The growing shortage of oncologists coupled with an anticipated 40% surge in cancer care demand is pushing healthcare institutions to reimagine their approach to cancer treatment delivery. At a recent American Journal of Managed Care's Institute for Value-Based Medicine event in Seattle, healthcare leaders gathered to address these challenges and discuss innovative solutions.
Sara J. Grethlein, MD, MBA, FACP, executive medical director at Swedish Cancer Institute, emphasized the urgent need to streamline collaboration between payers and health systems. She highlighted how current inefficiencies, such as redundant prior authorization processes, create unnecessary delays in patient care. "Why are we wasting resources? Why are we wasting time and treasure on fighting a battle where we have answers?" she questioned, particularly regarding treatments already approved in National Comprehensive Cancer Network guidelines.
Innovative Solutions in Team-Based Care
The Fred Hutchinson Cancer Center (Fred Hutch) has emerged as a leader in implementing effective multidisciplinary care models. Their integrative medicine service, which began in 2018 with just three members, has expanded to a 13-member team including pharmacists, naturopathic doctors, and various specialists. This growth reflects the institution's commitment to comprehensive patient care.
Rachel Feaster, PharmD, BCOP, BCPS, a clinical oncology pharmacist at Fred Hutch, emphasized the importance of seamless communication within their integrated model. The center has also pioneered an outpatient-specific model, designed to optimize patient value while reducing hospitalization time and costs.
Advancing Treatment Options and Access
The implementation of tumor-infiltrating lymphocyte (TIL) therapy represents a significant advancement in cancer treatment options. Sylvia Lee, MD, from the University of Washington Medicine, noted the therapy's promising 31% response rate, particularly significant for patients who have exhausted other treatment options.
However, the integration of new therapies brings its own challenges. Lee Cranmer, MD, PhD, FACP, described the process of implementing TIL therapy as "building a TILs machine," highlighting the complexity of coordinating multiple departments and establishing new protocols.
Balancing Guidelines with Personalized Care
While clinical guidelines provide essential frameworks for treatment, healthcare leaders acknowledge the need for flexibility in patient care. The workforce crisis in oncology makes standardized guidelines increasingly important for supporting team-based care, yet experts stress the importance of maintaining room for personalized approaches when cases demand it.
The discussion also touched on emerging technologies, including artificial intelligence in oncology care. Dr. Grethlein expressed cautious optimism about AI's potential while emphasizing the need for transparency in AI decision-making processes, particularly for complex cases that don't fit standard guidelines.
Future Directions in Cancer Care
As healthcare institutions adapt to increasing demands and workforce challenges, the focus remains on developing sustainable, value-based care models. The success of Fred Hutch's integrated approach demonstrates the potential of collaborative care models to improve patient outcomes while managing resources effectively.
Healthcare leaders agree that the future of oncology care lies in strengthening partnerships, improving communication channels, and maintaining a balance between standardized guidelines and personalized treatment approaches. These efforts aim to ensure high-quality care remains accessible despite growing workforce challenges.
