How to Manage a Population Genetic Screening Initiative
by CancerIQ, on Jan 4, 2020 10:03:29 AM
CHRISTUS Ochsner Lake Area Hospital's Wellness, Screening, and Genetics Center in Lake Charles, Louisiana is impacting their entire population through cancer risk assessment.
The Wellness, Screening, and Genetics Center screens patients for their genetic screening eligibility and have genetically tested over 1,700 patients. On average, the center sees well over 100 patients a week with 70-80 percent of patients being eligible for genetic services. This is remarkable, as centers usually find about 20 percent of eligible patients.
With this incredible volume of genetic testing information to manage, Leah Marcantel, Nurse Navigator, has thousands of patients relying on her for follow-up care - a lot more than your traditional nurse navigator tracking newly diagnosed cases. Leah is responsible for ensuring each patient tested receives a personalized cancer prevention plan and assisting patient compliance with the plan.
"The CancerIQ Manager was the biggest thing to help me know I am not missing or overlooking anyone," Leah said.
This post covers challenges CHRISTUS Ochsner Lake Area Hospital's Wellness, Screening, and Genetics Center faced before incorporating a digital cancer risk assessment tool and the impacts it has seen post implementation.
The Goal: Moving from Crisis Care to Preventative Care
The Wellness, Screening, and Genetics Center is a perfect example of the Personalized health care (PHC) approach to medicine, where according to Simmons et al, “prediction, prevention, intense patient engagement, shared health care decision making, and coordination of care are essential to cost effectively facilitate better outcomes.”
The program goal is to be proactive, and increase the likelihood of an early diagnosis of cancer by starting the cancer prevention discussion with patients earlier.
As shown in the exhibit below, the personalized health planning process is far more than diagnostic workup and risk assessment - but also the ability to engage in shared decision-making and ongoing follow-up.
The Challenge: Managing Patient Follow-up
CHRISTUS started the program in collaboration with a genetic testing lab able to provide initial resources to identify patients meeting testing criteria and deliver results that clearly laid out medical management options for each patient.
With those initial resources in place, the program allowed patients to gather their family history, speak with a tele-health genetic counselor, and ultimately learn about their hereditary cancer risk.
But to complete the most impactful stages of the process - shared goal setting and personalized health planning and follow-up - Leah needed more help.
The Solution - Going Digital with CancerIQ
The CancerIQ product suite not only helps with the initial family history data gathering, but truly supports the back end of the process:
Shared-Decision Making and Personalized Planning
Leah specifically pointed out the CancerIQ Care Plan features as part of the process change that has made an impact at CHRISTUS.
Instead of filing away a static genetic test report that lists out a range of appropriate options for the patient, CancerIQ serves up a dynamic list of evidence-based care plans users can discuss with the patient.
"The care plan has been amazing because I can click whatever meets criteria for the patient and whatever the patient wants to do."
After the discussion - Leah can easily document the surveillance or risk reduction strategy the patient chooses, and begin tracking the patient’s adherence with that initial plan.
Enabling Proactive Patient Care with Specific Dates
The care plans in the CancerIQ Specialist immediately flow over to the CancerIQ Manager, where Leah can determine the appropriate timing for follow-up and proactive reminders.
She has the ability to give herself a patient reminder, and if the patient would like to receive email reminders, Leah has the ability to set that up too.
Know What is Due When
Prior to CancerIQ, Leah used Excel spreadsheets with several columns trying to track when certain screenings and procedures were due. It was manageable when there were only a few dozen patients, but at the clinic’s current volume - the spreadsheet became a source of stress for her.
The CancerIQ Manager has a visual interface to see when patients are due for follow-up, and when patients are non-compliant or overdue.
"CancerIQ has helped with knowing which patients are due for which follow-up with this large volume of patients." and "If I didn't have CancerIQ, I'd be a lot more anxious trying to keep up with all of this follow- up"
The Impact of CancerIQ at CHRISTUS
The center was starting to scale back its initial screening and genetic testing efforts because of the sheer volume of results to manage.
With confidence that CancerIQ could improve the management of patient test results, Leah has been a champion for growth in testing activity this fall. During breast cancer awareness month this past October, CHRISTUS tested a record-breaking 196 patients - nearly double their monthly average since inception of the program.
These patients will receive the same quality of care and follow up as the 1,700 patients before - with the help of the CancerIQ Manager
To continue investing in the program and expand into other clinical specialties however, Leah needs to report on all the downstream revenue opportunities attributable to the program.
With CancerIQ, it is easy for her administrative leadership to estimate and forecast revenue opportunities on a regular basis. Below is an example of a weekly report generated by the system that Leah shares internally:
“It is nice to see how many patients are due and see who is coming in next month for an MRI. We can see how much we are going to generate in revenue.”
Interested in learning about the origin story for the CancerIQ Manager and how it supports preventative care? Hear from one of our earliest adopters in this presentation.