Insights Series, Issue 29: "Dealing with the “Surge after the Surge"

Insights Series Issue 29 siemens-healthineers.com/ transforming-care-delivery ERGENCY Dealing with the “Surge after the Surge” Key strategies for a successful post-pandemic cancer program A thought leadership paper on how to ‘Optimize cancer care clinical operations‘ co-authored with ECG Management Consultants SIEMENS Healthineers Preface The Insights Series The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. The Series explores emerging issues and provides you with practical solutions to today’s most pressing healthcare challenges. We believe that increasing value in healthcare—delivering better outcomes at lower cost—rests on four strategies. These four principles serve as the cornerstones of the Insights Series. Expanding Transforming Improving Digitalizing precision care patient healthcare medicine delivery experience Our Insights portfolio is an integrated collection of events, speaking engagements, roundtable discussions, and an expanding array of print and digital platforms and products all carefully curated to share ideas, encourage discussion, disseminate original research and reinforce our position as a healthcare thought leader. Please visit siemens-healthineers.com/insights-series Executive summary Years from now, when people look back on the COVID-19 Healthcare leaders have begun talking about the “surge pandemic, they will remember illness and death, they after the surge,” referring to the huge anticipated increase will remember fear, and they will remember staying at in patient volumes, as people begin feeling safer leaving home. Shelter-in-place orders swept the world during home, and safer visiting health providers. The strategies the early days of the pandemic, and that enforced proposed by ECG are designed to help cancer programs isolation had a profound effect. For people living with weather this surge. They are as follows: illness, particularly cancer patients, COVID-19 essentially prevented them from seeking the care they needed to • Prepare clinical operations to accommodate combat the disease. As for people developing cancer for an increase in patient demand while ensuring the first time, in many cases it would be months before patient and staff safety. they would find out. • Develop or maintain strict safety protocols The result of these delays is a pent-up demand for cancer to ensure the safety of patients. services and oncologist appointments—a demand that has already begun manifesting and which will surely • Prepare the clinical and nonclinical workforce increase in the months to come. Cancer programs need to respond to increases in demand. to start planning now for the backlog they know is coming, because their patients will likely need them more than • Update the physical environment to meet current they ever have before. social distancing requirements, while at the same time accommodating additional patient volumes. ECG Management Consultants, a strategic consulting partner of Siemens Healthineers, has a dedicated oncology • Thoughtfully resume clinical research efforts. consulting practice with over 30 years of experience working with cancer programs throughout the world. • Enhance communication with patients, allaying This paper is based on interviews by ECG’s Oncology their fears while also educating them about the risks consulting team with leaders from the from several inherent with delaying treatment. National Cancer Institute (NCI) designated cancer centers across the US.1 The strategies proposed in this paper • Deploy financial management systems by ECG Management Consultants reflect the advice to maximize revenue. from these leaders and can be adapted by cancer care programs everywhere in a post-pandemic world. Siemens Healthineers Insights Series · Issue 29 3 Introduction The effects of the COVID-19 pandemic have been felt Those concerns were borne out, in large measure everywhere. Shelter-in-place orders have kept millions of because many people experiencing the initial symptoms people around the world from leaving their homes, of a new cancer, such as strange pain or discomfort, except to perform necessary tasks such as shopping for either chose not to, or could not, access care. According groceries. Businesses have shut down. Schooling has to a recent study from Spain, 34% fewer lung cancer been affected. The very way people communicate with cases were detected in 2020, compared to 2019 one another has been transformed, possibly forever. pre-COVID-19.3 In the Netherlands, up to 61% fewer skin cancer cases were diagnosed in the early weeks of the From a healthcare point of view, it has been the effect pandemic, compared to the weeks before the first on patients—particularly cancer patients—that has been COVID-19 case was confirmed in the Netherlands.4 the most troubling. Access to care has of course been compromised, particularly in the early months. Healthcare Of course, it was not only new cases that were affected. providers, not to mention their staff and medical devices, The pandemic also disrupted ongoing cancer care and were diverted to battling the pandemic—their attention important follow-up appointments. In the UK, 29% of focused almost exclusively on helping those patients in cancer patients reported that delays, rescheduling and crisis. The promotion of screening programs was paused. cancellations had disrupted their treatment and 6% have had a test, scan or treatment cancelled.5 In addition, many patients simply withdrew. They were afraid of contracting COVID-19, and the last place they Screening was also affected. In the US, screenings for wanted to be was an office or