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                              PROFILE:  OKLAHOMA MGIONAL MEDICAL PROGRM




                     Grantee                  University o'f Oklahoma Medical Center


                     Direct6r                 Dale Groom, M.D.




                     Originally Prepared By:  Frank G. Zizlavsky


                     Original Date            September 1, 1969




                     Updated













                                              TABLE OF CONTENTS


                              I.  Geography

                             II.  Demography

                             III. Politics


                              IV. Historical Review


                               V. Core Staff


                              VI. Overall Organization

                             VII. Funded Operational Projects

                                  APPENDIX








                  GEOGRAPHY

                  Geographic Definition of the ReFion:
                  From the beginning this Region has been defined as the State of Okla-
                  homa.  The original judgement was that the State constituted a logical
                    gio al unit.  Neither Oklahoma nor its neighboring Re-ions have rigid-
                  re   n
                  ly interpreted inter-regional boundary lines.  For example, ORNP will
                  encourage communities in the far eastern portions of Oklahoma to part-
                  -icipate in any activities sponsored by the Arkansas Regional Medical
                  Program at Ft. Smith,Arkansas.  On the other hand., the cardiologists
                  in Ft. Smith are already cooperating with the Oklahoma @NIP coronary
                  .care project, with:approval of the Arkansas RMP.





















                                              ENID
                                                                 TULSA
                                                                  10



                                                    OI<LAHOMA CITY
                                                       0



                                                              ADA
                                                               0







                 11.    DEMOGRAPIIY

                        I-)-  Popu-l,at-ion -.2.52 million        (as of July 1, 1968)

                              a..  63/. Urban
                              b.   90% White, 7%       Negro, 3'/.   Other
                              c.   Median Age - 30 years (U.S.  average 29.4) 1960

                        2)  'Land Area - 68,887 squdre miles

                        3)    Health Statistics

                              Death Rates.by Selected Causes/100,000                   1967, Unpublished

                              a.   Heart Disease         368.8 (slightly higher)
                              b.   Malignant Neoplasms            157.6 (slightly higher)
                              c.   Vascular lesions - 127.4 (high)'
                              d.   General Arteriosclerosis - 19.9              (higher)
                              e.   Diab.etes - 21.     4 (very high)

                        4)    Facilities

                              a.   University of Oklahoma School of Medicine                     enrollment 396
                              b.   Schools of Nursing - 11 (3 college or University affiliated)
                              C.   Schools of Medical Technology 13
                              d.   Cytotechnology, University of Oklahoma (1)
                              e.   There are 138 hospitals with 19,202 beds

                        5)    Personnel Statistics

                              a... As of 1967, there were 2,904 physicians (2,483 M.D.s and
                                   421 D O.s) for a rate of 119/100,000.
                              b.   As of   1966, there were 6,582 total nurses of which 4,435 are
                                   employed.




           111.  POLITICS

                  Governor:                           Dewey F. Bartlett (R) 1968-Present

                  Senators:                           Fred R. Harris (D), 1966-1973
                                                           Government   Operations
                                                      Henry L. Bellmon (R), 1968-1975
                                                           Interior and Insular  Affairs

                  Representatives:                    Ed Edmondson (D)
                                                           Interior and Insular  Affairs
                                                      .John N. Happy Camp (R)
                                                           .Interior and Insular Affairs
                                                      John Jarman (D)
                                                           Interstate  and Foreign Connerce
                                                      Tom Steed (D)
                                                           Appropriations







           IV    HISTORICAL REVIFX


                 ]November, 1965:
                 Dr. James L. Dennis, Director and Dean of the-tniversity of   Oklahoma
                 Medical Center appointed a committee for Re-ional Medical Program,
                 charging it with the responsibility of establishing a PM.

                 February, 1966:
                 The Honorable Henry Bellmon,  Governor of the State of Oklahoma,
                 designated the University of  Oklahoma Medical Center as the  Planning
                 Agency for the State and charged it with the responsibility   of
                 carrying out the feasibility studies and planning  activities  for  the
                 establishment of a RNP.


