H. KORNEGAY DISTRICT 6 - GREENSBORO NORTH CAROLINA REGIOiNTi@L MEDICAL PROGRAM The North Carolina Regional Medical Program was among the very first for which a planning grant was awarded (effective July 1, 1966). All three medical schools in the Region (Bowman-Gray, Duke University, and the University of North Carolina) have cooperated closely in the planning and development of this Program. Planning and the study of health problems in the Region has progressed C) rapidly. Now in its second year, with a grant of $733,674, the North Carolina Regional Medical Program has already developed and submitted its initial operational proposal. Brief descriptions of the nine opera- tional projects for which support has been requested, are included in the attached summary. March 1968 DISTRICT 6-GREENSBORO NORTII CAROLINA REGIONAL Ml,"DICAT, PROG[TAM REGION State of North Carolina COORDINATING HEADQUARTERS Duke University (For Association for the North Carolina Regional Medical Program') STARTING DATE July 1, 1966 FUNDING Current Award: $773,674 Current Request: $1,570,0'07 Projected Next Year: $2,200,000 OPERATIONAL STATUS Currently under review AWROG@A_NL COORDINATOR Marc J. Musser, M.D. 4019 North Roxboro Road Durham, North Carolina 27704 ADVISORY GROUP 1. Chairman: Dr. George W. Paschal, Jr. 1110 lqake Forest Road Raleigh, North Carolina 2. Membership: 27 (attached) Practicing M.D.'s 4,-iNled4@cal Center 5, Hospital Administrators 2, Voluntary Health Agencies 2, Public Agencies 5, Allied Ilea"-th 5, Public 4. ORGANIZATION AND STAFFING The regional program is organized as the Association for the North Carolina Regional viedical Program. Duke University is the fiscal agent. The Association is composed of a Regional Advisory Council. The Council elects an eighteen member Board of Directors which meets monthly. An Executive Corir,,ittee of five members acts for the Board between meetinys. The ob ectives and policies of the Association are carried out by an administrative staff under the direction of the Pro;-,i..-am Coordinator. The administrative staff is divided into five divisions: 1. Administrative Services Div-Lsion 2. Research and Evaluation Division 3. Hospital Division 4. Professional Procram Developraent Division C, 5. Communications and Information Div@Ls-Lon qk,,ORTH CAROLINA - 2- The mechanisms for a viable and growing Regional Medical Program exist in North Carolina., Projects originate from a variety of sources both inside and outside of the Program. Proposals are submitted to the Association office for technical review. They are then reviewed by the Executive Office which forwards favorably reviewed proposals to the Board of Directors. The Board of Directors submits the proposals to the Advisory Council which reviews them through the involvement of eight subcommittees. The Council reports to the Board of Directors which then takes final action. An especially valuable resource is the Research and'Evaluation Division of the Core Staff which provides essential basic data and designs methods of evaluation for all pro4 ects submitted. i It is estimated that approximately 140 persons are actively contributing to the proaram either as full or part-time core staff members as cor.sultants, or as committee members. REGIONAL ADVISORY GROUP The Re-ional Advisory Group is composed of 27 members representing a considerable reservoir of experience, ability and leadership. The Group meets twice a year jointly with the Board of Directors and as many times as necessary to u i its responsibility to the program. It has met six times to date. According o the Articles of the Association, the Advisory Group has the following unctions: 1. to review the programs of the North Carolina Regional Medical Program with concern for the degree of relevance to the objectives of the overall program; 2. to advise as to the future directions of the program; 3i to encourage cooperation among participating institutions; 4. to approve operational proposals. T'ne eight subcommittees of the Regional Advisory Group work closely wi*lh t,qe Association staff and serve as a cohesive liaison with the full group. PLANNING ACTIVITIES Activities to date have brought the region to a level of readiness for operational status. An administrative and coordinating mechanism involving the health resources in the Recion has been formed. It has demonstrated its capacity for effective 0 decision-making, the relating of decisions to needs, and the stimulation of productive cooperative effort among the major health interests. Representative leadership has been recruited for the guidance and coordination of t,ie program. NORTH CAROLINA -3- During the planning period a comprehensive survey of the health needs, facilities, and manpower within the re(,ion was undertaken, cooperative 0 arrangements among institutions and local medical societies were