Mary Bird Perkins – Our Lady of the Lake Cancer Center (Cancer Center), located in Baton Rouge, is a premier destination for cancer care in the Gulf South, treating more patients each year than any other facility in Louisiana.
The Cancer Center is a partnership between Mary Bird Perkins Cancer Center and Our Lady of the Lake Regional Medical Center, which together provide high-quality, comprehensive cancer care. Mary Bird Perkins operates facilities in a total of five markets, with hospital partners throughout an 18-parish service area. All of the facilities in the Mary Bird Perkins-affiliated network benefit from the nationally-recognized Cancer Center in Baton Rouge.
In an era of increased pressure to deliver exceptional care while effectively managing costs, the Cancer Center has taken a comprehensive approach to adopting new medical technology that is designed to serve patients and physicians in Baton Rouge, but also in Mary Bird Perkins’ other markets. Recently, the Cancer Center needed to phase out the aging system it had been using for stereotactic radiosurgery (SRS) and identify a replacement system.
In evaluating its options, the Cancer Center sought to identify a new SRS system that would meet current patient needs while creating a foundation for clinical value over the long-term, and would also be economically sustainable under alternative payment models. The Cancer Center’s successful clinical and business outcomes in this endeavor provide learning opportunities for other healthcare institutions investigating the purchase and implementation of novel technologies, which are summarized in the following five tips.
Tip #1: Know what you need
A critical first step in adopting new technology is determining if there is a clear need that is best addressed by investing in emerging technologies rather than deploying existing resources in new ways. Develop a comprehensive understanding of how the new technology will provide patients with an enhanced experience, with special consideration of its potential to enhance treatment outcomes and quality of life, reduce side effects and enable more patient-friendly regimens that lessen the burden of treatment.
Understanding how the new technology will improve the clinician experience is equally important. While clinicians will seek ways to improve treatment safety and efficacy, consider how a new technology enables treatment of indications not amenable to current therapeutic regimens. Additionally, as clinicians face growing demands on their schedules, the potential for new technology to increase the number of patients treated in a given time period should not be underestimated.
Finally, cancer centers must also embark on evaluating new technology with a clear eye on its business models. Understanding the near-term economic costs and long-term economic benefits of investing in innovation is essential for success in today’s demanding healthcare economic environment.
The organization’s medical physics, facilities and operational teams provided critical input for designing plans for housing the new SRS system and maximizing workflows. The team identified several potential operational workflow challenges that might occur as a result of providers and stakeholders being located in different areas of the building, and in some, cases, at an entirely different location from where the new SRS system would be housed. In the end, the goal was to ensure that patients and physicians throughout Mary Bird Perkins’ network of facilities could easily access this technology.
With these factors in mind, the team evaluating various new technology options knows what questions to ask of potential vendors and are empowered to determine how specific products provide the answers that they need. After careful evaluation of its own needs and the available technology options, the Cancer Center selected the Leksell Gamma Knife Icon as the future of its SRS offerings.
Tip #2: It takes a village
Adopting and implementing new technology has implications beyond clinicians and patients, and it’s critical to consider how any new system will impact diverse functional groups throughout a cancer center. This includes health and safety, medical physics, information technology, facilities, operations, finance, marketing and patient services. Including all stakeholders at the start of the technology assessment process helps to ensure that potential issues or challenges in any of these areas is taken into account and addressed up front. This is essential for avoiding unanticipated obstacles that can complicate the implementation process or reduce the value that the new technology provides.
At the Cancer Center, early discussions identified a number of key issues among diverse stakeholders. Physicians wanted to ensure that they and their patients would have access to the new system and that the organization’s technical teams had the expertise to support and expand the system’s applications. The Cancer Center’s facilities, medical physics and operations teams were essential in designing the plan to house the new SRS system and developing workflows that maximized efficiencies and minimized impact on existing radiology equipment and activities. Additionally, the design of the new Icon treatment suite was based on positive patient feedback on a recent redesign of the Cancer Center’s Versa HD linear accelerator vault. This resulted in an Icon treatment suite that had soothing, adjustable lighting, artwork and satellite radio selections.
