What Matters to Our Patients Matters to Us, and We Must Keep Up, Panel Notes

Day 1 of this year’s Virtual COA 2020 conference kicked off with the panel discussion, “Top Oncology Issues Now & Looking Ahead,” led by Bo Gamble, director of Strategic Practice Initiatives at the Community Oncology Alliance. Topics covered ran the gamut: from Zoom being everyone’s new middle name to telehealth to caring for patients’ medical and social needs and beyond.

Permeating all facets of this discussion was coronavirus disease 2019 (COVID-19) and how it seems to have fundamentally changed the world of oncology care, especially how physicians and cancer caregivers and providers interact with their patients and loved ones.

Joining Gamble on the panel were:

• Kathy Oubre, MS, chief operating officer of Pontchartrain Cancer Center
• Barry Russo, MBA, chief executive officer of The Center for Cancer & Blood Disorders and conference co-chair
• Robert Braun, corporate vice president of Operations and Integration at Regional Cancer Care Associates, LLC

The panelists echoed each others’ sentiments throughout, touching upon common concerns that included telehealth; maintaining clear communication, perhaps being more upfront now than before; the fact that we are in unchartered territory and have to adjust on the fly; even that COVID-19 was a force majeure, an unforseeable circumstance. All the while, they stressed that it is the oncology community that has to keep up with its patients while helping them navigate an ever-adjusting healthcare system.

Gamble opened the discussion with this telling question, “How do you think the current is shaping the challenges for the future?” The panelists each provided an overview of their top concerns.

“We are trying to maintain a sense of normalcy for patients, knowing that permanent adjustments will need to be made when this public health emergency is over. What will that look like?” Oubre proffered. “Telehealth is here to stay. CMS is interested in hearing our thoughts and our comments on shaping that policy as we move forward.”

“For practices that operate within a financial-risk model, I think we're going to need organizations, our local representatives and those people on the federal level, to help us navigate those waters [and] come to a happy medium where our practices are not only stable, but where we can provide services to our patients and are ready to move forward,” Braun said.

Russo stressed, “Communication efforts need to expand and focus on keeping up the electronic aspect, because patients will be coming in to our practice less often and will continue to social distance. We will have to adapt to our patients, because they are adjusting so fast to the electronic world. How do we restructure, especially in a value-based world, our needs to interact and communicate with the patients on a much more frequent basis, but in a way that takes into account all the focus on social distancing and protection and patient expectations?”

Gamble next asked about the possible redesign of reform models in the future, given where we are today. Payer conversations predominated, but given the current ongoing uncertainty, the panelists brought up how important it is to think outside the box and be able to adjust on the fly, all the while collaborating and keeping the lines of communication open.

“We are in 2-sided risk with the OCM [Oncology Care Model], so we’re certainly very concerned about that,” Russo stated. “And we’re very concerned about the implications of some of our folks that have ended up in the hospital because of COVID-19, and the impact associated with that. And we we don't yet know when that means, and it's been a challenge. I really think, going forward, we're going to have to talk with the payers when these kinds of things, like a pandemic, happen.”

Oubre added, “We're just trying to keep our practices afloat and provide the best patient care we can, regardless of the cost or what that looks like. I mean, pandemic, public health emergency, these were not words in our lexicon 6 months ago. So I think it's time to start collecting data and have conversations, and we're gonna have to work through this together."

“The commercial payers have stepped up and have been very responsive in answering our questions. Obviously, COVID-19 is definitely going to have an impact on payment reform,” Braun noted. “But I think collectively that we're still going to really see growth in value-based contracting. I think we're going to have to have better business efficiencies to ensure our practices are viable and being profitable.”

Gamble then asked about how these challenges have changed how oncology is going to look at roles in the whole care journey itself moving forward. Patient satisfaction was the name of the game, in all circumstances, especially their psychologic well-being and addressing their needs beyond just the medical. Keeping outcomes in mind all the while.

“People are losing their healthcare or they are unemployed. We need to remember that, when we're looking at that patient as a whole. We need to address those social aspects as well,” Oubre emphasized.

Braun responded, “I think that we live in a world where we're taking care of very discerning patients. They want to know where they're getting their healthcare, how they're getting their healthcare, who is giving them healthcare. It's an opportunity to actually ask the patient what matters to them the most and what's concerned or what's concerning them, and not from just a physical point of view.”

“How we remain that safe place,” Russo remarked. “I think we're going to have to quickly adapt to finding the right patient electronic communication system structure. We are their safe place, and we have to remain so because it's a big part of the healing process. It's a huge part of the healing process.”

What major hurdles will oncology have to overcome and what adjustments will the cancer care world have to make to continue to meet patient expectations in a post—COVID-19 world? Have doctor–patient interactions fundamentally changed? What about the needs of all the parties? These questions hung in the air as the panel discussion came to a close.

“I want you to look at your crystal ball and tell me what it looks like 5 years from now and 10 years from now for your world,” Gamble asked, to conclude the discussion.

“I think we're all going to have to step it up in terms of our communication methods, and not just via email or text, or telemedicine, but other methods of how we communicate between practitioners,” Braun stated.

Oubre observed, “Telehealth is here to stay. Social distancing, in some fashion, is here to stay. I think it's important that we all have a seat at the table, though, to figure out what that is going to look like. And we have to do that with keeping the patient at the center of everything we do, to be able to maintain providing them with that safe environment.”

“I think what we're learning in value-based care is that all the other pieces of what's happening with a patient, all those pieces are part of the journey. I think that over the next 5 years,” Russo predicted, “because of value-based arrangements, because of our access to data, and because of our need and requirement to connect to patients more electronically, we're going to have a better picture of the longitudinal journey.”

Communicating with patients more, taking care of their needs beyond those that fall in the oncology spectrum, and getting a more complete picture of their needs: These are the top community oncology issues now and will be looking ahead.