hospital where people breast, colon, prostate and lung cancers decreased by up with the disease were being treated. And so they stayed to 85%, 75%, 74%, and 56% respectively in April 2020.6 away, canceling or postponing visits to their doctors, and Histopathology and cytopathology numbers also fell putting off screening tests. Over the course of much of significantly. In Belgium, one study found that there the pandemic, oncology providers saw a sharp decline in were 72% fewer samples for the laboratory in April 2020 outpatient visits. than there had been in January and February 2020.7 The results of this drop-off in care have been sadly Finally, given the widespread concern over infection and predictable. Early in the pandemic, researchers began people’s reluctance to interact with others, it should be warning of delayed detection of cancer, estimating that the no surprise that clinical trials were difficult to sustain. In time the disease went undiagnosed and untreated could the US, researchers have found that trial activations were lower the cancer survival rate in high-income countries down by 43%.8 Only 14% of European, 20% of American by as much as 10%.2 and 60% of Asian institutions were able to continue enrolling patients in ongoing cancer clinical trials at a rate comparable to before the pandemic.9 What all of this has created is, in effect, a perfect storm of new cancer patients now requiring care, as well as existing cancer patients waiting for the best time to return to their providers. 4 Issue 29 · Siemens Healthineers Insights Series The challenge The Surge after the Surge The expression “surge after the surge” has been creeping into discussions and writings about healthcare recently. 72% fewer samples The first “surge” refers to those stages of the pandemic Laboratory samples in histo- where COVID-19 cases were rising, the number of deaths pathology and cytopathology was increasing, fear was spreading and people—specifically decreased heavily (Belgium).7 patients—were staying home. The second “surge”, of course, refers to the anticipated influx of patients who are suddenly able to access their care providers, and are finally able to venture out to an office, clinic or hospital. There is without question a pent-up demand for cancer This paper is issued by our affiliated healthcare consulting screenings, diagnostic workups and treatments that have firm, ECG Management Consultants, and its Oncology been delayed since the start of the pandemic. As cancer Consulting Practice.1 Through ECG’s work, many cancer programs look to restart operations in the new environ- programs accept as fact that there will indeed be a surge ment, they will have to have plans in place for working after the surge, and that cancer programs that do not plan through what may very well be a backlog of patients. for this will experience problems, as will their patients. ECG’s Oncology Practice interviewed leaders from National Added to this, of course, is the added complication that Cancer Institute (NCI) -designated cancer centers across many existing patients will have cancers that have the US, exploring how they are planning for recovery. advanced in the months they have gone without care. ECG’s Oncology team proposes key strategies in seven A survey has shown that two-thirds of radiation oncolo- critical areas, all designed to help healthcare providers gists report that new patients more often have advanced- and organizations provide oncology services in a post- stage disease at their initial clinic visit.10 pandemic world, and weather the surge after the surge. -85% -56% Breast cancer Lung cancer screenings screenings -75% -74% Colon cancer Prostate cancer screenings screenings Cancer screenings decreased significantly in April 2020 (US)6 Siemens Healthineers Insights Series · Issue 29 5 The solution Key strategies for a successful cancer program recovery Planning for this surge will require cancer program leaders to implement strategies in all of these areas, in order to guide their organizations through a successful recovery, and ensure the safety of patients and staff while providing essential care to cancer patients. Clinical Quality Key strategies for a successful operations and safety cancer program recovery + Financial Research Facilities Workforce Communication performance a 6 Issue 29 · Siemens Healthineers Insights Series Clinical operations Over the last two to three years, many cancer Programs should look for opportunities to expand programs began experiencing the combined effects telehealth services, particularly related to survivorship of aging facilities, growing communities, the clinics, social work support, and clinical pharmacist integration of acquired practices, and the addition of follow-up visits for medication management. newly recruited providers. While the COVID-19 crisis may provide some temporary relief from the Operational debulking: Centers should carefully overcrowding experienced, this will last only until the evaluate clinical practices across the organization to recovery begins. It will be important, in preparation identify opportunities to reduce the number of on-site for recovery, for programs to deploy a number of clinical encounters. strategies to increase their capacity. • Eliminate unnecessary encounters (e.g., physician Telehealth: Most programs rapidly implemented or consultations before each chemotherapy procedure). expanded their use of telehealth during the COVID-19 pandemic. Leaders saw a 100-fold to 1,000-fold increase • Transition encounters to alternate care settings in use of the telehealth platform in March. For many (e.g., oral oncolytics or in-home