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.
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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NEJM Catalyst Innovations in Care Delivery
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Copyright © 2024 Massachusetts Medical Society.
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Published online: April 17, 2024
Published in issue: April 17, 2024
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