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Our Role in Addressing Barriers to Equity in Oncology

By Dr. Natalie Dickson, M.D., Chief Medical Officer, Tennessee Oncology .I recently participated on a National Comprehensive Cancer Network (NCCN) panel discussion focused on identifying and addressing barriers in equity in oncology. The other panel participants, moderator, Dr. Cliff Goodman, and I had a robust discussion about the challenges some patients face accessing high-value oncology care.

From low clinical trial participation among African-Americans and other minority groups, to an inability to adequately address the impact of financial barriers on care decisions, we’re unfortunately still a long way from outcomes equity in cancer care, where the treatment outcome is the same regardless of the age, race, gender or location of the patient. However, I am optimistic we’re on the right path in oncology – especially in community oncology – due to the personalized care community practices offer.

We’re close to our patients. We ask them the right questions and help them with every aspect of their treatment. During the conversation, as each of my fellow panelists described barriers to care equity, I considered how we approached similar situations at Tennessee Oncology. From re-designing our in-take forms to standardize patient perspective data to having an in-house pharmacy and dispensary help manage side effects and treatment compliance, our team collaborates to confront challenges and personalize care to address equity barriers.

Increasing patients’ access to clinical trials in community oncology practices is another way we are closing gaps in cancer care inequity.  As we discussed at the panel held at the National Press Club in Washington, D.C. participation in clinical trials among disadvantaged populations must improve. As a society, we must make an education and outreach commitment to include minorities as well as individuals who live in rural communities in trials.  When we do, the results are optimistic. For example, recent research shows that health disparities between cancer patients in metropolitan and nonmetropolitan regions of the country virtually disappear when nonmetropolitan patients are given access to the same guideline-based care that metropolitan patients receive in clinical trials.

Not only does increasing trial access save and extend lives today, but it helps the medical community better understand how therapies work differently in different populations. It’s increasingly important to recruit a more diverse patient population into trials so we can understand more about care pathways and what patients value.

I am as excited about oncology now as I was when I began practicing because for me it’s all about caring for patients. The confluence of burgeoning medical science, personalized medicine and using big data to solve problems makes care more individualized, which does help close gaps in care inequity.

OneOncology’s entrance in the marketplace is another factor that I believe can enhance our ability to personalize our patients care. Collaborating with physicians from across the country on a technology platform that is physician-designed to enhance data collection and analytical insights while also having the ability to replicate the best practices of premier groups will ensure that our patients get the best care possible close to their home.

Community oncology is vitally important in the pursuit of outcomes equity. I believe that through OneOncology we will accelerate this work as we join forces with our colleagues at West Cancer Center and New York Cancer & Blood. Access to cutting-edge therapies and clinical trials, high performing care teams, and learning through data analytics will allow us to more effectively address barriers to outcomes equity in cancer care.