                 March., 1966:
                 Governor Bellmon appointed a Regional.Advisory Council.

                 May 19, 1966:
                 Division of RNP received the first year planning application from
                 the Oklahoma Regional Medical Program.

                 Council's points of concern:
                      1.  Question as to whether minority groups were  included  in  the
                          Advisory Group.  (See February, IC967 #4)
                      2.  Relationship of the Advisory Group to the direction of the
                          project was not clear.  (See July, 1967 #1)
                      3.' Administrative relations were vague.
                      4.  How this project would relate to other Public Health Service
                          supported activities in Oklahoma needs    delineation.
                      5.  Relationship between budget and program activities was not clear.
                      6.  Concerned about the direction of the proiett.-since neither the
                                                                       (See February, 1967 #1
                          Director nor Associate Director was named.
                          and March, 1967 and October  1968)
                                                      3-
                      7.  Role of the different staff members needs amplification.

                 September, 1966:
                 01 Planning Award   $177,963  (9/l/66 through 8/31/67)

                 February, 1967:
                 Negotiating Site Visit:
                 Site Visit Team:
                      Dr. John Hamilton
                      Mr. Ira Alpert
                      Mr. Lawrence Coffin
                 1.  ORMP is negotiating with individual for position of Director of
                     Oklahoma RMP.
                 2.  RAG is not active, and presently no rules or bylaws established.
                     (See July, 1967 #1  and February, 1969
                 3.  Little actual planning has taken place.
                 4*  Negro dentist appointed to RAG.








                 March, 1967:
                 )(elly M..West, M.D.  appointed as Acting Director.   Oklahoma   RNP,
                 together with the  Missouri and  Kansas   Regions,   co-sponsored-an,
                 inter-regional Health Manpower   Conference, hosted  by  the  Kansas,
                 Region.

                 Julyo 1967:
                 ORNP requested $302,834 for second year planning.  Phase I     is
                 almost co  leted and Phase II will begin shortly.
                           MP

                 First year  Progress R@port:
                       1.  Two permanent advisory groups were established:  OUIP
                           Advisory Council and the University of Oklahoma Medical
                           Center Committee.
                       2.  Oklahoma State  Medical  Association  appointed  a  special
                           liaison committee on ORMP.
                       3.  Progress achieved developing liaison with various boards
                           and committees, i.e. Health Intelligience Facility Board,
                           Board of  Oklahoma  Health  Sciences  Foundation,  Oklahoma
                           Medical Research Foundation, etc.
                       4.  Preliminary study of health library resources was undertaken.
                       5.  Ad Hoc Committee on Heart and Cancer appointed.
                       6.  Regional planning activity launched in diabetes and nutrition.
                       7.  Ad Hoc Cancer Planning Group submitted preliminary report.

                 August,  1967:
                 Suggestions made from staff visit by Philip A. Klieger, M.D.:
                           Actively involve RAG  as  prooram  activities-  accelerate.
                                                        C)
                       2.. Submit a supplements  p anning grant.

                 02 Continuation  Planning  Award  -  $1562801.  This  represents  new
                 funding of $27,056 and  an  estimated  carry-over  of  $129,745  from
                 first year of ORNP planning grant.

                 Second year supplemental planning grant requested'in the amount.of
                 $125,299.  The increase in staff to be supported by the supplemental
                 grant would make it possible to involve more extensively the commun-
                 ity hospitals of the Region in the planning process.

                 liovemb6r, 1967:
                 Review Committee recommended funding for time and amount requested.
                 Council approved second year supplemental planning grant.

                 December, 1967:
                 02 supplemental planning grant awarded $125,299 for a nine month
                 period.  This will help their defined needs which were not anticipated
                 originally.








                 May, 1968
                 01 Operational Grant submitted.  This  application requests continuation
                 of core staff and includes a proposal  entitled "A Regional Emphysema
                 Program for  Oklahoma."

                 July, 1968:
                 Third year continuing planning grant submitted.

                 August  1968:
                 Council deferred action until November on application for new operational
                 grants and supplemental grants adding new operational  projects to ex-
                 igting operational programs.

