1. System Director, Oncology Service Line
Oncology Service Line LAPS-U10 Implementation “A Business Case for Improved UCHealth Integration”
W. Thomas Purcell, MD, MBA
System Director, Oncology Service Line

2. Background
NIH/NCI funding for cancer cooperative group trials dramatically changed with introduction of “NCTN” --- National Clinical Trials Network
CU Cancer Center has been leader in SWOG for years in old system (affiliates and numerous silos)
Expectation that we would be leaders in the new “NCTN” as Lead Academic Participating Site “LAPS” participant with UCH, PVHS and MHS as essential clinical components
LAPS U10 Grant submitted in 2012; announced in October ~$675k/yr x 5yrs

3. Geographic Importance to the State and Region
National Cancer Institute
Comprehensive Cancer Center
UCCC
Cancer Center
Comprehensive Cancer Center
2800 new analytical cases / yr
4500 new patients / yr
Patient Referral
Density (UCH)

4. Untapped opportunity for a
distinctive cancer program

5. Competitor Weaknesses – items for UC Health differentiation
Overall care coordination difficult– multiple EMRs
Not ideally suited for multidisciplinary care
Survival rates not published or available
Minimal subspecialty emphasis – most med/rad oncologists are generalists
Positioning for personalized medicine- research for biomarker or molecular targets leading to clinical trial enrollment

6. Putting “the Patient First”
Oncology Service Line
Vision…
Establish UC Health as the nation’s preeminent integrated delivery system for Oncology Services, as evidenced by the highest 5 year survival rates and best patient experience.
Putting “the Patient First”
in Decision Making
To achieve this, the service line must have
complete transparency
common quality/safety metrics
consistent clinical pathways and adherence
outstanding access for patients and physicians
recognized research leader across the world

7. System Director Oncology Region CEO/CMO/COO/CFO
UCHealth Oncology
Service Line –
Org Chart
CMO/ Interim CEO
System Director Oncology
Region CEO/CMO/COO/CFO
South
Oncology Services
Central
Oncology Services
North
Oncology Services
Rob Hoyer
Sloan Mayes
Tom Purcell
Jamie Bachman
Matt Sorensen
JoAnn Lovins
Rob Marschke

8. Operations Joint Operating Committee (JOC) Clinical Integration JOC
Oncology Service Line structure…
To achieve the vision the Service Line will organize by groups that report to a Steering Committee
Administrative Service Line Leader
Physician Service Line Leader
MD - Medical Oncology
MD - Radiation Oncology
Region CEO(s)
Oncology Service Line Steering Group
Operations Joint Operating Committee (JOC)
Clinical Integration JOC
Research
JOC
Maes
Bachman
Lovins
Kellackey
Strategic Planning for each location (local and system approaches)
North, Central, South
Litchtenberger

9. Research JOC
Positioning for LAPS grant implementation March 2014 for cooperative group studies
LAPS is foundation for future “Cancer Research Network” for entire UC Health
Disease program leaders vital for clinical trial prioritization

12. Disease Program Leaders are the cornerstone for system-wide approach
North, Central and South program leaders for each specific disease collaborate on:
clinical operations
research protocol prioritization
quality improvement
EPIC/beacon treatment plans merge / standardization
North Program Leader
Central Program Leaders
South Program Leader

13. Issues…at least some of them!
No UC Health infrastructure for clinical research---- hence RAMP Committee
Integration between School of Medicine and Cancer Center with UC Health
Regulatory cIRB versus local
Funding…. LAPS “cost” ~ $1.3 million per year

14. Differentiating Research Committees and Charges
Establish system-wide policies for health system
Determine processes within health system across service lines
RAMP
Research Administration Management & Planning Steering Committee
Forum for Researchers to bring forward issues
Sounding Board for getting feedback on proposed new processes including the Office of Clinical Research (OCR) initiative on Anschutz Campus
RAF
Research Advisory Forum
Streamline processes within service line
Increase research activity across system
Improve alignment of clinical delivery and research
Service Line JOCs
Model: Oncology Research Joint Operating Committee

15. RAMP---LAPS connection!
4 RAMP Primary Subcommittees:
Compliance; Business & Finance; IT and Operations (all but IT have formed workgroups).
Established a model for the organization of regional infrastructure
Determined responsibilities residing at the regional level vs system level and established framework for workflow
Aligned Oncology Research Pharmacy practices in UC Health
Have roadmaps for alignment of operations across pharmacy and lab services. Working on pathology and radiology services

16. Outstanding priorities to support LAPS
IT Subcommittee / updates to EPIC
Pricing Methodology and standards
Alignment of policies North/South draft policy on IRB of Record with UCD – create agreements as needed
Alignment of North/South Consent/HIPAA standard language with UCD
Agreement on standard CIRB language that will be used across all regions

17. Cancer Tsunami is Coming!

18. Thank You