Meena Pai M.D. Sharon Singleton R.N.

Transcription

1 ANNUAL CANCER REPORT 2016 KAISER PERMANENTE SAN JOSE MEDICAL CENTER Meena Pai M.D. Sharon Singleton R.N. THE PERMANENTE MEDICAL GROUP COMMISSION ON CANCER COMMITTEE DECEMBER 2016

2 2 OUR MISSION IS SIMPLE: Support our specialists in providing the best in personalized cancer care. Kaiser Permanente s integrated health care system brings together a team of specialized physicians and cutting-edge technology to provide each patient with the best in personalized cancer care.

3 Cancer Care Achievements Integrated Approach to Cancer Care..5 Commission on Cancer Accreditation...7 Kaiser Permanente s Cancer Research Paves the Way for Improved Outcomes..9 Trends in Cancer Diagnosis..10 Program GOALS Appendix..12 Breast Cancer Survivorship and Wellness Program...15 OUR COMMITMENT to Patients Cancer care touches our lives both professionally and personally. It is a top priority at Kaiser Permanente. All of our physicians work on cancer in one way or another whether to prevent it, detect it early, treat it when we find it, care for the survivors, or comfort those who may pass away as a result of the disease. We ve made huge strides and continue to challenge ourselves through our commitment to every patient. OUR WORLD-CLASS Cancer Care Team Includes: In the Community Above and Beyond.18 When Patients Ask, We Listen..21 Experienced specialists who treat high volumes of patients Support at every step of care: risk reduction, screening, diagnosis, treatment, and survivorship Seamless and timely care coordination Cutting-edge technology Patient-centered care Our specialists work collaboratively to ensure world-class cancer care treatment and outcomes for every patient, by leveraging our expertise, investing in cuttingedge technology, and pushing the boundaries of what s possible. Please note that this report published in December 2016 contains events that may have occurred during The cancer registry data relates to 2015 and earlier, however. 3

4 4 Cancer Care Achievements Cancer care is complex. We simplify screening, diagnosing, and treating patients with cancer through our integrated approach to care.

5 INTEGRATED Approach to Cancer Care As one of the largest integrated health care systems in the United States, we can quickly adapt to advances in treatment. We bring those benefits to our patients every day to perform thousands of treatments each year. At the same time, we create truly transformational innovations. Both rapidly adapting and developing new advancements is only possible by leveraging our specialists knowledge from many disciplines and medical centers linked together by our electronic health record system. We continuously weave advancements in equipment and techniques with each patient s medical history, preferences, and unique needs. This means we can automatically review incidental findings, such as a thoracic imaging study that can be reviewed by various experts. This process facilitates rapid and consistent follow-up on unexpected cancer discoveries at imaging. Our expert care team will work together to: Review newly flagged cases Meet with each patient to discuss next steps, treatment options, and personalized care recommendations It is the same as getting a second, third, and fourth opinion at the start of the process. Our integrative approach to care also allows us to apply the most effective screening protocols to save more lives, such as using universal reflex genetic testing for Lynch Syndrome of all newly diagnosed colorectal cancer patients. Our multispecialty physician team will: Recommend multiple ways to provide patientcentered care Bring cutting-edge treatment to patients This multidisciplinary approach is distinctive of our medical group and doesn t exist in the fragmented fee-for-service health care sector. We re able to standardize the best possible care, giving our patients their best chance to beat cancer. 5

6 6 CANCER CARE represents a large portion of our work at Kaiser Permanente. Only heart disease affects more people than cancer in the United States, and the number of cancer cases is quickly growing to surpass heart disease soon. We have an opportunity that other health care systems may not to change that trajectory. The Commission on Cancer provides a foundation to focus on key quality care standards and our cancer program can lead this change.

