The Comprehensive Cancer Care Network of Romagna: The Opportunities Generated by the OECI Accreditation Program

6546 Background: The VA Pittsburgh Healthcare System (VAPHS) Virtual Cancer Care Network was launched in January 2018 after we had established an electronic consult service where 555 hematology electronic consults were completed at VAPHS in FY17. The clinical video telehealth (CVT) clinic allows veterans from central Pennsylvania to receive their anticancer therapy at the VA in Altoona, Pennsylvania where the oncology pharmacy, nursing, telehealth, and supportive oncology staff are on site. Patients follow regularly and remotely during treatment via CVT visits with their oncologist located 93 miles away at the VA in Pittsburgh. Methods: A chemotherapy pharmacy and nursing infusion clinic were created at the VA in Altoona. CVT visits started in January 2018. Data including treatment, adverse events defined through CTCAE v5.0, gender, age, zip code, and other details were examined retrospectively. Results: 279 CVT visits for 89 patients were completed January 2018 through Sept 2018. 87 were male, 2 were female. Average age was 70 (range 45-90). Most common primary disease sites were prostate (19.1%), colorectal (13.4%), and lung (9%). 61.8% of patients were on treatment. Non-treatment visits were for surveillance and survivorship. Treatment administered included platinum doublets, fluorouracil doublets, immunotherapy, and oral anticancer therapy. 5.4% of patients had Grade 3-4 events due to febrile neutropenia, increased liver enzymes, and hemolytic anemia. 41.7% had grade 1-2 events due to peripheral neuropathy, neutropenia, anemia, thrombocytopenia, and infusion-related reactions. Using an average commuting speed of 60 mph and a travel cost of $ 0.56 per mile, the total commute distance averted was 49,579 miles. Mean distance averted per patient was 557 miles. Total commute time saved for veterans was 826 hours. Total mileage costs saved for veterans was $27,764. Conclusions: The Virtual Cancer Care Network reduced the travel time and costs for veterans who previously would have travelled from central Pennsylvania to VAPHS for their oncology treatment. Adverse events were tolerable and managed by the VA in Altoona. Integration of CVT secures safe access to cancer care and maintains patients’ primary relationships with their oncologists.

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Pediatric Cancer Care Network

10.32388/1erjis ◽

2020 ◽

Author(s):

Keyword(s):

Pediatric Cancer ◽

Cancer Care ◽

Care Network

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Development of a virtual cancer care network for distance oncology treatment.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.30_suppl.270 ◽

2018 ◽

Vol 36 (30_suppl) ◽

pp. 270-270

Author(s):

Vida Almario Passero ◽

Andrew D. Liman ◽

Hema Rai ◽

Laurie Harrold ◽

John Hotchkiss ◽

...

Keyword(s):

Cancer Care ◽

Anticancer Therapy ◽

Clinic Visit ◽

Nurse Specialist ◽

Missed Opportunities ◽

Care Network ◽

Palliative Intent ◽

Central Pennsylvania ◽

Common Diagnosis ◽

Oncology Treatment

270 Background: The VA Pittsburgh Healthcare System (VAPHS) Virtual Cancer Care Network was launched in January 2018 as the next step after we had established an electronic consult service where 555 hematology electronic consults were completed at VAPHS in FY17. The clinical video telehealth (CVT) clinic allows veterans from central Pennsylvania to receive their anticancer therapy at the VA in Altoona, Pennsylvania where the oncology pharmacy, nursing, telehealth, and supportive oncology staff are on site, while the patients continue to follow regularly during treatment via CVT visits with their oncologist located 93 miles away at the VA in Pittsburgh. Methods: A chemotherapy pharmacy and nursing infusion clinic were created at the VA in Altoona. CVT visits started in January 2018. Data including zip code and clinic visit details were examined through descriptive statistics. Results: A total of 89 CVT visits for 27 patients were completed from January 2018 to May 2018. All patient visits were follow-ups while patients were receiving active treatment. 16 patients received intravenous treatments, and 11 received oral anticancer therapy. 100% of the patients were male. Median age was 73 (range 56-89). The most common diagnosis was prostate cancer (26%). The majority of the patients were receiving therapy for palliative intent. 100% of patients chose VA Altoona rather than VAPHS as their treatment clinic location. Five oncology physicians and one oncology clinical nurse specialist completed the clinical video telehealth visits from VAPHS. Total commuting distance averted was 14,828 miles. With an average commuting speed of 60 mph and a travel cost per mile of 0.5 dollars, the total commute time saved for veterans was 247 hours, and the total mileage costs saved was $7414. Appointment compliance was 100%, and there were no missed opportunities. Conclusions: Implementing the Virtual Cancer Care Network has decreased the travel time and costs for veterans who previously would have travelled from central Pennsylvania to VAPHS for their oncology treatment. The integration of CVT technology has improved patient access to oncology care and maintains the patients’ primary relationships with their oncologists.

