Chapter 06: The Office of Health Policy: Focusing on Outreach
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Description
Dr. Foxhall lays out the history of the Office of Health Policy. He explains that it originated in the need to reach out to community physicians and develop their relationships with MD Anderson. He explains how a team was created to conduct surveys and also to work with programs internal to MD Anderson. Dr. Foxhall explains the issues that community physicians had in sending their patients to MD Anderson, largely in the area of need for more communication with the institution after their patients went into treatment at the institution.
Identifier
FoxhallLE_02_20140213_C06
Publication Date
2-13-2014
City
Houston, Texas
Interview Session
Lewis Foxhall, MD, Oral History Interview, February 13, 2014
Topics Covered
The University of Texas MD Anderson Cancer Center - An Institutional Unit; The Administrator; MD Anderson History; Beyond the Institution; Information for Patients and the Public; Education
Transcript
Tacey Ann Rosolowski, PhD:
All right. And the counter is moving. I’m Tacey Ann Rosolowski, and today is February 13th [2014]. The time is about twenty-five minutes after ten, and I’m in the Office of Health Policy interviewing Dr. Lewis Foxhall. This is our second session together. So, thanks again for talking to me.
Lewis Foxhall, MD:
Sure.
Tacey Ann Rosolowski, PhD:
We talked last time about your work with the Office of Referral [?] Relations, and you talked about how the referral system got set up and what were some of the issues at stake in those early years. And I wondered if you could tell me a bit, like sketch the history, because that office was established in 1994, and obviously a lot of time has passed. So what have been some of the big markers in the development of that office and its roles?
Lewis Foxhall, MD:
Sure. Well, this program was put together to address concerns of community physicians and challenges that they had in trying to get patients referred over to MD Anderson for care, and it was initially put together as a partnership with another one of our faculty members, Dr. Richard Babaian, at that time. We developed a program to begin to reach out to community physicians to better understand what their needs and issues were in relation to their interactions with the Cancer Center, and this led to the development of a program. We hired a director at that time, Mr. Lyle Green, who is still involved with the program, and with him we put together a team of support personnel to develop surveys of the physicians, assess their interests, needs, and satisfaction with their interactions with the hospital. We worked with our internal programs to develop a system to connect physician names with patients, so that we could understand who sent the patient in and be sure we got that physician information back about the patient’s treatment.
Tacey Ann Rosolowski, PhD:
Now, this—I’m sorry. This all followed on the heels of the self-referral laws. That’s correct?
Lewis Foxhall, MD:
That’s correct.
Tacey Ann Rosolowski, PhD:
So that really changed MD Anderson’s relationship with patients and with physicians. I think you mentioned some of the concerns last time. You said that physicians didn’t quite understand how they would relate to a big cancer center. Is that correct?
Lewis Foxhall, MD:
Well, not necessarily that, but they felt—or many physicians expressed concern that their patients were referred to the Cancer Center, never to be seen again, that they didn’t get follow-up information. The patient’s treatment and their outcomes were generally felt to be very favorable, but they just didn’t know what was going on until perhaps the patient eventually returned to the practice at some point in time. So that issue of communication was a primary concern for a number of the physicians and one that we tried to address by better capturing the physician information in our system, even if the patient were self-referred, to query the patient and identify any community physician either involved with her care or intended to be involved with her care going forward so we could keep them in the loop. Then as we developed our electronic portal at myMDAnderson, we also developed a section for physicians and their appointed medical staff support to be able to query the system and get reports and get information that they needed on their patients on a real-time basis, so that was also felt to be a real benefit.
Tacey Ann Rosolowski, PhD:
And when did that happen, the electronic piece?
Lewis Foxhall, MD:
Yeah. It was, I don’t know, maybe ten years ago or so, something in that range. But part of that, and still we attempt to forward the information. Initially, we sent paper copies of reports to physicians just to be sure that they would get up to date on exactly what was going on with their patients.
Tacey Ann Rosolowski, PhD:
Now, have some of the issues changed over the years or—you know, the patient population has obviously expanded enormously, and it seems, from what I understand, that even the complexity of treatment and duration of treatment perhaps has expanded over the years. Has that changed the way in which you interact with or have to work with interactions with community physicians?
Lewis Foxhall, MD:
Well, not that part in particular, but the major thing, I think, is our new focus on survivorship management. So we were able to set up a system so physicians could get follow-up reports. We decided we were successful when a physician finally complained that he was getting too many reports. (Rosolowski laughs.) But we did, we tracked—in a little more objective way, we tracked and developed a physician satisfaction survey and queried the physicians on a regular basis about their satisfaction with communication, and that did seem to improve.
Tacey Ann Rosolowski, PhD:
And what were some of the things that were important to them in terms of communication?
Lewis Foxhall, MD:
Basically what I mentioned, is getting timely reports on the treatment and recommended follow-up for their patients, better understanding what, if any, issues needed to be considered if they were still seeing the patient in their own practices. So that was really the main concern.
Recommended Citation
Foxhall, Lewis E. MD and Rosolowski, Tacey A. PhD, "Chapter 06: The Office of Health Policy: Focusing on Outreach" (2014). Interview Chapters. 855.
https://openworks.mdanderson.org/mchv_interviewchapters/855
Conditions Governing Access
Open
