Operationalizing Seamless Care Between Community and Academic Centers: Turab Mohammed, MD

Advancing frontiers in leukemia and lymphoma care was a pivotal discussion topic at the Institute for Value-Based Medicine (IVBM) event in Charlotte, North Carolina, on March 31, 2026.

In this Q&A with The American Journal of Managed Care^® (AJMC^®), panelist Turab Mohammed, MD, a hematologist-oncologist at Novant Health, highlighted the need for immediate communication protocols and the importance of monitoring T cell fitness for effective advanced therapies.

This transcript has been lightly edited for clarity.

AJMC: At a large community system like Novant Health, how do you operationalize collaboration with academic centers, so care feels seamless rather than fragmented for patients?

Mohammed: For seamless care, I think a strong care navigation support team is the cornerstone on both sides. This allows us to reach out to the team at the academic center and coordinate the care, get through the referral, and have the patient seen if there are issues with payers and whatnot. They communicate immediately with us through our communication protocols, and that allows us to seek a referral to a different center. Care support teams or groups of navigators who initiate their referral and coordinate the care are most important.

Coming to meetings like this allows us to put a face to the name in terms of the academic doctors, and then we outline the structure of shared decision-making, how the treatment decision would be made down the road, and how we will communicate it between ourselves. It is very helpful.

AJMC: Looking at real-world cases, are there common points where patients with leukemia or lymphoma miss the optimal window for advanced therapies like CAR T or bispecifics—and how can community practices better anticipate those moments?

Mohammed: A couple of instances that come to my mind are patients with very aggressive, high-risk disease. I think it is good to send them—before starting any form of therapy—to be seen at an academic center so that they have a foot in the door. And in case the patient has bad disease that does not respond to the upfront chemo-immune-based treatment, then there’s time to get a CAR T-cell therapy or some other form of advanced immune-based therapy, and it would be shorter if [they] were already established with that academic center.

The other situation, as I previously mentioned at the meeting as well, is that before every progression, I think it is good practice to run a case at the tumor board. If the practice has the ability to take part and discuss cases with the academic providers. If not, talk to them before initiating the treatment, because the advanced therapies are predominantly T-cell–based, and T-cell fitness matters a lot in how well the patient's going to respond to these treatments.

Before starting multiple chemo-based regimens, I think it would be wise to discuss it with the academic provider so that we can retain the T-cell fitness and then use CAR T at an optimal time.

AJMC: What are the biggest barriers to translating innovations from academic trials into day-to-day workflows in a community oncology setting?

Mohammed: Structural gaps are the biggest problem, currently, that I, as a community provider, face during my practice in terms of inability to provide clinical trial access due to limited clinical trial coordinators or inability to staff to appropriately monitor for the clinical trials.

The other problem is the administrative burden and the prior authorization burden that comes with trying to get the latest and greatest treatment for our patients. The insurance companies or the payers have difficulty approving it because either it's not yet FDA approved or not yet on the NCCN guidelines.

AJMC: In your experience, how much do nonclinical factors (caregiver support, transportation, work obligations) influence whether a patient ultimately receives advanced therapies?

Mohammed: Well, these are real issues, and we've known these for a while; socioeconomic disparity and inability to access care give one of these factors and limitations to delivering CAR T. But, thankfully, with the newer advancements, being able to bring other types of cell therapies, like bispecific combinations, into the second line, which hopefully on a longer follow-up may show potential, if not as good, but definitely certain improvement on the outcomes compared to the other standard of care treatments.

AJMC: As CAR T-cell therapy and bispecifics move earlier in treatment, how do you see the role of the community hematologist/oncologist evolving?

Mohammed: We have to understand that community oncologists and the academic doctors are partners, and we have to work together to be able to provide the best and the most appropriate care for our patients. Physicians in the community need to get involved in educational sessions, either through online media, continuing medical education, or in-person meetings to brush up on their knowledge on how to manage cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).

They can start with bispecific cell therapy to begin with, which has a lower incidence of CRS and ICANS but does have an incidence of these. And maybe once they get a taste of how to manage these patients and [referencing] our presentations, they can have—when they have these toxicities—maybe be more comfortable and easily manage a CRS and advance from CAR T-cell therapy.