Chapter 11: Grant-Funded Projects in the Office of Health Policy: The Texas Cancer Data Center

Chapter 11: Grant-Funded Projects in the Office of Health Policy: The Texas Cancer Data Center

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Description

Here Dr. Foxhall talks about a number of key projects run by the Office of Health Policy. He first follows up on a discussion of the Texas Cancer Data Center (discussed in Segment 10), explaining difficulties in collecting information in the early days of the project and then sketching how services have evolved an been updated since the late eighties. He lists the kinds of information that the Center provides, its heavy use (around one million hits per year) and its impact. Dr. Foxhall notes that it is used as a platform for educational programs supported via CPRIT money. He also describes how the Center provides information for individuals with no insurance and education for nurses and social worker to help people get access to care. This need has been intensified since Texas made the decision not to participate in the Medicaid portion of the Affordable Care Act.

Identifier

FoxhallLE_03_20140311_C11

Publication Date

3-11-2014

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - An Institutional Unit; Overview; MD Anderson History; MD Anderson Impact; MD Anderson and the Texas Legislature; Education; Information for Patients and the Public; Institutional Mission and Values; Beyond the Institution; Character, Values, Beliefs, Talents; Professional Values, Ethics, Purpose

Transcript

Tacey Ann Rosolowski, PhD:

All right. We are recording and the counter is moving. This is Tacey Ann Rosolowski, and today is March 11th, 2014. The time is about 9:04. And I’m having my third session this morning with Dr. Foxhall, Vice President of Health Policy. Thank you again for making time for me.

Lewis Foxhall, MD:

You’re welcome.

Tacey Ann Rosolowski, PhD:

And we just did our little strategizing and decided it would be a good idea to, this morning, focus on some of the grant-funded projects you’ve been working on and sort of the big themes. Let me rely on you to kind of prioritize which you feel are the most important ones, the ones that have had the most impact. So where would you like to start with that?

Lewis Foxhall, MD:

Right. Well, I think one of the early projects that I assumed direction of was the Texas Cancer Data Center. This was funded originally through the Texas Cancer Council, which was the agency that preceded the Cancer Prevention Research Institute of Texas. And the project was initially intended to serve as a resource or clearinghouse for cancer-related information focused on Texas at that time. Actually, this was put together initially before I arrived, but it was very difficult at that point to collect information, even basic information, from our Cancer Registry. It had been defunded and put out of business a few years earlier, and they were just really trying to get back on their feet and had very limited—

Tacey Ann Rosolowski, PhD:

Why was that?

Lewis Foxhall, MD:

Why does government do anything that doesn’t make sense?

Tacey Ann Rosolowski, PhD:

(laughs) I always like the smile you give when you’re like—oh, the cynicism [unclear].

Lewis Foxhall, MD:

Right. Anyway, so for whatever reason, I wasn’t there at the time, but for whatever reason, they decided not to fund it. But it did come back, but initially that time was really sort of the early days of the Internet, and connectivity as we now know it just didn’t exist, so—

Tacey Ann Rosolowski, PhD:

And this was around what year?

Lewis Foxhall, MD:

This was in the late eighties, early nineties. The program was initially put together as basically a dial-up modem sort of operation where people could contact the service and get information, basic information around cancer incidence and mortality and cancer services that are provided in the state.

Tacey Ann Rosolowski, PhD:

Now, when you took over leadership of this, what did you envision for this project? What did you want to achieve?

Lewis Foxhall, MD:

Well, the program was clearly providing a useful service, and at that point, we thought it might be best to update the service and convert it over to an Internet-based operation, so we moved ahead with that and, with our staff, were able to provide a broader range of information and try to update the information more regularly. So we included community services and cancer-control information for people to access that was in addition to the basic information that [unclear]. So we also used it as an opportunity to provide access to the Texas Cancer Plan. Texas was one of the first states to have a cancer plan, and we were able to get that document posted and put online so it could be easily accessed.

Tacey Ann Rosolowski, PhD:

Oh, wow. Okay.

Lewis Foxhall, MD:

So anyway, it worked out to be a very heavily used and long-lasting project. It continued in effect as it was through the funding through the Cancer Council, and then we shifted over to funding from CPRIT for a few years, and then eventually MD Anderson assumed the financial responsibility for operating it. So it still operates today.

Tacey Ann Rosolowski, PhD:

It still operates?

Lewis Foxhall, MD:

We’ve changed the name as part of our rebranding to Texas Cancer Information, so the last few years we’ve been operating in that sense.

Tacey Ann Rosolowski, PhD:

Now, what would you say is the impact of this particular program?

Lewis Foxhall, MD:

Well, it’s information dissemination. The site is used. We get around a million hits a year, something in that neighborhood, so several thousand individual users each year. So it’s information that the public is still interested in. Some of the capabilities of our Cancer Registry have improved, so people are able to get some of that information more readily through their website. But we’ve tried to continue to provide services in addition to make it user-friendly so people can access it and understand the information that they need.

Tacey Ann Rosolowski, PhD:

I’m sorry. Do you have any plans to develop it further, I mean with different technologies, you know—

Lewis Foxhall, MD:

Not at this point. Basically, we’re maintaining things as we go. We’ve used it as a platform for educational programming. We developed, with another super grant, we developed an educational program around access to care, so we developed a database that went county by county to give people information about how they could get government support if they were uninsured and needed cancer care, screening, those sorts of things, provided information on clinics and places that take patients who don’t have insurance. And then we developed an education module for nurses and social workers to help them be aware of that information and how to use it. So it’s been our latest. We’ve run that for the last couple of years, and we’re in the process of doing an update on that. But that’s been really sort of the most recent additional service that we’ve added. It seems to be something people are still very interested in.

Tacey Ann Rosolowski, PhD:

Well, I can imagine, because I know last time we talked about the kind of ups and downs in the number of uninsured and how many uninsured there are, and it sounds as though with this additional project with helping people with access, that that’s really key. Do you think that will continue to be a very important dimension of this particular project, the accessibility issue?

Lewis Foxhall, MD:

Well, information on access, I think, will be. Texas has decided to not participate in the Medicaid part of the Affordable Care Act, so there’s still a large number of low-income uninsured people that don’t have insurance and don’t have an obvious way to get insurance, at least for the time being.

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Chapter 11: Grant-Funded Projects in the Office of Health Policy: The Texas Cancer Data Center

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