Hartford Hospital Helen & Harry Gray Cancer Center, Hartford, Connecticut

Allows unique participation in program of discovery and innovation - important part of our identity Pillars in NCCCP pilot program are already a valued part of Hartford Hospital’s mission   Community outreach   Research   Information systems   Pathology Optimize our care Why is Hartford Hospital interested in being part of the pilot program?

Why participate in Program? (continued) Contribute to and benefit from important national program Participate in the development of models that other community hospitals might emulate Participate in the development of models that other community hospitals might emulate Health care disparities exist in our community Health care disparities exist in our community Geographically, Hartford is small city. Excess in mortality in certain racial/ethnic groups who only live few blocks away from healthcare facility (Hartford is only 15 square miles – unlike Boston or NY) Geographically, Hartford is small city. Excess in mortality in certain racial/ethnic groups who only live few blocks away from healthcare facility (Hartford is only 15 square miles – unlike Boston or NY) Move disease to an earlier stage or prevent it Move disease to an earlier stage or prevent it

What are the major challenges and opportunities you envision in participating in the pilot? Challenges Challenges  Simple wins already accomplished  Resources needed above those provided by grant  Private practice environment  Busy Cancer Center close to capacity  Collaborations barriers

What are the major challenges and opportunities you envision in participating in the pilot? Opportunities Opportunities  Excitement at HH and in community about NCCCP pilot-new collaborations  Greater awareness of outreach efforts  New staff provides sparks for progress  Sharing best practices with others  Enhanced work with NCI centers  Other grant opportunities

Research Challenges/opportunities o how to incentivize MD’s to participate in trials- o busy offices, documentation, etc., o Cost of operating research office o Recruiting & retention of experienced staff o Keeping data/information updated o Difficulty in identifying pts who might be candidates for studies – 5 satellite offices o Not overloading IRB What “local” factors do you anticipate as influencing these challenges and opportunities?

Information Technology Challenges/opportunities Complexity of multiple systems – integrating applications from various vendors Complexity of multiple systems – integrating applications from various vendors HIPAA compliance HIPAA compliance Opportunity to reduce frequency of asking patients for redundant information Opportunity to reduce frequency of asking patients for redundant information Insure accurate information/data flow Insure accurate information/data flow Insure important patient information is available to all caregivers wherever needed Insure important patient information is available to all caregivers wherever needed

Biospecimen Challenges/opportunities Over 40,000 surgical path & hematopathology specimens received/yr Over 40,000 surgical path & hematopathology specimens received/yr Biospecimen storage – 25 years (minimum legal storage 10 years) Biospecimen storage – 25 years (minimum legal storage 10 years) Efficient triaging of tissue specimens for national research protocols Efficient triaging of tissue specimens for national research protocols Clinical research publications Clinical research publications Opportunity for subspecialty interests including GYN, GU, pulmonary, breast, hematopathology and neuropathology Opportunity for subspecialty interests including GYN, GU, pulmonary, breast, hematopathology and neuropathology

“I’m a Radiation Oncologist not a Molecular Biologist!” Dammit Jim…

Disparity Challenges/opportunities Disparities in outcomes in Hartford Region– Disparities in outcomes in Hartford Region–  African American Women have 1.3 times higher mortality from breast cancer higher mortality from breast cancer  African American men have 2 times higher mortality from prostate cancer Need new ways to reach people/communities Need new ways to reach people/communities Growing number of other cultures living in CT (South America, Bosnia, Asia) will require needs assessment and new approaches Growing number of other cultures living in CT (South America, Bosnia, Asia) will require needs assessment and new approaches

Disparity Challenges/opportunities (Continued) Opportunities for increased collaboration with federally qualified community health centers, coalitions, faith-based, shelters, etc to bring awareness and screening to medically underserved. Opportunities for increased collaboration with federally qualified community health centers, coalitions, faith-based, shelters, etc to bring awareness and screening to medically underserved. Enhance novel outreach methods to bring awareness/screening to community – mobile mammography, barbershop program Enhance novel outreach methods to bring awareness/screening to community – mobile mammography, barbershop program Methods to increase minority clinical trial accrual Methods to increase minority clinical trial accrual

What "extra-local" factors will have an important influence? Access to collaborations with NCI Comprehensive Cancer Centers, other NCCCP pilot sites, and others for whom the door may now be open Access to collaborations with NCI Comprehensive Cancer Centers, other NCCCP pilot sites, and others for whom the door may now be open Clinical research trials related to community. This will enhance our present collaborations with Dana-Farber/Partners CancerCare, Yale, University of Wisconsin Clinical research trials related to community. This will enhance our present collaborations with Dana-Farber/Partners CancerCare, Yale, University of Wisconsin Access to national dialogues on disparities best practices, research accrual methodologies, IS and biospecimen protocols Access to national dialogues on disparities best practices, research accrual methodologies, IS and biospecimen protocols

What "extra-local" factors will have an important influence? Enhance existing valued efforts through new strategies Enhance existing valued efforts through new strategies  CDC BCCEDP  Communications research (CHESS)  Connecticut Cancer Partnership  Prostate cancer awareness-Barbershops  ONS/ONCC  Prevention trials  Patient navigation  Multidisciplinary care and support programs

What is your experience with community (patients) and experience with community providers (physicians)? Programs designed to meet patient and family needs. Programs designed to meet patient and family needs. Multiple site-specific multidisciplinary program models, including breast, prostate, gynecologic, thoracic and neurooncology. Multiple site-specific multidisciplinary program models, including breast, prostate, gynecologic, thoracic and neurooncology. Multidisciplinary care is a hallmark of what our institution has stood for and is engrained in our culture. Multidisciplinary care is a hallmark of what our institution has stood for and is engrained in our culture. Meet MD needs and look for win-win partnerships Meet MD needs and look for win-win partnerships Receive community advice-PBC Community Advisory Board Receive community advice-PBC Community Advisory Board

What is your experience with community (patients) and experience with community providers (physicians)? Long tradition of working with community. Long tradition of working with community.  Development of mobile mammography program  Partnered with The Prostate Net to reach African American men with prostate cancer awareness information through their barbers  CDC special projects grant to extend “Reaching African American Men with Prostate Cancer Awareness Information” to New Haven and Bridgeport, CT.  CHESS research with University of Wisconsin/MD Anderson (free laptop loans to those without them).  Wisewoman, SCOPE, Komen, Avon grants to enhance outreach Physicians support Cancer Program activities, including attendance at tumor boards, medical staff conferences. Physicians support Cancer Program activities, including attendance at tumor boards, medical staff conferences.

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