When faced with a cancer diagnosis, patients measure time not in days but sleepless nights. Cancer centers are responding by focusing on speed to access and care.
In early 2024, Chartis asked leaders at 48 cancer centers across the country about the state of access for their patients. Most respondents said they are trying to see newly diagnosed cancer patients within a week: 40% of respondents aim to see patients within 3 days, and another 42% aim to see them within 7 days. This is notably more aggressive than our poll of cancer centers in 2019.
Achieving these goals requires cancer centers to redesign workflows, rapidly match patient need with the appropriate clinical expertise, and expand capacity for new patient visits. We heard that more cancer centers are moving toward leading practice as they seek to expand cancer access and meet patient preferences:
- Minimize barriers to scheduling: 72% of cancer centers now schedule some or all appointments without records, seeking to gather records after confirming the appointment.
- Initiate care through navigation: 3 in 4 respondents said they have a navigation program, but the patient touchpoints of navigators differ significantly by program.
- Manage provider capacity: 67% identified optimizing provider templates as a top access initiative for 2024.
- Deploy advanced practice providers (APPs) to “top of license”: 31% of respondents are now positioning their APPs to do mostly independent visits.
- Align capacity to meet patient needs: In addition to extending clinic hours, 46% of respondents said they have dedicated oncology urgent care centers.
Five leading practices to expand cancer access and meet patient preferences
1. Minimize barriers to scheduling
What we heard: Cancer centers have shifted to collecting “minimum” required records after booking the appointment, instead of requiring upfront retrieval.
They are also starting to offer online scheduling for new patients, building upon growth of self-scheduling for imaging and return visits. While this still represents the minority of programs, it is a trend we expect to increase, especially for certain tumor types.
What it means: Cancer programs must provide easily accessible entry points for patients (including patients who don’t yet have confirmed diagnoses) by breaking down institutional barriers and establishing new norms for rapid access. The focus is “one contact, one appointment.”
2. Initiate care through navigation
What we heard: Three-quarters of respondents said they have a navigation program in place. Though one-third of respondents said they assign a navigator to all new patients, only a subset position navigators to connect with all patients prior to their first visit.
What this means: Cancer programs can realize more than a 20% increase in completed first appointments and more than a 10% increase in patient retention for treatment by assigning a navigator to connect with the patient prior to the first appointment.1
This figurative “warm hug” gives patients and caregivers peace of mind as they begin the care journey. Navigation services also can be especially reassuring at critical times of patient transition throughout their care journey. Cancer programs have an added opportunity as these navigation services are now reimbursable.
3. Manage provider capacity, including template optimization
What we heard: More than two-thirds of respondents identified their top priority for 2024 as optimizing provider templates.
What this means: Template optimization should be part of broader capacity management efforts. In addition to routine template hygiene work, cancer program leaders should consider implementing weekly minimums on new patient visits and level-loading provider time across the week and in alignment with same-day treatment modalities. This smoothing of clinical activities creates operational efficiencies and maximizes the benefits of clinical templates.
4. Deploy APPs to top of license
What we heard: Half of respondents indicated that deploying APPs to “top of license” is a top access priority. Increasing top-of-license practice in ambulatory care includes APPs seeing patients independently with their own template and billing.
What this means: Optimizing how APPs are deployed can increase capacity for seeing patients. Realizing the benefit of the expanded capacity through APP templates requires:
- Thoughtful definition of appropriate patient types
- Clear patient messaging about the role of the APP
- Exam room availability aligned to the tempo of the template
- Staff support aligned with the role of the APP
- A change management approach to align physicians to the expanded APP role
5. Align hours to meet patient needs
What we heard: Cancer centers are changing how and when patients access care to meet demand. 46% of respondents said they have dedicated oncology urgent care centers. Half of those are open extended hours and weekends.
Additionally, cancer centers are expanding clinic availability by level-loading provider time to create consistent access within and across the workweek. They are also now addressing operational constraints and implementing weekend clinics to increase access and compliment weekend infusion. While these services are not widespread, they are indicative of how cancer centers are adjusting to meet the patient demand for greater ease of access.
What this means: While organizations take different approaches to the operating model and location, APP-led oncology urgent care centers are a key success factor in opening access for clinics and infusion. They also alleviate the need for patients to seek care in the emergency department and prevent double bookings in the clinic.
Enable more rapid access to cancer care
Cancer centers are not standing still when it comes to access. Leaders are pursuing ways to increase and improve patient access to care. This includes making available patient-preference-based scheduling and improving capacity management through APP deployment and expanded care delivery models. Doing so is enabling more rapid access to care, translating to an organization’s ability to attract, retain, and care for their patients.
