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t m c » p u l s e | d e c e m b e r 2 0 1 4 26 Initiatives for Change embracing the enormous potential within houston's life science community, the texas medical center health policy institute searches for solutions to improve the health of texans B y A l e x O r l a n d o The amazingly unique thing about the Texas Medical center, in the realm of health policy, is that if you have 55 institutions, you have 55 approaches to health policy. Rather than emphasizing our differences, it's about embracing the different approaches that we can utilize— that's an opportunity that nobody else in the world has. — aRThUR gaRSOn JR., M.d., MPh director of the texas medical center health policy institute F rom the micro to the macro, at some level, health policy influences each of the member institutions within the medical center. Health policy requires a broad spectrum of legislative and regulatory efforts, from improving the efficiency of public programs to preparing health professionals to meet those patient needs. For the budding Texas Medical Center Health Policy Institute, on the cusp of rolling out a series of six evidence-based policy solutions to advance the health of Texans statewide, that may be a daunting task, but it's one well worth striving for. "Our mission is to provide value to the member institutions, the city and the state," announced Arthur Garson Jr., M.D., MPH, director of the Texas Medical Center Health Policy Institute. "Every one of our pro- grams, whether focused on the Texas Medical Center or beyond, was not here a year ago; that provides us with a blank slate, but one we have to draw upon carefully, as we only get to do 'new' once. By collabo- rating across the vast and unique talent housed here, the Texas Medical Center Health Policy Institute will become a source of unbiased information, helping to develop policies that reduce barriers to health. "We had a tremendous kickoff with the Texas Medical Center health policy design team and have used their strategy as an important guide," he added. "Many of the design team members are on our Institute Executive Committee." With an emphasis on drawing from rigorous data- driven approaches and real world experiences, these initiatives reflect the Texas Medical Center Health Policy Institute's broad scope and aspirational mind- set. Their first project, known as "Decision Support," aims to solidify their status as a source for accurate, unbiased data that can help support legislative deci- sion-making. While culling large swaths of informa- tion and presenting it in accessible terms is no easy feat, the Texas Medical Center Health Policy Institute is setting a high standard with their turnaround time—72 hours for both data and analysis. "In the typical academic world, that's 72 days or even 72 months," laughed Garson. "This will be a service for state and local legislators and the gov- ernment relations representatives from the medical center institutions, for free, and they'll have the option to keep their information confidential. Otherwise, it'll be archived for others who might want to see the question and their response." In preparation for the upcoming legislative session, an online submittal system will be in place, where requests can be made and logged, beginning January 10, 2015. No more than three days later, the submitter will receive what data exists, any necessary sources, graphs and commentary for interpreting the information, and two to three brief analyses from Texas Medical Center experts. "A lot of what influences policy is based on people's personal experiences, or the experiences of people close to them," reflected Stephen H. Linder, Ph.D., associate director of the Texas Medical Center Health Policy Institute. "As a consequence, there needs to be an alternative source to provide evidence based on a wide variety of experiences that has some validity in terms of how the data was gathered and interpreted. We want to provide a part of that. "The legislature is such a fast moving process, once it begins, and it takes some twists and turns that aren't predicted ahead of time," added Linder, who is also associate director of the Institute for Health Policy at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health. "The big thing about this kind of service is that it functions so quickly, which is essential when you're providing some neutral basis on which to make decisions." That inventive, large-scale approach is evident in another of the Texas Medical Center Health Policy Institute's ambitions—developing a program to improve access to care throughout the state. "We've been working with other groups, both locally and nationally, to help further the idea of improved access to Texas," said Garson. "Ultimately, this is about creating plans that the state can utilize to improve access for the uninsured, and there are over 6.2 million uninsured citizens in Texas. "We may think that being employed takes care of health insurance—and Texas has twice the percentage of full-time workers in the U.S. average—but we still have the highest rate of uninsured in the country, due to the high cost of health insurance and the fact that individuals and small businesses have difficulty affording it," he added. "The cost of health care is way too high and those of us in the medical profession need to do our part to figure out how to reduce the cost as well. There is a lot of waste out there—the esti- mate is about one third of all our health care dollars." Furthering that goal, the Texas Medical Center Health Policy Institute will be working with other groups, both in the state and nationally, to develop uniquely Texan approaches for improving access to care. Cultivating unique approaches necessitates an understanding of the people that you're trying to help. Taking the pulse of citizens throughout Houston and Harris County, the Texas Medical Center Health Policy Institute will be initiating a yearly survey on what health consumers want. Providing data of interest to the medical center, the city and the state, it has the added benefit of potentially generating new research in the process. "It's something that will not only inform us," said Garson, "but since we're going to repeat it yearly, it will be something that we can use to watch trends develop about how the attitude of Texas consumers changes over time. That way, we can ensure that we deliver what people need and want." Appropriately named "What Matters Most to the Health Care Consumers of Texas," the survey strives to provide context, clarity and purpose to efforts throughout the medical center, and beyond. Providing the scaffolding to support the devel- opment of emerging policy, the Texas Medical Center Health Policy Institute has cultivated a grants