In 2008, a disease management program was initiated at the Hudson Valley Veterans Health Care System in Montrose, NY, in an effort to decrease time to diagnosis and/or treatment for veterans with newly diagnosed cancer. Administrators at the health system chose the disease case management team model as a potentially useful solution to enhance and expedite healthcare delivery for this patient population. The researchers presented the study at the 2016 ASCO Annual Meeting.
The team consisted of three RNs working under the auspices of the Quality Management Division rather than a specific oncology clinic. The researchers assessed the timeline in days for veterans to get scheduled for recommended tests and consults before and after the disease management team initiation from 2009–2014 among those with primary liver, colon, and lung cancers.
Oncology consults increased by 62% among those receiving the disease management intervention, whereas interfacility consults from tests (positron emission tomography/computed tomography scans) and treatment (neurosurgery, radiation, urology, and head and neck surgery) increased by 153% among those receiving the intervention. A reduction in time from diagnosis to treatment intervention was observed among 50% of those with colon cancer and 46% of those with lung cancer. For patients with liver cancer, time to treatment was reduced 66%, from 92 days in 2010–2011 to approximately 31 days in 2015.
The data indicate that this team model is feasible.
The researchers concluded, “These data show that the introduction of the disease management team model shortened the number of days from diagnosis to treatment by facilitating referrals, clinical testing, and/or treatment initiation in veteran cancer patients, resulting in timely care intervention.”