The Oncology Service Line in the Coming Year: 4 Developments

The ever-evolving field of cancer care brings with it new treatments and new challenges in 2013. Eric Louie, MD, medical director at Sg2, a healthcare analytics and consulting firm, shares his thoughts on what 2013 holds for the oncology service line.

1. Targeted cancer therapies. The National Cancer Institute defines targeted cancer therapies as drugs or other substances that prevent cancer cells from growing and dividing uncontrollably by blocking the signals that cause them to grow. These therapies cause little or no damage to normal cells because they are focused on cellular changes specific to cancer. Most targeted cancer therapies have fewer and less toxic side-effects than chemotherapy.

According to Dr. Louie, these therapies are shown to control cancer for long periods, but not eradicate it. In most cases, these therapies will be used along with other treatments such as chemotherapy or radiation therapy, resulting in fewer toxic side-effects, according to the American Cancer Society.

Many targeted cancer therapies have already been successfully developed, such as Herceptin, which is a drug made specifically to target tumor growth in breast cancer. But the drugs continue to evolve and "newer ones are being developed," says Dr. Louie. An oncology service line that does not yet offer targeted therapies should consider doing so, as it can be an attractive option for patients.

2. Hypofractionation. Hypofractionation is a method of administering a radiation treatment in fewer sessions with a larger dose of radiation in every session. These doses are given to the patient every other day or several days apart as opposed to typical radiation treatments that are given daily. Research has indicated that this type of treatment is effective and because it is more convenient for patients, it is growing in popularity, says Dr. Louie. For hospitals, the use of this treatment may result in increased capacity because they can provide therapy for more patients per year.

3. Pay-for-performance.
Increasingly, there is a push towards incentivizing the value of care for patients by focusing on the quality of outcomes rather than on the volume of care provided by physicians. "We need to restructure and reengineer our processes to provide better care for our patients," says Dr. Louie.

In an attempt to reengineer care processes, service lines need to coordinate care across different sites (such as inpatient or outpatient clinics), across the time continuum (from diagnosis to the outcome and beyond) and among the various care providers. Care coordination among providers is a particularly relevant for oncology because cancer patients are almost always treated by a team of physicians from different sub-specialties. To achieve better outcomes and patient satisfaction, physicians within various sub-specialties will have to work together and with the institution that is providing the infrastructure.

4. Early detection.
The sometimes controversial role of early cancer detection and screening will also impact the oncology service lines in 2013. There is a great deal of debate about the effectiveness of early cancer screenings, such as mammograms, pap tests and prostate specific antigen tests. While early screening is advantageous, in that cancer can be caught and treated early, there is a chance that people who don't have cancer will be subjected to tests that they don't need, says Dr. Louie. The outcome of this debate will affect service lines' strategic planning efforts as physician decisions on early detection and screening could impact cancer center volumes and patients' disease progression upon referral.  

Cancer is one of the leading causes of death in the United States, but Dr. Louie says there will be advancement in the field in 2013, provided there is a greater collaboration between the clinicians who make the decisions regarding treatments and the institutions that have the business acumen to gather the required resources.

More Articles on Oncology:

Considerations for Community Cancer Centers Exploring a Clinical Affiliation
Community Hospitals Seeking Partnerships: Q&A With ValleyCare's Scott Gregerson
Beloit Health System in Wisconsin Plans Cancer Center

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