Dr Peter Aran on What Oncologists Implementing OCM Can Learn From Existing Models

Over the next years, these spheres (ACOs, primary care, and oncology) that are going on in CMMI need to be coalesced together so that when we have learning collaboratives, not only do we have learning collaboratives within each of these spheres, but we learn from each other in these similar projects, said Peter Aran, MD, medical director of Population Health Management at Blue Cross Blue Shield of Oklahoma.

Transcript (slightly modified)

What can oncologists who are implementing OCM learn from existing models in other practice areas?

So, I think oncologists already, relative to other physicians, have transformed practices. They’ve had nurse navigators for decades; they’ve understood team-based care for decades; they’ve taken care of critically ill patients using evidence-based medicine for decades. All that’s new. I think what’s not quite as new to oncology practices is expanding their team outside of their historical teams. Their historical teams have been physicians, nurses, social workers, pharmacists, nutritionists, physical therapists; that’s the historical team they’ve been working with for years. I used to be a transplant physician, and we had the same kind of team.

But what these new models tell us is that you have to expand those teams outside of your normal definition of team. You need to include organizations outside of medicine: churches, schools, even insurance companies, pharmaceutical companies. All of those people and organizations have a role in helping us take care of patients the 99% of the time when they’re not in our office and not in the hospital. That I think is one of the bigger things that the practice has learned from this, is that here are the not thought of team members vital to taking care of our patients.

I have 1 more hope. The other hope is that parallel to the oncology care model, we have several other big models going on in the country that are care transformation projects. The oldest of the 3 are accountable care organizations. The second oldest of the 3 are primary care initiatives such as the comprehensive primary care initiative, or the ones going on now, the comprehensive primary plus initiative. The comprehensive primary plus initiative, by its name, is dealing with family physicians and internists and primary care providers. The oncology care model, by its name, is dealing with cancer specialists. We need to learn how to venn diagram those 3 spheres: ACOs, the primary care sphere, and oncology sphere.

The oncology sphere is going to be, I hope, the prototype for all other subspecialty models. So, oncologists are just naturally built to do this because they’ve been doing some of these same patient-centered medical home principles for decades. That’s not true for urology, that’s not true for orthopedics, that’s not true for general surgery, and in many cases that’s not true for primary care. So, over the next years, these spheres that are going on in CMMI need to be coalesced together so that when we have learning collaboratives, not only do we have learning collaboratives within each of these spheres, but we learn from each other in these similar projects.