Preventing Patient Leakage With Early Detection and Genetic Data

Aug 29, 2020

The moment a person learns they have cancer is one they’ll never forget. In that instant, and all the weeks and months after that, patients click into survival mode: They’ll stop at nothing to pursue the best and most comprehensive care. 

That includes traveling thousands of miles and paying their life’s savings out-of-pocket to attend a prestigious academic medical center—one with millions in marketing budget for TV ads, billboards, and prominent magazine spreads.

It’s at that moment that community centers lose revenue potential from patient leakage, an amount quantified as much as $650,000, on average, over the lifespan of a single patient. Patients transfer to the big-named systems, attracted by NCI designations and the “perception” of superior care.

But what if there were a way to plug those leaks, retain those patients, and salvage the lost revenue? Early detection is that opportunity. And genetic screening, enabled by virtual tools amid our new normal, is the vehicle to get there.

A Stronger Center of Gravity for Local Cancer Care

A patient’s likelihood of staying with a local care center versus transferring to a bigger-name facility depends mightily on cancer staging. The later the diagnosis, the more complicated the care plan and the more likely they’ll transfer out. In general, leakage to academic medical centers can begin to accelerate around stage 3, when patients are willing to jump through any hoop or over any obstacle to receive the most promising care. This includes traveling long distances for care.

Inversely, the earlier the stage, the more likely the community system can retain those patients over their treatment journey and beyond. This isn’t just because of care plan complexity, though that’s a part of it. There’s also the intrinsic value of relationship-building and coordination through a local center that patients simply can’t get anywhere else.

And what’s the anchor that serves the dual purpose of diagnosing patients early as well as keeping them long-term?

Genetic data.

After all, up to 10 percent of all cancers are hereditary—and when you involve a patient’s core genetic data into their lifelong care planning, it creates an even stronger center of gravity for cancer care. Test their family members and include them in your patient pipeline, and you have an even more robust and integrated care model.

Why would patients or their families go anywhere else when their local community center not only has the intel to surveil for, detect, and treat cancers early, but also to coordinate healthcare holistically?

> Early diagnosis leads to better patient retention, improved long-term care planning, and unmatched relationship building over a patient’s lifetime. Explore this in action by reading Mary’s story, an OSF patient whose breast cancer was detected early—even after receiving a normal mammogram—thanks to proactive high-risk patient management and genetic testing.

Putting Prevention into Practice

Methodist Jennie Edmundson Hospital Breast Health Center in Iowa, a 230-bed hospital, has prioritized a genetic testing-based early detection program and shifted staging earlier.

In 2018, the majority of patients at the center had their cancers diagnosed at Stage 3 or higher. To foster early detection, Jennie Edmundson digitized their clinical and workflow tools and shifted to genomically-informed care. Such changes helped the program better identify, track, stratify, and manage high-risk populations. Patients were educated on the need for testing and post-test interventions, and care continuity was improved through automated clinical decision tools including NCCN Guidelines and COC reporting.

By 2019, Jennie Edmundson flipped its ratios of early-to-late cancer staging and saw a 25.8 percent increase in cancers caught early (stages 0 and 1).* 

*The sample size is limited and the time frame small. We hope to see continued and significant improvement over time and will continue to monitor and update.

A Win-Win Scenario for Patients and Providers

By boosting early detection programs with a genetic testing focus, the benefits are aplenty for both patients and providers. Most importantly, lives are saved and quality of life improves. Cancers detected in earlier, more treatable stages often require less toxic and invasive treatments than late-stage diagnoses.

Patients also get the benefit of comprehensive oncology care, done under one roof, without having to travel farther distances or wrestle with the idea of paying for out-of-network providers for the sake of “prestigious” care.

From the provider’s perspective, not only do they glean operational efficiencies via the use of digital tools and clinical decision support, but they can also preempt patient leakage to academic medical centers. With patients in their care ecosystem for life, centers also generate downstream revenue from them, their families, and any other referrals they make.

So indeed, relationships are precious in community oncology care. Patients don’t want to leave you—but fear can make a person do just about anything. Catch cancers early with an augmented genetic testing program, and you can help preempt that fear, plug leaks, generate revenue, and keep those relationships going for years to come.

Topics: High-Risk Patients| Health Systems| Nurse Navigators| Preventive Care| Cancer Centers| Telehealth| Precision Health