infusions) programs, the adoption of telehealth services led to a redesign of clinical workflows (e.g., no longer requiring • Reduce the number of encounters required (e.g., hypo- a physician visit before chemotherapy). Telehealth has fractionation for radiation therapy patients). been embraced by many patients and providers and is a logical tool for managing routine follow-up and survivor Surgical alternatives: Facilitate discussions with visits. Leading centers are planning to maintain telehealth medical staff leadership to develop or update clinical as a core service delivery tool, anticipating that 25% to protocols regarding the use of radioembolization, radio 50% of office visits will be conducted remotely. Telehealth frequency ablation, and cryoablation as alternatives services offer both near- and long-term benefits. to surgical procedures. • They increase capacity by allowing the physical center Addressing bottlenecks: Identify operational bottle- to care for more in-person patients while also offering necks in the system (both in the cancer center and in care remotely. upstream/diagnostic service areas) and develop solutions to improve capacity (e.g., extended operating hours, • They improve social distancing by reducing the number increased staffing). of patients in the center. Operating hours: Most of the NCI center leaders are • They create market differentiation, as early results planning to extend operating hours in order to increase from both patients and providers indicate positive their capacity. Centers should develop a clear plan that feedback to virtual visits. addresses factors such as when to implement extended hours, how to staff the clinic, etc. Siemens Healthineers Insights Series · Issue 29 7 Decanting to smaller centers: Many NCI centers are Visitor policy: All the surveyed NCI centers had imple- looking to use their community-based network to decant mented a strict no-visitor policy. While these policies are volume out of the main center. Doing so requires a viewed as being in the patients’ best interests, it was staffing plan, clinical algorithms regarding the appropriate acknowledged that they take an emotional toll and are care locations, and the potential use of telehealth services not very patient-friendly. Although these policies are to augment the provider services in community clinics. currently necessary, centers must evaluate alternative Centers that have begun implementing this strategy report models to support visitors, such as COVID-19 testing, increased patient satisfaction in being able to receive care required use of PPE, or other strategies. The phasing back closer to home. in of visitors will also need to be gated with the pace of recovery and the incidence rate in the community. None- Testing: A key concern is COVID-19 testing protocols theless, centers should monitor this policy vigilantly to for patients and staff. All the leaders recommended ensure that they provide an optimal healing environment. developing a set of policies governing the routine testing of asymptomatic patients and staff. The frequency Social distancing: Policies have been enacted across each of testing will evolve, based on the availability and center to increase social distancing. Examples include: turnaround time for tests; however, the following steps were recommended: • Not collecting copays to minimize the number of patients at reception. • Test all patients before initiating treatment. • Conducting virtual scheduling of new patients • Test patients receiving therapy every two to four weeks. (including collecting all necessary financial information). • Develop protocols for staff testing, although there was • Reducing the number of infusion chairs in operation no consensus regarding the frequency of this testing. to increase the distance between patients. + Extend operating hours Telehealth Decanting to + smaller centers 8 Issue 29 · Siemens Healthineers Insights Series Quality and safety Workforce The post-outbreak period will present a number of 49% of oncology professionals workforce challenges. Programs will need to balance reported that they were unable to do their staffing to meet patient demands with efforts to job at the same standard compared to the prevent burnout among the workforce; specific time before COVID-19.11 78% had concerns for personal safety at work.11 challenges will likely vary by employee category. Increase capacity: Develop plans to scale up staffing, as appropriate, to meet increased patient demand. Given Now, more than ever, quality and safety issues are the physical limitations of each facility, many could find of paramount importance. Cancer centers will simul- this involves moving to extended hours of operation, as taneously seek to adopt new care models and refine most of the center leaders are planning to do. Begin by operational practices to improve patient access and surveying staff to understand their preferences and/or ensure patient safety. However, change creates flexibility for alternative work schedules. With limited day disruption and must be carefully monitored to avoid care options, younger parents may favor work schedules adverse impacts on patients. that allow them to balance child care with their partner. At the same time, evaluate your compensation policies to Infection control: Many programs adopted a variety of ensure that staff are fairly paid and incentivized to infection control policies during the pandemic, such as provide much-needed services. requiring patients to pass a COVID-19 screening, restricting visitors, limiting vendor access, and mandating use of PPE Provider staffing: Evaluate your provider (physician and by patients and