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Going “All In” to Transform the Tulsa Community’s Health and Health Care Workforce

Clancy, Gerard P. MD; Duffy, F. Daniel MD

doi: 10.1097/ACM.0000000000000039

Oklahoma’s health status ranks among the lowest of the states’, yet many Oklahomans oppose the best-known aspects of federal health reform legislation. To address this situation, the University of Oklahoma College of Medicine’s School of Community Medicine in Tulsa adopted an “all-in,” fully committed approach to transform the Tulsa region’s health care delivery system and health care workforce teaching environment by leading community-wide initiatives that took advantage of lesser-known health reform provisions. Medical school leaders shared a vision of improved health for the region with a focus on equity in care for underserved populations. They engaged Tulsa stakeholders to implement health system changes to improve care access, quality, and efficiency. A partnership between payers, providers, and health systems transformed primary care practices into patient-centered medical homes (PCMHs) and instituted both community-wide care coordination and a regional health information exchange. To emphasize the importance of these new approaches to improving the health of an entire community, the medical school began to transform the teaching environment by adding several interdependent experiences. These included an annual interdisciplinary summer institute in which students and faculty from across the university could explore firsthand the social determinants of health as well as student-run PCMH clinics for the uninsured to teach systems-based practice, team-based learning, and health system improvement. The authors share lessons learned from these collaborations. They conclude that working across competitive boundaries and going all in are necessary to improve the health of a community.

Dr. Clancy is professor, Department of Psychiatry, University of Oklahoma School of Community Medicine, and president of the University of Oklahoma–Tulsa campus, Tulsa, Oklahoma.

Dr. Duffy is professor, Department of Internal Medicine, and former dean, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.

Funding/Support: Specific projects were supported by the George Kaiser Family Foundation, the Oklahoma Health Care Authority, Blue Cross Blue Shield of Oklahoma, the Office of the National Coordinator for Health Information Technology, the Health Resources and Services Administration, and the Centers for Medicare and Medicaid Services Innovation Center.

Other disclosures: None.

Ethical approval: Not applicable.

Correspondence should be addressed to Dr. Clancy, University of Oklahoma School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135; telephone: (918) 660-3300; e-mail:

© 2013 by the Association of American Medical Colleges