                 August, 1968:
                 03 Continuation planning project awarded
                 $323,993 (Direct costs)
                    43,707 (indirect costs)
                 $367,700

                 October  1968:
                 Dr.  Dale Groom became Director of Oklahoma RMP/
                 Review Committee recommended deferral for site visit on new operational
                 grant.

                 November, 1968:
                 Site Visit Committee:
                 Henry Lemon, M.D., Chairman
                 Elliott Rapaport,  M.D.
                 Ralph W. Ingersoll, Ph.D.
                 Anthony Komaroff,  M.D.
                 Mrs. Patricia  McDonald
                 Comments:
                 This application should be reviewed in a  way that strengthens the
                 community outreach from the medical center and the innovative involve-
                 ment of,communities away from the medical center.

                 February, 1969:
                 Election of ten new members to Oklahoma's Regional Advisory Group.

                 February, 1969:
                 Council approved new operational award which consisted of  the following
                 ten projects:  Core (for 10 months only),  coronary care,  emphysema,
                 continuing education, cancer control, library, smoking and health
                 uiam-nography, nutrition and diabetes, cancer of the prostate.

                 March, 1969:
                 Representatives of ORMP met with DPJQ staff for  a negotiation meeting.'
                 At this meeting, the O@ was given the option of continuing under two






                 grant awards until September,  1.970 or terminating the planning grant
                 early to have one operational grant in effect as of either April I
                 or May 1, 1969.  The ORNP selected the one mechanism for funding effect-
                 ive May 1, 1969.

                 May, 1969:
                 01 Operational Grant awarded
                 $1,074,145 (Direct costs)
                    181,099 (Indirect costs)
                 $1,255,244 Total

                 This period begins May 1, 1969 through April 30, 1970.  The planning
                 grant that had supported the 1970 core program has been terminated.







                    CORE STAFF
                                                                              'INSTITUTION
                    NAM                            TITLE                      AFFILIATION           % OF 'kIllE

                    Dale  Groom,  M.D.             Director                   U. Okla. Med          100%
                                                                              Center

                    Neal  H. Hardin, M.S.          Program Manager            U'. Okla.  Med        100%
                                                                              Center

                    Robert G. Tompkins,    M.D.    Coordinator,               St.    Francis           25%
                                                   Tulsa    Planning          Hospital, Tulsa
                                                   Program

                    Kenneth C. Hager               Coordinator,               U.  Okla.   Med.      100%
                                                   Health  Career   Re-       Center
                                                   cruitment Programs;
                                                   Exec. Directors
                                                   Okla.  Council   for
                                                   Health'Careers

                    Larry A. Fowler                Public Health              Division  of.         100%
                                                   Advisor                    Regional  Medical
                                                                              Programs

                    Donna Barlow                                              U.   Okla. Med.          50%
                                    R.N.3          Coordinator, Nurs-
                    Ph.D.                          ing    Activities          Center

                    John M. White, Jr.,    M.S.    Coordinator,    Con-       U.   Okla. Med.       locr/.
                                                   tinuing    Education       Center
                                                   Health    Related
                                                   Professions


                    Roger Wolfe                    Coordinator,    Com-       U.  Okla.   M6d,      1000/.
                                                   munications    Media       Center

                    Norman E. Goodwin              Director, Health           U.  Okla.   Med.      100%
                                                   Intelligence               Center
                                                   Facility







              BIOGRAPHICAL INFCiRiIATION

              1)   Dale  Groom, A.B.,, M.D., M.S. (In Medicine)

                   a.  Born Tulsa, Oklahoma - 1912
                   b.  1936   A.B. - Hiram College, Ohio
                       1943   M.D. - Medical College of Virginia
                       1949   M.S. - In Medicine, University of Minnesota
                   c.  Internship    Passavant Memorial Hospital, Northwestern Univers'ty      I
                                                                                         I       94i
                   d.  Fellow in Medicine, Mayo Foundation, 1945-49
                   e. -Director of Postgraduate Education, Medical Colle e of South
                                                                          9
                       Carolina - 1960
                   f4  Associate Professor of Medicine - 1965; Assistant Dean    at Medical
                       College of South Carolina - 1966
                   g.  October, 1968 - Became Director of Oklahoma RYIP

