Primary Care Extension in Oklahoma: An Evidence-Based Approach to Dissemination a

描述（由申请人提供）：该项目的目的是完成全州范围内，以县为基础的质量改善（QI）和社区健康改善基础设施的发展，这将有助于初级保健实践成为以患者为中心的医疗之家，并改善俄克拉何马人的健康。我们还将向另外三个邦提供援助，帮助他们建立类似的基础设施。由俄克拉何马州研究人员开发并在俄克拉何马州实践中进行了测试的QI方法现在已被几个州机构和组织实施，全国各地的许多组织都将其纳入国家责任医疗法案，并在本申请中加以说明。俄克拉何马州获得了医疗卫生信息技术区域推广中心（REC）和卫生信息交换（HIE）的联邦拨款。该奖项的申请人俄克拉何马州HIE信托基金的成立是为了在全州推广HIE。由AHRQ资助的区域卫生信息组织SMRTNet已经连接了全州的各种卫生数据源。已经出现了县级卫生改善活动，并得到卫生部、HIT REC和SMRTNet的支持。地区健康教育中心准备成为区域协调中心。从现有的部分中组装一个有凝聚力的、可持续的基础设施将需要：1)临床医生的教育、动员和投入；2)协调主要机构和质量保证提供者；3)组织蓝图，包括行政机构、规章制度、政策程序、岗位描述、沟通渠道、报告要求以及县级非营利组织的形成；（四）执业辅导员的招聘、培训和认证计划；5)制定识别和确定改进项目优先次序的过程；6)确定可持续资金，以补充项目专项资金。我们选择了三个传播州，阿肯色州、宾夕法尼亚州和俄勒冈州，它们在全州范围内开展了良好的QI活动。我们的团队前往每个州，参加全州范围的利益相关者会议，以及每个州的领导人召开个人和团体会议，以协调利益相关者团体。四个州之间的沟通将在收到奖项后立即开始，并在整个项目中持续进行。

DESCRIPTION (provided by applicant): The purpose of this project is to complete the development of a statewide, county-based quality improvement (QI) and community health improvement infrastructure that will help primary care practices become patient-centered medical homes and to improve the health of Oklahomans. We will also provide assistance to three other states, helping them to create similar infrastructures. The QI approach developed by Oklahoma researchers and tested in Oklahoma practices has now been implemented by several state agencies and organizations, many organizations throughout the country, incorporated into the national Accountable Care Act, and specified in this Request for Applications. Oklahoma received federal grants for an HIT Regional Extension Center (REC) and for Health Information Exchange (HIE). The Oklahoma HIE Trust, the applicant for this award, was established to promote HIE throughout the state. An AHRQ- funded Regional Health Information Organization, SMRTNet, has already connected a variety of health data sources throughout the state. County-level health improvement activities have emerged and are being supported by the Department of Health, the HIT REC, and SMRTNet. The Area Health Education Centers are prepared to become Regional Coordinating Centers. Assembling a cohesive, sustainable infrastructure from the existing pieces will require: 1) clinician education, mobilization, and input; 2) alignment of the principal organizations and QI providers; 3) an organizational blueprint including administrative structure, bylaws, policies and procedures, job descriptions, communication channels, reporting requirements, and formation of county-based non-profits; 4) a plan for recruiting, training, and certifying practice facilitators; 5) development of a process for identification and prioritization of improvement projects; and 6) identification of sustainable funding to supplement project-specific funding. We have chosen three dissemination states, Arkansas, Pennsylvania, and Oregon, with well-developed statewide QI activities. Money has been budgeted for our team to travel to each state, for a statewide stakeholders meeting, and for leaders in each state to conduct the individual and group meetings required to align stakeholder groups. Communication between the four states will begin as soon as the award has been received and continue throughout the project. PUBLIC HEALTH RELEVANCE: We will complete development of a statewide, county-based quality improvement infrastructure that will improve primary care services and community health in Oklahoma using evidence- based methods. An initial focus will be on widespread implementation of HIT and HIE.