7 COMMISSION on Cancer Accreditation There are more than 1,500 Commission on Cancer (CoC) accredited cancer programs in the United States, representing only 30 percent of all hospitals and treating more than 70 percent of all cancer patients. All Kaiser Permanente facilities are accredited or pursuing accreditation. To earn this prestigious accreditation, a cancer program must meet or exceed 34 quality care standards, be evaluated every 3 years, and maintain levels of excellence in the delivery of comprehensive patient-centered care. When cancer patients seek care at a CoC-accredited cancer center, they gain access to comprehensive, state-of-the-art cancer care close to home. Kaiser Permanente takes this one step further. Our integrated health care system allows for true multidisciplinary, end-to-end care, and treats cancer as a complex group of diseases treated by a team of specialists. Because of this approach, patients have access to clinical trials, new treatments, genetic counseling, and patient-centered services, including psychosocial support, patient navigation, and a survivorship care plan. We improve our patients quality of life both before and after cancer. These integrated partnerships result in improved patient care. 7

8 8 Clinical Trials Matter to Us We re proud to offer cancer patients access to cutting-edge treatment through participation in clinical trials. 8

9 Kaiser Permanente s Cancer Research Paves the Way for Improved Outcomes We re recognized for participating in numerous clinical trials with national and international research organizations. All of our medical and radiation oncologists are investigators on our cancer research team. There are more than 70 clinical trials available to patients at any given time. Because of this, we offer patients access to cutting-edge treatment options and research in symptom management, screening, and prevention. In 2014, Kaiser Permanente was awarded a 5-year grant of 10.4 million dollars from the National Cancer Institute (NCI) to conduct cancer clinical trials and cancer care delivery research studies. We joined 4 other Kaiser Permanente Regions to form an NCI Community Oncology Research Program (NCORP). This new program represents 1 of every 40 patients in the United States and continues to bring cutting-edge treatment options to our patients while comparing existing cancer treatments on a patient-by-patient basis. The new funding will allow Kaiser Permanente to expand its focus on research into care delivery by: Evaluating alternative treatment delivery systems Examining disease prevention Exploring pain and symptom management Investigating disparities in cancer outcomes and how to eliminate them 9

10 TRENDS in Cancer Diagnosis The cancer registry is an essential component of the Commission on Cancer (CoC) accredited cancer program and an invaluable tool in the fight against cancer. Like all CoC-accredited facilities, Kaiser Permanente maintains a cancer registry and contributes data to the National Cancer Database (NCDB). This nationwide oncology outcomes database is the largest clinical disease registry in the world. All types of cancer are tracked and analyzed through the NCDB and used to explore trends in cancer care. CoC-accredited cancer centers, in turn, have access to information derived from this type of data analysis, which is used to create national, regional, and state benchmark reports. Our cancer registry data aids in identifying trends, assists in program planning, and allows our continuous evaluation of cancer care. Specialists at this hospital interface with patients throughout our system. Our specialists experience within the system is summarized in Table

11 Table 1. Kaiser Permanente, Northern California Region All Cancer Cases Diagnosed : All Behaviors, All Stages Leading Diagnoses by Year of Diagnosis (Ranked for 2015 Diagnoses) SOURCE: Kaiser Permanente Northern California Cancer Registry (08/22/2016) 12 11

12 Table Kaiser Kaiser Permanente, Permanente, Northern California San Jose Region Medical Center All : All Behaviors, All Stages Cancer Leading Diagnoses Cases bydiagnosed Year of Diagnosis (Ranked for 2015 Diagnoses) by Site and Year of Diagnosis SOURCE: Kaiser Permanente Northern California Cancer Registry (08/22/2016) 13 11

13 San Jose San Jose San Jose Some photos may include models and not actual patients. 2016, TPMG, Inc. All rights reserved. Regional Health Education (Revised 9/16) 14 17

14 Program GOALS Breast Cancer Survivorship and Wellness Program Our program goal for 2016, was the Breast Cancer Survivorship and Wellness Program. The aim is to establish a clinic where our breast cancer survivors can be followed after their diagnosis and treatment. Patients face many challenges to survivorship. Recognizing these challenges and discussing them is important. In the Breast Cancer Survivorship and Wellness Program, patients are seen in the clinic on a regular basis for their care and follow up; education and resources are provided to assure not only surveillance for their cancer but continuing to promote their health in many ways. The care team consists of Grace Daun, who is an oncology nurse practitioner, and patient s oncologist working with their primary care physician to address their survivorship needs and many aspects of their health and well being. Grace Daun is our Nurse Practitioner who follows our patients in the Breast Cancer Survivorship clinic. She has a Bachelor of Science in Nursing degree from UCLA. She obtained her Master of Science in Nursing and Family Nurse Practitioner (FNP) from Duke University. She is certified as an advanced oncology nurse practitioner by the Oncology Nursing Society and as a family nurse practitioner by the American Nurse Credentialing Center (ANCC). She is also the president of the local chapter of the Oncology Nursing Society. Apart from her credentials and 13 years of work in the Oncology Department at Kaiser Permanente San Jose, her patients love her sunny disposition, caring and compassionate ways. She is driven by her true desire to be part of their healing to attain their best health. 15