employees. Extend these policies for advanced practice provider) staffing model soon. Stress- the foreseeable future in order to ensure a safe, healing test the model to determine how much additional capacity environment for cancer patients. it can absorb, and then begin looking for additional resources to fill any gaps. Also, consider potential changes Guideline relaxation: With an eye to the future, establish in the provider mix and roles (e.g., more advanced practice the criteria and policies that will be used to determine providers working at the top of their license to manage when to relax COVID-19 infection control measures. follow-up and survivorship visits). Programs with a clinical affiliation partner may be able to tap into Triage criteria: Anticipating periods during the recovery additional resources, either to provide in-person care surge when the program is overwhelmed by patient or to support telemedicine visits. demand, develop (or adopt) a set of triage protocols that govern access to services. The triage protocols published by American Society of Clinical Oncology and American College of Surgeons to guide patient management through the pandemic may provide a baseline from which to begin. Siemens Healthineers Insights Series · Issue 29 9 Facilities Preparing cancer care facilities for the post-outbreak This will free up additional office space for clinicians or volume recovery involves readiness for an increase provide an area for positive pressure zone(s). in patient volume while also ensuring patients’ health and safety. Additional space: The combined effect of social distancing and patient volume increases may mean that Maintain distancing measures: Until a vaccine is widely additional office space must be found for consultations. distributed, plan on continuing key safety measures that Begin identifying nearby options now, potentially in the were implemented during the pandemic, such as physical offices of other specialists or clinics that are not projected barriers for reception, decreased seating capacity in to experience a surge in volume. In identifying additional waiting areas, screening stations at entrances, and clinical space, it is important to ensure that spatial and/or similar measures. Distinct egress and circulation for temporal distancing from the non-oncology patients can patients and staff should be defined to minimize risk be achieved and that the spaces will be cleaned and within the building if possible. Doing so will help to maintained in a manner that is similar to the primary prevent the spread of COVID-19 through the center and oncology spaces. reassure patients that their health and safety is of paramount importance. Telehealth space: Given the increase in digital and telehealth care in the industry, additional space for Adjust the air pressure environment: An updated air telemedicine clinicians should be made available. Using pressure environment will help supplement the distancing existing clinical offices on site, with support of the main measures already in place. Establish a positive air oncology staff, could prove valuable. environment to better protect patients from COVID-19 entering their room (or zone). For patients who have Alternative waiting spaces: Evaluate alternative options tested positive for COVID-19, a negative pressure for check-in and patient waiting to avoid large groups of environment should be established, or measures put patients in waiting areas. For example, consider a pager in place, to filter air in exiting rooms or zones housing system that allows patients to wait in their car until the those patients. These spaces should be developed by first provider is ready. Another alternative is to install assessing current conditions, installing room pressure temporary structures (e.g., modular trailers) outside, monitors, and then updating operations of the centralized adjacent to the main building egress point. HVAC system. In general, establishing positive pressure zones is a low-cost measure that can be accomplished Parking: The surge of patient volume may be more than with most existing HVAC systems. Establishing negative the site’s parking was originally planned to accommodate. pressurization usually requires more costly modifications Give top priority to patients needing access close to or adjustments to existing systems. the building’s egress point(s). Short-term solutions that could be implemented quickly include implementing Off-site operations: Consider relocating nonclinical and or expanding shuttle service, leasing additional space, nonessential staff and operations off site from the cancer and/or rezoning staff or physician spaces near the center. center. Doing so will reduce the density of people in the building and support efforts to create spatial distancing. 10 Issue 29 · Siemens Healthineers Insights Series Research As of early May 2020, approximately 10% of clinical Research staff: Cancer centers need to continually monitor research sites remain open to enrollment, as most the workload of the respective study teams. Some may research programs have halted screening and enrolling consider centralizing their clinical research staff to better participants. For ongoing trials, research teams have manage study deployment, while others may create struggled with protocol adherence due to fewer patients dedicated backup teams to manage any staff shortages. and research staff. The good news is that a significant backlog of trials is planned. Cancer centers will be able Blood and tissue samples: Many organizations stopped to continue to serve their patients with novel treat- collecting biospecimens for all patients in the early