SUMMARY PROVIDER WORKING GROUP December 4, 2014 Generosa Grana, MD MD Anderson Cancer Center at Cooper

COMMITTEE MEMBERSHIP Original Members Generosa Grana* Brandon Hayes–Lattin* Renee Nicholas Wendy Susswein* Karen Kelly Thomas* Laura Tillman JoAnne Zujewski Current Roster Generosa Grana Brandon Hayes-Lattin Laura Tillman Karen Kelly Thomas Katrina Trivers - CDC Jung-Min Lee / Joann Zujewski- NIH Summer Cox – Oregon Deb Duquette – Michigan Deborah Story / Lindsay Avner– Bright Pink Michael Wilkes – UC Davis

ACTIVITY TO DATE Refine target: “patients” and “providers” Assess work ongoing Successful strategies Potential Collaboration Work of CDC genomics grants Work of new communication grants Work at CDC – Trivers et al

CHARGE TO COMMITTEE Role: input / recommendations / guidance Result: targeted, effective educational strategies disseminated to the right audience of Health Care Providers Focus of larger committee: Women High risk women (strong family history or mutation +) Young breast cancer survivors

REFINE “HEALTH CARE PROVIDERS” Primary care physicians (internal medicine, family medicine, ob/gyn, ) Focus on trainees NP / PAs ADD Naturopaths (in west- association AANP) Insurance providers (based on 3 state projects) Societies

SURVEY OF PROVIDER EDUCATION & PRACTICE GAPS 1.need exists to survey HCP 2.areas of interest to survey --general breast health for young women; --risk assessment and genetic testing; --needs of young breast cancer survivors. 3. ways to survey --Doc styles; insurers; licensing groups; professional societies --Potential use of CDC state grantees – Work of grantees focuses on: surveillance; policy; public and provider education around hereditary syndromes

HOW TO REACH HEALTHCARE PROVIDERS Organizational meetings Licensing board Training programs Insurance providers medical directors of health plans (EX. Michigan) National partners – Aetna, United Health, Signa Newsletters blasts Conferences for providers

PROGRAMS TARGETING TRAINEES Katrina Trivers – CDC Planned Parenthood – Deb Duquette, Dr. Mark Perlman, Courtney Benedict Bright Pink Michael Wilkes –UC Davis Others????

PROGRAMS TARGETING TRAINEES Katrina Trivers et al Inside knowledge / Emory Target Trainees in family medicine, internal medicine and ob/gyn Module on Ovary / uterine cancer & genetics Use case based modules – will create web based modules to sit on CDC website How to disseminate & promote

PROGRAMS TARGETING TRAINEES Bright Pink Targeting residency programs in Ob/gyn 4 case study module Cover “risk assessment, stratification & management” Thus far 16 medical professionals trained & 28 facilities scheduled. Goal – over 3 years to have curriculum integrated into 240 ob/gyn residencies nationwide Adaptability to NP and internal medicine trainees??

PROGRAMS TARGETING TRAINEES Dr. Mark Perlman / Deb Duquette / Courtney Benedict- Planned Parenthood 1700 clinicians nationwide – 75% NP and 20-30% Physician / 700 health centers + Affiliates /Broad based geography Train the Trainer program 2.5 hours of e learning courses done prior to in person training In person training done by trainer (Dr. Perlman) includes: Case scenarios Silicone model detection training Breast exam practice on standardized patients

PROGRAMS TARGETING TRAINEES Evaluation ongoing acquisition (use of guidelines, genetics) & change in practice of breast exam. Dissemination Planned Brisk Model being used for identification of women with personal or family history of B/O cancer

PROGRAMS TARGETING TRAINEES Michael Wilkes – UC system E learning program – trainees and practicing primary care physicians Expansion to residency programs in UC system – More information needed

CDC ROLE WITH REGARDS TO TRAINEE PROGRAMS Identify best practices Make materials available Modules produced by planned parenthood Modules produced by Michael Wilkes Brisk tool Others Gather groups working in same areas and foster collaboration & Dissemination

OTHER STRATEGIES: CDC FUNDED PROGRAMS Genomics grants Michigan, Oregon, Connecticut, Utah All 4 have provider education component Looking at novel models to improve provider education CDC to help shape program across all 4 states Representative from these to be invited to our subcommittee. Communication Grants

CDC FUNDED GRANTS & PROVIDER WORKING GROUP Review shared elements vs. innovative components focused on health care providers to avoid duplication of efforts and foster innovation. Assess data being collected to ensure it will be complimentary Discuss dissemination

SURVEY OF PROVIDER EDUCATION & PRACTICE GAPS - TO BE TACKLED- Need exists to survey HCP Areas of interest to survey – general breast health for young women; risk assessment and genetic testing; needs of young breast cancer survivors. Ways to survey: Doc styles; insurers; licensing groups; professional societies Potential use of CDC state grantees