St. Joseph Hospital St. Joseph Hospital Cancer Center & Cancer Cancer Center & Cancer

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St. Joseph Hospital St. Joseph Hospital Cancer Center & Cancer Cancer Center & Cancer

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NCCCP Pilot ProjectNCCCP Pilot Project

SJO Service Area SJO Service Area CharacteristicsCharacteristics

SJO Service Area SJO Service Area CharacteristicsCharacteristics

Dense urban population Ethic diversity

– 53.7 % Latino– 17.3 % Asian– 25.9 % White

~ 25% Undocumented migrants 53% Managed care > 30 Hospitals in region

– 7 within 3 mi of SJO

Cancer in Orange CountyCancer in Orange CountyCancer in Orange CountyCancer in Orange County

14,000 New Cases per Year

2,300 Breast2,300 Prostate 1,700 Lung1,400 Colorectal1,200 Leukemia,

Lymphoma and Myeloma

600 Melanoma

St. Joseph Hospital St. Joseph Hospital Cancer Center & Cancer Cancer Center & Cancer

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St. Joseph Hospital St. Joseph Hospital Cancer Center & Cancer Cancer Center & Cancer

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Pilot Project InterestPilot Project Interest

Aligned Goals & Aligned Goals & InitiativesInitiatives

Aligned Goals & Aligned Goals & InitiativesInitiatives

Site-specific multidisciplinary care Patient navigation Cancer physician credentialing EMR Research expansion Cancer genetics expansion including

biospecimens Improved support for disadvantaged patients

Increase National Increase National CollaborationCollaboration

Increase National Increase National CollaborationCollaboration

NCI

– Expand linkages with NCI Comprehensive Cancer Centers

– Align SJO IT initiative with CaBIG development

– Contribute and influence future of cancer care

Other Pilot programs– Identify new approaches and best practices

– Collaboration with programs of similar vision

Enhance Patient & Enhance Patient & Program SupportProgram Support

Enhance Patient & Enhance Patient & Program SupportProgram Support

Access to care & financial support guidance

Navigation for disadvantaged patients

Research expansion

Cancer Genetics/Biospecimen expansion

IT Integration of Survivorship plans

Challenges & OpportunitiesChallenges & Opportunities

Fragmented Care - Fragmented Care - ChallengesChallenges Fragmented Care - Fragmented Care - ChallengesChallenges

Private practice MDs (Local)

Multiple care locations (Local)

Managed care (Regional)

Access to care (Local, Regional, State)

Isolated data and patient information (Local)

Disparate IT systems or none (Local)

Fragmented Care - Fragmented Care - OpportunitiesOpportunities

Fragmented Care - Fragmented Care - OpportunitiesOpportunities

New cancer center (Local)

Site-specific multidisciplinary teams (Local)

Navigators (Local)

Cancer specialist credentialing (Local)

NCCN Guidelines (National)

Benchmarked outcomes (National)

IT connectivity (Local and National)

Research (Local, National)

Healthcare Disparities - ChallengesHealthcare Disparities - Challenges

Cultural and language barriers Undocumented patients Financial limitations to access to care ER frequent source for primary care Financial assistance coordination Lack of comprehensive approach to care Lack of consistent approach to care

Healthcare Disparities - OpportunitiesHealthcare Disparities - Opportunities

Mission Integration (Local)

Strong financial assistance program (Local)

Staff Recruitment/interpreter services (Local)

Community partnerships & outreach (Local, Regional & National)

Nurse practitioner for underserved (NCCCP)

Financial Assistance Counselor (NCCCP)

Expansion of Research & Expansion of Research & Biospecimen Repository - Biospecimen Repository - ChallengesChallenges

Expansion of Research & Expansion of Research & Biospecimen Repository - Biospecimen Repository - ChallengesChallenges

MD awareness of available trials Limited time/resources for private practice MDs Not second nature for private practice MDs Participant identification fragmented Limited staff and resources – Hospital Limited trials meeting patient needs and MD

interest Access to data for research capture and

integration

Expansion of Research & Expansion of Research & Biospecimen Repository - Biospecimen Repository - OpportunitiesOpportunities

Expansion of Research & Expansion of Research & Biospecimen Repository - Biospecimen Repository - OpportunitiesOpportunities

Linkages with NCI Centers

Common EMR for participant ID and data capture

Hospital research team efforts

Navigator extension of research staff efforts

Philanthropic and external funding support

Hospital operations support for cancer research

Diverse patient populations for biospecimen sources

Community and Physician Community and Physician ExperienceExperience

Community and Physician Community and Physician ExperienceExperience

Strong Organizational Strong Organizational Values and Commitment to Values and Commitment to Care for CommunityCare for Community

Strong Organizational Strong Organizational Values and Commitment to Values and Commitment to Care for CommunityCare for Community

Mission Integration Strong financial assistance program Philanthropy to assist unmet care needs Organizational support for non-reimbursed

services (dietician, counseling, RN navigators) Cancer center design and services

– Resource Center– Supportive care– Common infusion center design

Physician- Led Physician- Led Multidisciplinary TeamsMultidisciplinary TeamsPhysician- Led Physician- Led Multidisciplinary TeamsMultidisciplinary Teams

Oncology Steering Committee (Leadership) Site-specific & program multidisciplinary

teams– Case conferences– Business plans– Research– Website

Oncology Council (Guidelines) Cancer Research (Oversight)

Cancer Center - Integration of Cancer Center - Integration of Community, Patients, Physicians Community, Patients, Physicians

and Hospitaland Hospital

Cancer Center - Integration of Cancer Center - Integration of Community, Patients, Physicians Community, Patients, Physicians

and Hospitaland Hospital

Comprehensive services in single location Patient participation in design and philanthropy Community shared conference center Dedicated Multidisciplinary Center for

integration of clinical expertise and support Infusion timeshare to reduce overhead and

invite increased program collaboration Oncology EMR

– individualized care/survivorship plans– MD connectivity