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Coordinated Care for Patients with Lung Cancer

October 30, 2015

Referring physicians no longer have to coordinate the care of patients who may have lung cancer. They can now contact a thoracic oncology nurse navigator at Baystate Medical Center to take over this time-sensitive and time-intensive process and navigate patients through every step of care.

As soon as the call is placed, a thoracic navigator takes over. The navigator orders tests, follows up on results, and coordinates diagnosis with the multidisciplinary team. If there is no cancer, the patient goes back to the referring physician’s care. If there is cancer, the navigator continues to coordinate the patient’s care, always keeping the primary care physician apprised of next steps.

This coordinated care is backed by a multidisciplinary team working together to assess each patient’s case. The team, comprised of specialists from thoracic surgery, pulmonary medicine, medical oncology, and radiation oncology, looks at the case from all angles. They decide on what tests to order and on the best treatment plan for the patient.

The navigator then schedules the patient’s first appointment with selected specialists. Since tests have been ordered ahead of time, the specialists are prepared to start treatment immediately. For the patient, there is no time wasted waiting for appointments with different specialists to determine a course of action and there is no duplication of tests.

“This is a patient-centered process that allows us to connect with patients while being more efficient and effective in treating lung cancer,” says Dr. Gary Hochheiser, chief of Baystate Thoracic Surgery, who spearheaded this process and worked in collaboration with thoracic surgery, pulmonary medicine, medical oncology, and radiation oncology.

Lung Cancer Screening

This coordinated, multidisciplinary process that is triggered by the thoracic navigator is part of another initiative: a lung cancer screening program for patients at high risk of developing lung cancer.

In March, Baystate Medical Center was named a Lung Cancer Screening Center of Excellence by the Lung Cancer Alliance, a designation that means it has agreed to follow specific guidelines and best practices to ensure the highest quality of screening and follow-up care. The program was developed in partnership with thoracic surgery and pulmonary medicine (the two specialties to which most lung cancer patients are referred) and radiology. Baystate is one of 250 such Centers of Excellence in the U.S., and the only one in western Massachusetts

The impetus for the program was the 2011 National Lung Screening Trial (NLST) findings that show low-dose computer tomographic (CT) screenings of high-risk patients reduce lung cancer mortality. Data from the trial also showed that lung cancer screenings improve survival rates better than breast or colon cancer screenings.

Under the program, physicians are asked to use criteria developed by the NLST clinical trial to determine high-risk patients. The patients are then sent for CT screening. If cancer is found, the nurse navigator comes into play, and, once again, the primary care physician is kept in the loop, but is not responsible for following up, finding care, and tracking progress. This is a coordinated process backed by a team of experts that distinguish Baystate’s lung cancer screening program from others. To attack lung cancer at its source, patients are also referred to a smoking cessation program.

Last February, Medicare announced it will cover lung cancer screening for people at the highest risk – potentially saving tens of thousands of lives.

A physician referral is required. To refer a patient: 413-794-LUNG (5864).