stages ments; this will be balanced against the need to conduct of the pandemic. Coordinate with infection control to research in a new, post-outbreak environment. It is vital document handling precautions for COVID-19–infected that research efforts be coordinated with previously and noninfected patients. There are typically no additional discussed processes, especially around PPE distribution, handling precautions for noninfected samples; however, infection control, and facilities management. biospecimens from COVID-19 patients should have clearly documented procedures around collection, processing, Virtual studies: Research participants are hesitant to and disposal. travel to their health systems for care. This has forced research teams to implement and expand telehealth, mobile nursing, and other remote monitoring tools throughout the pandemic. While there are few clinical oncology studies that can be fully managed in a virtual format, investigators and research teams should continue Less patients were enrolled to embrace remote consent, telehealth, remote patient into ongoing clinical trials.9 care, and mobile nursing visits with research participants. Sponsor management: Providers report continued Institutions reported the rates at which they enroll challenges with protocol modifications due to the pandemic patients in ongoing clinical trials. that are starting to lighten up as the entire industry adapts to the need for flexibility in contracting, site visits, and drug distribution. Clinical research administration must docu- USA Europe ment, by sponsor, their respective protocol modifications 20% 14% and make this information available to study teams. 20% 86% 60% Study management: Protocol deviations will continue to be a concern, as research participants may be reluctant to fully comply with their scheduled visits. Research teams must continue to fully document whether these constitute Asia minor or major protocol deviations, with any major 60% Yes, same rate as usual deviations being reported per organizational protocol 20% Yes, but at a lower rate to the appropriate IRBs. 20% No enrollment Siemens Healthineers Insights Series · Issue 29 11 Which information matters for cancer patients?12 Communication Importance and satisfaction level of respondents relating to information received about care and its implications. Chemotherapy Communication with patients is vitally important, now 4.51 4.11 more than ever. For months, patients have seen images on television of overwhelmed hospitals, and many Clinical Trials 4.49 are avoiding healthcare services for fear of being at 4.09 an increased risk of exposure to COVID-19. However, Hormonal therapy for cancer patients, these fears may place them in 4.49 greater danger for an unfavorable outcome from 4.16 their disease. Now is the time for cancer programs Surgery to proactively begin a dialogue with their patients. 4.49 4.05 Education: Providers should educate patients about local Tests and investigations developments in the community and how these impact 4.48 4.07 their treatment. Financials 4.44 Safety: Patients need to understand that providers are 3.64 taking their safety seriously. Communication to patients Overall experience should highlight the various safeguards put in place 4.41 to protect them, such as those highlighted above. 4.03 Diagnosis Risks: Providers also need to make certain that patients 4.39 fully understand the risks inherent with delays in treatment. 3.93 For cancer patients, this is a key concern—delays in Radiation therapy treatment may result in a more advanced disease and/or 4.35 4.04 may affect the type of therapy they receive. Supportive care 4.1 Compassion: Cancer is a scary and emotional journey for 3.33 patients. Providers should seek to engage with patients Psychosocial aspect of care to understand their fears and concerns as a treatment 3.88 plan is being formulated. In certain cases, the care team 3.53 may consider alternative treatment pathways, such as the Sexual aspect of care use of neoadjuvant therapy, to navigate these challenges. 2.99 By empowering patients to have a role in establishing 3.29 their treatment plan, providers can better address 1 2 3 4 5 patients’ psychological needs while treating their physical Importance level Satisfaction level needs, thereby keeping them engaged with their therapy. 1 = not important 1 = very dissatisfied 2 = slightly important 2 = dissatisfied 3 = neutral 3 = neither satisfied 4 = important nor dissatisfied 5 = very important 4 = satisfied 5 = very satisfied 12 Issue 29 · Siemens Healthineers Insights Series Financial performance One of the most significant challenges of COVID-19 is • For contracts that are currently being negotiated, the financial strain it places on programs. During the toughen the negotiation stance if possible and take height of the pandemic, programs have likely been advantage of the fact that payers are likely to be operating at reduced revenue levels. This will be in a favorable financial position. followed by periods of volume growth, although the payer mix will likely be less favorable than before. • Negotiate with payers to extend or expand telehealth Many patients may transition to government plans coverage models that were implemented during the (Medicare or Medicaid), an exchange product, or have pandemic. Seek especially to preserve telemedicine no insurance after losing private insurance that was rate parity with facility-based services. tied to their jobs. Financial navigation: Recognizing the financial challenges Programs need to develop a holistic financial improvement that many patients may be facing, develop or expand your plan, complete