duke oncology network

D U K ECOMPREHENSIVE

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Duke Oncology NetworkOverview of Affiliated Programs

Public Affairs and Marketing Network

May 6, 2008

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Duke University Health System

Duke University Health SystemLong history of Reaching Out

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1939 American College of Surgeons Cancer Program Accreditation

1972 Duke Designated by the NCI as a Comprehensive Cancer Center

1989 Duke Comprehensive Cancer Center Affiliations Program Established

2001 Integration of Cancer Affiliations between Cancer Center and Health System InitiativesD U K E

COMPREHENSIVE

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1974 Duke University Medical Center Clinical and Education Affiliations Established


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Duke Oncology Network

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Duke Oncology Network Rationale for Developing Affiliate Relationships

Is consistent with Duke’s goal of becoming an internationally recognized leader in oncology medicine.

Enhances treatment options, outcomes, and the quality of life for members of the local community.

Generates funds in support of its academic mission.

Provides the opportunity to develop new markets and new sources of patients (in DUHS Service Area).

Enables Duke to maintain its pre-eminent position in research and education by adding sites for additional training opportunities and clinical research.

The mission of the Duke Oncology Network is to provide an array of oncology related services in a regional network of community cancer programs that have made a commitment toward excellence in cancer care. The Duke Oncology Network seeks to support and strengthen the mission of the affiliated organizations by:

Providing state-of-art cancer care to patients in the communities we serve;

Providing and promoting cancer prevention, screening, diagnosis and treatment through clinical research;

Offering educational opportunities to healthcare practitioners and the community at large; and

Enhancing the effectiveness and efficiency of cancer care delivery through performance improvement and outcomes measures.

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Duke Oncology NetworkMission Statement

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Duke Oncology Network Sites of Service

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Oncology Research Programs

Southeastern Regional Medical Center

Johnston Memorial Hospital

Duke Raleigh Hospital

Beaufort Memorial Hospital

Virginia Oncology Associates

St. Mary’s Hospital

Durham VA

First Health Moore Regional

Oncology & Hematology of Southwest Virginia Associates

Memorial Hospital of Martinsville & Henry County

Durham Regional Hospital

Granville Medical Center

CALGB Affiliates

Clinical Radiation Oncology Clinics

Bone Marrow Transplant Programs

Clinical Medical Oncology Practices

Oncology Program Development

Consultative Clinics

Maria Parham Medical Center

Comprehensive Cancer Care, PA

Columbus County Hospital

South Carolina Oncology Associates

Community Memorial Healthcenter

PersonMemorial Hospital

NortheastMedical Center

AshevilleVA

ScotlandMemorialHospital

Florida Hospital

Phoebe PutneyMedical Center

Palm Beach Cancer Institute


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DUMC Affiliated Counties

AnchorSecondaryTriangle

Duke AffiliationsAnchor Communities


VacantAssociate DirectorRemote Mkt Affil

Julie ClaytonStaff Specialist

Rusty Anderson, MD

Gail Leget, MD

Kelvin Raybon, MD

Community PDCPhysicians

Kaushik Sen, MD

Ivy Altomare, MD

DON Med OncFaculty

Marty PolovichNursing Director &

Assoc DirOnc Clin Ops

Primary Responsibilities:

1) MD practice oversight/ faculty development

2) Clinical care (MD and nursing)

3) Clinical trials (clinical aspect)

4) CME (clinical content)

5) Program development

6) Planning


1) Affiliated program operations (admin operations/ interface with Hospital)


3) DON operations

4) Clinical trials (operations)

5) Education programs (logistics)

6) Contracting

7) Planning

Sharon Taylor, MD

May 6, 2008

Gina Vaccaro, MD

Mid-Levels

Brianne Buchanan, PA

Beth Moore, , PA


1) Affiliated program operations (QA, nursing oversight, etc.)


3) Clinical care

Ahmad Mahmood, MD

Yuri Fesko, MD

Administrative (DUHS): 14.8 FTEs

Clinical Providers (SOM): 6.2 FTE’s

Lena CarverStaff Assistant

Monica RobersonProgram Coordinator

Renee MuellenbachDirector


Angela Latta Medical Secretary

VACANTClinic Supervisor

Johnston Cancer Center

Chris Marino, RNResearch Nurse

Annie Langley, RNResearch Nurse

Melanie WatsonAssociate Director

Clinical Trialsand Ed Programs

VacanttFinancial Analyst III

Paul LindiaAssociate Vice President

Clinical Program Development

Linda Sutton, MDMedical Director


Vacant

Linda Owen, PhD

Clinical Trials Manager

Beth Clapp CCRP, AAS

Regulatory Specialist

Rhonda Bergey

Staff Specialist

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Network Services Divisions

Strategic Operations

Clinical Planning and Market Research

Affiliations and Market Development

Corporate Relations/DHD

Duke Heart

Network


Specialty Outreach Programs/Contracting Services

Physician Recruitment

14 Admin/Support FTEs

6 DUHS Clinical FTE

4 PDC PhysiciansDuke Network Services

Total FTEs ~ 40

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How Elements Work Together

Clinical Planning Identify opportunities and strategies for clinical differentiation and new program growth Extend service line vision across health system entities and network

Affiliations and Market Development Identify opportunities for new business and new market development Relationship management with CEOs and MDs in key referral markets Physician sales and customer service

