8.25.2008

Lean Lung Cancer Clinic Leads to Faster Treatment

My wife’s doctor is part of a medical group that has its own laboratory. That is convenient because it means the patient can have a blood test, for example, done at the same place and time as a visit with the doctor. It also significantly reduces the time it takes for the doctor and patient to learn the results of the test.

That kind of integration involves the same lean principles used in setting up a manufacturing cell. You break down the silos and bring together parts of the process that should follow each other.

A
story in the St. Petersburg Times describes a similar healthcare example, this one involving a new clinic in New Port Richey, Florida, to do testing related to lung cancer. And this one not only speeds up the process; it might save lives as well.

Typically, when a patient is suspected of having lung cancer, he or she may have to undergo a series of tests, usually at a variety of locations over a period of time.

That drawn-out process exhausts patients and delays treatment of an aggressive disease that kills more Americans than any other kind of cancer.

The new clinic tries to address this problem.

The clinic, which opened last week, works like this: A patient sets up an appointment, either through his primary care physician or through a self-referral, at the clinic, held once a week at North Bay's Cardiovascular Center. He undergoes a range of tests, such as CT scans and blood tests, procedures that have typically been performed on different days and at different offices.

The patient hangs out at the clinic while the test results come back. Then a multidisciplinary team of doctors — a thoracic surgeon, medical oncologist, radiation oncologist and a pulmonologist — review the results, get together in a conference room and develop a treatment plan…

Rosemary Giuliano, the "nurse navigator" who will coordinate the patients' visit and treatment, said the clinic will be especially helpful to younger patients, who may otherwise have to miss multiple days of work to go to various appointments.

Hospitals around the country are using the clinic approach for lung cancer diagnosis. One of them, Sanford Cancer Center in South Dakota, says its patients begin getting treatment within 16 days of coming to the clinic.

That compares to industry averages of more than three months, the clinic says in information on its Web site.

Giuliano said the North Bay clinic, which took about eight months worth of planning, is modeled after a community hospital program outside Atlanta. That program cut the average time from the onset of symptoms to treatment from 83 days to 14.

If you had lung cancer, wouldn’t you want treatment to begin within two weeks, rather than three months?

The article, by Jodie Tillman, makes clear that there are practical problems involved in creating this type of clinic. One is bringing together busy doctors from different locations. Another is that not all of the doctors at the clinic may be part of the insurance company network for any given patient.

But those should be viewed as challenges to be overcome, not reasons to abandon the idea. This is a good, lean concept, and I hope it ultimately becomes an industry standard.

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