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Improving Head and Neck Cancer Outcomes

Joe Cantlupe, for HealthLeaders Media, January 8, 2011
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While service line directors are touting the benefits of TORS, Weber, at MA Anderson, says service line officials should be cautious about any “gee whiz” technology until there are more controlled studies, which he says have yet to occur.

The robot requires a tremendous monetary cost—about $1.5 million per machine—and that, too, must be evaluated in terms of care, he says.

Success Key No. 3: Detection, diagnostics
The Mount Sinai Medical Center’s Head and Neck Cancer Center in New York City eliminates redundant testing, improves communication among physicians, and reduces patients’ average wait time between diagnosis and head and neck surgery under a partnership with an ear, nose, throat, and allergy group.
The ENT & Allergy Associates group offers routine evaluation of thousands of patients and referrals for possible surgery in the complicated head and neck diagnostic area. The partnership allows for diagnostics of disease that may not be ordinarily detected, says Genden.

Under the partnership, patients of ENTA have direct access to Mount Sinai otolaryngologists and can be seen at the center within 24 hours of diagnosis at an ENTA facility. In addition, patient records are shared automatically, and Mount Sinai and ENTA physicians collaborate on cases. So physicians can have instant access to critical patient health information.

Genden says the hospital’s multidisciplinary approach as well as its partnership with ENTA has been meaningful for patients. Noting the hospital’s working relationship with ENTA, Genden says the group sees more than 35,000 patients a year. Many of those patients are afflicted with relatively minor conditions. However, the group is in a position to direct patients to the hospital for more complex treatment, he says.

“Patients are very sophisticated here,” Genden says. “There is word of mouth about our multidisciplinary approach. We have tripled the number of patients [within the past decade]. People see the coordinated work that we do here. As a result, it has just blossomed. You look at the number of referrals and revenue to the hospital and it has increased.” Genden did not offer specific numbers of patients or income, but notes “the key is not the specifics in terms of revenue. What is important is efficiency of care.”

For instance, the average head and neck treatment time for patients decreased from an average of 31 days in 1997 to six days last year, he says. Overall lengths of stay have decreased from 12 hours to two hours for surgery, and average hospital stays dropped from 9.7 days to 1.7 days.

“That’s our economic model,” he adds. “There are complex patients who are high risk, and we have significant complexity to put together a seamless transition of care.”

Genden describes the process as important for the patients’ outcomes.

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