with scenario modeling and quantification financial navigation program by increasing the number of potential tactics, as soon as possible to understand of dedicated FTEs. available tactics, their financial impact, and potential strategic implications. Strategies to include in such Accounts receivable (A/R): The irregular distribution a financial improvement playbook can be found below. of patients created unique challenges from a cash flow and A/R perspective. In preparation for the recovery surge, Payer strategy: Begin key conversations with payers early. add support for A/R functions, either by staffing up in this Conversations with the NCI center leaders indicate that department or by seeking short-term vendor support. most have yet to begin these efforts. Given the potential competition for limited skilled resources, develop a solution early, before costs increase. • Identify alternative payment constructs that support changes to the care delivery model discussed above Expense management: Look for creative ways to reduce (e.g., shorter course therapy, oral chemotherapy). costs and eliminate waste, such as the consolidation of regional programs or termination of underperforming • Explore potential development of value-based programs or services. Given the potential lead time to payment models that may generate additional income implement these strategies and the expense management for the practice. efforts already under way, this is unlikely to be a primary strategy for most programs. • Identify potential areas of assistance that payers are offering (e.g., accelerated or advanced payments) and Capital investments: Operational decanting and debulking enroll in these programs. strategies should create considerable capacity that will likely endure beyond the period of COVID-19. Centers may find that this virtual capacity enables them to delay potential capital investments that would otherwise have been required to expand physical capacity. Siemens Healthineers Insights Series · Issue 29 13 Conclusion The COVID-19 pandemic had a compounding effect on The strategies proposed in this paper by ECG Management patients suffering from serious illness or disease, as Consultants reflect the advice from leaders in cancer care cancer patients now know only too well. In many cases, in the US, and can be adapted by cancer care programs they had to deal with the pain and discomfort of a terrible everywhere. Without question, providers must begin disease, with little or no relief from their doctors or planning now for the surge in demand from patients that hospitals. In addition, they dealt with the stress and worry they know is coming, and that has in fact already begun. of knowing that they were suffering from a disease that A comprehensive recovery plan, adapting the strategies grows and spreads if it is not treated, hoping against outlined above, will ensure that the necessary resources hope that they would be able to access care before their are in place to maintain support for the cancer patients cancer had spread too far. who need care. The plan will need to encompass the care delivery model, operational requirements, financial impli- Cancer programs must make it a priority to give their cations, and near- and long-term strategic considerations. patients the attention they have gone without for so long. Because it is certain that patients will be coming back. In For people in the best of circumstances, the pandemic has many countries, there is already an increase in outpatient been a stressful and trying time. For cancer patients, it visits. Studies in the US showed a rise in cancer screening has been a physical and emotional ordeal. There is nothing and testing for the time from September to the beginning that can be done to get them back the time they have lost, December 2020 that exceeded the numbers seen before but with the right strategies in place, their providers can the pandemic.13 In the UK, the NHS has experienced begin preparing them for the future. a record high of urgent suspected cancer referrals since March 2021, and aims to reduce waiting times to pre- pandemic levels by March 2022.14 The challenge is clear, and while it is daunting, it can be overcome. 14 Issue 29 · Siemens Healthineers Insights Series Suggested follow-up on siemens-healthineers.com/insights/ transforming-care-delivery • Insights Series, Issue 19: Unlocking the Digital Front Door: How healthcare can be made more accessible. Available at: siemens-healthineers.com/ insights/news/unlocking-the-digital-front-door • Insights Series, Issue 7: Do one thing, and do it better than anyone else. Available at: siemens-healthineers.com/ insights/news/martini-klinik-specialization- optimization.html • Insights Series, Issue 5: Reducing the fear and anxiety associated with breast cancer screening. Available at: siemens-healthineers.com/insights/ news/redesigning-patient-experience.html i Information: The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. It explores emerging issues and provides practical solutions to today’s most pressing healthcare challenges. All issues of the Insights Series can be found here: siemens-healthineers.com/insights-series Contact: For further information on this topic, or to contact the authors directly: Matthew Sturm Principal at ECG Management Consultants msturm@ecgmc.com Jessica Turgon Principal at ECG Management Consultants jturgon@ecgmc.com Dr. Herbert Staehr Global Head of Transforming Care Delivery staehr.herbert@siemens-healthineers.com Siemens Healthineers Insights Series · Issue 29 15 About the authors Matthew Sturm Jessica Turgon Principal Principal at ECG Management Consultants at ECG