Patient Navigation Grant to Help Identify Barriers to Digital Health Literacy
The American Cancer Society awarded $300,000 to the University of Alabama at Birmingham O'Neal Comprehensive Cancer Center and the University of South Alabama Health Mitchell Cancer Institute. The grant, which will help investigators identify barriers to digital health literacy, is one of 14 patient navigation grants awarded by the American Cancer Society with the aim of facilitating timely and equitable access to care for cancer patients and their families.
"Digital tools will increasingly become a standard part of navigating care and supportive resources," said Gabrielle Rocque, MD, Associate Scientist at the O'Neal Comprehensive Cancer Center and principal investigator of the research. "This grant will advance training curriculum for navigators, social workers, and nurses to improve digital health literacy and engagement of under-resourced populations to improve their cancer journey."
In addition to supporting patients with barriers to health care delivery, the patient navigation workforce is ideally positioned to facilitate patient engagement with technology. Currently, navigators use an electronic medical record web-based software to capture patient-reported data, including symptoms during both clinical encounters and at home.
The funds from this grant will provide a foundation for training navigators in digital health literacy, which will support the growing needs for patients to engage with technology. This will be used to minimize disparities associated with unequal access to technology that have the potential to improve health outcomes. Ideally, these grants will lead to the identification of best practices that positively impact patient outcomes. ACS will evaluate the patient navigation programs based on the number of lives touched and capacity for sustainability.
Three Individuals Take on New Roles at Cedars-Sinai Cancer
Lali Medina-Kauwe, PhD, former co-leader of the Cancer Biology Program in Cedars-Sinai Cancer, has assumed a new role as Associate Director for Basic Research. The Cancer Biology Program will now be led by Dolores Di Vizio, MD, PhD, Professor of Biomedical Sciences, Pathology, and Laboratory Medicine in the Department of Surgery, and Xue Sean Li, PhD, Professor of Medicine and Biomedical Sciences.
"Dr. Medina-Kauwe is an outstanding scientist with broad experience who will help ensure our basic science programs are well-integrated and translate their research discoveries in areas relevant to the Cedars-Sinai catchment area," said Dan Theodorescu, MD, PhD, Director of Cedars-Sinai Cancer and the PHASE ONE Distinguished Chair. "As co-leaders of the Cancer Biology Program, Dr. Di Vizio and Dr. Li will foster collaboration among disciplines, facilitating the translation of scientific discoveries to clinical care. All three appointments contribute to the advancement of the mission and priorities of Cedars-Sinai Cancer as a national and global center of excellence."
Medina-Kauwe, who joined the Cedars-Sinai faculty in 2003, has a PhD in molecular biology. Her lab's current efforts are focused on using non-infective virus proteins to deliver therapeutic agents that target triple-negative breast cancer that has metastasized to the brain. "Many therapies cannot cross the blood-brain barrier, making these tumors difficult to target," she noted. "Our bioparticles so far show promising results."
Cedars-Sinai has been at the forefront of developing such state-of-the-art technologies that support translational research across the institution. Medina-Kauwe pointed to the development in the Board of Governors Regenerative Medicine Institute of organoids-tiny, simplified versions of organs grown in a petri dish from patient tissues.
"This technology allowed me to test my particles in a human-derived system-something that wouldn't otherwise be possible," Medina-Kauwe said. "I'm helping to promote and support our focus on bioengineering and biomedical technologies such as this for development of research taking place within Cedars-Sinai Cancer."
Di Vizio has been at Cedars-Sinai for 10 years. She earned her medical degree and a PhD in molecular and cell biology in Italy, did postdoctoral work at Albert Einstein College of Medicine and Harvard University, and was an instructor and Assistant Professor there before joining the Cedars-Sinai faculty. One important part of her research is a focus on extracellular vesicles (EVs), small "envelopes" that contain RNA, DNA, and protein and are used by cells to communicate with each other. All cells in the body release EVs and they can circulate in bodily fluids.
"Cancer cells, especially when they become aggressive, release EVs that are almost surrogates of the cancer itself, but are much smaller and can circulate more easily," Di Vizio said. "When they do, they are like weapons that weaken the defenses of organs so that the cancer can spread."
Within the Cancer Biology Program, Di Vizio's goal is to identify and support areas of excellence while also uplifting unique research areas that distinguish Cedars-Sinai from other cancer centers nationally. "We are in an era of team science," she said. "We cannot be strong enough to project our programs into the future if we do not work together."
Di Vizio noted tremendous synergy in her partnership with Li, who joined the Cedars-Sinai faculty 2 years ago. His research is focused on sex differences in development and diseases.
"Based on very robust epidemiological studies here and worldwide, males have a much higher cancer risk than females across multiple tumor types, such as bladder, liver, and skin," Li said. "And we find similar differences in animal models, which points to fundamental biological reasons rather than just lifestyle or behavior."
As a cancer and developmental biologist, Li said questions about how the fundamental differences between males and females affect disease outcomes resonate with him. One major topic of interest is how sex chromosomes affect cancer risk. Response to therapy can also be different due to different male and female metabolisms.
"This becomes an important issue because many drugs are proposed for clinical use based on studies in males but not females," he noted. "There is a clear need to study sex as a biological variable, and our team has the expertise."
Li noted that his team's work is in sync with other Cedars-Sinai institutes, including the Smidt Heart Institute, which studies sex differences in cardiovascular disease. Because their areas of study are so different, Li said he and Di Vizio will complement each other rather than overlap.
"Having two scientists of the caliber and backgrounds of Drs. Di Vizio and Li co-lead the Cancer Biology Program will allow us to cover all programmatic needs, facilitate interaction among researchers in multiple areas of investigation, and promote areas of science that we are well positioned to lead," Theodorescu said.