developed and an active public health professional information program was initiated. A feasibility study (A State-wide Diabetic Consultation and Education Service) and two pilot projects (The Development of and Training for Intensive Coronary Care Units in Community Hospitals, and Education and Research in Community Medical Care) have been initiated and are progressing favorably. Nine operational projects now in various stages of development have been submitted for support. The Operational objectives of the program are: 1. Improved utilization and augmentation o health resources to meet needs; 2. Continued evaluation and survey of impact of Regional Medical Programs; 3. Research. S@,DIARIES OF PL@OPOSED OPERATIONAT, PROJECTS .L. Education and Research in Community Medical Care To develop resources for training more medical and allied medical students; to provide new types of educational experiences which will make family practice more attractive; to have a postgraduate education program.at the medical school; to strengthen ties between the medical school faculty and practicing physicians; and to have the medical school become involved in community planning for improving the quality and availability of medical care. 2. Coronary Care Training and De o -,n n@t 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 provided to nurses and physicians, consultation will be available to nurses and physicians, consultation will be available to hospitals in establishing CCU'S, and a computer-based systen of medical record keeping. 3. Diabetic Consultation and Educational Services To establish three medical teams to deliver services throughout the state.; to assist -Ln expansion of diabetic consultations and teaching clinics; to provide seminars for nurses and pat-Lents to assist in organization of a 0 state Diabetes association and local chapters; to test techniques of data collection. NORT!I CAROLINA -4- 4. Development of a Central Cancer Registry To devise a uniform region-wide cancer reporting system, integrated with the PAS, the computer-stored data from which can be retrieved to serve a broad range of educational, research, statistical, and other purposes. 5. Medical Library Extension Service 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. Bibliographic request service will be established. 6. Cancer Information Center To provide physicians with immediate consultation by telephone and follow-up literature. Each of the three medical schools will be responsible for providing service in its geographic locale. 7. Continuing Education in Internal Medicine To bring practicing internists to the Medical Center for a month of up-to-date training in their subspecialties. They will share responsibilities with attending physicians and make ward rounds with students, staff, and together. 8. Continuing Education in Dentistry To provide physicians and dentists with the knowledge o' mutual concern which will enable them to be more effective memDers 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. 9. Continuation Education for Physicia n TheraDists 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. ADVISORY COMMITTEE FOR PLANNING FOR REGIONAL MEDICAL PROGRAMS IN NORTH CAROLINA Chairman Dr. George W. Paschal, Jr. 1110 Wake Forest Road Raleigh, North Carolina Voluntary Agencies Dr. Eloise R. Le;qis, President N.C. State Nurses Association Greensboro, North Carolina Dr. E. H. EI'Linwood N.C. Public Health Association Greensboro, North Carolina Miss Elizabeth Hendrik N.C. Society of Medical Technologists Chapel Hill, North Carolina Mr. Paul Roberts N.C. Physical Therapy Association Asheville, North Carolina Mr. Elisha M. Herndon N.C. Health Council Durham, North Carolina Dr. Georae F. Kirkland, Jr., Pres., N.C. Dental Society Durham, North Carolina Dr. I-lark M. Lindsey N.C. Division of American Cancer Society Hamlet, North Carolina Mr. W. James Logan N.C. Heart Association Chapel Hill, North Carolina Mr. S. D. Griffin N.C. Pharmaceutical Association Burling&-on, North Carolina Officia ncies Dr. L. L. Schurter N.C. Division Vocatio-,ial Rehabilitation Raleigh, North Carolina Mr. Robert H. Ward N.C. Board of Public Welfare Raleigh, North Carolina Dr. Jacob Koomen, Director N.C. Board of Health Raleigh, North Carolina Representatives of the Public Mr. Francis C. Bourne, Jr. Murphy, North Carolina Mr. Thomas Bridgers Wilson, North Carolina Mr. R. Harold Staton Greenville, North Carolina Mr. Thomas H. Wright, Jr. Wilmington, North Carolina Physicians at Large Dr. George W. Paschal Chairman Raleigh, North Carolina Dr. Paul Sanger Charlotte, Nortb Carolina Dr. Frank Sullivan Wilson, North Carolina Dr. Joseph Walker Winston-Sale,-ii, ',North Carolina Community Hospitals Cabarrus Memorial Hospital Concord, North Carolina No representatives named to date Cone Memorial Hospital Greensboro, North Carolina