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The cancer care network clinical trials program: Rising from the camp fire ashes.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.27_suppl.168 ◽

2019 ◽

Vol 37 (27_suppl) ◽

pp. 168-168

Author(s):

Ofilio Ramon Vigil ◽

Dana Ann Little ◽

Kristin J. Mensonides ◽

Richard J. Bold

Keyword(s):

Clinical Trial ◽

Clinical Trials ◽

Rural Communities ◽

Cancer Care ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Trial Participation ◽

Care Network ◽

Research Oversight ◽

The City

168 Background: The UC Davis Health Cancer Care Network (CCN) in Sacramento improves quality through partnerships with community cancer centers and the UC Davis Comprehensive Cancer Center (UCDCCC). The UCDCCC, as an NCI Lead Academic Participating Site (LAPS) grant recipient, lists Adventist Health Rideout Cancer Center (RCC) in Marysville (42 miles north of Sacramento) as a component. The Adventist Health Feather River Cancer Center (FRCC) and the town of Paradise were devastated by the 2018 Camp Fire, forcing FRCC’s relocation to the city of Chico (49 miles north of Marysville). FRCC was forced to disband its local IRB and unable to continue clinical trials research operations during the aftermath of this natural disaster. The CCN established an affiliation with the FRCC in April 2019. Future plans include establishing an IRB agreement and adding FRCC as a LAPS component. The CCN identified strategies to facilitate the participation of FRCC patients in clinical trials. Methods: The CCN identified 13 NCTN clinical trials with 34 enrolled patients that were in need of appropriate research oversight. Four of these trials were previously never activated at the UCDCCC or its affiliates. CCN staff engaged leaders at the various institutions involved: Quality Assurance (QA) Managers at each NCTN research base, the CIRB, the local IRB, the CTSU, and other leaders within UC Davis and Adventist Health. Results: Stakeholders acknowledged the unusual and urgent nature of our requests and questions, while contributing to the development of a plan allowing patients to continue clinical trial participation. QA managers approved a plan transferring patients to the RCC, allowing research staff to collect and submit data while patients continue receiving care closer to home. Together we developed a notification letter to inform patients of this plan. Conclusions: The relocation of facilities and patients brought rare challenges while conducting clinical research in rural communities. We learned that the cooperation and flexibility of all parties involved was crucial in supporting the continued care for FRCC's clinical trial patients and research contributions.

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Cancer care network: Structure analysis of enabled services

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.63.10.890 ◽

2017 ◽

Vol 63 (10) ◽

pp. 890-898

Author(s):

Marisa Riscalla Madi ◽

Giovanni Guido Cerri

Keyword(s):

Cancer Care ◽

Secondary Data ◽

Sao Paulo ◽

Cancer Surgery ◽

The State ◽

Primary Data ◽

São Paulo ◽

Unequal Distribution ◽

Care Network ◽

Comparison Results

Summary Introduction: Cancer has now become part of the agenda of health managers, prompting them to consider new models of system organization. Objective: To study the cancer care network of the Brazilian public health system (SUS, in the Portuguese acronym) in the state of São Paulo by analyzing the structure of the installed and enabled network for treatment and its characteristics. Method: A single, integrated case study. We used secondary data from the following sources: Datasus, Inca, RHC and CNES, and primary data from official documents from the Reference Committee on Oncology of the State of Sao Paulo. We used the official guidelines to able services from the National Health Department to make comparison. Results: According to the CNES, in April, 2013 there were 72 cancer care services authorized by SUS in the state of Sao Paulo. Using the population criterion, the state had one service enabled for every 581,961 inhabitants, in an unequal distribution throughout the 17 health care regions. In terms of available structure and services, 80% of the hospitals were compliant for cancer surgery, 31% for chemotherapy and 74% for radiotherapy. In terms of minimum production, only 13% of hospitals were compliant with cancer surgery, 42% with chemotherapy and 14% with radiotherapy. Conclusion: The installed network proved to have sufficient size and structure to meet the demand from new cancer cases. However, there were both regional differences, as well as a wide variation in productivity between services, which probably had an impact on patient access.

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