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On the final day of the 43rd National Oncology Conference, a series of interactive panel discussions explored innovative strategies for remote patient monitoring across the globe, improving quality and safety amidst complex treatments, financial challenges in precision medicine and clinical trials, and more.
The final day of the 43rd National Oncology Conference (NOC) invited members not just to learn, but to share their own ideas. Interactive panels, discussions on care across states and countries, and a town hall with ACCC’s Vice President of Membership facilitated deep discussions on the future of oncology.
For the third year, ACCC invited panelists from across the globe to share the challenges and successes of cancer care outside the US. The year’s session, moderated by Andrew Ambort, DO, Palliative Care Consulting Physician at WellSpan Cancer Institute, focused on remote patient monitoring. The panel consisted of Misha Kaur, DPM, MPP, Chief Operating Officer of Cureety, and three providers from France who use Cureety's technology to reach patients in between visits: Audrey Faveyrial, MD, Medical Oncologist at Centre François Baclesse; Carole Helissey, MD, Medical Oncologist at Hôpitaux Saint-Joseph; and Valentin Précourt, M Sc Inf, Advanced Practice Nurse at Centre François Baclesse.
Remote monitoring is a strategy to collect information about a patient's health without a visit with the provider. Whether patients report symptoms by phone or through an app, this approach offers a proactive way to identify toxicities and address adverse events at the first sign, even between scheduled appointments. "Proactive care is about making sure the right patient receives the right care at the right time," said Dr. Faveyrial.
For Dr. Helissey, there was a clear impetus for her institution to roll out remote monitoring. "The turning point was COVID," she said. Patients were alone and afraid to go to the hospital, so providers needed a strategy to make sure serious AEs weren't getting missed.
For others, the change was more gradual. Dr. Faveyrial's institution started remote monitoring in 2014, with nurses calling patients 48 hours in advance of their appointment. As patient numbers grew and technology advanced, phone calls were replaced by an app-based reporting mechanism. Précourt, an advanced practice nurse also at the same institution, has seen patient care improve alongside this evolution. His patients report feeling safer and better supported because they know their concerns are being heard. The extra information also helps him make informed choices as a provider. "As a clinician, I feel like I can provide better care,"Précourt said.
Dr. Kaur provided the industry perspective on the panel and reminded providers in the room to hold Cureety—as well as other industry partners—responsible for continuous support. Her organization takes time to understand the unique workflows, staffing models, goals, and challenges of each cancer center to set up the optimal tool and ensure it is sustainable. "This only works when it's designed well for the program," she said.
The next panel explored quality improvement initiatives as a tool to optimize patient care. Moderator Andrew Munchel, MSN, RN, OCN, CPHQ, Oncology Quality Program Administrator at WellSpan Cancer Institute, opened the floor for panelists to share successes from their own institutions.
The rollout of a new electronic health record (EHR) system at Northwest Medical Specialties sparked an opportunity to integrate tech into supportive services. Abra Kelson, LICSW, Director of Quality and Value Based Care, explained how her team embedded existing screening tools into the new digital system, including assessments for stress, depression, and social drivers of health. Providers are prompted through clear workflows based on patient scores, leading to improved efficiency in follow up and documentation time, consistency and quality in care, and confidence in responding to positive screenings. Embedding screenings in the EHR also helps to keep data centralized and accessible for future quality improvement initiatives.
At Atrium Health, leaders recognized an opportunity to prevent serious complications by increasing rates of testing for dihydropyrimidine dehydrogenase (DPD) deficiency. This enzyme helps to break down chemotherapy, and a deficiency can lead to severe toxicities or death if the dose is not adjusted appropriately. In 2020, testing was standard of care before starting treatment in several other countries, but not in the US. Starting in just one clinic of Atrium Health's multi-state healthcare system, a pop-up message in the EHR prompted oncologists to order the test upon diagnosis. Providers shared how the test fit into their workflows so the institution could modify its processes to keep testing sustainable. "Implementation fails if there's extra burden on the care team," said Jai Patel, PharmD, Associate VP of Translational Research and Director of Pharmacology and Pharmacogenomics. Today, DPD deficiency testing is mandatory across Atrium Health to ensure no patient experiences avoidable toxicities.