              2)   Neal Harris Hardin, Jr.

                   a.  Born 1917 - Texas
                   b.  1954 - B.S., Mathematics; Trinity University
                       1964 - M.A., Psychology; University of Arkansas
                   c.  1964-1967 - Deputy Commandant, United States Air Force
                       Extension Course Institute
                   d.  1967 to Present - Program Manager

              3)   Robert George Tompkins, M.S. (Med),  M.D.

                   a.  1943:- B.S, - University of Washington
                       1947.- B.M. - Northwestern University
                       1949,- M.D. - Northwestern University
                       1953 - M.S. - University of Minnesota
                   b.  1949-50 Assistant Resident in Medicine     King County Hospital
                       System, Seattle, Washington
                   C.  Fellow.in Medicine - Mayo Clinic - Rochester, Minnesota      5 years,
                       2'years in cardiovascular physiology and research
                   d.  1960-64 Chairman, Department of Medicine, Saint Francis    Hospital,
                       Tulsa, Oklahoma

              4)   Larry A. Fowler

                   a.  Born -1938
                   b.  1963 - B.S.   University of Louisville (Presently completing
                       requirements for Master's degree in Public Health at University
                       of Oklahoma)
                   e.  Division of Regional Medical Programs, Programs Assistance
                       Branch assignee to O@IP








                         OVERALL  ORGANIZATION



                                                         search and  Deve opment  Office of
                  The grantee-is the Medical    Center Re'
                  the University of Oklahoma    FoLindation2 Inc.  The University of Oklahoma
                  Medical Center continues to serve as the agent for planning and oper-
                  ations.



                  A.   Planning Groups

                       Oklahoma City:

                       1.  Director and eight   full-time staff.
                       2.  Coordinator (1)
                       3.  Secretary-Administrator (1)
                       4   Program Manacer (1)
                       5:  Public Health Advisor (1)
                       6.  Ph.D. - Behavioral Scientist (1)
                       7.  Consultants (3)

                       Tulsa:

                       1.  One Coordinator (1/3 time)
                       2.  Secretary-Administrator (full-time)
                       3.  Coordinator for Planning Activities    in Nutrition and Diabetes-.
                           (part-time)

                       Ada:


                       No Staff


                       Enid:


                       No Staff

                       The chairmen.of the planning groups in Ada and Enid report directly
                       to the Director of the Oklahoma


                  B.   Regional Advisory Group
                  'The Advisory Council serves as  the supervisory body and its    functions
                  and  responsibilities are those  set forth in the law creating the @fp
                  and  the guidelines by which these programs are administered.  The
                  principal Executive Officer for the program is the Director who is
                  responsible to the Advisory Council and to the Vice President for
                  Medical Center Affairs of the University of Oklahoma.  The Executive






                   Committee is   composed of ei&ht members:'    @Hono@ary Chairman   is   Governor
                   Dewey F. Bartlett  and  Chairman  is  Dr.  James  L.  Dennis  wlio-is  also.Vice
                   President    and Dean  of  the  University  of  Oklahoma  Medical   Center.   The.
                   position  of  Chairman-Elect  of  the  ORMP  Advisory  Group  is  nominated  at
                   the last meeting of  the  year  for  the  next  year's  term  of  one  year.  In
                   the    following year he automatically becomes Chairman of the      O@NFP  Ad-
                   visory  Group..  This  position  is  voted  on  by  all.o@T  Advisory   Group
                   .-members.   The Regional  Advisory  Group  is  composed  of  37  members   who
                   broadly represent the state.  One of the major and most useful functions
                   of the  Advisory  Group  has  been  the  very  substantial  amount  of  parti-
                   cipation  of  individual  members  in  various  aspects  of  the  program.   The
                   Advi6ory  Group  has  also  provided  policy  guidance  and  has  developed
                   policy.  The RAG meets four times a year.

