Hartford Hospital

Helen & Harry Gray Cancer Center,Helen & Harry Gray Cancer Center,

Hartford, ConnecticutHartford, Connecticut

Allows unique participation in program of discovery and innovation - important part of our identity

Pillars in NCCCP pilot program are already a valued part of Hartford Hospital’s mission Community outreach Research Information systems Pathology

Optimize our care

Why is Hartford Hospital interested in being part of the pilot program?

Why participate in Program? (continued)

Contribute to and benefit from important national programParticipate in the development of models that Participate in the development of models that other community hospitals might emulateother community hospitals might emulate Health care disparities exist in our communityHealth care disparities exist in our communityGeographically, Hartford is small city. Excess Geographically, Hartford is small city. Excess in mortality in certain racial/ethnic groups who in mortality in certain racial/ethnic groups who only live few blocks away from healthcare facility only live few blocks away from healthcare facility (Hartford is only 15 square miles – unlike Boston (Hartford is only 15 square miles – unlike Boston or NY)or NY)Move disease to an earlier stage or prevent itMove disease to an earlier stage or prevent it

What are the major challenges and opportunities you envision in participating in the pilot?

ChallengesChallenges Simple wins already accomplishedSimple wins already accomplished Resources needed above those provided by Resources needed above those provided by

grantgrant Private practice environmentPrivate practice environment Busy Cancer Center close to capacityBusy Cancer Center close to capacity Collaborations barriersCollaborations barriers

What are the major challenges and opportunities you envision in participating in the pilot? OpportunitiesOpportunities

Excitement at HH and in community about Excitement at HH and in community about NCCCP pilot-new collaborationsNCCCP pilot-new collaborations

Greater awareness of outreach effortsGreater awareness of outreach efforts New staff provides sparks for progressNew staff provides sparks for progress Sharing best practices with othersSharing best practices with others Enhanced work with NCI centersEnhanced work with NCI centers Other grant opportunitiesOther grant opportunities

Research Challenges/opportunitiesResearch Challenges/opportunitieso how to incentivize MD’s to participate in trials-how to incentivize MD’s to participate in trials-

o busy offices, documentation, etc., busy offices, documentation, etc., o Cost of operating research officeCost of operating research officeo Recruiting & retention of experienced staff Recruiting & retention of experienced staff o Keeping data/information updated Keeping data/information updated o Difficulty in identifying pts who might be Difficulty in identifying pts who might be

candidates for studies – 5 satellite officescandidates for studies – 5 satellite officeso Not overloading IRBNot overloading IRB

What “local” factors do you anticipate as influencing these challenges and opportunities?

Information Technology Challenges/opportunities

Complexity of multiple systems – integrating Complexity of multiple systems – integrating applications from various vendorsapplications from various vendors

HIPAA complianceHIPAA compliance Opportunity to reduce frequency of asking Opportunity to reduce frequency of asking

patients for redundant informationpatients for redundant information Insure accurate information/data flowInsure accurate information/data flow Insure important patient information is available Insure important patient information is available

to all caregivers wherever neededto all caregivers wherever needed

Biospecimen Challenges/opportunities

Over 40,000 surgical path & hematopathology Over 40,000 surgical path & hematopathology specimens received/yrspecimens received/yr

Biospecimen storage – 25 years (minimum legal Biospecimen storage – 25 years (minimum legal storage 10 years)storage 10 years)

Efficient triaging of tissue specimens for national Efficient triaging of tissue specimens for national research protocolsresearch protocols

Clinical research publicationsClinical research publications Opportunity for subspecialty interests including Opportunity for subspecialty interests including

GYN, GU, pulmonary, breast, hematopathology GYN, GU, pulmonary, breast, hematopathology and neuropathologyand neuropathology

“I’m a Radiation Oncologist not a Molecular Biologist!”

