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