Interviews

Fear and denial can contribute to a patient’s hesitancy to seek prompt treatment, says Beth Wittmer, RN, OCN, manager of care management at Florida Cancer Specialists and Research Institute.

While the community has seen the first clinical trials and first FDA-approved therapy for pediatric multiple sclerosis, it remains challenging to treat, said Tanuja Chitnis, MD, associate neurologist at Brigham and Women’s Hospital and professor of neurology at Harvard Medical School.

Janice Mehnert, MD, Head of the Phase I Developmental Therapeutics Program at Rutgers Cancer Institute of New Jersey, and the Head of the Melanoma Research Team, explains the importance of including patients with comorbidities in clinical trials and what could be done to promote it.

Care coordinators are a support system for the clinical and the clerical teams to make sure that nothing falls through the cracks, explained Jessa Dunivan, patient services manager, Northwest Medical Specialties.

Sometimes, patients may misunderstand the role of the social worker as part of the care team, but ultimately, they end up really being appreciative of the services, said Abra Kelson, MSW, LSWA-IC, medical social work supervisor, Northwest Medical Specialties.

Communication starts with understanding, interacting with, and engaging people before sensitive issues can be discussed, explained Victor Murray, director for care management initiatives at the Camden Coalition of Healthcare Providers.

I think we’re in a bit of a lull for exciting new therapy developments, likely because the development of the checkpoint inhibitors has just been so extraordinary revolutionary, explained Janice Mehnert, MD, Head of the Phase I Developmental Therapeutics Program at Rutgers Cancer Institute of New Jersey, and the Head of the Melanoma Research Team.

Most patients with multidrug-resistant HIV can still be treated with existing therapies, explained Paul Sax, MD, clinical director of the Division of Infectious Diseases at Brigham and Women's Hospital and professor of medicine at Harvard University.

Discharged patients who can’t understand their postdischarge plan may potentially be readmitted or face devastating consequences to their health, said Maritza Gomez, program assistant for community engagement at the Camden Coalition of Healthcare Providers.

While it is likely that the Trump administration's proposed International Pricing Index would lower drug prices in the United States by at least a little, there are a number of potential unintended consequences that aren't clear at this point, said Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy; director of the Healthcare Markets and Regulation Lab in the Department of Health Care Policy at Harvard Medical School; and co-editor-in-chief of The American Journal of Managed Care®.

Alison J. Moskowitz, MD, medical oncologist, clinical director, lymphoma inpatient unit, Memorial Sloan Kettering Cancer Center, discusses how the standard of care for Hodgkin lymphoma varies based on several different factors.

Janice Mehnert, MD, Head of the Phase I Developmental Therapeutics Program at Rutgers Cancer Institute of New Jersey, and the Head of the Melanoma Research Team, discusses the role that multiple biomarkers and the microbiome play in treatment decisions in oncology.

Having the Medicaid program value social determinants of health and the idea that health is not just about healthcare is important, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

Community health workers act as translators, have immense understanding of the makeup of the community and its needs, and are in-tune to feelings around certain healthcare and nonhealthcare-related topics, explained Victor Murray, director for care management initiatives at the Camden Coalition of Healthcare Providers.

There are so many different areas that a social worker can help with in a medical practice that they can be more a case manager, pointing patients to resources for financial assistance, looking at their insurance, or helping with disability, said Abra Kelson, MSW, LSWA-IC, medical social work supervisor, Northwest Medical Specialties.

Having more people in the doctor's office who speak Spanish and take time to explain what patients who don't speak any English are going through could help improve community health, said Maritza Gomez, program assistant for community engagement at the Camden Coalition of Healthcare Providers.

When data is allowed to flow freely, it can be used to understand the patient better and wrap a targeted intervention around them, explained Victor Murray, director for care management initiatives at the Camden Coalition of Healthcare Providers.

W. David Hardy, MD, adjunct professor of medicine, Johns Hopkins University, discusses the importance of identifying patients with undiagnosed HIV and preventing new infections for accomplishing President Trump's plan to end the HIV epidemic in 10 years.

The National Center for Complex Health and Social Needs sits at the intersection between healthcare and behavioral health and social services, and it is critically important that the systems work together to be able to serve the populations that we need them to serve, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

Currently, minimal residual disease testing is being used for prognostication not for treatment decisions, explained Thomas G. Martin, MD, clinical professor of medicine, Adult Leukemia and Bone Marrow Transplantation Program, associate director, Myeloma Program, University of California, San Francisco (UCSF); co-leader, Hematopoietic Malignancies Program, Helen Diller Family Comprehensive Cancer Center.

Faith-based organizations teach members how to live a healthy lifestyle in ways that integrate with their faith, explained Maritza Gomez, program assistant for community engagement at the Camden Coalition of Healthcare Providers.

There are questions of hiring of staff, of leadership buy-in, of funding that all come into play when you are talking of how to scale a model beyond a single site, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

There are individuals who have a lot of needs and struggle to navigate different systems to get their needs met, and there are systems that don’t necessarily cooperate, partner, and collaborate in effective ways in order to address the needs of that cohort, said Victor Murray, director for care management initiatives at the Camden Coalition of Healthcare Providers.

The National Center is a place where experts come together, share their learning, redesign systems of care and develop practices and tools to support those who need it most, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

All providers, regardless of where they work have a role in the shift to value-based care, but independent physicians need to have a voice in the transition, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

The biggest barrier to molecular profile testing right now is a financial one, explained Elizabeth Griffiths, MD, associate professor of oncology, department of medicine, Roswell Park Comprehensive Cancer Center

Jeff Sharman, MD, medical oncologist, Willamette Valley Cancer Institute and Research Center; medical director, The US Oncology Network, explains how personalized medicine has changed the way physicians think about treatment for patients with chronic lymphocytic leukemia (CLL).

As the first clinically integrated oncology network, the Quality Cancer Care Alliance (QCCA) brings together the best practices and shares knowledge on value-based care, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.