Showing posts with label hartford health care. Show all posts
Showing posts with label hartford health care. Show all posts

Sunday, September 22, 2013

"Bigger is better"

New York — Memorial Sloan-Kettering Cancer Center has launched a transformative initiative to improve the quality of cancer care and the lives of cancer patients. Hartford HealthCare, a multi-hospital health care system in Connecticut, was selected as a pioneering member of the newly formed Memorial Sloan-Kettering Cancer Alliance.

The MSK Cancer Alliance is designed to enable an ongoing, living, breathing dynamic partnership between the comprehensive cancer center and community oncology providers, in order to bring the newest knowledge into the community setting.

The critical need for such an Alliance can be found in a report recently issued by the Institute of Medicine (IOM) that described the challenge of delivering high-quality cancer care as a national “crisis” and noted advances in treatment may be unavailable to patients who lack access to sophisticated genetic tests or clinical trials.
“Currently, the vast majority of cancer care in the United States is delivered by community oncologists, but cancer advances can take years to be adopted in a community setting,” said José Baselga, MD, Physician-in-Chief of Memorial Sloan-Kettering, who notes that ongoing, interactive real-time relationships are needed to effectively close this gap. “We want to rapidly accelerate the pace of integrating the latest advances of cancer care into a community setting. This unprecedented approach will demonstrate real value to both organizations and most importantly will improve the lives of cancer patients,” he added.
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BUT HERE AT THE CRBCM WE BELIEVE :
THE MORE VERSATILE, COST EFFICIENT SMALLER CLINIC  IS THE ANSWER FOR BETTER STREAMLINING OF CANCER RESEARCH AND APPLICATION OF NEW KNOWLEDGE.  THE PROBLEM IS NOT THE COMMUNITY ONCOLOGIST'S LACK OF WILLINGNESS TO LEARN,  BUT INDEED THE MEANS OF COMMUNICATION WITH RESEARCHERS IN THE FIELD.
Researchers are taking over main Oncology publications by publishing non readily useable information while support for conferences is dwindling.  It is amazing how many Oncologists do not read Blood or JCO because the immediate relevancy of information/articles are perceived as relevant to day to day practice.  Among oncologists, FDA approval and whether a randomized phase III trial has demonstrated benefits, seems to be the overwhelming standard for adoption of new therapeutics.  Of course the input from trusted authors and opinions from their local referral center also drives the practice.
Larger Institutions could serve a purpose of streamlining referrals if carefully orchestrated, however something may be lost in quality of care (may be because staff there lose a bit of compassion) and money and administrative weight increase dramatically to impair the quick delivery of care they mean to better!
The weight of overheads, the number of meetings, size of committees and political infighting, tends to slow the process by the nature of the beast!  These larger institutions attract more research money for a relatively poor output.  The CPRIT experience proves this case.  Over half of the money given to date went to large institutions in Texas, we are still waiting for the return on investment, and communities overall have still to see lingering effects.
At the CRBCM we like the idea of smaller, more versatile organizations with more effect and efficiency. We believe that science does not belong to any particular institution,  and that we can not lead from behind and that we absolutely need to create new paths.  This is driving how we perceive new scientific progress results,  and most of all how readers will note that our interpretation of facts may be at odds, but that is deliberate and ready to open new approaches! And at least open the debate!  If we have not progressed as fast as wished, it is because of political elephants in the room!