Dr. Debra A. Wong, Medical Oncologist at City of Hope and Medical Director at AccessHope
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What is the background of Dr. Debra A. Wong and her organization?
Welcome to the Becker's Healthcare Podcast. I'm Elizabeth Gregerson, a reporter here at Becker's, and I'm thrilled to interview Dr. Deborah Wong. She's a medical oncologist at City of Hope and medical director of Access Hope. Dr. Wang, thank you so much for joining me. I'm so grateful to have you on today to share your insights with our podcast audience. Before I dive into my questions, could you just briefly introduce yourself and tell us a little bit about your background and your organization?
Hi, Elizabeth. It's great to be here with you. By training, I'm a medical oncologist and palliative care physician. By nature, I'm someone who's always been driven by making a meaningful difference in people's lives and especially when they or a loved one is facing cancer, which is a disease unlike any other and has touched us all in some way or another. I'm assistant professor in medical oncology and therapeutics research at City of Hope, and I help lead the development and integration of clinical strategy at Access Hope, which was founded by City of Hope. Through a novel approach to optimizing cancer care delivery, regardless of where someone lives or where they're being treated, we provide remote expert opinions to patients and their treating oncologists wherever they call home.
Great. That leads perfectly into kind of our discussion today. You had a recent study come out that highlighted how remote second opinions from NCI designated specialists are led to changes in treatment recommendations for over half of the cancer cases reviewed. What were some of the key infrastructure or technology enablers that made this kind of, you know, academic to community collaboration possible at scale? You know, what did it take to kind of scale all these remote second opinions?
First, a team-based clinical network facilitated approach where all involved have a common goal is paramount. Research has shown us that patient outcomes like survival are better at NCI-designated comprehensive cancer centers, but it isn't feasible or practical to expect all people with cancer to be able to travel and be cared for at one of these centers. We developed a model where partnerships with employers, health plans, local oncologists, and other leading cancer centers enables patients and their treating oncologists to benefit from the latest cancer care knowledge, no matter where they live or practice. It's this infrastructure between the different sectors, payers, clinicians, and cancer centers of excellence, that supports a unique collaboration between academic and community oncologists
How do remote second opinions impact cancer treatment recommendations?
across urban and non-urban regions and across different socioeconomic settings for accelerated dissemination of information and knowledge transfer in what is a very rapidly advancing field. We've developed a sophisticated healthcare compliant and technology enabled review system that allows us to do this at scale. Cancer subspecialists in our clinical network can securely review a patient's information provide their expert opinion regarding testing, treatment, and potentially clinical trial options. And then with skilled IT data scientists and clinical staff, we're able to deliver those expert opinions anywhere they're needed, as well as analyze practice patterns and outcomes.
Perfect. And I wanted to highlight too, one of the key findings of the study was that patients in non-urban or disadvantaged areas were significantly more likely to benefit from those treatment changes that happened after receiving the second opinion from an NCI designated specialist. I'd love for you to walk us through, you know, what that finding tells us about what health systems could or perhaps what they should be doing to better support the frontline oncologists that are practicing in those resource-limited settings.
We did find that in over 5,000 cases, remote expert opinions recommended changes in cancer treatment more than half the time. Moreover, those recommendations were disproportionate. Patients in socioeconomically disadvantaged and non-urban areas had about 30% higher odds of receiving recommendations for changes in their cancer treatment compared with those patients in the least disadvantaged or urban regions.
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