Engaging Community-Based Cancer Physicians: Experience of the Memorial Sloan Kettering Cancer Center Cancer Alliance

Abstract

Background: The proliferation of relationships between community health systems and academic medical centers has created a need to identify effective components of these models. This article reports on frontline physician experiences, with one such relationship established through the Memorial Sloan Kettering Cancer Center (MSK) Cancer Alliance. MSK created the Alliance with the goals of rapidly bringing the newest standards of care into community settings and increasing patient access to clinical trials in their local communities. Methods: Alliance leadership administered a 10-question anonymous survey to physicians treating patients with cancer across the 3 Alliance member health systems: Hartford HealthCare Cancer Institute, Lehigh Valley Cancer Institute, and Miami Cancer Institute at Baptist Health South Florida. The purpose of the survey was to identify opportunities to improve physician engagement. Results: There were 103 clinician respondents across Alliance members, of which 87 reported participation in a disease management team and were included in the final analysis. Most respondents reported high value from Alliance activities, such as attending MSK tumor boards (94%) and lecture series (96%), among those who reported them applicable. Across all respondents, most reported satisfaction with engagement opportunities, such as MSK physician participation in their institution’s meetings (76%). When asked where they would like to see increased engagement, the most commonly reported response was for more lecture series (45%). Most respondents (88%) reported that the Alliance led to practice change, either for themselves or for other clinicians at their institution. Many attributed this practice change to MSK disease-specific process measures. Conclusions: The activities most valued by community physicians were heavily physician relationship–based. The encouraging experience of the MSK Cancer Alliance suggests that activities involving physician investment may be effective for promoting practice change in the context of cross-institution relationships. Future research is needed in this area.

Which strategies support the effective use of clinical practice guidelines and clinical quality registry data to inform health service delivery? A systematic review

“…Five articles reported registry processes not restricted to a specific health condition. Five studies each were from Sweden [ 24 , 25 , 31 , 32 , 37 ] and Australia [ 7 , 13 , 26 , 27 , 36 ], two from USA [ 33 , 34 ], one joint study from Denmark/England [ 30 ] and one each from Denmark [ 29 ] and Norway [ 35 ]. PICOS information is available in Table 2 , and study findings are summarised in Additional file 6 .…”

“…Several National Cancer Institute (NCI)-designated Comprehensive Cancer Centers in the USA have established academic and clinical partnership models, including the Duke Cancer Network, MD Anderson Cancer Network, the Memorial Sloan Kettering (MSK) Cancer Centre Alliance [ 34 ] and Fox Chase Cancer Center Partners Program [ 19 ]. These programmes typically provide community hospital partners with access to consultative services, treatment protocols, research and clinical trials.…”

“…A preliminary environmental scan identified examples of effective registry design and utilisation in terms of QI, value-based purchasing (VBP) and public reporting N/A ∘ Based on results from the environmental scan, in-depth analyses of effective registries were conducted in 4 clinical areas ∘ An analytic framework called “positive defiance” used to understand factors that enable registries to be used successfully for quality monitoring and improvement • In-depth analyses were conducted with staff from 2 to 5 effective registries in each clinical area Review of effective (positive deviant) registries. Included in-depth interviews with registry staff Lipitz-Snyderman, USA, 2019 [ 34 ] 103 clinicians across Memorial Sloan Kettering Cancer Alliance invited to participate. 87 reported participation in a disease management team and were included in final analysis Survey to physicians treating patients with cancer across the 3 Alliance member health systems, covering: awareness and perceived value of engagement opportunities through MSK Cancer Alliance, which engagement opportunities would they like and has clinical practice changed due to MSK membership.…”

“…This tool does not recommend calculating an overall score or excluding studies with low methodological quality [ 39 ]. In total, 9 studies met all five criteria [ 17 , 21 , 22 , 25 , 30 – 32 , 37 ], two met four [ 26 , 29 ], one met three [ 24 ], four met two [ 16 , 18 , 23 , 34 ] and one met none [ 36 ].…”

“…The 15 CQR articles included the following: four beforeand-after studies [26][27][28]36]; four survey studies [24,29,31,34]; four case studies [7,25,32,35]; and three interview studies [30,33,37]. Again, the lack of rigorous study design limited the confidence in findings from these studies and their generalisability.…”