gue PUBLIC HEALTH SERVICE : HEALTH RESOURCES ADMINISTRATION , BUREAU OF HEALTI{ RESOURCES DEVELOPMENT Acting Director : DATE: Division of Regional Medical Programs January 23, 1975 MALL cw LOL AE 20M : Matt éw Spea Public Health Advisor ARMORANDUM DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE JBJECT: Trip report; Arthritis Conference, Kansas City, Missouri, Jan. 19-20,1975 This an interim report on the conference. There is to be a Conference Report, but that will not be available earlier than late February. The conference expressed its desire that the traveller undertake to draft the arthritis report. I acceded to this request by indicating that I had made preliminary arrangements with Mr. David Shobe for the writer staff of the Arthritis Foundation to assume this task if circumstances prohibited my ability to effectively carry out this responsibility. , The Arthritis Conference was Chaired by Dr. Roger D. Mason, Senior Vice President for Health Affairs, Blue Cross/Blue Shield, Omaha, Nebraska. More than 100 persons participated in the conference, representing arthritis program and project directors, and some of their staff, RMP gr Coordinators and arthritis program administrators, and some of their staff, the writer (DRMP), and Dr. Lawrence M. Petrocelli, Director of. Arthritis Activities, NIAMDD. The above participating groups included representatives from the conference sponsoring, and host organizations. Dr. Gordon R. Engebretson, Director Florida RMP, participated in the conference proceedings as the representative of the Program Account~ ability and Reporting (PAR) group of the NARMPC. The conference was organized to devote attention on the first day primarily to substantive aspects of the pilot arthritis program to identify its characteristics, and associated needs and opportunities. The output from these discussions was presented to the conference orally, and in written form at the end of the first day as background for the second day's deliberations. . The first day's material was developed through short talks on five (5) “selected program areas, a luncheon talk by Dr. Engebretson, a dinner talk by Mr. David Shobe, on the new arthritis law (PL93-640), and six (6) workshops. These workshops addressed pilot program aspects of physician, ‘allied health, and patient education, demographic factors, and arthritis services, and service deployment. , @ The focus of the second conference day is most succinctly characterized by the question, "Where do we go from here?" A panel discussion wa s presented first to explicate overall arthritis program documentation and assessment, vs. project evaluation. Four (4) workshops followed to discuss, and bring back to plenary session recommended conference perspec~ tives, positions, and proposals regarding Program Documentation, Care Delivery Initiatives, Special Report Opportunities, and Program Continuity. The afternoon was devoted to hearing the workshop reports, and conference action on workshop recommendations, All of the materials needed to prepare an accurate and comprehensive conference report are not yet at hand. However, there are enclosed mater~ jalsabout and from the conference which elaborateg on this brief report. These are: , Exhibit 1. Conference Program Exhibit 2. Roster of workshop Co-Moderators 1/Exhibit 3, Responses to Program Interrogatory i/ Exhibit 4. Summary of "A Workshop" reports (first day, A-] through A-6). , Exhibit 5. Instructions to Evaluation Panel Exhibit 6. Summary of "B Workshop"reports (2nd day, B-1, through B-4), including recommendations. All of the second day workshop recommendations were supported by a majority vote of the conference. However, there were a number of modifications which cannot be accurately reflected until the writer receives a transcript of the Monday, January 20, plenary session. i/The Program Interrogatory was a simplified application of a brainstorming technique, The objectives were to obtain overall conference participant input to the respective A workshops, and to quickly involve the participants in (a) thinking about mutual concerns, and (b) stimulating thought proces- ses about matters which would be addressed in the workshops. The extent to which these objectives were met is moot; minimally, the conferees obtain- ed insight about the spectrum of viewpoints shared by their colleagues and associates on the question subjects. The Interrogatory process required a question to be asked orally, and res- pondents were given one (1) minute to record their responses on 3" X 5" ‘slips of paper. These slips were immediately collected, and later reviewed for categorization in written pages referred back to the respective work- shops. Questions 13, 14, and 15 (not here available), were posed later as ‘a reflection of conference enthusiasm; No. 13 from the floor during the Interrogatory, and Nos. 14, and 15, by Dr. Engebretson in connection with the panel discussion on Program Evaluation, January 20. The 13 questions were posed in between the five opening session speakers on January 19, The questions were: Affected How can arthritis physicians achieve optimal util- How can arthritis services deployment be defined, How can the allied health role as service extenders How can the arthritis capabilities of several provi- der institutions be coordinated for better care deliv- very? (The responses to this question were lost in the mass of generated paper slips, and could not be How can patient vulnerability to non-prescribed How can existing, or proposed, arthritis services be made more responsive to demographic characteristics How can family physician resistance to education in How can the deployment of arthritis services improve How can continuing education in arthritis be main- tained for practicing allied health personnel? How can an arthritis center best support, or back-up How can patients be motivated to follow prescribed How can demographic information be accumulated through How can special needs of children be addressed by Question Workshop Sequence Question A-1 1 ization of their skills? ‘A~6 2 or characterized? An-2 3 be improved, or expanded? A-5 4 reported.) A-3 5 medications and devices be reduced? A-~4 6 ‘of the locality? A-1 7 arthritis be reduced? A-6 8 the integration of local resources? A-2 9 A-5 10 community services? A-3 11 regimens? A-4 12 current program activities? Genéral 13 arthritis resources? Panel 14 How can the approach used to evaluate drugs be used to evaluate education, training, and services? As suggested above, a speaker was scheduled for each meal period. At the Sunday luncheon, Dr. Gordon R. Engebretson, Coordinator, Florida RMP, discussed the adaptability of a PAR-developed cancer program evaluation procedure to the arthritis program. He also offered PAR assistance in reporting, and assessing this program. At the Sunday buffet dinner, Mr. David Shobe, Director of Government and Community Affairs, Arthritis Foundation, described and discussed the "National Arthritis Act of 1974", P.L. 93-640. At the Monday luncheon, Dr. Evelyn V. Hess, University of Cincinnati Medical Center, discussed the standard nomenclature and data base for arthritis developed by her staff under the auspices of the American Rheumatism Association. Administrative arrangements for the conference were superbly organized and directed by Mr. Charles Hine, Kansas RMP, and Mr. Gordon Waller, Executive Director, Kansas City Division, Arthritis Foundation. For instance, plenary sessions and workshop reports were performed by a team of Court Reporter students made available at no cost by a Kansas City business school; workshop Co-Moderators were able to dictate alfl reports. , All sections of the conference proceeded on schedule, and participants generally ( satisfaction with the meeting. A number of noteworthy results may result, all of which cannot be reported at this time. For instance, it appears that PAR will organize and execute overall program documentation; PIMA Health Systems, Tucson, Arizona, has funds and resources to support evaluation of many, if not all projects; and the allied health participants proposed to organize a special arthritis program session at their annual meeting this year at New Orleans in June. Enclosures