Comprehensive Cancer Care Centers and Integrated Delivery Systems

Web Exclusives - COVID-19

The Association for Value-Based Cancer Care (AVBCC) webcast, titled Comprehensive Cancer Care Centers and Integrated Delivery Systems: COVID-19 Impact on Cancer Care and Road to Recovery, moderated by Burt Zweigenhaft, PhD, D.Litt, Founder, AVBCC, brought together a distinguished panel of 4 practitioners and executives from some of the major cancer care centers in the country. These experts explored what has already occurred regarding the delivery of care as a result of the COVID-19 pandemic and speculated on changes that will need to occur as healthcare systems adjust to the “new normal.”

Dr Zweigenhaft said that the discussion was an important one “because we have no disaster plans or playbooks for what the road to recovery is going to look like.” The panelists offered their assessments of what recovery might look like and the factors that stand in the way, as well as their predictions for the future.

Christian Downs, MHA, JD, Executive Director, Association of Community Cancer Centers, began with a high-level overview of the middle to large integrated health delivery systems that have roughly 3 or more cancer programs or delivery sites, typically with surgery, radiation, and laboratory medical oncology all under one roof. He focused on the coordination of care across disciplines and the anticipated surge in demand for services once the coronavirus restrictions are lifted. Mr Downs also remarked on the need for financial counseling owing to the complexity of systems and the personal circumstances of patients.

“We need to remember that, for decades, clinical trials represented the standard of care in oncology,” said Al Benson, MD, Professor of Medicine, Lurie Cancer Center, Northwestern University, and Past Chair, National Comprehensive Cancer Network, who launched into a discussion regarding the disruption of that process and how it might regain its footing. “As we know, sometimes a clinical trial may actually be the best option for a patient. We continue, however, to have concerns about clinical trials in the United States,” Dr Benson said.

Laura Bosserman, MD, FASCO, FACP, Clinical Assistant Professor, City of Hope National Medical Center, continued the discussion with a look into the issues arising around the extended use of telemedicine, elaborating on the many disparities in patient age and access to necessary technology that will make the remote delivery of cancer care challenging. The other members of the panel weighed in on the points she raised, stating that they have seen many of the types of issues she described in their own practices. Describing herself as a “true optimist,” Dr Bosserman laid out a vision of positive change for the delivery of care.

“I hope that we’re not going to go back to not having the patient at the center of care. So I look forward to working together to promote the science and to help each other share best practices,” she said.

“It's really just incumbent on us to pay attention to what happens in the next month and follow the guidance, where we need 2 weeks of downward trending incidents before we throw open the doors,” said Julian Schink, MD, Chief Medical Officer, Cancer Treatment Centers of America, in conclusion, “and before any of the changes and improvements can be implemented.”

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