Oncology Service Line

LAPS-U10 Implementation“A Business Case for Improved UCHealth

Integration”

W. Thomas Purcell, MD, MBA

System Director, Oncology Service Line

tom.purcell@ucdenver.edu

Background• NIH/NCI funding for cancer cooperative group trials dramatically

changed with introduction of “NCTN” --- National Clinical Trials Network

• CU Cancer Center has been leader in SWOG for years in old system (affiliates and numerous silos)

• Expectation that we would be leaders in the new “NCTN” as Lead Academic Participating Site “LAPS” participant with UCH, PVHS and MHS as essential clinical components

• LAPS U10 Grant submitted in 2012; announced in October 2013--- ~$675k/yr x 5yrs

Geographic Importance to the State and Region

Geographic Importance to the State and Region

3

Cancer CenterComprehensive Cancer Center

2800 new analytical cases / yr 4500 new patients / yr

Patient ReferralDensity (UCH)

UCCC

National Cancer Institute Comprehensive Cancer Center

Untapped opportunity for a distinctive cancer program

Competitor Weaknesses – items for UC Health

differentiation• Overall care coordination difficult– multiple

EMRs• Not ideally suited for multidisciplinary care• Survival rates not published or available• Minimal subspecialty emphasis – most med/rad

oncologists are generalists• Positioning for personalized medicine- research

for biomarker or molecular targets leading to clinical trial enrollment

Establish UC Health as the nation’s preeminent integrated delivery system for Oncology Services, as evidenced by the highest 5 year survival rates and best patient experience.

To achieve this, the service line must have•complete transparency•common quality/safety metrics•consistent clinical pathways and adherence•outstanding access for patients and physicians•recognized research leader across the world

Oncology Service Line Vision…

Putting “the Patient First” in Decision Making

CMO/ Interim CEO

System Director Oncology Region CEO/CMO/COO/CFO

SouthOncology Services

CentralOncology Services

NorthOncology Services

Rob HoyerSloan Mayes

Tom PurcellJamie Bachman

Matt SorensenJoAnn Lovins

UCHealth Oncology Service Line –

Org Chart

Rob Marschke

8

Oncology Service Line structure…

To achieve the vision the Service Line will organize by groups that report to a Steering Committee

Oncology Service Line Steering GroupOncology Service Line Steering Group

Operations Joint

Operating Committee

(JOC)

Operations Joint

Operating Committee

(JOC)

Clinical Integration

JOC

Clinical Integration

JOC

Research JOC

Research JOC

Administrative Service Line LeaderPhysician Service Line LeaderMD - Medical OncologyMD - Radiation OncologyRegion CEO(s)

Strategic Planning for each location (local and system approaches)North, Central, SouthNorth, Central, South

Strategic Planning for each location (local and system approaches)North, Central, SouthNorth, Central, South

Bachman Maes Lovins

Litchtenberger

Kellackey

Research JOC

• Positioning for LAPS grant implementation March 2014 for cooperative group studies

• LAPS is foundation for future “Cancer Research Network” for entire UC Health

• Disease program leaders vital for clinical trial prioritization

Disease Program Leaders are the cornerstone for

system-wide approach

• North, Central and South program leaders for each specific disease collaborate on:– clinical operations– research protocol prioritization– quality improvement– EPIC/beacon treatment plans merge /

standardization

12North

Program Leader

North Program Leader

Central Program Leaders

Central Program Leaders

South Program Leader

South Program Leader

Issues…at least some of them!

• No UC Health infrastructure for clinical research---- hence RAMP Committee

• Integration between School of Medicine and Cancer Center with UC Health

• Regulatory cIRB versus local

• Funding…. LAPS “cost” ~ $1.3 million per year

Differentiating Research Committees and Charges

RAMP---LAPS connection!• 4 RAMP Primary Subcommittees:

– Compliance; Business & Finance; IT and Operations (all but IT have formed workgroups).

• Established a model for the organization of regional infrastructure

• Determined responsibilities residing at the regional level vs system level and established framework for workflow

• Aligned Oncology Research Pharmacy practices in UC Health

• Have roadmaps for alignment of operations across pharmacy and lab services. Working on pathology and radiology services

Outstanding priorities to support LAPS

• IT Subcommittee / updates to EPIC• Pricing Methodology and standards• Alignment of policies North/South draft

policy on IRB of Record with UCD – create agreements as needed

• Alignment of North/South Consent/HIPAA standard language with UCD

• Agreement on standard CIRB language that will be used across all regions

Cancer Tsunami is Coming!

Thank You