Dana McDaniel, DNP, FNP-C, AOCNP, Director of Oncology and Clinical Research at Mosaic Life Care, spoke about her institution's efforts to reduce avoidable emergency department (ED) visits. A multidisciplinary team tasked with addressing the issue found that patients often turned to the ED when they were unsure which member of their care team would be best to contact. In response, Mosaic Life Care developed a printed stoplight tool with symptoms rated green, yellow, or red based on the level of severity. Importantly, there is a single phone number printed at the top of the handout for all patients to use, regardless of the time of day, their concern, or which provider they see. By creating a single call center for triage, patients understood better what symptoms may be serious, felt more confident contacting the clinic, and knew what steps to take before heading to the ED.
Finally, Samantha Skubish, MS, RT(R)(T), Chief Technical Director of Radiation Oncology at Mount Sinai Health System, spoke about her department's efforts to reduce workplace injuries. From 2020-2022, there was a significant increase in workplace injuries sustained from moving patients with limited mobility. Providers had some tools to support transitions between beds, wheelchairs, and radiation equipment, but availability varied between clinics and providers were often unsure how to use them. "Bringing our lead radiation therapists to the table from the very beginning was very important," said Skubish. From those conversations, they developed a custom patient mobility screening tool and improved training and availability for mobility tools.
A key takeaway from the panel came from Dr. McDaniel, who said that if a problem is avoidable, then it is actionable. She offered this as a guidepost to identify promising targets for quality improvement initiatives across settings.
Case studies, enthusiastic panelists, and a game-show-style experience led by Kristen Kipping-Johnson, MPH, Director of Network Research Operations at the University of Chicago Comprehensive Cancer Center, raised the energy in the room for a session on improving access to clinical trials. Each panelist represented a different role and provided unique perspectives on the substantial barriers that prevent patients from receiving the care they need.
Carrie Friedman, BSN, RN, OCN, Clinical Trials Nurse Navigator at Virginia Cancer Specialists, described the core of her role as empathy and education. Each patient comes with their own concerns and priorities, which span from finances to parenting to transportation. She explained that it is important for patients to understand the reality of participating in clinical trials, including practical considerations. When the care team and the patient are on the same page about where difficulties may arise, they can collaborate on proactive solutions.
One of the most common concerns patients share about participating in clinical trials is cost. Aimee Hoch, MSW, LSW, OSW-C, FACCC, Program Manager at ACCC and former financial navigator, discussed the many overlapping factors that patients must weigh: insurance coverage, research costs, legislative policies in the state, travel costs, and financial implications of taking time off work. Like Friedman, she explained that a proactive approach is vital. "Good financial navigation practice is meeting the patient upon diagnosis," Hoch said.
Dhruv Bansal, MD, Director of Immunotherapy at Endeavor Health, provided the oncologist perspective. Many of the barriers to participation he sees stem from misunderstandings about the process. For example, patients often assume that treatment cannot be delayed long enough to explore clinical trials, but in many cases it can. Providers need to explain urgency on a case-by-case basis so the patient does not feel rushed to begin treatment before exploring their options. CAR T-cell therapy is another common area of misunderstanding. Knowledge and confidence in managing toxicities associated with this therapy have grown tremendously in the last decade, but there are still misconceptions that CAR T-cell therapy clinical trials are dangerous.
Laurie Adami, Cancer Legislative and Patient Advocate at LA Patient Advocacy, has first-hand experience with CAR T-cell therapy trials. Eight years ago, she participated in an early study and experienced severe toxicities. Now, she shares her life-saving experience with other patients and educates patients on how this therapy has evolved to be safer and better tolerated. Beyond knowledge gaps, she often sees a breakdown in partnerships between cancer centers. "There can be a reluctance in the community setting to pass a patient over [to an academic center]," she said, but emphasized the importance of building trust so patients' options are not limited.
