New Department of Health Services Research for quality cancer care

Oncologist and cancer care outcomes researcher Sharon H. Giordano, M.D., leads the new Department of Health Services Research at The University of Texas MD Anderson Cancer Center, a multidisciplinary area of research that examines the delivery, quality and costs of health care.

Giordano, who continues to see breast cancer patients, has tackled health quality research for many years and sees her new role in the Division of Cancer Prevention and Population Sciences as an opportunity to position MD Anderson as a leader in the field.

"We have a growing need to develop strategies regarding cancer care delivery as well as to demonstrate value in health care, specifically in prevention, treatment and survivorship," said Giordano, professor and chair of the Department of Health Services Research.

"Cost of care is important on a national level," she said. "We need to provide the best care without bankrupting the country."

Health Services Research incorporates an array of established areas of research and brings together investigators from diverse specialties including breast medical oncology, general internal medicine, gynecology, radiation oncology, economics, biostatistics, epidemiology and surgical oncology. The strategy is to identify the best personalized treatment for individuals and evaluate the effectiveness, timeliness and appropriateness of treatments for patients, thus improving access, cost and quality of care.

"Health Services Research in oncology is a timely and enormously important topic for MD Anderson and for the broader community as we are challenged to think in new ways about what quality cancer care means and how to deliver such care in the most efficient manner," said Ernest T. Hawk, M.D., vice president and division head of MD Anderson's Cancer Prevention and Population Sciences. "We are delighted that Dr. Giordano, one of the few experts in the topic, was selected to lead our new research department."

"The Institute of Medicine defines "quality care" as that which is delivered to maximize six essential characteristics - safety, timeliness, effectiveness, efficiency, equity, and patient-centeredness," said Hawk. "We would add to that, the notion of "sustainability" in the numerator, and place "costs" in the denominator as essential components of the equation."

In both her health services and breast cancer research, Giordano taps national databases to determine health care needs so that information can be used to improve the quality of care for everyone. Giordano notes that it is fortunate that MD Anderson provides outstanding care to patients, but there are situations where everyone does not have the same access to care.

"In the era of health care reform this area of research is increasingly important," said Giordano. "Particularly, as the country tries to find ways to define, measure and manage costs for high quality care, as well as determine how to provide the most people with the best quality care and the best value of care."

Hawk said Giordano and her colleagues in the new department are appropriately experienced and well-positioned to evaluate oncology's processes of care across the continuum of prevention, screening, treatment and survivorship; to define standardized metrics of care quality and costs at each stage; and to advance the appreciation and delivery of high-quality care at MD Anderson, and more broadly.

There are many ongoing institutional efforts already in place, but the new department will help lead the academic efforts and intersect all of the different fields already involved.
"It's very exciting to have the opportunity to build a new department at MD Anderson," said Giordano. "I think it will help foster collaborations and growth for the field."

Giordano, who is also a professor in the Department of Breast Medical Oncology, helped develop breast cancer treatment guidelines on an expert panel of the National Comprehensive Cancer Center Network, an alliance of 23 of the world's leading cancer centers dedicated to improving the quality and effectiveness of cancer care.