Tip #3: Get ahead of the trend
While it is important to address current needs when considering the purchase of new technology, understanding future needs makes the difference between spending on—rather than investing in—innovation. In addition to evaluating existing demographic and utilization data, it’s important to model how and by whom the new technology will be used down the road. This requires identifying trends in treatment and population demographics in order to understand future demand for the technology in question. In this case, the Cancer Center identified a growing trend toward using SRS rather than whole brain radiation therapy (WBRT) to treat multiple brain metastases, which predicted an increasing demand on its SRS resources. The optimized workflows that could be achieved with Icon were important factors in selecting this platform as the Cancer Center’s SRS solution.
Tip #4: Making the money work
No framework for evaluating new technology is complete without consideration of how its use will be reimbursed, and innovative medical devices may have uncommon, uncertain or complex reimbursement challenges. The importance of identifying these challenges at the start, rather than the end, of the evaluation process cannot be understated, and developing a plan to address these challenges should be completed prior to selecting any product or service in order to ensure that it is economically viable.
In this instance, Mary Bird Perkins faced an important barrier to adopting Icon as its SRS platform: Medicare only reimburses Gamma Knife procedures that are performed in a hospital setting, while Mary Bird Perkins is considered a free-standing treatment center. By implementing Icon as a partnership with Our Lady of the Lake, its hospital partner, Mary Bird Perkins was able to qualify its Icon procedures for reimbursement. The partnership also helped to increase access to the new SRS platform by integrating it into the hospital’s offerings, which provides benefit to more patients and clinicians.
Tip #5: A journey of a thousand miles
A key learning opportunity from the Cancer Center’s experience with adopting a new SRS platform is that turning on a new device is the beginning rather than the end of a technology adoption process. Successful technology adoption also requires engaging in proactive outreach and marketing to patients and referring physicians to ensure that as many people as possible are aware of, and have the opportunity to benefit from, the new technology.
Mary Bird Perkins has a strong track record of success in developing unique and innovative programs to extend its reach and drive its mission, including its Prevention on the Go education and early detection services for the community and workplace, as well as gold-standard survivorship programs and numerous, physician-driven, site-specific multidisciplinary care teams. The Cancer Center built on this success to develop the Conquer Differently campaign, a disruptive marketing approach that prominently used paintbrush strokes and a uniquely painted face as the hero to symbolize and celebrate true individuality. In addition, the concept folded in the Cancer Center’s well-known personal approach and its highly-individualized treatment plans, all akin to artistry through treatment and care. These concepts and the Cancer Center’s flourishing art program provided the inspiration for this unique “non-technology,” technology campaign.
The Cancer Center also had a well-defined plan for creating awareness of and excitement about Icon among referring physicians. This included educating medical staff on patient benefits of the technology and leveraging physician experiences to educate their peers and referral sources. A primary element of the marketing and communications plan for physicians included hosting events/tours to showcase the technology and facilitate peer-to-peer learning. A physician-targeted brochure was also developed and made available in a printed packet or as a downloadable resource from the Conquer Differently microsite. The microsite served as the digital hub for all Gamma Knife Icon information and provided content for both consumers and physicians. A special digital newsletter focused on Icon is distributed to Cancer Center physicians several times a year and future efforts will focus on expanding physician-to-physician communication.
Philanthropy is central to the Cancer Center’s operations and engagement with the community. While the Icon was not purchased wholly with philanthropic dollars, it was supported in vital philanthropic ways, which ultimately fueled more innovation. As a result, the Cancer Center is leveraging the Icon’s adoption as an example of the innovation that can happen when physicians, scientists and the community collaborate to enhance care. This is an important message that is helping drive increased contributions to the organization’s philanthropic initiatives and is advancing the mission.
Beyond the field of dreams
The value of the tips enumerated above is supported by the clinical and financial benefits the Cancer Center has achieved since implementation of its new Icon system. These include cost-efficiencies enabled by the acquisition of software that allows pre-treatment prep work, imaging and treatment planning to be conducted at other Mary Bird Perkins’ facilities throughout southeast Louisiana, close to where patients live, minimizing the number of trips they need to make to Baton Rouge for treatment. This software also facilitates collaboration among providers located at different facilities across the Mary Bird Perkins network, helping to ensure seamless patient care and sharing of knowledge that can help enhance outcomes on a network-wide basis.
The Cancer Center has seen an increase in number of patients undergoing SRS, driven in large part by increased use of SRS instead of WBRT for the treatment of multiple brain metastases and use of SRS following post-surgical resection of brain metastases. The organization’s physicians are now evaluating the use of Icon in the treatment of larger/more complex brain tumors and the potential to expand the use of the system to treat other complicated, debilitating diseases. And that is a dream that everyone wants to see realized.
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