NCI NCCCP Pilot Launch

Catholic Health InitiativesJune 25-26, 2007

Presenters

Debbi Honey, RN, MHA

CHI Vice President Clinical Operations

CHI liaison and contact for NCCCP Pilot

Mark Krasna, M.D.

Medical Director, St. Joseph Cancer Institute, Towson, MD

Principal Investigator, Catholic Health Initiatives NCCCP sites

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Catholic Health Initiatives

Nation’s second largest Catholic healthcare system - not for profit

Facilities • 72 hospitals

• 43 long-term, assisted-living and residential care facilities

• 5 community-based health ministries 19 States Approximately 500,000 acute care admissions annually Approximately 66,000 full and part-time employees $8.8 billion in assets $7.1billion in NPSR 11% or $797 million as quantifiable community benefit (as

percent of total revenues)

Quantifiable community benefit (provided to the poor and broader community) as a percentage of total revenues: 11% or $797 million

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Basis for Participation – Quality of Care

The broad geographic, size and service level diversity demands discipline and rigor to support quality care

Goal for all patients in a CHI facility to receive comparable high levels of quality care in services provided

System commitment to continual improvement in quality and patient safety STEEEP

Central standardized information repository

Coordinated standard competency process

Active intra-facility collaboration increasing with oncology most active and engaged

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Basis for Participation – Strategic Alignment

Mission and Vision Creating Healthier communities

Commitment to serve disparate and underserved persons and populations

Supports strategic direction of organization Focus on key service lines

Alignment and partnership with community providers

Enhancing and continually improving services available to patients in our communities

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Basis for Participation – Strategic Alignment

Growth Strategy Local– MBO oncology service line growth and

development

National – Advancement of clinical services through an integrated approach across CHI

Innovation Creating a culture that fosters innovation

Promoting transfer of new ideas and proven practices

Focused clinical service-line innovations: oncology, cardiology, ortho/neuro

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Basis for Participation – Strategic Alignment

Research and Development CHI Board initial commitment of $25M to new R&D

function

Focus on creative approaches to transforming healthcare delivery

National partnerships and linkages will be key component

Integrated approach to clinical research activities across CHI

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Basis for Participation – Distinctive Disparities

St. Joseph Medical Center, Towson, MPeople Served - 1.8 million

35% are African American Over 26.2% are older adults considered Highest incidence of thoracic malignancies

Penrose-St. Francis Health Services, Colorado Springs, COPeople Served – 564,776

Medically Underserved designation in primary market area Health professional shortage designation in primary care for low

income populations.

Nebraska Hospitals – Good Samaritan Hospital, Kearney; St. Elizabeth Regional Medical Center, Lincoln; St. Francis Medical Center, Grand Island

People Served – Collectively 920,000 Large rural geographic areas with limited access due to distance and

economic and personal issues. Limited number of available trials makes Nebraska a prime target for

an increase in both trial numbers and participant levels.

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Basis for Participation – CHI MBO Complement to NCI Cancer Centers

CHI Acute MBO Cancer Programs (40)

Source: www3.cancer.gov/cancercenters/descriptionmap.html; modified on 4/09/06

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Basis for Participation – System Advantages

Rural and Urban hospitals

National resources

Financial support

Clinical Expertise

Infrastructure for clinical and knowledge transfer

Infrastructure for standardized information in place to support outcome measurement

Leadership support, engagement and excitement at all levels of the organization

System-wide approach to service line strategies – example CHON

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Local Considerations

Challenges Collaboration

Physician referrals Building confidence at

“community” level

Changing established referral patterns

Disparate population participation Awareness

Access

Unanticipated resource needs Infrastructure

Equipment

Human Resources

Opportunities Access to leading edge care

for cancer patients

Expansion of outreach opportunities

Sharing of resources and scarce expertise

Positively supports one of the system’s identified strategic service lines

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“Extra Local” Considerations

Clinical Expertise – Sharing and Supporting Specialty providers

Clinical and technical providers

Genetic counselors

Coordination with local agencies

Garnering collaboration between hospitals for service designation

Encourage and enhance ability to near “real-time” share lessons learned and best practices

Reputation for multidisciplinary care

Focus on innovation

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Community Experience

Enjoy excellent reputation with consumers

Patients voice the desire to receive care at or near home when possible

High level patient satisfaction in facilities

State-of-the-art cancer facilities in several markets; commitment to enhance markets in development

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Physician Experience

Medical staff actively involved

Believe hospitals/CHI are committed to quality and the community and actively partner with the facilities

Asked and participate in strategic planning activities

Actively participate in cancer committees at local level and participate in intra-facility

Complements existing private practice in local markets

Physician alignment – Strategies for recruiting and working with partner providers

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NCCCP PILOT: NCI and CHI Synergy

Microcosm of U.S. Healthcare System

Geographic Diversity and Scope

Leadership Commitment

Commitment to Local Communities

National Infrastructure and Resources

National Information Strategy

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System Dissemination and Integration

CHON Development of a network for all CHI facilities with cancer

programs to work together

Teleconferencing

Enhance ability to actively participate in clinical research and trials

Infrastructure enhancements

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Catholic Health Oncology Network - CHON

Goals:

Research Multi-d Care

• Become a highly sought after partner in the clinical development of new therapeutic approaches for cancer treatment

•Establish multi-disciplinary care as the standard for treating oncology patients across CHI

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CHON: Strategic Rationale

• Providers that support clinical trials are viewed as being on the leading edge

• Clinical research provides best cancer care

• Clinical research across CHI is not organized, managed or marketed in a unified program

• CHI is not benefiting from the advantages associated with being a leading research-focused system

• CHI can address the many needs of research sponsors:

access to large, diverse pools of patients in a variety of disease areas

Participation by highly qualified, proven clinical investigators

Systems to acquire and deliver quality clinical data in a timely manner

• Access to all therapeutic options; fully involving all team members improves quality of care

• Cancer is by nature multidisciplinary, requiring services from several specialists

• Multi-d teams allow the cancer program to address the continuum of patient care

• Multiple benefits to building multidisciplinary oncology programs in a community setting:

For patients: make more informed decisions and receive better care (access, wait times)

For providers: provide better care, communication and work environment

For programs: build unique capabilities and market share

Clinical Research Multi-disciplinary Care

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Business and Research Alignment:

The benefits to be gained from a CHON will be best realized by implementing systems and processes which:

Align CHI’s strategic, business and clinical objectives

Integrate and coordinate resources and activities to create efficiencies

Ensure properly shared infrastructures and uniform approaches to key activities

Foster timely and efficient communication and learning throughout the network

Enhance existing programs by complementing/partnering with other CHI sites/central office

Catholic Health Oncology Network - CHON

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Create a coordinated team of dedicated specialists who willprovide the highest quality, compassionate care to patientswith malignancies, in an efficientand patient-friendly manner

Reinforce the positive clinical benefit of multidisciplinary care to patients, nurses and physicians

The Cancer Institute at SJMC: The Mission

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CHON: A Vision for the Future

Goals

Multidisciplinary care as the paradigm throughout CHI facilities

Provide access to multidisciplinary conferences

Facilitate live video/consultation or referral within the network to all specialties

Provide access to “state of the art care” at all rural CHI sites

Collaborate on new research initiatives

Offer state of the art access to clinical research trials

Collaborate with industry partners

Increase oncology market share

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Questions

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