DammitJim…

Disparity Challenges/opportunities

Disparities in outcomes in Hartford Region–Disparities in outcomes in Hartford Region– African American Women have 1.3 times African American Women have 1.3 times higher mortality from breast cancerhigher mortality from breast cancer African American men have 2 times higher African American men have 2 times higher

mortality from prostate cancermortality from prostate cancer Need new ways to reach people/communitiesNeed new ways to reach people/communities Growing number of other cultures living in CT Growing number of other cultures living in CT

(South America, Bosnia, Asia) will require needs (South America, Bosnia, Asia) will require needs assessment and new approachesassessment and new approaches

Disparity Challenges/opportunities (Continued) Opportunities for increased collaboration with Opportunities for increased collaboration with

federally qualified community health centers, federally qualified community health centers, coalitions, faith-based, shelters, etc to bring coalitions, faith-based, shelters, etc to bring awareness and screening to medically awareness and screening to medically underserved.underserved.

Enhance novel outreach methods to bring Enhance novel outreach methods to bring awareness/screening to community – mobile awareness/screening to community – mobile mammography, barbershop programmammography, barbershop program

Methods to increase minority clinical trial accrualMethods to increase minority clinical trial accrual

What "extra-local" factors will have an important influence?

Access to collaborations with NCI Comprehensive Access to collaborations with NCI Comprehensive Cancer Centers, other NCCCP pilot sites, and Cancer Centers, other NCCCP pilot sites, and others for whom the door may now be openothers for whom the door may now be open

Clinical research trials related to community. This Clinical research trials related to community. This will enhance our present collaborations with will enhance our present collaborations with Dana-Farber/Partners CancerCare, Yale, Dana-Farber/Partners CancerCare, Yale, University of WisconsinUniversity of Wisconsin

Access to national dialogues on disparities best Access to national dialogues on disparities best practices, research accrual methodologies, IS and practices, research accrual methodologies, IS and biospecimen protocolsbiospecimen protocols

What "extra-local" factors will have an important influence?

Enhance existing valued efforts through new strategiesEnhance existing valued efforts through new strategies CDC BCCEDPCDC BCCEDP Communications research (CHESS)Communications research (CHESS) Connecticut Cancer PartnershipConnecticut Cancer Partnership Prostate cancer awareness-BarbershopsProstate cancer awareness-Barbershops ONS/ONCCONS/ONCC Prevention trialsPrevention trials Patient navigationPatient navigation Multidisciplinary care and support programsMultidisciplinary care and support programs

What is your experience with community (patients) and experience with community providers (physicians)? Programs designed to meet patient and family needs.Programs designed to meet patient and family needs. Multiple site-specific multidisciplinary program Multiple site-specific multidisciplinary program

models, including breast, prostate, gynecologic, models, including breast, prostate, gynecologic, thoracic and neurooncology. thoracic and neurooncology.

Multidisciplinary care is a hallmark of what our Multidisciplinary care is a hallmark of what our institution has stood for and is engrained in our institution has stood for and is engrained in our culture.culture.

Meet MD needs and look for win-win partnershipsMeet MD needs and look for win-win partnerships Receive community advice-PBC Community Receive community advice-PBC Community

Advisory BoardAdvisory Board

What is your experience with community (patients) and experience with community providers (physicians)?

Long tradition of working with community.Long tradition of working with community. Development of mobile mammography program Development of mobile mammography program Partnered with The Prostate Net to reach African American men with Partnered with The Prostate Net to reach African American men with

prostate cancer awareness information through their barbersprostate cancer awareness information through their barbers CDC special projects grant to extend “Reaching African American CDC special projects grant to extend “Reaching African American

Men with Prostate Cancer Awareness Information” to New Haven Men with Prostate Cancer Awareness Information” to New Haven and Bridgeport, CT.and Bridgeport, CT.

CHESS research with University of Wisconsin/MD Anderson (free CHESS research with University of Wisconsin/MD Anderson (free laptop loans to those without them).laptop loans to those without them).

Wisewoman, SCOPE, Komen, Avon grants to enhance outreachWisewoman, SCOPE, Komen, Avon grants to enhance outreach Physicians support Cancer Program activities, including attendance at Physicians support Cancer Program activities, including attendance at

tumor boards, medical staff conferences. tumor boards, medical staff conferences.

THANK YOU