Insights in Action: Best Practices for Cancer Center Operations
October 13, 2020
How Hospital Sisters Health System was able to engage many more specialists and support services team members in tumor board conferences without sacrificing efficiencies.
We recently sat down with Dr. Colette Salm-Schmid, MD, FACS, Breast Surgeon and Kathy Simmet, RHIT, CTR, Coordinator Cancer Registry, at Hospital Sisters Health System, St. Vincent Hospital Cancer Center. We wanted to better understand how the team has been able to maximize engagement from providers, specialists and support teams while also managing some of the industry’s most efficient tumor boards – discussing on average 10- 11 patients during each one-hour session. According to Dr. Salm-Schmid and Simmet, it all comes down to preparation and consistency with a strong dose of technology to keep everyone on track.
A Q&A Session with Hospital Sisters Health System
DR. COLETTE SALM-SCHMID, MD, FACS Breast Surgeon Medical school: Northwestern University Medical School Residency: General Surgery, Marshfield Clinic Marshfield, Wis. Fellowships: Breast Cancer Surgery Fellowship, Northwestern Memorial Hospital
ABMS Board Certification: American Board of Surgery Affiliations: Fellow, American College of Surgeons Vice-Chair, Education Committee, National Accreditation Program for Breast Centers Surveyor, National Accreditation Program for Breast Centers Surveyor, Commission on Cancer, American Society of Breast Surgeons
KATHY SIMMET, RHIT, CTR Coordinator Cancer Registry Responsibilities: St. Vincent Regional Cancer Centers and St. Nicholas Hospital Care Center Credentials: RHIT: July 2014 CTR: July 2016 Affiliations: National Cancer Registrar’s Association
HOSPITAL SISTERS HEALTH SYSTEMS
Integrated delivery system caring for patients in 14 communities representing 2.6M lives in Illinois and Wisconsin • 15 hospitals • 230 community-based health centers & clinics • 3,225 physicians on staff • 15,600 staff members MISSION: “To reveal and embody Christ’s healing love for all people through our high quality Franciscan health care ministry.”
Tumor Board Efficiencies
You’re known for running one of the most efficient and effective tumor boards across the health system. What is your secret to success?
DR. SALM-SCHMID: As an NAPBC-accredited institution, it is important that we engage as many care team members as possible who can contribute to the best possible outcome for each patient. We believe everyone should have a seat at the table and that their voices must be heard, so we have to have a way to efficiently yet thoroughly cover as many patients as possible each week. Some may think engaging multiple specialists and support service team members would lead to long, unproductive tumor boards, but we’ve found a way to make our conferences very productive. The first step is making sure all of the information is readily available and easily accessible for everyone, anytime, anywhere. The next piece is making sure I structure questions that are going to get us the answers we need to make solid decisions. For example, if we know the patient needs radiation therapy, I don’t ask whether or not the patient needs therapy. Rather, I ask what types of radiation therapy the patient is eligible for. This not only gets us the answers we need faster, but also helps elevate everyone’s understanding of the types of therapy available and how they are different. And because all of the information is loaded into the system in advance, we can quickly move through the information and data we need on each OncoLens patient. We keep things moving.
SIMMET: One of the other things that has really helped us achieve extreme efficiencies is hosting our tumor board conferences on the OncoLens platform. Not only does it give us a single location where every document, image or report can be easily accessed by any team member anywhere, it also helps us stay on track with standardized “smart” templates that are populated during the discussions. And because it’s easy to invite others to join virtually, we have seen an increase in participation among other specialists and support service members, such as nutritionists and even primary care physicians. All of this gives us the most complete picture of the patient and leads to the highest quality care.
The OncoLens Decision
What made you decide to implement the OncoLens treatment planning platform?
SIMMET: I have a history of using technology to help organizations create efficiencies, and that’s where we started with OncoLens. I was looking for a way to reduce the time and manual burden associated with preparing for tumor board conferences. During this process, COVID hit, and we realized it was time to utilize the OncoLens platform with virtual tumor board capabilities. We knew this was exactly what we needed to do. The only silver lining with COVID is that everyone was willing to try something new so we could continue to meet for the benefit of our patients.
We were live on the platform within a week, hosting our first-ever truly virtual tumor board. We quickly learned it could do so much more and have been using it as the platform for all of our tumor boards ever since – even those where some of our providers now preferred to meet in person.
DR. SALM-SCHMID: OncoLens immediately became a critical vehicle and communication tool for us during the pandemic. When the COVID quarantine hit, we knew we had to find a way to continue to host our weekly tumor boards. It was the only way we were able to check in with everyone – see how they were doing, what services were available and what had changed. It was our lifeline for several weeks. Making sure patients didn’t get mixed messages was huge for us. OncoLens still remains a critical tool for everyone in many ways, even though some of our physicians and support services have returned to work at one of our facilities.
Were there any surprise benefits once you started using the platform more?
DR. SALM-SCHMID: Yes, there were several surprise benefits. When we first decided to implement it, I thought it would slow us down, but it is very intuitive and easy to use. It was definitely able to keep up with our pace, and we typically discuss 10-11 patients per hour. We were also amazed at how much clearer the radiology and pathology images were, because everything was right there on our screen in front of us instead of across the room on a big screen projector. We could see the extreme detail of the images like never before. Also, we were pleased with how easy it was to bring others into our tumor boards, which helps us get a more well-rounded view of the patient and ultimately make more informed clinical decisions. And finally, I recently noticed how easy it is to reassign or repost a case.
