Chapter 05: Gathering Records and Conducting Follow-Up Training

Chapter 05: Gathering Records and Conducting Follow-Up Training

Loading...

Media is loading
 

Description

In this chapter Mrs. Hermes continues to talk about her work on the cancer registry. This entailed traveling to cities in Texas to research records and enlist the staff’s aid in the process. She talks about going to Beaumont, Texas to set up a “cancer clinic” where she indexed and abstracted all information on patients going back five years. She also trained the clinic secretary to follow up on living patients to collect cancer related information. She also went to Austin to research death records in the effort to locate living patients in efforts to document the progression of their disease, if any.

The goals of the project, she says, were 1) to promote the concept of good follow up, 2) to promote a model of clinical specialties working together, and 3) to collect comprehensive data. She notes that some physicians were reluctant to share patient records for fear of government interference, however the project was successful in securing records for all patients in all hospitals in Texas with over fifty beds. She notes that the head of the health department and Dr. MacDonald were active in convincing the hospital administrations to participate.

Mrs. Hermes talks about some of the individuals she worked with and notes that she taught people to code records. She tells a story of how records were used: she talks about a study of thyroid tumors for which records were used to identity the characteristics of patients.

Identifier

HermesKL_01_20180122_C05

Publication Date

1-22-2018

City

Houston, Texas

Topics Covered

Building the Institution; The Researcher; Overview; Devices, Drugs, Procedures; Building/Transforming the Institution; Multi-disciplinary Approaches; Working Environment; MD Anderson History; MD Anderson Snapshot; Research; The Business of MD Anderson; The Institution and Finances; MD Anderson Impact; MD Anderson Impact; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care

Transcript

Kay Hermes, BS:

I think cancer, up until—now let’s see, I worked there, for Eleanor, until 1956, and then I had been married and my first child was born. My husband, with the discovery of non-oil and gas minerals, he traveled all the time. We decided one of us had to stay home and that one was me, and that was all right, because I had had a wonderful time working for Eleanor. In those year, from ’50 to ’55, we did build a very sizeable part of the Cancer Record Registry. The county of El Paso, all the pathologists in fact, contributed their data in El Paso, to the Cancer Record Registry, and Eleanor did—I don’t know that she was author of the paper, but she certainly was responsible for much of the work that was done on skin cancer in El Paso, because it was a very big portion of the population had skin cancer.

T.A. Rosolowski, PhD :

Now, was it a challenge to convince pathologists and physicians, other physicians, to give their records?

Kay Hermes, BS:

I think it was. T.A. Rosolowski, PhD Why is that?

Kay Hermes, BS:

Of course that wasn’t my job. I mean, there had to be somebody above me. Yes, I can remember going into—well, say, I remember specifically, because I was still working for Eleanor then, going to Beaumont to set up a cancer clinic in Beaumont. The modus operandi was that we would talk to the local physicians about …we would come into the hospital and index and abstract the patients with cancer going back five years, so at the end you’d have the five-year results. Then, we would train a tumor clinic secretary to follow up on all the living patients, through the doctors who had treated them, and to promote having the doctors, several specialty doctors, see patients in these small cancer clinics. Because Eleanor always used to give the example that a family physician might only see one case of cancer of the tongue in his whole practice, but in a clinic, there would be enough doctors that would see perhaps the patients. They would have—it was very good to bring more experience to the evaluation of the patients, and especially, there really wasn’t any organized follow-up, I mean there were very little. We would take those indexes up to the state capitol in Austin and sit down in the basement and check the death records, so that we would be able to identify the living and dead patients. And of course, patients that we found that were still living, we would try to track that back through—it was very recent, and these were not huge numbers, so it wasn’t… It got to be a bigger chore, I think, in later days, but at that time it wasn’t such a big chore. Anyway, that was the modus operandi, was to use the Cancer Record Registry to bring doctors together to form these cancer clinics or outpatient clinics, for follow-up. It wasn’t so much diagnosis as follow-up. T.A. Rosolowski, PhD Now, I understand that you weren’t directly involved in convincing people to share their records, but do you have a sense of why they might be reluctant to do so?

Kay Hermes, BS:

The same reason they were reluctant all along, hostility to government control. That was very prevalent. I think it might still be prevalent. You can’t get very far with it today because, you know, nobody has any privacy. The government knows every detail, every mole on your body, I guess. In any event, that, I think was the pervading feeling, I think it was. I don’t know if you’d call it a conservative philosophy. Probably, it probably was, but Texas was a pretty democratic state in that time period, I believe. I think that was up until—you see, I wasn’t working on that project after 1956. I do remember working in record rooms. I worked in Fort Worth, in the hospital in Fort Worth, where the plan was to index and abstract all the cancer records in the hospitals of over fifty beds, in Texas, to identify the patients who were still living, identify the living and dead, abstract the records, send them into Eleanor. They would be coded and punched, to form a database. We worked through the person who was the head of the Health Department, because he would be the person that would convince people to share their records, well and Eleanor did too. She did travel some. I think she herself, made all the arrangements for the registry in El Paso. She convinced the pathologists to contribute their records and the doctors to contribute their records.

T.A. Rosolowski, PhD :

Now, what were the kinds of things she said about the importance of this project?

Kay Hermes, BS:

Well, the importance of this project, I think was twofold. The first thing was to promote the concept of good follow-up for cancer patients, and also, to promote the idea of clinical specialties working together, and then to collect the data on cancer patients so that you could eventually come up with the incidence and mortality of cancer in Texas. T.A. Rosolowski, PhD Who were some of the people you worked with closely?

Kay Hermes, BS:

I worked very closely with—in 1952, I think, Eleanor hired an assistant whose name was Eleanor Hassett, H-a-s-s-e-t-t. She was from Connecticut, and I think she had worked with Eleanor, in the Health Department there. Eleanor convinced her to come to Texas and she took over as Eleanor’s assistant in the office, getting people hired and taking care of a lot of—she took care of all the administration I think, and she did work with assigning, she did work with different projects. Like, she would always give me the project of teaching somebody to code, because I was good at anatomy and chemistry, and also, I could read the path reports pretty well. So, I did have—that part of my education was very valuable, because it did enable me to do that kind of work. So anyway, I taught people to code the records and teach them what they needed to know. I coded, still, records. I think the only study I did while I was still working for Eleanor, I did a study on benign thyroid tumors, for a Dr. Kelsey, and I think that was the only study I did of my own, but again, it was to identify the characteristics of not only people, but you didn’t have the ability to identify too many pathologic characteristics. It was important to classify cancer by the anatomic site carefully, because that really determined the treatment, the anatomic site and the extent of the cancer, as you could determine it. T.A. Rosolowski, PhD Would you mind if we paused just for a sec?

Kay Hermes, BS:

Pardon me?

T.A. Rosolowski, PhD :

Would you mind if we paused just for a minute?

Kay Hermes, BS:

Yeah, sure. [The recorder is paused]

Conditions Governing Access

Open

Chapter 05: Gathering Records and Conducting Follow-Up Training

Share

COinS