3 Days To Cancer

Almost 10 years ago I was asked by a board of directors to design and develop an oncology service line. I was given 3 metrics for success by the board: be on time, be on budget, and to differentiate on technology.

Time: 8 months (during the winter)

Budget: $25M

Technology: Leading edge

Build a facility. Recruit and hire physicians, nurses, technical and support staff. Create all of the policy and procedures. Negotiate with payers. Everything.

In the midst of the chaos I paused to take time and listen to the market.

I interviewed around 1000 patients. I asked patients the following types of questions:

  1. When you hear the word “cancer” what is the first thing that comes to mind?
  2. What is the one thing you wish you would have known prior to starting your journey that you know now?
  3. What was the one thing you still wish you knew about your diagnosis or journey that you still do not completely understand?
  4. How did you manage to keep track of your appointments, medications, and daily tasks?

The most important insight I took away from all of the answers, interviews, and discussions was the concept of time.

When patients or family members heard the word cancer, a clock began to tick inside of their mind.

I began my own research to understand how long it took patients to go from “I think I may have cancer, to being informed of their diagnosis.”

I wanted to understand how long it took patients to begin treatment, as well as when treatment ended.

I wanted to learn how all of this information was being communicated. I wanted to understand the preferences of styles of communication that patients preferred.

It was in those insights that I realized that the opportunity was not in the treatment, or even in the technology.

The real “magic” resided in the diagnosis.

I pulled the ‘right team’ of pathologists and radiologists together to map out the turn around times. (you can see my data in the above chart)

You can see (at that moment in time) there was a lot of variation in time between the cancer type as well as where a patient was seeking treatment.

If you were a lung cancer patient going to the VA you may have to wait up to 50+ days.

If you happened to be a patient with breast cancer in a community setting it may take about 20 days.

I worked with our team of physicians, clinical and technical staff to reduce the time delay to 5 days.

After months of work, mapping new processes, and designing a new communication model we were able to achieve our metric of 5 days.

A week before our opening I challenged the team to deliver the same service and information to our patients in 3 days. (or less)

It was inherently important to me to provide each and every patient the power of choice.

The power to decide how fast (or slow) they wanted to learn if they had cancer, and if so, to recieve their treatment options based on their expectations.

We were able to deliver cancer in 3 days.

Most importantly, our team was able to provide the power of choice to patients at the N of 1.

As always you can feel free to email me at cancergeek@gmail.com or follow me on Twitter @cancergeek



2 responses to “3 Days To Cancer

  1. Dear CancerGeek, I am one of those cancer patients who was misdiagnosed for eight months, and then went from “stomach ulcer” (and maybe she’s an alcoholic) to metastatic kidney cancer one morning while prepping for a liver biopsy. Though I am well post the metastatic kidney cancer, I am now also involved in helping other patients understand the impact of the diagnostic process, its errors, and the real possibility that even a ‘cancer’diagnosis is not a complete diagnosis. Not to know what, where, what subtype, what pathology, what genomic issues and so on must be gathered and considered before a meaningful diagnosis is provided the patient. And then there is the need to deliver the diagnosis is such ways as to be helpful to the patient in making decisions about treatment.

    My background in kidney cancer has led me to understand how this lack of diagnosis subverts the treatment plans for fellow patients. Can we talk about what would really constitute a diagnosis, in terms of preventing errors which could otherwise proceed from that limited or incomplete diagnosis? Now I am involved with the Society to Improve Diagnosis in Medicine, and my concern is about getting a diagnosis that will lead to treatments likely to improve outcomes.

    Love to hear your wish list for patients at the time of diagnosis.

    Peggy Zuckerman

    Peggy Zuckerman http://www.peggyRCC.com

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