After 6 Years of Leadership and Growth, Jefferson's Health Policy Office
Forging Unique National Niche
In the healthcare world of 1989, few professionals saw the importance
of issues like practice guidelines, continuous quality improvement, practice
profiling, cost effectiveness, pharmacoeconomics. Very few had the foresight
to sense how important these and other issues would be for the dual major
themes of the 1990s ­p; increased quality and lowered costs.
Two who did were Joseph S. Gonnella, MD, senior vice president for academic
affairs and dean, Jefferson Medical College, and Thomas J. Lewis, senior
vice president for healthcare administration and hospital chief executive
officer. Firmly believing that Jefferson should be a key player in this
new arena, Dr. Gonnella and Mr. Lewis created the Office of Health Policy
and Outcomes and recruited David B. Nash, MD, MBA, from the University of
Pennsylvania to lead it.
Jefferson Vision Paying Off Today
Today, thanks to the vision of the two senior officers and the leadership,
initiative and vision of Dr. Nash, Jefferson is the only hospital in the
Philadelphia area to benefit from the collaborative programs, research,
and funding such an office provides.
It's an office and area where the term "unique" accurately applies.
Not only is it the only one of its kind in the Philadelphia area, several
of its efforts stand alone nationally. The managed care fellowship program
with U.S. Healthcare (see related story on page 1)
is one. Other examples are summarized below.
In the six years since Dr. Nash arrived to meet the challenge, the office
has grown in such scope and variety that, today, it conducts numerous programs
and collaborations in conjunction with the private sector and carries out
33 funded projects totaling nearly $2 million.
Mission of the Office of Health Policy and Outcomes
Its mission during this growth has been threefold:
- To improve the quality of medical care and, in so doing, decrease costs;
- To effect positive change in the delivery of healthcare services through
innovation in research, policy and education;
- To promote communication and an understanding of concerns and priorities
held by both the providers and purchasers of health care.
The collaborative nature of the Health Policy Office stands out in almost
all its features and activities, many of which mirror Dr. Nash's dual background
in economics and medicine. Some examples:
- Part of the office's pharmacoeconomics research activities is the Technology
Assessment and PharmacoEconomic Services (TAPES) Center of Excellence, a
landmark collaborative effort between TJU and the Philadelphia College of
Pharmacy and Science. Its purpose is to help private companies expedite
technology assessment and economic evaluation of healthcare products and
- A joint five-year MD/MBA (or MHA) program with Widener University to
educate doctors in both medicine and business is one of six such programs
in the country.
- Funding for staff and projects draws from a diverse range of three major
sources: Major foundations; a long list of pharmaceutical companies, some
the largest in the world; an eclectic mix of health-related companies, several
of which are nationally prominent in fields like hospice care and rehabilitation.
"Such funding diversity is important," says Dr. Nash, "as
any good investor knows. It's especially important in the current healthcare
Dr. Nash also stresses that the growth and diversity of the office and its
staff stem from funding successes which pay for salaries and operations.
Examples of clinical activities include clinical evaluative sciences, outcomes
management and health services research.
Other education and training activities include the monthly Health Policy
Forum, a health policy course (the "January" Plan) taught to first-year
JMC students, training seminars and research fellowships. The Grandon family
endowed lectureship is held annually, and the Jefferson Health Policy
Newsletter is published tri-annually for a circulation of more than
David Macfayden, MD, Lays Foundation for Health Policy Office
In assessing the office's success over the past half-decade, Dr. Nash gives
first credit to its visionary beginnings by Dr. Gonnella and Mr. Lewis and
the foundation laid by his predecessor, David Macfayden, MD, who in 1988-89
was serving a visiting professorship at Jefferson from the World Health
"David Macfayden is largely responsible for bringing the vocabulary
of health policy to Jefferson and, of course, for starting the Health
Policy Newsletter and putting down the roots of our educational program,"
Dr. Nash stresses.
"Dean Gonnella and Tom Lewis were extremely prescient in their vision
of identifying the important issues before the year 2000 and the next 10
years. None of the office's successes would have happened without their
shared vision. My 'assignment' was basically to bring to reality what they
foresaw for the benefit of both the medical college and the hospital."
Dr. Nash points to the true team approach of his highly skilled and energetic
staff as being key to the evolving and present success of the office.
"Probably the most important common theme about our staff is that they
are a highly self-motivated group of people. Everybody understands that
they must rely on everybody else to get the work done. It's a true team
"And since we are on the leading edge of so many new, and sometimes
controversial, issues, it's the only way it can be. The entire staff is
motivated by the strong belief that high quality care costs less. Our job
is to apply that belief, teach it and do research on it."