chairman, Professional Practice Committee Washington State Dental Association Renton, Washington Mrs. Jeanne M. Irving Director of iNursing Everett Junior College Everett, Washington Mrs. Isabelle S. Lamb Hoquiam, Washington Robert Leahy, M.D. Medical Director Division of Vocational Rehabilitation Olympia, Washington John N. Lein, M.D. Assistant Dean School of Medicine University of Washington Seattle, Washington Charles N. Lester, M.D. Seattle-King County Health Department Seattle, Washington Robert M. Levenson, M.D. Past President, Washington State Heart Association Seattle, Washington Allan W. Lobb, M.D. Medical Director Swedish Hospital Seattle, Washington Gordon A. Logan, M. Director, Providence Heart Center Providence Hospital Seattle, Washington Patrick A.Lynch, M.D. Co-thairman, Central Washington Regional Medical Program Group Yakima, Washington 3 Robert Ogden President, North Coast Life Insurance Company Spokane, Washington William E. O'Neil Seattle, Washington William 0. Robertson, M.D. Associate Dean, Medical Director Affiliated Hospitals University of Washington School of Medicine Seattle, Washington Carl P. Schlicke, M.D. Past President, Washington State Medical Association Spokane, Washington Paul Shields, M.D. President, Northeastern Division Washington State Heart Association Spokane, Washington Jess B. Spielholz, M.D. Washington State Department of Health Olympia, Washington Thomas B. Stewart Judge, Superior Court President, Alaska Heart Association Juneau, Alaska Harry Wheeler, Administrator Deaconess Hospital Spokane, Washington W. R. Williams Spokane, Washington Bruce C. Wright, M.D. Chairman, Alaska Coordinating Committee for WARMP Anchorage, Alaska