Establishing Clinical Pathway Treatment Guidelines for Tumors
“To think like a system, not like a building.” That’s the end goal that Edward S. Kim, MD, chair of Solid Tumor Oncology and Investigational Therapeutics, sees as he describes the recent creation of tumor clinical pathway treatment guidelines within Carolinas HealthCare System’s Levine Cancer Institute.
Since coming from the University of Texas MD Anderson Cancer Center to the Institute in July 2012, Dr. Kim has been instrumental in helping Institute physicians draft these guidelines. The guidelines cover 15 different tumor sites and are aimed at ensuring treatment is consistent for all Institute patients, no matter the facility in which they’re being treated. It’s a unique, unified model that takes comprehensive care and leadingedge research and brings it directly to the patient.
“We don’t want the perception that medicine is better in one place over another,” Dr. Kim says of patients having to travel great distances to be treated. “The Institute has a lot of expertise spread throughout the system, and we want to make sure that all physicians are treating patients with the same level of care using one of several care plans.”
These guidelines follow best practices and are a conglomeration of national guidelines, society guidelines and current clinical practice, he says.
A Gathering of Expertise, A Team Approach
Behind the scenes, great pains have been taken to make sure the guidelines are effectively being used across all the Institute’s charter member facilities. Each week, a multidisciplinary team of oncologists and other cancer care experts, or “tumor boards,” meet to discuss patient cases. On a monthly basis, “tumor sections” convene and focus on specific cancers, including lung, breast, genital/urinary, gastrointestinal, neuro/brain and melanoma/immunotherapy. (A sarcoma and head/neck cancer section is in the works, according to Dr. Kim.) Guidelines are discussed, including the need for any changes, as well as current research, research protocols and potential clinical trials. Any provider, no matter his or her specialty, can participate in these meetings.
A major component of the guidelines moving forward will be giving patients greater access to the latest clinical trials, which, according to Dr. Kim, will help the Institute create its own identity as a leader in research excellence, both here in the Carolinas and nationally. He foresees multiple Institute sites conducting clinical research, as well as physicians writing their own studies and conducting them at a host of sites within the system. “To have your own study and then to run it in 12 to 15 places at the same time—that’s unheard of,” Dr. Kim says. “But we’re going to put these trials in your backyard. Improving our patients’ care is the top priority, and the quicker we get answers from these clinical trials, the faster we can help our patients.”