The panel concluded with each speaker sharing one tangible step to make clinical trials more accessible:
As ACCC members across the country are involved in healthcare legislation at the local, state, and federal level, there are valuable lessons to be shared from their experiences and successes. Jorge J. García, PharmD, MS, MHA, MBA, FACCC, FACHE, President-Elect of ACCC, Corporate Strategy-Pharmacy Clinical Enterprise at Baptist Health, and Founder and Principal of Patagonia Healthcare, began the session with a high-level overview on some of the federal policies expected to have a large impact in the coming years.
The 2022 Inflation Reduction Act requires the US Centers for Medicare and Medicaid Services(CMS) to negotiate the price of select high-cost drugs under Medicare. The policy rolled out in 2026 with ten Part D drugs, with 15 more to follow in 2027 and other Part B drugs in 2028. Aside from cost savings for patients, this marks a change in the relationship between CMS and pharma companies. "Medicare is moving from being just an administrator of drug reimbursement to actually influencing the drug prices," said Dr. García.
CMS is also proposing to align Medicare 340B reimbursement more closely with hospital acquisition costs and estimate that this change would lower Medicare drug payments by 4.55 billion dollars. The greatest impact would be seen in the core cancer program economic engine with potential downstream impacts on sub programs and departments. The outstanding question is who will truly absorb the costs saved by cancer programs.
Another pressing issue is the new Medicaid work requirements which go into effect in 2027. There are exceptions for those who are medically frail, but cancer is not listed as an automatic exception. "I see this causing fewer patients to be eligible for Medicaid," Dr. García said, along with higher administrative burden for patients and navigators submitting requests for exemptions.
Dr. García then invited two panelists onstage to talk about their experience with state-level advocacy. Ruiling Yuan, MD, Community Oncologist and Hematologist at Self Regional Healthcare, never planned to be an advocate—only to provide care. At her cancer center in South Carolina, she watched her patients struggle with transportation, prior authorization, and other barriers to care. She realized that in these cases, the best way to care for patients was to step into advocacy.
"We are the ones on the front lines, we know what our patients want and need, and we can tell their story to the policymaker," Dr. Yuan said. However, this does not necessarily mean going to Capitol Hill. She suggested participating in virtual meetings or inviting policymakers to visit the cancer center as more accessible ways of getting involved.
Similarly, Joanna Metzner-Sadurski, MD, Director of Self Regional Healthcare, sees the role of policymakers to ensure patients can access care in a timely fashion and close to home. She recommended leveraging resources from organizations like ASCO to get involved. Anyone can submit a policy proposal to ASCO for review by their Health Policy Committee. If the idea is approved, they provide guidance on how to move the idea forward at the state legislative level. Policy change is a collective effort, and support is available no matter where advocates live.
The 43rd NOC wrapped up with a town hall focused on the most important part of ACCC: its members. Jim Burnett, Vice President of Membership at ACCC, joined by Assistant Director Arnold Sripinyo and Assistant Manager Melissa Sanchez, MS, shared their vision for serving the cancer care community over the next year, and invited attendees to play an active role in helping to shape this future.
Burnett explained that the goal is not an overhaul, but rather to connect all of ACCC's initiatives into a single meaningful membership. "Your experience of ACCC should be better than the sum of its departments," he said. The strategy over the next year is to listen and diagnose what members want, devise infrastructure and strategy, and roll out new benefits that reflect the greatest needs of the cancer care team.
A common suggestion from the audience was to publish oncology benchmarks and data. These tools are vital for making hiring cases and evaluating areas of growth, but the information is not currently available from any other organization. ACCC can fill that gap. Another theme was advocacy, with audience members calling upon ACCC to take a stronger stance on policy and provide more resources to support members who want to get involved at a local level.
In this final session of NOC, the Membership team reaffirmed ACCC's commitment to the heart of this annual meeting’s success: extraordinary oncology professionals sharing knowledge and experiences to strengthen cancer care for every patient. Learn more about the benefits of being an ACCC member on the Membership page and email membership@accc-cancer.org with questions or suggestions.
Read the two previous blogs for coverage of day one and day two of the 43rd National Oncology Conference.
