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How I Practice Now: Reopening of In-Person Care at Texas Oncology?

Publication: Journal of Clinical Pathways
04/30/2020

Journal of Clinical Pathways spoke with Lalan Wilfong, M.D., vice president of quality programs and value-based care, Texas Oncology, on whether the reopening of society will correlate with the reopening of in-person cancer care at Texas Oncology as well as the reliability of mass and rapid testing.

For cancer care, I think the thing we have to focus on is what care is important and vital for our patients today, and if we delay that care, will their health and outcomes be impacted because of that delay.

We have an approach within Texas Oncology of being able to open our clinics back up, specifically our surgeons, who almost all have stopped surgery at this point. We have a way to open surgery back up so that they can perform surgeries on patients with cancer to prevent poor outcomes from delayed care while keeping our patients and staff safe and maximizing the importance of PPEs for our hospitals.

So that’s a challenge and is going to be regionalized – depending on the locations, outbreaks, availability of protective gear, and things like that and whether there is an approach to that.

As far as testing goes, it is challenging. If you look at all the tests out there, and there are some very well written editorials lately about this, much of the testing that we have has not been validated. The sensitivity and specificity of that testing is not known. It makes it challenging to do that testing on a real-time basis because we don’t know what a negative test means or what a positive test means because of false-positives and false-negatives. How does that actually correlate in to managing our patients and doing that patients care.

Rapid testing is important, but we have to make sure that testing is valid and that we understand what the sensitivity and specificity of that test is before we can completely rely on that testing to change the way that we approach patient care.
 

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