Oncology and Heart Networks Build volume and share for affiliates and DUHS Maintain involvement when care translates to local setting

Program design, development and operations Advance clinical research and education

Affiliations Contracting Off- site clinical activities and selected GME rotations

Outreach Clinics Specialty programs in local communities Advance education

Corporate Relations/ Duke Health Direct Relationship management and sales for regional employers

Physician Recruitment Servicing DUAP, CPDC, DUHS and selected SoM divisions

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Defining Value of Network Services

Grow targeted referral volumes DUH, PDC, DHRH, DRH, affiliated programs

Generate income from clinical activities Specialty clinics and affiliated programs

Advance academic priorities Clinical trainees and clinical trials

Improve access to Duke health care New services to priority medical communities

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Duke Oncology Network Affiliations

Tiered Affiliation Structure

Research Affiliation

Clinical Program Staffing and Management

Program Development Affiliation

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Duke Oncology Network Qualifications for Affiliate Relationship

Patient care and the delivery of high quality services must be first and foremost.

Commitment from medical staff and administrative staff to work as partners and provide resources for the delivery of oncology services and to participate in clinical trials Appropriate staffing Adherence to regulatory requirements (IRB, etc.) Senior administrative time and support Information Systems

A long term agreement

Affiliate will maintain resources to support an ongoing, collaboratively developed QA/PI plan

Maintain JCAHO accreditation and ACoS designation

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Research AffiliationsKey Research Functions

Access to clinical trials In-house studies National cooperative groups Pharmaceutical industry Collaborative research

Offer opportunities to be recognized in publications

Offer opportunities to participate in grant funding

Provide education and training of clinical trials staff

Provide assistance in the establishment of a Protocol Office

Provide current regulatory and IRB updates and support to facility-based IRB

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Research AffiliationsKey Educational Functions

Participation in Tumor Boards by Duke faculty

Assistance in clinical training

Liaison with academic medical center physician colleagues

Recommendations for Faculty appointments

Coordination of medical and nursing symposia

Continuing nursing education for research nurses

Rotation for learners

Liaison with pharmacy contacts

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Research AffiliationsKey Research Development Functions

Assessment of needs Opportunities for telemedicine conferences Assistance in cancer control initiatives Assistance with the development of Quality Improvement

Programs Assistance with physician referral services Access to other clinical program development efforts within

the Duke Comprehensive Cancer Center and Oncology

Network Assistance with research policy and procedure development

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The Duke Comprehensive Cancer Center partners with Duke Oncology Network affiliates to produce a co-branded newsletter highlighting research and patient care initiatives at Duke as well as news and events from the affiliate.

Strength through communication

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Strength through communicatione-newsletter for referring physicians

Bi-monthly e-newsletter Distributed to referring

physicians Highlights new trials or trials

having difficulty accruing Links to cancer.duke.edu for

a complete listing of trials Features a different cluster

in each issue


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Affiliations and Market Development

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Supporting the Duke Oncology NetworkAffiliations and Market Development

Establish and maintain relationships with medical communities in the DUHS service area Serve as the central point of contact for DUHS clinical program development and

outreach activities Primary market intelligence

Grow targeted referral volumes Practice (>1500/yr) and Hospital ( > 100/yr) Visits in Targeted communities Marketing Materials Hand Delivered (> 1000 sites/yr) New Appointments – (personally facilitated) Admissions – (personally facilitated) New physicians identified

Identify opportunities for clinical program development that create “win-win” situations between DUHS and community providers

Planning process used

Liaison between referring physicians and DUHS to improve patient outcomes and expedite care

24/7 customer service for referring physicians Troubleshoot access problems

Market new and existing DUHS programs to referring physician

Promote education of community physicians and other healthcare providers.


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Subspecialty Outreach Clinics and Affiliations Contracting Services

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Outreach Programs and Clinical ContractsMission / Role

Coordinate implementation of outreach clinics and contract review process with • Clinical Providers• Operational Managers• Legal Counsel• Risk Management

Provide Oversight in the establishment of clinics and/or contract management process to clinicians, business managers, DUHS and SoM staff

Develop

Im

plem

ent

Manage

Rev

iew

Monitor and oversee outreach clinics and contracts to ensure compliance with regulatory requirements and contractual obligations with DUHS, DU and PDC administration, clinical care providers and sites

Annually ensure alignment with DUHS and SoM strategic plans, renegotiate and/or terminate contracts for the provision of services

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Duke Oncology NetworkDefining Value

Grow targeted referral volumes 32 services in 25 communities 4 CPDC, 3 PDC medical and 3 radiation oncology physician practices

Generate income from clinical activities Net Income to DUHS from DON ~50% of Oncology patient volume from Greater Triangle and Anchor regions

Advance academic priorities 10 med onc fellows at 5 community sites, generates funds for DOM fellowship activities Numerous self-supporting CME symposia and CME lectures (unrestricted educ grants) Patient accruals to clinical trials Funds to Duke through CALGB accruals

Improve access to Duke health care Duke Raleigh Hospital – Medical and Radiation Oncology Durham Regional Hospital – Radiation Oncology Affiliated medical and radiation oncology sites

duke oncology network

Documents

oncology medicine

duke oncology networkmission

cancer prevention

art cancer care

education affiliations

affiliated organizations

local community

academic mission