1,050
Over past 25 years, only
State with worsening
Age-adjusted Death Rates
1,000
950
Tulsa and
Oklahoma
Oklahoma:
 Last in the US in health system performance.





Only state with worsening death rate.
Last in US in physicians per capita.
Tulsa - 14 year difference in life expectancy.
Upper quarter of health care spending.
Innovative health system and insurance expansions.
900
Tulsa
US
US
850
Death Rate
800
1980
1985
1990
1995
OU School of Community Medicine:



1.
2.
3.
4.
5.
6.
Nation’s first School of Community Medicine
Serves as the region’s platform for change
Goal – Improve health of entire communities;
Recruit for and maintain altruism – MDs, PAs, Nurse
Practitioners – using clinical experiences, scholarship and
loan payback efforts to motivate.
Curriculum – add public health, systems engineering,
student run clinical services.
Expansive network of innovative primary care, specialty
care programs out in neighborhoods most in need - e.g. 19
school based clinics.
Patient Centered Medical Home – for uninsured and
Medicaid populations implemented.
Partners with OU social work, early childhood education,
school systems, urban planners etc.
Health Information Technologies – patient to doctor, doctor
to doctor: reduced need for face to face visits by 52%.
Consortia in place for Health Information Exchange and
Health Information Coordination.
14 year difference
In life expectancy
between North and
South Tulsa
2000
2005
Advanced Medical Home 2011
Diagnostic
Testing &
Imaging
Urgent
Care
Services
Wellness &
Fitness
Clubs
Specialty
Dx/Rx
Services
EMRBased
& HIE Team
Primary
Care
Web-based
Communication
Portals
Health Information
Integration
/
Decision
Support
Coordination
Pharmacy
& Health
Foods
Surgical &
Intensive
Services
HEALTH
CARE
SYSTEM
Chronic
Disease
Service
Getting Organized - “Tulsa Health” (black = established, blue = in development or proposed)
Front Doors to Care
Emergency Rooms:
• Saint Francis Hospital
• St. John Medical Center
• Hillcrest Medical Center
• OSU Medical Center
Acute – Walk In Care:
• OU Bedlam Evening Clinics
• OU Bedlam Evening Pharmacy
• OU Bedlam Evening Clinics
Case Management and Referral
Programs
• Good Samaritan Clinics
Safety Net Clinics
ER Diversion Programs:
• OU Tisdale Health Center
Urgent Care Clinic
• OU ER Diversion and
Follow Up Clinic
• OSU / St. John Program
Prevention Initiatives
• 211 Line
• Baby Line
• OU Nursing Prenatal Care
• Harvard Project - Cycle
of Poverty
• PENN Project – Anchor
Community Schools
Primary Care Clinics and Medical Homes
I
N
S
U
R
E
O
K
L
A
H
O
M
A
-M
E
D
I
C
A
I
D
• OU Bedlam Longitudinal Clinic – PCMH Model
6 sessions / week
• OU School-based Clinic = 19 sites – PCMH Model
• OU Housing Authority Clinics = 2 – PCMH Model
• OU Micro-clinics – Day Center for the Homeless – 5 days
per week
Neighbor for Neighbor, Neighbors Along the Line,
• OU Physicians Clinics – Hillcrest – PCMH
Schusterman Center - PCMH
• OSU Physicians Clinics – SW Boulevard, Houston Park
• OSU Physicians – Country Club Gardens
• Morton Clinics – FQHC – Lansing Park, East Tulsa
• Community Health Connections – FQHC - East Tulsa,
3rd and Lewis.
• Patient Centered Medical Home Patient Portal with IBM
• Greater Tulsa Health Access Network – Greater THAN –
Health Information Exchange and Care Coordination
Pharmacy Services
• Tulsa County Pharmacy
• OU STEP Pharmacy
• OU Bedlam Pharmacist Program and
5 community pharmacies
Intensive Outpatient Programs
• PACT Teams – Severe mental illness
• COPES Team – Emergency Psychiatry
• ER Frequent Flyer Team –
Multiple medical illnesses
Specialty Care
• MAP / Voucher Specialty Care Network
• Northland Imaging Center
• OU Physicians Clinics at St. John, Saint Francis
and Hillcrest Medical Centers,
• OU Schusterman Center Clinics
• OSU Physicians Clinics at OSU MC,
Houston Park, SW Boulevard
• OU OB Outreach – e.g. Margaret Hudson.
Porter, Community Health Connections
• OU Xavier Breast Health Clinic
• OU Bedlam Specialty Clinics – Derm, HIV,
Gynecology, Hep C
• Heart Intervention Project
• OU Diabetes Center
• OU Cancer Institute
• OU Tisdale Specialty Health Center
• Doc 2 Doc e-consultations between primary care
and specialists
Clancy 8 / 2009
Our Organization’s Enthusiasm Levels:
A Project Lifecycle
ENERGY / SUPPORT
Announcement
Culture
Crisis
Sept ‘08
Mar ‘09
TIMELINE