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Seattle Cancer Care Alliance among first to apply multispecialty care approach to kidney cancer
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Seattle Cancer Care Alliance opened its multispecialty clinic specifically for kidney cancer patients in April, one of the first-of-its-kind in the nation.
The new clinic is focused primarily on serving patients who have been newly diagnosed with metastatic kidney cancer.
Experts at Seattle Cancer Care Alliance (SCCA) conceived the idea for the multispecialty clinic after they noticed a steady rise in patient volume in their kidney cancer program over the last 5 years. The program treated 116 new patients with kidney cancer in 2011 and 195 patients in 2016, representing nearly a 70% increase in new patients, in addition to established patients within the program who receive ongoing care.
Eventually, these numbers reached a point where a multidisciplinary approach — a model that has been implemented and well received at institutions across the country in various cancer types, like breast and lung cancers — could best serve patients. Under the model, patients referred to the clinic are evaluated by a medical oncologist, urologist and radiation oncologist, all in a single appointment.
“The ability to receive opinions from three different specialty providers in real time is a great advantage for the referring physician, as well as the patient, because very quickly there is a comprehensive treatment plan made available and laid out,” Scott S. Tykodi, MD, PhD, medical oncologist at SCCA, told HemOnc Today. “This allows the physician to assess their participation in, and satisfaction with, what's going to happen to the patient and know very quickly if they need to receive them back.”
Most initial appointments span approximately 4 hours. After meeting with the patient, the three specialists meet privately with a radiologist and pathologist; five different disciplines provide input on patient care.
The clinic also incorporates nurse navigators who track patients’ progress after their initial visit. If patients choose to continue their care within the SCCA network, the nurse navigator will help with scheduling appointments, follow-up after appointments and act as a point of reference for the patient.
The clinic operates under a half-day, biweekly format that can see up to four patients per day and around 100 annually. Depending on demand, the clinic may expand to a weekly schedule.
The main goal of the multispecialty approach is to accelerate a patient’s access to treatment by consolidating multiple specialists with backgrounds in kidney cancer care into a single facility.
“Patients are anxious to be seen as quickly as possible,” Tykodi said. “Before, if a patient needed to be referred by the medical oncologist to another specialist, nothing would happen until the patient scheduled an appointment, went to a separate location and returned with the specialist’s opinion. With this new clinic, we are accelerating timelines to actually deliver care.”
Under the traditional organizational structure, it could take patients days — even weeks — to obtain opinions from multiple specialists, Tykodi said. Now, clinicians are hopeful patients can get all the information they need in a single visit to begin making informed decisions about their care.
Coordination of the various specialties within the multidisciplinary model was the primary hurdle in making the new clinic a reality, Tykodi said.
“In our network, different doctors work in different physical locations and the billing and administrative infrastructure varies across the different parts of the campus,” he said. “It took us literally a year from the time the three different services committed to opening this clinical service to actually having it open, staffed and serving the first patient.”
Moving forward, the new clinic also aims to make more clinical trial participation opportunities available to patients with kidney cancer.
“We are a clinical research center, so part of this effort is to also identify areas where patients have the option to participate in clinical research and potentially embedding our clinical research staff as part of the assessment for patients,” said Tykodi. “We want to present these opportunities to the patient right away, instead of waiting until they see another provider independently following their first assessment. With this new approach, we hope patients will know of every option that is available to them from their very first visit.” – by Kyle Doherty
For more information:
Scott S. Tykodi, MD, PhD , can be reached at stykodi@fredhutch.org.
Disclosure: Tykodi reports no relevant financial disclosures.