Drawn from the report, States' Roles in Shaping High Performance Health Systems.

States shape the health system in many ways, influencing key components such as insurance coverage, quality of care, and information and provider infrastructures. This report presents findings from the State Health Policies Aimed at Promoting Excellent Systems project, undertaken by the National Academy for State Health Policy, with support from The Commonwealth Fund. After conducting surveys of multiple agencies in states across the country, as well as review of related literature, this study found that states are pursuing system improvements across the full spectrum of their authority, including health care purchasing, regulation of providers, reporting of performance data, integration of public health with health care approaches, and improving the availability and affordability of health insurance. Despite this activity, this study finds room for states to do much more. Ongoing efforts to track, study and diffuse information on state activities could accelerate adoption of promising polices and practices.

Oklahoma is developing a Public Health Oklahoma Client Information System (PHOCIS) that will allow the state to draw detailed information from a variety of public health interventions. It will collect demographics, information on population-based services provided by Oklahoma State Department of Health employees, and electronic encounter and outcome records for health services provided by a variety of customers. These customers include schools, day-care centers, hospitals, and other government agencies. The PHOCIS system will also include billing information from Medicaid and Medicare.

This coordination of data will allow analyses of programs like the state's SoonerStart initiative, for example, which provides early intervention services for vulnerable infants and toddlers with developmental delays. SoonerStart can use PHOCIS to access Medicaid claims information to track a child's immunizations, and then use vital records data to determine whether the intervention has been effective in reducing long-term costs and achieving desired outcomes.

Along with PHOCIS implementation, Oklahoma also is engaged in several related projects to move to electronic health records and to integrate tribal, private, and public medical records, which will further enhance the state's ability to monitor and analyze overall health.

Sources: Oklahoma Public Health SHAPES survey response, SoonerStart logic model, http://se.sde.state.ok.us/ses/preschool/publications/SoonerStart%20Logic%20Model%20525.pdf, and 2004 data report of the Arthritis Education and Prevention Program, http://www.health.state.ok.us/program/apep/arthWebFinal.pdf.