Froedtert clusters cancer services under one, new roof

19.05.2008 04:06 Health - Source: JS Online

To leaders of Froedtert Hospital, the least important feature of their new $95 million cancer center may be the bricks and mortar.

"This is more than a building, it's a new philosophy of care," William Petasnick, chief executive of Froedtert & Community Health, said at the dedication ceremony last week.

The center, which opens today, embodies one of the most significant changes in the past decade in cancer care: the focus on multi-disciplinary teams of doctors and other health care providers, working together to plan the best course of treatment.

The cancer center, designed with that in mind, enabled Froedtert to restructure its cancer services.

Under the model, surgeons, medical oncologists and radiation oncologists who specialize in specific types of cancer will work with the same nurses and support staff in 13 programs.

Those programs, in turn, are assigned to one of four clinics at the center. The patient will go to the same clinic for all of his or her care.

That means patients will no longer find themselves roaming through the hospital to meet with doctors, have tests done or receive treatments.

"It's kind of overwhelming when you have cancer and you have to go to all these different parts of the hospital for your care," said Bob Scheldroup, who has survived liver cancer. "You are running around all over the place. And it's confusing as heck."

Frank Wilson, chairman of radiation oncology for Froedtert Hospital and the Medical College of Wisconsin, calls that "the gumshoe method."

"We are eliminating that completely," Wilson said.

The goal is to improve the coordination of care. And, with cancer, the coordination and timing of treatments matters.

"The design of this new building is an outgrowth of that," Wilson said.

Cafe, pharmacy, therapy

Froedtert Hospital, the academic medical center of the Medical College of Wisconsin, also hopes the new model will set it apart from its competitors.

The cancer center is part of a 500,000-square-foot addition to the hospital that includes three levels of underground parking solely for cancer patients and two floors for future expansion.

The 173,000-square-foot center is distinguished by its warm colors, wood tones and flood of natural light. It includes a small cafe, with food from Outpost Natural Foods, and a pharmacy solely for cancer patients.

There also are ancillary services, such as nutrition, physical therapy, massage therapy, yoga, genetic counseling, psychology and palliative care.

The four clinics, with names such as Courage and Hope, have a total of 65 exam rooms. Each new patient is assigned a "journey coordinator" and a nurse, who are the liaisons to the doctors and other services.

When Bruce Campbell, a surgeon who specializes in head and neck cancers, saw a new patient last week, he needed to make just one call to schedule appointments with medical and radiation oncologists.

"It saved me 45 minutes of phone calls," Campbell said.

Part of a trend

Froedtert doesn't have a monopoly on that model. Other hospitals also use nurse coordinators to help arrange care for patients with certain types of cancer.

For that matter, every health care system now talks about providing integrated and "patient-centered" care.

Alexis Levy, associate director of Navigant Consulting Inc.'s health care practice, expects to see more health care systems and hospitals stressing coordinated care in their marketing campaigns.

Better coordination of care is considered essential to improving quality in a fragmented health care system. It is particularly important when treating cancer patients.

"There are some very clear guidelines on how you manage patients," said Kenneth Bastin, clinical director of radiation oncology and radiosurgery at Aurora St. Luke's Medical Center and president of Radiation Oncology Associates, a physician group that works at Aurora hospitals.

Froedtert, which has about 200 doctors who treat cancer patients, has an advantage in that all its doctors are affiliated with the Medical College of Wisconsin. That can make it easier to coordinate care than when doctors work for different medical practices. But all the health care systems in the Milwaukee area employ oncologists and other specialists.

Still, Froedtert's patient volume enables more of its specialists to focus on a single form of cancer. It has three radiologists who read almost only mammograms, for example, and one surgeon who operates only on breast cancer patients.

The same holds true for Aurora St. Luke's and Aurora Health Care.

That health care system, which sees about 6,000 new patients a year, employs surgeons who specialize in specific types of cancer, said Marija Weidman, director of cancer services for Aurora. It also has several surgeons, for instance, who focus solely on breast cancer.

Patients who need specialized care for certain types of cancers will be referred to St. Luke's, she said. But Aurora's philosophy is to provide cancer care close to where people live.

That's the preference of most cancer patients, who often don't want to travel long distances when going through the ordeal of chemotherapy.

Profitable practice

But cancer patients also are more likely than other patients to choose where to get care as opposed to relying on referrals from doctors.

Cancer care is also one of the most competitive and one of the most profitable services provided by hospitals.

"A lot of hospitals recognize that it's a growing market and want to be part of it," said Levy of Navigant Consulting.

Froedtert, which sees about 2,600 new cancer patients a year, has the second-largest share of the oncology market in the Milwaukee area, behind Aurora St. Luke's. Cancer care accounted for roughly 20% of its $712 million in revenue last year.

Froedtert has seen its market share increase in recent years.

"In cancer, your first shot is your best shot," said Susan Derus, Froedtert's executive director of cancer services.

The hospital has long needed more room for its cancer services. And it expects its growth to continue.

The new center could add to that growth.

"It is more streamlined," said Scheldroup, whose liver cancer was treated at Froedtert. "It is easier on the patient, and it would seem that the communication would be better."

He toured the addition last week and was impressed.

"It's definitely going to be an asset for Milwaukee."

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