1. Realizing Integration: Defragging the Health Care System Mark D. Fox, MD, PhD, MPH David C. Kendrick, MD, MPH Section of Medicine/Pediatrics

2. Overview Framing the issue Context of health “system” performance Opportunity for innovation

3. Disclaimer Original planned title: Social justice and health information technology Anchoring lectures process Challenge to clarify abstruse connection

4. Social Injustice Denial or violation of economic, sociocultural, political, civil or human rights of specific populations or groups in society based on perception of inferiority by those with more power or influence –Often involves stereotypes and stigmatization

5. Social Injustice 2 Policies or action that adversely affect the societal conditions in which people can be healthy IOM definition of public health: What we, as a society, collectively do to assure the conditions in which people can be healthy Populations and groups in first definition are usually especially vulnerable to these forms of social injustice

8. Shorter Life Expectancy Real Health Disparities Longer Life Expectancy NORTH TULSA SOUTH TULSA 14 Year difference in Life Expectancy Across Tulsa County

9. …And its not because we are not spending enough money on healthcare

10. The State’s Next Challenge - Securing Primary Care for Expanded Medicaid Populations Leighton Ku, Ph.D., M.P.H., Karen Jones, M.S., Peter Shin, Ph.D., M.P.H., Brian Bruen, M.S., and Katherine Hayes, J.D.

13. Vulnerable Populations Tulsa’s primary care safety net Challenges of access Fragmentation of care –By system (SFH, Hillcrest, SJMC, OSU) –By free clinic (Day Center, Sallie, Dream Center, Bedlam, Good Samaritan) –By provider within those clinics

14. Bedlam/OU Community Health Experience EMR implementation to link diffuse network of clinic operations Improve efficiency Reduce redundancy Improve safety Make network more functional