Our CEO, Srulik Dvorsky, recently sat down with Dr. Mark Soberman from Ethicon, Michael Trapani from Memorial Sloan Kettering Cancer Center, and the Association of Cancer Executives, to discuss COVID-19’s impact on oncology administration, and building a more sustainable practice. The recurring theme throughout the discussion was that many of the quick adaptations that practices and providers have had to make are worth maintaining even after COVID-19, since they both lessen the burden for patients while allowing providers to deliver the same level of care in a more efficient way.
Challenges to delivering quality patient care during COVID-19
By now, most oncology practices are familiar with the challenges that arose with COVID-19. There are the financial burdens: unemployed patients losing healthcare coverage, financial toxicity, and pressure on the provider’s bottom line, where margins are often already slim, specifically in the non-profit area. In addition, there are the challenges in delivering high quality care: patients are fearful of going to medical appointments and screenings, deferment of elective and non-elective procedures, and the need to maintain safe physical distancing.
The compounding challenges demanded that practices apply quick and creative thinking to minimize gaps in care and funding. Dvorsky of TailorMed discussed the intense pace of change this past spring, referencing the New York Times’ article on telemedicine adoption in the U.K. and “10 years of change in one week.”
Dr. Soberman, Senior Safety Executive at Ethicon, recommended that cancer program executives need to be “open-minded and willing to do things that they might not have been as open to before.” He recommends reallocating resources to leverage technology and outsourcing as a way to maintain revenue streams. By being flexible during an unprecedented time, providers stand a greater chance of making through to the other side of the pandemic. Read more about COVID challenges for healthcare administrators in our earlier interview with Dr. Soberman.
Organizational changes and adaptations to weather the COVID storm, and beyond
To understand the real-time pace of COVID-related change, Michael Trapani, the Patient Financial Services Manager from Memorial Sloan Kettering Cancer Center, outlined the organizational changes that MSK went through at the start of the pandemic. In early March MSK began plans for remote work, two weeks later all staff were set up to work from home, and by the end of March MSK already had 80 COVID positive inpatients. Within one month, like many hospitals in the NYC area, MSK pivoted its operations to meet the new challenges brought on by COVID-19.
Trapani discussed MSK’s responses, both short and long term, to the COVID challenges. In terms of immediate organizational response, MSK instated a hiring freeze, shifted to telehealth, work from home, took in patients from surrounding hospitals to help free up beds, and expanded the copay program. Long-term changes included expanding the telehealth infrastructure, transitioning to online Adobe forms (removal of pens from the hospital), the expansion of TailorMed’s financial navigation solution, and expediting relevant hospital initiatives. Trapani discussed how MSK plans to keep many of the long-term solutions in place even after COVID-19.
Maintaining quality of cancer care through the pandemic
The key for cancer care providers right now is maintaining the same level of care for patients while adapting the organization to face the COVID-19 challenges. Trapani explained how Memorial Sloan Kettering shifted the patient experience in a few ways. One example was shifting to subcutaneous admin routes for chemo, in order to shorten the length of time a patient needs to spend in the hospital. “It can literally mean the difference between minutes in the chair, or hours in the chair,” explained Trapani. Other therapies were able to be shifted to limit the frequency that patients needed to come into the hospital. A committee was established to evaluate each individual new case and understand if restricting the new visit would put the patient at risk.
Remote consulting and screening, as well as collaborative virtual decision-making speeds up delivery of care, while often making life easier for the patient. For example, the costs of simply parking at the hospital can add up to thousands of dollars on top of already hefty bills. If some of these appointments are remote, it saves patients time, money, and additional stress.
“The perfect storm for digital acceleration”
Large healthcare systems and providers can often be slow to adopt new technologies and practices, so the advent of COVID-19 forced an adoption of digital solutions that is likely unmatched in its speed throughout history. This situation, while challenging, is “the perfect storm for digital acceleration,” explained Dvorsky. Technology has allowed for shifts in cancer care delivery that are both beneficial to the provider’s financial bottom line, while maintaining a high quality of care for patients.
Dvorsky discussed how technological solutions can also help automate labor-intensive solutions, such as prior authorization or scheduling. This frees up employees to perform other tasks, and increases the financial viability of provider organizations. Dvorsky discussed TailorMed’s partner, Philips, who is “offering virtual tumor boards to create connectivity between physicians… and bringing collaborative decision-making into the hands of physicians that might not have the ability to physically meet with their peers.”
TailorMed there was a quick reaction to COVID-19, Dvorsky explained, because the team understood the new challenges that oncology administrators and financial navigators would be facing. TailorMed rolled out a remote navigation solution to allow for the seamless transition to remote work for financial navigators.
Lessons for the future
Organizations are realizing that many of the quick changes are sustainable and worth scaling in the future, even after the COVID-19 pandemic. Dr. Soberman envisions that “we’re going to see more telehealth… it will be leveraged much more, not just in cancer care, but across the board. This will lead to increased adoption of other technology for online navigation, patient call centers, triage, etc, to be able to interact with patients in a very personal way but not necessarily face-to-face.”
Michael Trapani discussed that “administration at Memorial Sloan Kettering learned that we are much more agile and innovative than we thought. We have also seen that telehealth as a viable way to care for patients,” as the benefits became overwhelmingly clear in the past few months, creating personal and convenient ways to meet with patients. In addition, it’s important to implement long-term plans to keep changes that improve the patient experience. Remote and digital solutions can be just as effective and provide a high quality of care, while being more comfortable for patients and lessening their burdens.