                   Composition of the Advisory Group:

                   in March, 1966, the Governor@of the State@of Oklahoma activated a
                   "Regional Advisory
                                        Council."  In  accordance  with  the   provisions   of
                   Public  Law  89-239,  members  were  broadly  representative  of  both  the
                   total health care  system  of  the  State  and  the  Citizens  served  by  this
                   system.

                   To insure that the composition of the      Advisory Group retains this
                   broad  representation  which  is  so  essential  to  its   effectiveness   in
                                                                                          i
                   January of each year the Advisory Group will undergo a process of
                   appointments and retirements to be accomplished as follows:

                       Terms of  the  Advisory  Group  members  will  normally  be  for  three
                       years.  No  member  will  serve  more  than  four  consecutive   years.
                       Approximately  one-third  of  the  total  membership  will   be   retired
                       each   year.
                       Prospective  new  members  will  be  nominated  by  the  "Steering   Comm-
                       ittee"  (see  Section  III,  B-6)  prior  to  the  last  scheduled  annual
                       meeting  of  each  year.  The  Advisory  Group  members  will  have   the
                       opportunity  to  review  the  nominees  and  to  make  additional   nomina-
                       tions  from  the  floor.  Selection  of  new  members  will  be  by  written
                       ballot.  The  Advisory  Group  shall  determine  the  number   of   members
                       required..to  carry  out  its  functions  most  effectively.   The   size
                       of the Advisory Group will be determined by the vote of new appoint-
                       ments.  The Steering Committee will also determine which of           the
                       present  members  are  recommended  for  continuation  beyond   the   normal
                       three-year term.

                   ,it is the responsibility of the Director. ORNP, to insure that each new
                   member has been thoroughly briefed on all facets of the o@@T prior to the
                   first meetina  after  selection  to  and  acceptance  of  Advisory  Group  uiem-
                   bership.








                  Organization of-the Advisory Group:

                  The Governor of  the State of Oklahoma will be Honorary Chairman of
                  the Advisory Group.

                  A quorum for conduct of Advisory Group business will consist of a
                  -majority of the membership. All  members  must  be  notified  when  business
                  is to be conducted.


                  Beginning in December, 1968, the  Advisory  Group  will  select  from  its
                  membership a Chairman and  a  Chairman-Elect.  The  term  of  the  Chairman
                  will be for one calendar year (beginning January 1, 1969).  Each
                  subsequent year, at the last scheduled  meeting  of  the  year,  the  Ad-
                  visory Group will select a  Chairman-Elect  who  will  assume  his  responsi-
                  bilities on January 1 of the  next  calendar  year,  concurrent  with  his
                  predecessor's assumption of  the  Chairmanship.  The  Advisory  Group  may.
                  delegate to the tteerino, Committee  authority  to  act  for'the  Advisory
                  Group provided that the nature and limitations of such delegation
                  are defined by the Advisory Group in advance.

                  The Director of the ORMP, with  the  concurrence  of  the  Advisory  Group,
                  will designate a permanent Secretary.  The Secretary will be a member-
                  without-vote of the Advisory Group and a member of the ORNP professional
                  staff.


                  Working committees will be appointed  by  the  Chairman  from  the  member-
                  ship of the Advisory Group. The  number  of  such  committees  will  be  at
                  the discretion of the  Advisory  Group.  Each  committee  will  be  guided
                  in the conduct of its business by a Committee Chairman and a Comm@
                  ittee Vice-Chairman.  The  selection  of  the  committee  membership  and
                  designation of its officers will be the responsibility of the...Chairman
                  of the Advisory Group in consultation  with  the  chair'man-Elect  and  the
                  Director of the ORNP. Persons  who  are  not  Advisory  Group  members  may
                  be appointed to these committees,  but  each  Committee  Chairman  and  a
                  majority of the members of each committee must be Advisory Group members.

                  An Advisory Group Steering Committee composed of the Advisory       Group
                  -Chairman, Chairman-Elect, the  Committee  Chairmen,  and  the  permanent
                  Secretary will be responsible  for  the  general  governance  of  Advisory
                  Group business.  The Director of the ORMP will be advisory to, and
                  non-voting member of, the Steering Committee.

