Nursing Innovation Links Rural Facilities to Resources and Experts to Provide High-Quality Care Across the Country

December 04, 2020

When a patient comes to the doctor’s office with a generalized symptom such as an ongoing cough or chest heaviness, they are bound to have anxiety. In Wayne’s case, a patient with a lung mass that was identified unexpectedly, his anxiety was further compounded by feeling alone: his wife has dementia and his grown children live out of state. He also lives in a rural area and must drive a significant distance to get to a center for testing and diagnosis.

ONS members Meghan Coleman, DNP, RN, CRNP-BC, AOCNP®, ACHPN, from Asplundh Cancer Pavilion at Abington–Jefferson Health in Willow Grove, PA, and Alison McDaniel, BSN, RN, OCN®, from Ochsner Clinic Foundation in Baton Rouge, LA, put themselves in Wayne’s shoes and asked: how will he get access to evidence-based testing with all of the other challenges he faces? 

Coleman and McDaniel’s ultimate answer was to conceptualize the EQUIP (Evidence-based Quality Understanding in Pathology) program, an app that connects pathologists, oncologists, nurses, support staff, and patients and easily access treatment guidelines and recommendations to make the best decisions. The app facilitates a virtual care team even across institutions and allows providers to be available for patients in real time.

Nursing Innovation Links Rural Facilities to Resources and Experts to Provide High-Quality Care Across the Country

The project received the first-place award in the inaugural ONS Hackathon (https://voice.ons.org/news-and-views/winning-team-reduces-disparities-to-biomarker-testing-in-first-ever-ons-hackathon) competition in November 2020. A project of the ONS Center for Innovation, the intensive two-week event brought together nurses and mentors to innovate ways to address challenges in the delivery of quality cancer care. ONS partnered with Hackworks, Inc. (https://www.hackworks.com/en/), a strategic consulting service, to conduct the hackathon. 

This experience was definitely a first for me,” McDaniel said. “ONS and Hackworks provided us with the tools we needed to streamline our thoughts and structure our project into something tangible.” McDaniel said that she and Coleman found the concept boards especially helpful because they enabled the team to lay out all of their ideas related to the challenge area and funnel them down to the key contenders.

“The mentors were experienced members of the healthcare community who spent hours with us, talking about our options, troubleshooting roadblocks, and providing data and research to support our efforts,” McDaniel said. “We had moments where we both felt lost and craved more guidance from the Hackworks/ONS team, but the beauty of a hackathon is that nothing you try is right or wrong. We ended up with a concrete and passionate pitch that we likely wouldn't have reached had we been held to more confining competition rules. Once we had the direction we wanted to take, Hackworks really helped us formulate that train of thought and end the two weeks with something of which we were incredibly proud.”

Improving Delivery of Home-Based Treatment

A second team comprising Rika Villar, MSHI, BSN, RN-BC, from Memorial–Sloan Kettering Cancer Center in New York, NY; Ryne Wilson, RN, OCN®, from Mayo Clinic Cancer Center in Minnesota; and Gina Quinlan, BSN, RN, CCM, BMTCN, from University of Pittsburgh Medical Center Home Healthcare in Pennsylvania, received the runner-up award for their project called CARE CORE (Care Reimagined: Centralized Oncology Resource Environment).

Nursing Innovation Links Rural Facilities to Resources and Experts to Provide High-Quality Care Across the Country

In a time in which treatments can be provided in a variety of locations, CORE CARE reduces zip code–related health disparities via a 3G-enabled tablet-style device that provides bidirectional communication between the patient and care team. It helps facilitate IV cancer therapy administration at home and is even capable of integrating existing healthcare technologies, such as smart pill boxes, falls bracelets, or smart pumps, into one resource hub to simplify and synchronize patient care, Wilson explained.

“By providing this virtual gateway into the cancer center, patients with cancer who face barriers because of lack of resources are able to receive a significant amount of their cancer care from the comfort of their home without sacrificing quality,” he said.

How Hackathons Fuel Innovation

Over a two-week virtual experience, hackathon team members attended a variety of workshops designed to fuel innovative thinking and plan multiple brainstorming sessions, along with frequent check-ins with mentors to obtain feedback and advice on further direction. They pitched their ideas to a team of three judges on November 20, 2020. Pitches were evaluated based on patient experience; impact, innovation or ingenuity; use of data and technology; and feasibility. 

“The ONS Hackathon was a wonderful and exciting experience,” Wilson said. “I speak for all of my team members when I say how grateful we are to have been selected to help cultivate solutions to many of the problems patients with cancer face. The hackathon platform provided expert training on design thinking and helped all of us create realistic solutions to the real-world problems we face.”

Mentor Benjamin Kolt, director of client experience at IBM Watson Health in Cleveland, OH, and an expert on electronic health records, is a veteran of hackthons from both the participant and mentor side. He said he was impressed with ONS’s participants and their genuine commitment to improving patient care.

Every participant I encountered was open to everyone’s ideas,” he said. “When we had brainstorm sessions, they both contributed and listened to the ideas of others, which has not been always the case with past hackathons in which I’ve participated. These nurses are among the most dedicated, knowledgeable, and selfless healthcare professionals. I have been repeatedly impressed by both their depth of knowledge and their willingness (maybe hunger) for more knowledge and information.”

ONS Hackathon team members had not met each other before the project, and all are volunteers, including the mentors. Kolt said he thinks that structure is what makes the opportunity unique. “Hackathons are great because building random teams gives participants an opportunity to approach problem solving outside of their normal workflows,” he said. “Participants get a huge amount of networking outside their traditional orbits. In the case of the ONS Hackathon, participants from all over the country interacted with people in and outside their normal domain and, I believe, benefitted from the exposure.”

ONS has more hackathons planned for 2021 as part of its commitment to innovation, according to Michele Galioto, DNP, RN, CNS, assistant executive director for the ONS Center for Innovation.


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