HJBR Jan/Feb 2022

CANCER WARS 12 JAN / FEB 2022 I  HEALTHCARE JOURNAL OF BATON ROUGE   OLOL continued... Dianne Hartley, Editor: Thank you for your time today to sit down and discuss cancer care in the BatonRouge area. Howdo you feel that the BatonRouge area and Louisiana as a whole are doing in regard to cancer screen- ing, cancer rates and cancer death rates? Catherine O’Neal, MD: I’m going to take that one step at a time. I don’t think we are meeting what any- body would define as their metric. It doesn’t matter what your metric is. I don’t think we’re meeting it on all three points. When it comes to cancer screening — it’s really about making sure that you have access to screening. You have a wide variety of patients, right? You can’t just focus when you talk about screening. Screening is for whole population, and that means that you have to have a system that can capture whole population, which is hard in Louisi- ana, because care’s fragmented. Recently, we started a cancer screening program that doesn’t require patient partici- pation. Anytime you access medical care at the Lake in the Baton Rouge region, one of our facilities, if you get a CT scan, we screen you for cancer. So, you may come in with a gallbladder attack, and we screen you for cancer. Meaning that our computer system looks for cancer, so we have implemented AI on top of our CTs to look for inciden- tal nodules. That’s just part of the process of improving screening, because we’re not where we need to be for broad-based popu- lation screening. Catherine S. O’Neal, MD, is the chief medical officer at Our Lady of the Lake Regional Medical Center (OLOL) in Baton Rouge. As one of the Gulf Coast’s premier experts on infectious diseases, she became the go-to healthcare voice for COVID-19 during the pandemic and remains a valued source on both the local and national level. O’Neal is also an associate professor of clinical medicine, specializing in infectious diseases, at Louisiana State University Health New Orleans School of Medicine, Baton Rouge. Her areas of interests are in the use of rapid diagnostic tests to decrease antibiotic utilization and the prevention of hospital-acquired infections through process improvement. On how we’re doing with cancer rates? Our cancer rates are going up, but like all things, when you look at them, they prob- ably are higher, right? We’re not catching cancers early enough, and that’s part of the screening. So, if you do screening well, your cancer rates are going to go up even more; but to some degree that’s success, because you’re supposed to be catching them early. You’re supposed to be curing them and creating a survivorship pool. We’re just not there yet, because we haven’t gotten to where we need to do a screening. Lastly, that all contributes to the cancer death rate. So, to summarize, we have to fix screening for everybody, and that really does require a systems-based approach. When we do that, we’ll start to see the other metrics fall into place. Editor: Just as a follow up to the screening that you say you’re doing for a CAT scan, is that covered by insurance? Is that being done throughout the country? How are you bill- ing that? O’Neal: We don’t bill for it. It’s a service pro- vided by the health system. It’s meant to be a benefit of being a patient, and it’s meant to be an early detector. So, it’s not a charge. It’s just an implemented AI package on top of our scanning technology. What that does, is it creates an additional layer to our lung cancer nodule screening program. We have a team of people guided by our surgeon, Dr. Cassidy, who we added on to our program about five years ago, and she runs our lung nodule clinic. She receives the AI information, goes through at first blush, contacts the patients, contacts the patients primary care providers, and then if they don’t have access to care, she plugs them in. If they do have access to care, she lets their primary care provider guide the rest of their journey. We’ve just added AI as a service. That navigation component, we had in place, and we asked that navigation team to become the gatekeeper for this information. Editor: I’m going to ask a quick administra- tive question. How can we do better with regard to those three elements? O’Neal: I think it really starts with coordi- nation and building programmatic develop- ment. We’ve set several goals inmotion over the last several years with our new cancer institute and our new leadership. It really gives us the opportunity to put that strategic goal for the entire package, the entire insti- tute. And, we’re looking forward to doing that, but, like any goal, whether it’s a sports goal, whether it’s a goal for an individual patient, the first thing you have to do is set a timeline and expectations. That’s what we’re doing now with our team and Dr. Nuss [recently named as leader of the next phase of development for can- cer services] — really getting the crucial group of people together and saying, “This is our goal, and how are we going to hit it?” Catherine O’Neal, MD Chief Medical Officer Our Lady of the Lake Regional Medical Center