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The Case for Decentralizing Cancer Care: The Rural Oncology Home

Published April 17, 2024
NEJM Catal Innov Care Deliv 2024;5(5)
DOI: 10.1056/CAT.23.0344

Abstract

Despite significant advances in cancer therapies over recent decades, the United States grapples with growing disparities in cancer-related outcomes between its rural populations and urban and suburban counterparts. These disparities can be attributed, in part, to the centralization of oncology services within urban centers, which concomitantly imposes heightened travel demands on rural patients, constricting their access to comprehensive cancer treatment and specialized care. Historically, strategies such as the visiting consultant outreach model have been deployed to improve service accessibility, yet they offer only fragmented solutions to the multifaceted challenge of equitable care distribution. In response to this challenge, the authors introduce the rural oncology home, an alternative model for rural oncology care delivery. This innovative approach is centered on a community-based, team-oriented framework that incorporates medical specialists and emphasizes supportive services. By leveraging advanced practice professionals and care coordination, the model aims to enhance the accessibility of specialized cancer care for rural patients. Such models for rural oncology care delivery are emerging, with a pronounced emphasis on leveraging telehealth technologies. The Lakewood Health System Rural Oncology Home model can potentially create a more equitable system of cancer care delivery that can bridge the rural cancer gap and improve outcomes for rural patients with cancer.

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Notes

Wade T. Swenson is a medical oncologist at Lakewood Health System and is a salaried employee of the Lakewood Clinic. He is also on the system board of directors at Lakewood. Missy Lindow is the Vice President of Operations at Lakewood and is a salaried employee of the hospital. Joe Reycraft is the Chief Financial Officer at Lakewood and is a salaried employee of the hospital. Lisa Bjerga is the CEO at Lakewood and is a salaried employee of the hospital and reports to the board of directors. Emily Westergard is an oncology fellow at Gundersen Health System but will join Lakewood in September 2024. Abigail P. Swenson and Zachary Schroeder have nothing to disclose.

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Published In

NEJM Catalyst Innovations in Care Delivery

History

Published online: April 17, 2024
Published in issue: April 17, 2024

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Wade T. Swenson, MD, MPH, MBA, FACP
Medical Director, Oncology/Hematology, Lakewood Health System, Staples, Minnesota, USA
Clinical Professor, Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
Founder, RuralCancer.org, Fergus Falls, Minnesota, USA
Missy Lindow, MBA
Vice President of Operations, Lakewood Health System, Staples, Minnesota, USA
Joe Reycraft
Chief Financial Officer, Lakewood Health System, Staples, Minnesota, USA
Lisa Bjerga, CPA, MBA
President and CEO, Lakewood Health System, Staples, Minnesota, USA
Zachary Schroeder
Medical Student, University of Kansas School of Medicine, Kansas City, Kansas, USA
Secretary, RuralCancer.org, Fergus Falls, Minnesota, USA
Abigail P. Swenson
Medical Student, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Treasurer, RuralCancer.org, Fergus Falls, Minnesota, USA
Emily Westergard, DO
Medical Oncology and Hematology Fellow, Gundersen Health System, La Crosse, Wisconsin, USA
Vice-Chair, RuralCancer.org, Fergus Falls, Minnesota, USA

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