How Karmanos built a more accurate cancer risk assessment tool

Detroit-based Karmanos Cancer Institute launched a questionnaire that identifies high-risk cancer patients with a few extra questions.

The questionnaire, which debuted in March, added a few detailed questions to Karmanos' breast cancer patient screening survey to identify risk levels, Eric Brown, MD, a breast surgeon at the institute, recently told Becker's. The answers are fed into a program that produces a letter that identifies the patient's risk and the next steps to take. The letter is sent to the Karmanos team, the patient and the patient's primary care physician.

Karmanos has screened more than 10,000 women so far and found almost 800 who were considered high risk. 

"The last thing you want to do is identify somebody at high risk and kind of drop that information on the lap of the primary care physicians who already have enough on their plates," Dr. Brown said. "We've created a system that doesn't end at the assessment. In the letter, there's phone numbers for nurse navigators. We give the primary care physicians the opportunity to send the patient to their place of choice or to use Karmanos."

Patients and physicians work together to make a personalized care plan depending on what the risk assessment shows. Some patients may be referred to the genetics team, others may return for annual mammograms, breast MRIs or an ultrasound, or receive medication.

The regular screenings can become a win-win for hospitals and patients, Dr. Brown said. Hospitals generate revenue by performing more tests and screenings, while patients have early detection and potentially better survival rates.

The program was built to be patient centric but also to consider other providers helping the patient.

"If you offer a pathway that's kind of a plug and play, it's attractive to independent physicians because it's off their plate and they know what is happening and how the patient is being cared for," Dr. Brown said.

The questionnaire is being applied to lung and colon cancer and has the potential to be used in almost any cancer, Dr. Brown said.

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