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Implementing formative health planning under PL 93-641.

The National Health Planning and Resources Development Act of 1974 (PL 93-641) melds the Hill-Burton program, Regional Medical Program and Comprehensive Health Planning into a new network for health planning and resources development. Health-systems agencies will possess broader powers than predecessor agencies, particularly in the areas of regulation, control of federal funds, resources development and implementation. PL 93-641 thus offers the possibility of transforming the basic concept of health planning from reactive to "proactive." Successful legislative implementaion will require each health-systems agency to build local legitimacy, ensure constructive consumer/provider dialogue, and respond to state and national managerial requirements. Many questions about planning implementation, the role of subarea councils, agency co-ordination and local governance remain unresolved. The new health-planning network has the potential to assume the function of active system transformation, but will be critically dependent on adequate program budgeting to fulfill this promise. (N Engl J Med 295:698-703, 1976).

Delivery of Health Care

Evaluation of the community phase of a regionalized medical education program.

Evaluation of the community phase of a regionalized medical education in the states of Washington, Alsska, Montana and Idaho (WAMI) is producing data to suggest that peripheralization of medical education, including remote site clinical training, offers a viable alternative to traditional methods.

Area Health Education Centers

Mobilization of duplicates in a Regional Medical Library Program.

An overabundance of duplicate journals without an efficient and economical method of distribution caused one library's staff to reassess traditional methods of dispersal. A simplified form for listing duplicates was devised. In conjunction with the Regional Medical Library Program and the extension program, lists of duplicates were distributed to hospital and clinical libraries. These libraries selected materials to strengthen their ability to fill information needs at the local level and to conserve RMLP support for esoteric and expensive materials. In a two-year period, 86,000 individual pieces were distributed. Some lessening of interlibrary loan requests from heavy users was documented. In an evaluation survey users expressed satisfaction with the program. The successful use of the duplicate program will lead to a further experiment--the library will attempt to fill interlibrary loan requests for common journals with hard copy rather than photocopy in a cost and time reduction effort.

Book Collecting