Carolinas Health cancer center finds success in decentralizing patient care

Though integration and consolidation are the norm in today’s healthcare industry, providers that decentralize their approach to specialty care may do a better job of meeting patient needs.

Carolinas HealthCare System’s Levine Cancer Center found success after taking that path, according to a NEJM Catalyst post written by Andrew M. Ibrahim, M.D., Robert Wood Johnson Foundation clinical scholar at the University of Michigan’s Institute for Healthcare Policy and Innovation, and Justin B. Dimick, M.D., director of UM’s Center for Healthcare Outcomes and Policy.

Levine tackled decentralization in four prongs:

• Sharing expertise: Many of the doctors working in the center were general oncologists but had developed their own specialty areas, according to the blog. Physicians were encouraged to make care pathways for specific types of cancer that reflected their clinical experience. This experience helped better guide primary care providers when caring for cancer patients.
• Spreading out: Some patients may face significant travel times for specialty care, and distance is a major barrier to care for many. Levine spread out more common procedures and clinical trials to more locations, allowing more patients to participate easily.
• Improving care coordination: Levine hired patient navigators to help patients find follow-up care closer to home if they were treated at a central Levine clinic, according to the blog. The center also invested in telehealth to improve communication between providers.
• Embracing collaboration: Leaders at Levine actively promoted a culture of collaboration among staff members. They also distributed oncology leadership across sites to further emphasize the need to work together.

Though Levine Cancer Center found success with decentralization, Ibrahim and Dimick note that most providers will likely need to embrace an approach that incorporates both consolidation and decentralization. They predict that large providers particularly will embrace decentralization to reach more patients.