15 Our annual Seeds of Hope Cancer Survivors Day Celebration and Conference was held on June 12, 2016 at the Kaiser Permanente San Jose Medical Center that focused on Total Lifestyle Survivorship. Our keynote speaker was the Director of Integrative Oncology at MD Anderson Cancer Center, Dr. Lorenzo Cohen. The event highlighted integrating modern cancer treatments with healthy lifestyle practices that promotes total well-being in mind, body and spirit. There were four lecture series on Nutrition, Physical Activity, Sleep and Stress Reduction and a session on Hereditary Cancer Risks. There were twenty educational booths on cancer screening information, lifestyle prevention booths, information on cancer and the environment and community partners and resources. Twelve activities included ones that help people to increase their activity such as Dance 4 Healing and Zumba, and opportunities to try relaxing activities such as Restoration Yoga, Reiki, Massage, Mindful Meditation, and Tai Chi. 16

16 The KP San Jose Relay For Life Survive and Thrive Team joined the Blossom Valley community on May 21, 2016 and raised funds that help fuel the mission of the American Cancer Society on community programs and services to help people with cancer and their families. KP San Jose Medical Center and Santa Clara collaborated on a joint partnership at the Relay For Life on August 6, 2016 held in Eastridge Center Shopping Mall Center Court. It was an indoor event that raised funds to fight cancer and to increase awareness of the importance of Colorectal Cancer Screening especially in the Latino community. Both KP San Jose and Santa Clara once again joined the American Cancer Society at the Making Strides Against Breast Cancer of Silicon Valley on October 29, to raise money for the breast cancer research to better understand, prevent, find and treat the disease. Spanish language Fecal Immunochemical Test (FIT) kits, Fotonovela and Spanish language brochures on Colon Cancer prevention and screening were available. 17

17 ABOVE and BEYOND: JoAnn Bergoffen, MD As the recipient of The Permanente Medical Group 2016 Sidney Garfield Exceptional Contribution Award, Dr. Bergoffen, who is the Chief of the Genetics Department at Kaiser Permanente San Jose, worked with a multidisciplinary team to establish a systematic Lynch Syndrome Screening Program by reflex genetic testing of all newly diagnosed colorectal cancer patients. Lynch Syndrome is a genetic condition whose carriers have a high lifetime risk of colorectal cancer up to 80% compared to 6% in the general population and are at risk for other types of cancer as well. Studies have shown that early diagnosis of Lynch Syndrome followed by proactive management saves lives. Because the condition may be prevalent among relatives, detection is critical to protecting their lives too. The Lynch Syndrome Screening program has been valuable in identifying patients with this condition. When we identify a patient with Lynch Syndrome, we can also provide potentially lifesaving information to their at-risk family members. As a geneticist, this means the world to me. JoAnn Bergoffen, MD 18

18 ABOVE and BEYOND: Daniel Jacobs, MD 2016 Award For Outstanding Achievement In Medicine by the Santa Clara County Medical Association Dr. Daniel Jacobs is the Chief of General, Vascular, and Plastic Surgery at Kaiser Permanente San Jose Medical Center. The Award for Outstanding Achievement In Medicine is given to a physician member of the Medical Association who, during his/her medical career, has made unique contributions to the betterment of patient care, for which he/she has achieved widespread recognition. Consideration is given to research and/or the development of procedures, methods of treatment, pharmaceutical agents, or technological advances in the field of medicine Under the leadership of Dr. Jacobs, surgeons at Kaiser Permanente San Jose began using new technologies in breast reconstruction. Apart from cosmetics and reconstruction what drives Dr. Jacobs is knowing he has improved a patient s quality of life and contributed to a person s well being. 19

