Tell us about the LIVESTRONG Cancer Institutes.
The mission of the LIVESTRONG Cancer Institutes at the University of Texas at Austin (LCI) is to radically improve people’s cancer experience and quality of life; revolutionize how we treat cancer; and reinvent the way cancer patients are cared for. The vision of the LCI is to become an accessible, patient-centered, collaborative, and high-value cancer ecosystem which places cancer patients at the center of all we do and works collaboratively with local scientists, clinicians, and the community to discover, develop, and deliver high impact options for cancer patients. In addition, we are developing novel models of care delivery that tackle the complexities of cancer care locally and beyond.
We are working towards a soft launch in December where we will start to incubate parts of our model through providing some services to patients and their caregivers affected by gastrointestinal and gynecological cancers.
What cancer conditions or diagnosis will your team treat initially?
Initially, the sub-specialties that will be available will include gastrointestinal and gynecological cancers. These two specialty areas are not only ones that are common in this region but we have nationally recognized medical oncologists who were recruited to Dell Medical School and UT Health Austin to build robust programs in these areas.
Do you plan to expand to a full cancer center? What services will you open with?
Our vision is ultimately, over the next several years, to open a flagship LIVESTRONG Cancer Institutes outpatient clinic utilizing the CaLM concept that offers subspecialty treatment for a wide variety of cancer types. This plan is in the intermediate term as we will be making plans to build out a brand new cancer clinic space that is co-designed by patients and survivors. In the meantime, the initial launch of our clinics using the CaLM concept will occur in the Health Transformation Building (HTB) in temporary space.
What is the CaLM Concept?
The LCI is developing an innovative care delivery model that is value-based in which personalized medicine is optimized for patient outcomes. Central to our approach is the creation and operationalization of what we are calling the “CaLM concept:” a flipped clinic model, that is a comprehensive, patient-centered clinical and supportive ambulatory service with wraparound care for patients and their loved ones in all phases of the cancer journey. In many traditional models of cancer care, patients prioritize seeking services from the medical treatment team to address their options for cure or slowing progression of their disease. The other aspects of care – social, emotional, spiritual, cultural, practical, and financial, when addressed, usually are addressed in one of two ways:
- The patient is referred to an in-house social worker or other supportive care staff who is able to address some of these issues; but usually without integration with the medical treatment team.
- The patient is referred to external community services and the onus is on the patient to make appointments and seek out those supportive services. Any services offered are completely disjointed from the patient’s medical treatment.
As a result, the traditional (and predominant) model of cancer care leaves the patient and their loved ones trying to navigate the system; filling out the same paperwork over and over; having a number of providers that don’t communicate or even know that others are treating the patient; receiving disjointed services that don’t address all of their needs.
CaLM is an acronym for “CAncer Life reiMagined” but also stems from the work of Dell Medical School resident experts Dr. Elizabeth Teisberg and Scott Wallace at the Value Institute for Health and Care, who have generated the concept of “Capability, Comfort and Calm” being the most important outcomes that matter to patients in a healthcare experience. They define these three concepts as:
- Capability: the frequency or degree to which you can do the things that matter to you
- Comfort: freedom from physical and emotional pain
- Calm: the ability to live your life as you pursue healthcare (free from the chaos of the healthcare experience).
CaLM is essentially an oncology medical home approach that will integrate high acuity, sub-specialty clinical cancer care with comprehensive, ongoing supportive care. Patients will receive diagnosis and treatment services, but additionally they will also receive a suite of completely integrated practical, emotional, physical, and financial services to truly care for the “whole person” and their family. These services will be available to caregivers and children because we recognize that cancer affects the whole family unit and not just the person with the disease.
Tell us about your team? What are the roles of the various team members?
At the core of the CaLM concept will be the Patient Support Team, a multidisciplinary team of supportive care experts including social workers, palliative care providers, nurse practitioners, financial and fertility navigators, and a physical therapist, dietician, genetic counselor, pharmacist, psychiatrist, legal counselor, spiritual chaplain (if requested), fitness expert, and integrative care providers (acupuncture doctors, naturopaths) who have expertise in oncology and collaboratively manage patient care in a team-based approach.
The Patient Support Team collectively assesses and monitors the patient’s care, using the patient’s values, need and goals as the north star. This is a huge shift from a patriarchal health system where the doctor “knows what’s best ” to one where the doctor/care team acts as a shepherd or guide and the patient (and family) makes decisions about their care in partnership with their care team’s support. The clinical teams of disease specific cancer experts (medical oncologist, radiologist, surgeon) will work seamlessly with the Patient Support Team to provide care that puts the patient and their family in the center of the treatment and survivorship experience, in one single location as much as possible.
How do you see the Institute and team changing the way cancer patients are cared for in Austin and Central Texas?
“You have cancer”are terrifying and surprising words to hear. Words that instantly alter our world, family, and life. Our health system has evolved to treat the disease of cancer. We have found efficient ways to fight the uncontrolled division of abnormal cells in the body. New treatments are available that improve the trajectory of survival or disease progression. But, along the way, we have somehow forgotten that the social, emotional, spiritual, and practical aspects of the human experience are fundamental to living with vitality and resilience.
We are building a model that treats the mind, heart, and soul and delivers cutting-edge cancer therapies. We will prioritize not just survival, but supporting every person’s capability, comfort and calm as they fight cancer. And, we will use this model to improve access for all people, regardless of geography, socioeconomic status, disease type, or age.