Management Consultants Matt is co leader of ECG’s Oncology Services practice. Jessica co leads our Oncology Services practice and has Utilizing more than 17 years of experience, he assists clients more than 20 years of experience in coaching and advising with developing and expanding their oncology programs oncology leaders at health systems and within service through improved clinical coordination, enhanced lines, at oncology practices, and at NCI-Designated physician leadership, and increased clinical capabilities. Cancer Centers. Jessica understands the challenges that Matt has established a track record of developing cancer programs and patients face, and she is driven to innovative solutions to complex problems and focused his help clients realize transformative cancer care in their career on improving access to high-quality clinical care, communities. Whether it is connecting patients through especially for those with life-threatening conditions. new digital tools or advising clients on the programmatic To this end, he works with health systems to create changes to improve tumor site–specific care models, enhanced, sustainable, and comprehensive care delivery Jessica delivers data-driven decisions with an understanding models. Matt has completed nearly 130 oncology-related of the change management and implementation actions engagements with over 70 clients. He views every required. Clients, both at academic centers and community oncology project as an opportunity to aid in the war programs, have successfully realized strategic objectives on cancer; his technical expertise, relentless drive, and through Jessica’s and her team’s advisory services, collaborative approach yield enduring benefits for the including market expansion, recruitment of top-tier clients and organizations he serves. Matt’s work has researchers and clinicians, NCI designation, and financial included developing strategic plans, providing support in sustainability. She is a national speaker on cancer topics launching new clinical modalities, and assisting programs related to performance improvement, advanced payment with growth and expansion opportunities through methodologies, patient access and engagement, and acquisition and partnership. He has also helped several strategic marketing positioning. She coauthored Oncology: leading cancer centers pursue NCI comprehensive Strategies for Superior Service Line Performance, a book designation and develop new or expanded services. published by HealthLeaders Media. Prior to joining ECG, Recently, Matt worked with an NCI center to develop a she spent almost 10 years leading cancer programs at regional growth strategy that enabled the organization to academic medical centers. provide care to more patients and expand the reach of its clinical research enterprise. The strategy involved a combi- nation of opening new greenfield sites, collaborating with other healthcare organizations, and acquiring existing oncology providers. In addition, Matt also regularly speaks at industry conferences and has authored pieces on current trends in oncology for leading publications. 16 Issue 29 · Siemens Healthineers Insights Series Meagan O’Neill Senior Manager at ECG Management Consultants Blending her policy background and analytical expertise, Meagan helps clients take advantage of opportunities in ECG Management Consultants their markets to improve the delivery of healthcare. Meagan’s experience with strategic initiatives across the ECG specializes in providing consulting assistance to leading healthcare providers across the U.S. healthcare industry helps her clients gain a comprehensive In November 2019, ECG entered into a partnership understanding of the issues they encounter and identify agreement with Siemens Healthineers, the global leader actionable and lasting solutions. Meagan has nearly in medical technology and digital health transformation. ECG has a dedicated group of Oncology Consultants, 10 years of experience working in consulting and project dedicated to the work of improving cancer care and management for healthcare organizations. At ECG, Meagan performance. This team has worked with more than assists providers with strategic and financial planning on 1,000 cancer centers, hospital, health systems and oncology practices to enhance strategies, improve initiatives related to service line development, organiza- performance, and expand access to value-based cancer tional restructuring, and business and affiliation planning. care. As an independent affiliate, ECG collaborates with Meagan’s detailed understanding of key service lines, the Siemens Healthineers’ global enterprise services practice, providing subject matter expertise, smart combined with her systems-level work on broader strategic counsel, and pragmatic solutions. initiatives, enables her to approach the complexities of program planning from a health system viewpoint. Meagan is an emerging leader in the firm’s Oncology practice and has led dozens of oncology engagements spanning a broad range of project types, including planning, affiliations, transactions, physician alignment models, and financial analysis. She is passionate about helping cancer organi- zations navigate the challenges of a rapidly evolving field and evaluate opportunities that will ultimately lead to more sustainable and successful programs. Siemens Healthineers Insights Series · Issue 29 17 Dr. Herbert Staehr Dr. Ralf Meinhardt Vice President Senior Global Marketing Manager Global Head of Transforming Care Delivery at Siemens Healthineers at Siemens Healthineers Ralf Meinhardt leads Siemens Healthineers’ thought Herbert Staehr serves as Global Head of