                  Conduct of Advisory Group Business:

                  The Advisory Group will meet at the    call of the Chairman  at  least  three
                  times each calendar  year to insure an  orderly  and  continuing  review  and
                                                                                 co
                  evaluation of the ORNP planning and operational processes.








                The Director of the O@IP is responsible for establishing an effective
                system for review and evaluation of the ORNP planning and operational
                pro-ects which as a whole comprise the Oklahoma Regional Medical
                    i
                Program.  The Advisory Group in this review and evaluation process will
                insure that the total program is structured to achieve the goals and
                objectives-as specified in the Act and as further defined by the
                -Advisory Groupi



                C.  Pattern of Flow


                The Oklahoma RIIP has further formalized and modified their previous
                review process.

                    1.  A proposal in detailed form is  submitted to the ORNP.  These
                        are reviewed and modified by staff.
                    2.  Primary reviewers (two to four RAG members and sometimes, one
                        or two outside consultants) meet with the staff and any appro-
                        priate consultant prior to the RAG meeting.
                    3.  Proposals are returned for correction to be developed to a
                      - final form.
                    4.  "Final" form proposal submitted to RAG meeting where final
                        review occurs.  If approved, the project proposal is submitted
                        for Division of Regional Medical Programs approval.  If dis-
                        approved, the project is returned to Project Director with
                        notification and comments on disapproval.





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                                                                                                                                                                                                 ARTTVTTTES







           Vi I?,  FUNDED OPERATIONAT. PROJECTS

                       CORE SUPPORT

                 Objectives:  This project will support core staff and central
                              administrative 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  re-
                              quest for future years will be total funding since
                              the planning grant will expire after this
                                                                          year.


                 #2    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 unable to develop complete coronary caie
                              units. The program calls  for  the  development  of  "central
                              monitoring units" (C@iLis) in larger, usually urban hospitals.
                              The OlUs will serve As coronary care  units,  but  will  also
                              monitor  electrocardiographic  tracings  relayed  continuously
                              by telephone lines from patients in smaller hospita
                              "remote stations"  (RS).  Training  programs  for  physicians,
                              nurses  and allied health personnel are included.

                 #3    A REGIONAL EMPHYSEMA PROGRAM FOR OKLAHOIIA

                 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-
                              sultativd 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.






                         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.

                  #5    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 4 computerized
                                tumor registry combining data from three major 'Tulsa
                                hospitals. A third part proposes  to  integrate  the  continuingI
                                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 @i
                                of rehabilitation services for cancer in Tulsa  and  in  four
                                representative smaller communities.

                        A REGIONAL PROGRAM TO IMPROVE LIBRARY 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.

                ..#7    A REGIONAL 'PROGRAII OF PUBLIC.EDUCATION ON SMOKING AND HEALTH
                        (VUNDED IN CORE)

                 .Objectives:   This program would merge the efforts of OMV and the
                                Interagency Council on Smoking and Health    ORMP would
                                essentially provide a coordinator for this already
                                functioning Council.  The Council, in turn, would support
                                the necessary staff, the bulk of the operational costs,
                                and would mobilize volunteer support.




                  #8    A REGIONAL PROGRAM TO PROMOTE EARLY DIAGNOSIS   OF BREAST  CANCER
                        WITH.'SPECIAL EMPHASIS ON MAMOGRAPHY
                  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.
                  #9    A REGIONAL PROGRAM IN NUTRITION AND DIABETES FOR OKLAHO@IA
                  Objectives:   This pro-ram seeks to improve the care  of  diabetic  patients
                                at the community level, and to  improve  nutritional  services
                                                                                     'The
                                in hospitals and nursing homes throughout Oklahoma.
                                program would help support an ongoing diabetes demonstra-
                                tion clinic at the University Hospital  which  would  develop
                                the teaching materials and manpower to  extend  improved  care
                                for diabetic patients throughout the Reclion.  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.

                        REG10NAL UROLOGY PROGRAM WITH INITIAL ENPRASIS ON CANCER OF
                        THE PROSTATE
                 Objectives6    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@t.reatment 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.


































                                           APPENDIX