ACCC Announces 2022 Innovator Award Winners
The Association of Community Cancer Centers (ACCC) announced the winning programs for its 12th annual ACCC Innovator Awards, highlighting the year's leading-edge solutions to improve cancer care delivery and the patient experience. The award recipients each delivered a presentation to their oncology care colleagues from across the country at the ACCC 39th National Oncology Conference.
The five ACCC Innovator Award winners feature programs across the multidisciplinary team and the cancer care continuum in areas such as remote patient monitoring, improving oral oncolytic compliance, addressing social determinants of health, and more. Winners are selected based on the potential of their program to have a real-world impact on the delivery of cost-effective, patient-centered care with replicable solutions in the areas of care coordination and quality improvement, technology, patient engagement, innovative training and staffing models, the provision of supportive care services, among many other areas of focus. The winners include the following programs.
Deploying Technology Across an Interdisciplinary Team to Improve Oral Oncolytic Compliance
Baptist Health's Miami Cancer Institute
This cross-departmental team of clinic nurses, nurse navigators, pharmacists, and pharmacist technicians partnered to evaluate existing processes and leverage technology to improve compliance to oral oncolytic education, consent, and adherence standards. Readily available technology like Zoom and Cisco Jabber supported patient education, DocuSign allowed digital signatures, and Microsoft Teams facilitated ongoing review of oral oncolytic prescriptions. After this quality improvement initiative, oral oncolytic education and consent compliance increased from 60 percent on initial audit to 100 percent, with 90 percent occurring on the same day the oral oncolytic was prescribed.
A Model for Embedding Primary Care in Oncology
ChristianaCare Health System/Helen F. Graham Cancer Center & Research Institute
This person-centered model of care embeds a primary care provider (PCP) in the cancer clinic to see patients with comorbidities who are in active treatment and who report having no PCP. In the first 6 months of this pilot, oncologists referred more than 70 patients to this nurse practitioner (NP). When patients complete active treatment, the NP can connect them with a PCP outside the cancer clinic to help support their transition to survivorship care. This interdepartmental collaboration between the oncology service line and the department of family medicine reaped across-the-board benefits, including improved patient access and care coordination, decreased levels of patient stress, the ability to quickly and efficiently address comorbidities and other health concerns, and a reduction in treatment delays.
Chemotherapy Care Companion: A Remote Patient Monitoring Program
Ochsner Health/Ochsner Cancer Institute
Upon receipt of a completed Chemotherapy Care Companion consent questionnaire sent via an online patient portal app, patients receive an iHealth digital scale, blood pressure cuff, and ear thermometer free of charge and are assigned a series of daily tasks with automatic push notification reminders for completion in their patient portal app, including daily symptom survey, weight entry, temperature entry, AM/PM blood pressure, and heart rate reading. Vital signs are uploaded automatically from the integrated Bluetooth devices to the patient portal and into the EHR. From January 2020 through December 2021, 284 enrollments occurred with 50 percent being Stage IV patients. Ages ranged from 23 to 86 years old with a compliance rate of 67 percent, which indicated that patients successfully completed more than 50 percent of their daily vitals and questionnaire tasks. Preliminary data shows that Chemotherapy Care Companion reduced the total number of ED visits and admissions by 33 percent.
Expediting Cancer Treatment Through a Rapid Access APP-Led Diagnostic Clinic
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James)
In response to data that showed a significant decrease in both the volume of cancer screening tests and the number of cancer diagnoses, the James Cancer Diagnostic Center opened to provide patients with direct, expedited access to diagnostic testing. Open 5 days a week for same or next day in-person or virtual appointments, this advanced practice provider-led center provides a novel "front door" to the cancer hospital. To date, more than 600 patients have been seen in this center, with 40 percent being referred onto a sub-specialty provider, offering a unique opportunity to extend diagnostic services from the inpatient to the outpatient setting.
Addressing Social Determinants of Health Through a Medical-Legal Partnership
Virginia Commonwealth University Health System/VCU Massey Cancer Center
This collaboration of legal and health care professionals helps patients with cancer resolve social and environmental factors that contribute to health disparities and which have a remedy in civil law. Through this program, the cancer center partners with a non-profit organization that connects low-income patients with cancer to pro bono legal services, as well as financial counseling and community resources. They learn how embedding lawyers in a health care setting can directly resolve specific problems for individual patients, help clinical and non-clinical staff navigate health system and policy barriers, and transform institutional practices. More than 90 percent of patients using this program report that this assistance allowed them to focus more time and energy on their health.
Mario Lemieux Foundation Donates $5 Million to UPMC Children's Hospital Foundation to Establish Pediatric Cancer Research Institute
UPMC Children's Hospital Foundation received a $5 million gift from the Mario Lemieux Foundation to establish a pediatric cancer research institute. UPMC and UPMC Children's Hospital Foundation will provide matching funds to establish the Mario Lemieux Institute for Pediatric Cancer Research at UPMC Children's Hospital of Pittsburgh.
Under the leadership of Linda McAllister-Lucas, MD, PhD, Chief of the Division of Pediatric Hematology/Oncology at UPMC Children's Hospital, the new institute will push the frontier of childhood cancer research. It will focus on supporting future research leaders who will help generate new scientific breakthroughs and cutting-edge clinical trials in pediatric cancer research and translate that research directly to patients.
"Until research progresses, families around the world will continue receiving unimaginable news that their child diagnosed with cancer may not survive," said McAllister-Lucas. "There is still much work to be done to save every child diagnosed with cancer, and research is the only way to get there. The new institute will give us the opportunity to advance our research programs with the goal of improving long-term outcomes for all childhood cancer patients."