Transforming Care leadership activities related to Transforming Care Delivery. Delivery for Siemens Healthineers, driving the company’s Previously, Ralf worked in the pharmaceutical industry, as activities and messaging around delivering high-value care. well consulting and scientific research. Ralf holds a Doctor In this capacity, he develops and executes programs and of Economics and Social Sciences degree from the outreach strategies aimed at healthcare providers around University of Erlangen-Nuremberg. He also holds a Master the world, as well as stakeholders in every branch of the of Science degree in Management as well as a Bachelor of healthcare industry. Before joining Siemens Healthineers, Arts degree in Business Administration. In addition to his Herbert spent several years with one of Germany’s leading academic work at the University of Erlangen-Nuremberg, private hospital groups, as head of the Corporate Develop- he also studied at the Indian Institute of Management, ment department and serving as Managing Director of Bangalore (IIMB). His scientific background is in the field an acute care and a post-acute care hospital in Germany. of corporate strategy, a subject on which he has authored He also spent several years with McKinsey & Company several publications. with their healthcare practice, providing strategic advice to a wide range of international clients. Herbert holds a doctorate in Healthcare Economics from the University of Hohenheim. 18 Issue 29 · Siemens Healthineers Insights Series References 1. Sturm M, Turgon J. After the Outbreak: 7. De Pelsemaeker MC, Guiot Y, Preparing for the Return of Cancer Cases. Vanderveken J, Galant C, Van Bockstal MR. 13. Labaki C, Bakouny Z, Schmidt A, ECG Management Consultants 2020; The Impact of the COVID-19 Pandemic Lipsitz SR, Rebbeck TR, Trinh QD, et al. Available from: ecgmc.com/thought- and the Associated Belgian Governmental Recovery of cancer screening tests and leadership/articles/after-the-outbreak- Measures on Cancer Screening, Surgical possible associated disparities after the preparing-for-the-return-of-cancer- Pathology and Cytopathology. first peak of the COVID-19 pandemic. cases Pathobiology. 2021;88(1):46–55. Cancer Cell. 2021;39(8):1042–4. 2. The Lancet Oncology Editorial. 8. Unger JM, Xiao H. The COVID-19 14. NHS England. 2021/22 priorities and Safeguarding cancer care in a post- pandemic and new clinical trial operational planning guidance: October COVID-19 world. Lancet Oncology. activations. Trials. 2021;22(1). 2021 to March 2022. 2021. 2020;21(5):603. 9. Upadhaya S, Yu JX, Oliva C, Hooton M, 3. Escola-Verge L, Cuervo G, De Alarc A, Hodge J, Hubbard-Lucey VM. Impact Sousa D, Barca LV, Fernaandez-Hidalgo of COVID-19 on oncology clinical trials. N. Impact of the COVID-19 pandemic Nature Review. Drug Discovery. on the diagnosis, management and 2020;19(6):376–7. prognosis of infective endocarditis. Clinical Microbiology Infection Journal. 10. American Society for Radiation 2021;27(4):660–4. Oncology (ASTRO). Results of a national physician survey by the American Society 4. Dinmohamed AG, Visser O, Verhoeven for Radiation Oncology (ASTRO) RHA, Louwman MWJ, Nederveen FH van, Overview Key Survey Findings. 2021. Willems SM, et al. Fewer cancer diagnoses during the COVID-19 epidemic in the 11. Banerjee S, Lim KHJ, Murali K, Netherlands. Lancet Oncology. Kamposioras K, Punie K, Oing C, et al. 2020;21(6):750–1. The impact of COVID-19 on oncology professionals: results of the ESMO 5. Macmillan Cancer Support. Resilience Task Force survey collaboration. The Forgotten “C”? The impact of European Society for Medical Oncology. Covid-19 on cancer care. 2020. 2021;6(2):1–10. 6. Patt D, Gordan L, Diaz M, Okon T, 12. Chua GP, Tan HK, Gandhi M. What Grady L, Harmison M, et al. Impact of information do cancer patients want COVID-19 on Cancer Care: How the and how well are their needs being Pandemic Is Delaying Cancer Diagnosis met? Ecancermedicalscience. and Treatment for American Seniors. 2018 September 25;12:1–16. JCO Clinical Cancer Informatics. 2020;(4):1059–71. Siemens Healthineers Insights Series · Issue 29 19 At Siemens Healthineers, our purpose is to drive innovation to help humans live healthier and longer. Through our products, services and solutions we help physicians, medical staff, and healthcare providers prevent illnesses from occurring and to correctly diagnose and determine siemens-healthineers.com/ the right treatments for people who do become ill— insights-series resulting in fewer complications, shorter hospital stays, and faster patient recovery. Our mission is to enable healthcare providers to increase Did you enjoy the read? Make sure to subscribe to value by expanding precision medicine, transforming our newsletter to always receive the latest thought care delivery, improving the patient experience, and leadership insights. digitalizing healthcare. With our comprehensive portfolio— from in-vitro diagnostics and imaging to therapy and All issues of the Insights Series can be found here: siemens-healthineers.com/insights-series follow-up care—we address the complete care continuum for many of the world’s most threatening diseases. Every hour, more than 240,000 patients are touched by technologies provided by Siemens Healthineers. We are at the center of clinical decision making with almost three-quarters of all critical clinical decisions influenced by our solutions. We are a leading medical technology company with over 120 years of experience and more than 65,000 highly dedicated employees around the globe who are innovating every day, truly shaping the future of healthcare. 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