1. Sanford USD Medical Center Sioux Falls, SD Becky Nelson, Senior VP & COO Health Service Operations Sanford Health

2. Motivation to Participate in the NCCCP Pilot Project Improve cancer care to all patients in our region Expand multidisciplinary care to additional tumor sites Formalize survivorship care Increase access and accrual to clinical trials Develop patient navigation Develop our national network within NCI

3. Additional Benefits to Participation Further define our own biospecimen and tissue banking initiative Demonstrate value of investment in EMR Increase exposure of Sanford to National Healthcare Scene Further develop integrated system for cancer care Leverage knowledge gained to other Centers of Excellence

4. Our Disparate Population: Rural and Frontier Population density 9.9 per sq mi Distance to tertiary care and multi-specialty physicians 20% Age 65+ Economically disadvantaged

5. Our Disparate Population: Native American Geographically Isolated Distribution of Medical Services Poverty Cultural Barriers Low cancer screening rates Low compliance with treatment regimens High cancer mortality

6. Major Opportunities Integrated Health System Sanford Health Sanford USD Medical Center –Flagship Tertiary Care Center Sanford Clinic –375+ physicians at 115 Clinics Sanford Health Network –24 hospitals, 13 nursing homes, 27 home health programs, 19 pharmacies Sanford Health Plan –45,595 enrolled members in 39 states Sanford Health Foundation –$400+ million in assets, 350 named endowments

7. Major Opportunities Sanford Initiatives Medical School Affiliation –Sanford School of Medicine at the University of South Dakota Strength of Pilot Core Group

8. Major Opportunities Cont. Well developed cancer program –9-16% accrual rate to clinical trials –Lung/Thoracic Tumor Clinic –Certified Genetics Counselors State of the art technology for cancer diagnosis and treatment –da Vinci Surgical Robots, Novalis LinAcc, PET/CT One of the largest breast centers –40,000 procedures annually

9. Major Opportunities Cont. Established relationship with Mayo Clinic through North Central Cancer Treatment Group Lead organization of regional Community Clinical Oncology Program Active Children’s Oncology Group and Gynecologic Oncology Group participation Participation in Statewide cancer awareness, prevention and screening initiatives Collaboration with basic research

10. Major Challenges of the Pilot Low screening rates –Colorectal rate among SD Medicare pop: 8% –Native American women 50+ years clinical breast exam and mammogram incidence: 39.4% over 2 year period Distance to medical services Engaging non-Sanford physicians

11. Major Challenges Cont. Qualified health care staff in rural and IHS Rural farm family culture Native American culture Funding –Pilot Project –Services delivered Interface and integration of stand alone electronic systems for healthcare Cancer specific physician credentialing and education

12. Sanford USD Medical Center