Jamie Reese, RN, BSN, CMSRN | Image Credit:
St. Elizabeth Healthcare Cancer Care Center
Michael Gieske, MD | Image credit:
St. Elizabeth Healthcare Cancer Care Center
“Implementing sustainable processes for widespread cancer screening is a win at every stage of the care continuum,” the nonprofit organization serving the Northern Kentucky/Cincinnati metropolitan area said yesterday at the association. This was highlighted by two presenters from St. Elizabeth Healthcare. 40th National Oncology Congress of Regional Cancer Centers.
The cancer screening program was conducted at St. Elizabeth Healthcare Cancer Care Center in Kentucky. The center opened only three years ago, and he is one of six such centers. ACCC 2023 Innovator Award Winners At this year’s conference. His 244,000 square foot facility is the largest cancer center within a 400 mile radius. We currently serve more than 396,000 patients. There are 766 health care providers, of whom 479 are physicians and 287 are advanced practice providers. It encompasses 44 specialties and services, including addiction medicine, infectious diseases, medical oncology, palliative care, and radiation oncology. There are 169 clinics in 11 counties. And he is proud that one out of two of his girlfriends is part of a values-based care program. In 2022 alone, there were approximately 2.1 million patient visits, approximately $500 million in total revenue, and 8% net provider growth.
The challenges that Dr. Jamie Rees, RN, BSN, CMSRN, Manager of the National Health Support Service (PHSS) and Michael Gieske, MD, Director of Lung Cancer Screening, have had to face with their new cancer screening initiative are: The goal was to implement a process. Reach out to patients with backlogged cancer screening requests. Previous efforts to achieve this goal have included hiring social workers for comprehensive primary care initiatives. When the COVID-19 pandemic began, medical assistants were brought to the Center for Integrative Oncology. Activate virtual health teams consisting of nurse triage and school-based health.
“We didn’t have a sustainable process when assigning cancer screening orders. We knew our providers were having these conversations with patients, but we didn’t have a follow-up process. was not being done,” Reese said. “Everyone has their own role and responsibility, and as an organization we needed to make this a priority for our patients.”
Screening programs are not only good for patient care, but economically there are three main ways that cancer screening can benefit and add value to the health care system. Each completed cancer screening has the potential for direct revenue and reimbursement, and once a patient passes through the hospital, follow-up imaging, diagnostic tests, and biopsies are performed, all based on St. Elizabeth’s values. Introducing incentive programs and moving away from burdensome fee-for-service care could theoretically reduce the total cost of patient care. The aim was to detect cancer at its earliest stages, stage I or stage II.
Breast, lung, and colorectal cancers are targeted by the screening program implemented in August 2021, and a 2019 analysis of downstream revenue shows that each cancer were associated with $1 amounts: $125.84 per mammogram (breast cancer), $280.13 per low-dose lung CT (lung cancer), and $253.39 per colonoscopy (colorectal cancer). We also have a dedicated team of outreach specialists, consisting of six full-time registered nurses and six nurse navigators, each serving as the focus of outreach for one of three cancers. I selected one.
St. Elizabeth’s Hospital has also implemented a new workflow process called “Order Completion” to contact patients by phone through PHSS. The first step included identifying patients who had an open screening order, were not actively receiving treatment, or were not enrolled in hospice. From there, patients were prioritized based on whether they had multiple care gaps or had been seen in the past year. Two outreach attempts were made to contact each patient, and then every 6 months until the screening order was completed or expired. Successful contacts mean engaging with patients, educating them about the importance of screening, filling any open care gaps, and providing referrals as needed. Patients who could not be reached were left with a voicemail and a specific callback number direct to the nurse communicator who called.
Reese credits the program’s success to PHSS’ team culture, which encourages networking, values every contact, dials in with a smile, and takes pride in being the outreach arm of St. Elizabeth’s University. I think there is. There was also significant collaboration with the care management team, lung cancer nurse navigator, breast health center, and quality transformation team.
“Patients are so happy that someone takes the time to schedule an appointment for them,” Reese emphasized. Just knowing that someone cares enough about them that he calls them and says, ‘Hey, this is important, let’s have you look at it.’ ”
So what were the results?
- In 2022, 6,441 mammography exams and 4,990 low-dose lung CT exams were scheduled from January to December, and 6,276 Cologuard results were featured.
- Year-to-date screening completion rates in 2023 were 29% for 4,172 mammograms ordered, 38% for 2,375 low-dose lung CTs ordered, and 42% for Cologuard open orders.
- By July 2023:
- The number of people undergoing breast cancer screening was 35,862, an increase of nearly 10% from July 2019, and only 2,044 people compared to the 2022 total.
- The number of people undergoing colon cancer screening was 79,431, an increase of about 3 percent from July 2019 and just 2010 behind the 2022 total.
- The number of people undergoing lung cancer screening was 3,969, an increase of almost 18 percentage points from July 2020 and 3,528 fewer than the 2022 total.
“Screening saves lives, right?” Reese asked the audience. “There’s nothing more gratifying than when you call a patient and say, ‘Let’s explain this problem and let’s get you diagnosed with preventive cancer screening.’ This gives patients more birthdays together.” Because we get to celebrate.”
reference
Ries J, Gieske M. A model for demonstrating sustainable support for cancer screening. Presentation location: Association of Regional Cancer Centers 40th National Oncology Conference. October 4-6, 2023. Austin, Texas.