19 ABOVE and BEYOND: Plastic Surgery Kaiser Permanente San Jose Under the leadership of Dr. Jacobs, Plastic Surgeons at Kaiser Permanente San Jose began using new technologies in breast reconstruction. For the last 40 or so years, breast reconstruction following mastectomy has been performed according to the standard of putting the implants under the muscle. The pectoralis major muscle is divided along its origin next to the sternum in order to raise the muscle and make room for an implant pocket. The problem with that technique has been that dividing the muscle causes pain, often permanent, and it also allows the muscle to roll up towards the shoulder when contracting - such as pushing a grocery cart or getting out of a pool. That rolling up can create a bizarre deformity that makes wearing normal clothing or bathing suits challenging. Plastic surgeons at KP San Jose use new techniques to place the implant over the muscle, thus avoiding the surgical trauma of dividing the muscular origin. The result is less pain, complete avoidance of the rolling up deformity, and probably a longer lifetime of the implant. Many patients now present to San Jose specifically to change their reconstructive implants from under the muscle to over it. While others may have experimented in one way or another with placing implants over the muscle, the San Jose breast surgery group was amongst the earliest in the world to do so routinely, in large numbers, and to present such results to others. In collaboration with our radiation oncologists at KP Santa Clara, San Jose is also at the "cutting edge" worldwide in terms of offering immediate reconstruction for patients that might be denied the option elsewhere, even at large cancer centers in the US. Regardless of the cancer stage, San Jose patients are offered immediate reconstruction in ways that do not impair cancer treatment but yet preserve the possibility of world class reconstructive outcomes. Currently, approximately 80% of patients undergoing mastectomy at San Jose receive immediate reconstruction a number that speaks for itself. 20

20 When Patients ASK We LISTEN The Oral Chemotherapy Oral chemotherapy drugs In this program, patients are Social services also may be Navigation Program was have been increasing in followed by phone by clinical involved in cases where there developed to enhance number and being pharmacists and their may be financial burden to a coordination of care of patients prescribed oral prescribed more and more for a variety of cancers.. physicians. Their medications are ordered ahead of time to patient or transportation needs or other social barriers a patient chemotherapy and Often, these are targeted prevent any lapse in their dose may be experiencing. address any barriers therapies that may be and dose adjustments and patients and the care expensive but also may modifications are done in time Communication to the patient team may have in have many side effects that to address any issues patients and care team is ongoing and prescribing or taking the can affect patient s tolerance may have in taking them. patients have consistently found medication. and compliance this service to be excellent and would recommend to other patients 21

21 COMMISSION on Cancer Committee Members Assistant Physician-In-Chief and Cancer Committee Chair Meena Pai, MD Cancer Program Administrator/Assistant Medical Group Administrator Sue Colby, RN Chief of Oncology /Cancer Liaison Physician Pilar Ivanov, MD Clinical Research Coordinator Natallia Maner, RN Community Outreach Coordinator Julie McAllister, Irene Medriano, RN Director, Outpatient Quality Annabelle Zabal, RN, BSN, CPC Genetic Counselor Vinaya Murthy, MS, LCGC Medicine Subspecialty Sr. Staff Assistant Rebecca Pagaza Northern California Cancer Registry s Practice Leader Michael Oehrli, MPA, CTR Cancer Registry Analyst Kem Wong, CTR Oncologist Sejal Jhatakia, MD Oncology Nurse Julie McAllister, Nana Wilford, RN Oncology Nurse Practitioner/Cancer Conference Coordinator Grace Daun, NP Palliative Care Team member Jennifer Cohen, MD Pathologist Nalini Bhat, MD Project Manager Michelle Sheene Chong, MS Psychosocial Services Coordinator Kristina Johnson, PhD Public Affairs Communication Manager Alan Villatuya Quality Management / Quality Improvement Coordinator Irene Ching, RN Radiologist Yueyi (Irene) Liu, MD Social Worker Jennifer Jackson, MSW Surgeon Susan Kutner, MD 22 16

22 Some photos may include models and not actual patients. 2016, TPMG, Inc. All rights reserved. Regional Health Education (Revised 9/16) 23 17