SIMMET: There were also a few nice surprises on the operations side. For one, the checklists the system provides us for compliance and accreditation purposes are very helpful. They not only ensure we cover everything we are supposed to for compliance purposes, but they also capture the bulk of the data that is required for reporting. My favorite benefit is how easy it makes it for everyone to prepare for the weekly tumor board conferences. I am responsible for up to four conferences a week, and it was challenging to pull all of the necessary documentation and images together in time, especially when cases are requested last minute. Now, the system tells everyone exactly what information needs to be provided, and it all sits in one, centralized, online location. Our radiologists love it too, because more of their team members are able to participate as presenters since they don’t have to travel to be on-site, which allows them to coordinate their schedules to participate remotely.
Delivering High Quality Care
How has OncoLens impacted your health system’s goal of delivering the highest quality care?
DR. SALM-SCHMID: Because we are able to give everyone a seat at the table in our weekly tumor board conferences, OncoLens helps us make sure everyone’s voice is heard. It brings us together, whether remotely or in person, and it helps us make better clinical decisions for our patients. But it’s flexible enough to let us shape it to do whatever we want it to. For example, in our breast board conferences, we can bring forth high-risk patients. We can have someone from genetics educate us all on new information about CHEK2 inhibitor or something new in the field that we need to know.
SIMMET: We are a fairly large health system, and OncoLens gives us the framework for more structured and consistent discussions about our patients across the organization and across our different tumor boards. The templates guide us to ensure we cover all aspects of a patient presentation and discussion, and every support service is considered. We go through this section of the template, which prompts discussion. With a click of a few buttons, we are able to enter our metrics for CoC compliance. Oncolens’ built-in reporting makes the process of preparing our Cancer Committee reports simple and quick!
Extreme Customer Service
Introducing new technology can be challenging sometimes. How did your implementation of OncoLens go? What has the response been from team members?
SIMMET: I’ve been involved with technology implementations for more than 20 years. Some are a smooth transition and some, not so much. Because OncoLens was built specifically for cancer centers, it’s been easy for our clinical staff, physicians and specialists to jump in and start working in the system immediately. And because it is web-based, users can access it at any time, from anywhere. I was also extremely impressed with the OncoLens support team. It is superior to anything I’ve been involved with before. On a scale of 1 to 10, I give them a 10+. They are very intuitive and very responsive to our needs. They even sat in on our tumor boards and held our hand to make sure everything went smoothly. Within one week of calling for the virtual tumor board technology, we were live and productive.
DR. SALM-SCHMID: I was pleasantly surprised at how easy it is to use the OncoLens platform. It’s very intuitive, and the support team is very responsive. One time I was having trouble logging in at 6:30 a.m., and I called the support line, and someone was able to help me immediately.
Efficient & Productive Tumor Board Conferences
How has OncoLens contributed most to your ability to efficiently run your tumor board conferences?
SIMMET: I think one of the biggest benefits we’ve seen that is directly tied to OncoLens is the ability to let everyone log into the system in advance of tumor boards and know exactly what they need to have prepared to present or discuss. Everyone comes to the conference more informed and is able to quickly view relevant information with the click of a button. These features boost our conference productivity, efficiency and reporting. In addition, the system automatically creates the agenda and presentation for tumor board conferences, so we’ve seen about a 90% reduction in prep time. And finally, when it comes time for cancer committee meetings and accreditation reports, all of the detailed data we need is already in the system.
The Future of Tumor Boards
Where do you see technology and tumor boards going over the next few years?
DR. SALM-SCHMID: I think we will see more and more virtual meetings occurring. The advancements being made in technology and the convenience they afford are hard to resist. The ability to be more inclusive with our care networks allows everyone to see how they can contribute to patient success. I think as we see some of the reductions in support services, they will be challenged to attend every conference. Yet, their recommendations will already be loaded in the system and available for everyone to see. Because of COVID, we’ve all learned how to do things differently and in a manner that still provides the highest quality of care for our patients. It will be interesting to see how organizations adapt to all of the new technologies over the coming months and years.
SIMMET: We want to continue to grow the number of conferences we have across cancer types so all of our patients can benefit from the multi-specialty conversations, and OncoLens will allow us to grow using existing staff. It is also helping us to create tighter relationships across care providers in our network and in the communities we serve. For example, when discussing a patient, we may identify that the patient would benefit from a referral to an oncology dietitian. With OncoLens, we can quickly submit a referral to the dietitian who can easily log into the system and see all of the necessary case details. This also helps satisfy CoC requirements by bringing support services discussions into patient tumor board presentations.
“I am 100% all in on keeping OncoLens for tumor boards and for the radiologist doing tumor boards remotely. It is much more functional and consequently better for the tumor board to have me show on OncoLens. That way, I can use my regular workstation. Scheduling tumor boards for radiologists is also better, which improves participation by the most appropriate radiologist for each tumor board.” – Henry Feider, MD, Radiologist