Intervention Area: Chicagoland Area
CHICAGO – As cancer treatments evolve and grow in complexity, it can be very difficult for cancer patients to receive continuous, high-quality care: while the majority of cancer treatment journeys begin with primary care physicians, patients typically move between a wide variety of facilities and specialties throughout the course of their care. They may receive surgery at one hospital, get transferred to a different facility for chemotherapy, and then go back to primary care physicians for information on survivorship care. With each transfer, there is a potential for miscommunication, resulting in care delays and frustration for patients and their families. This fragmentation is especially dangerous for minority and underserved populations, who are more likely to be diagnosed with cancer at later stages (cancers are likely to be more aggressive), have financial challenges, lower levels of social support, poor nutrition, and low physical activity levels.
Northwestern University Feinberg School of Medicine developed the 4R model to provide patients with a clear project plan of their treatment, regardless of how many facilities may be involved in their care or their stage of treatment. 4R care plans include information on cancer care, managing their care alongside other chronic illnesses independent of their cancer diagnosis (comorbidities), preventive care, supportive services, and lifestyle choices. The goal of this intervention is to optimize the coordination, flow, consistency, quality and satisfaction of care and communication among the care team, patients, and caregivers (family members, etc.). With the care plan serving as an “anchor”, patients will be more likely to make use of support services necessary and appropriate for optimal health, regardless of location of care, patient income, race/ethnicity, or other factors.
The 4R Model has been progressively enhanced through a series of multi-disciplinary studies of challenges in breast cancer care delivery and insurance reimbursement; work with over 30 cancer treatment centers and 50 imaging centers in Chicago; several multi-disciplinary roundtables that included providers, payers and patient advocates; and through patient focus groups. Feinberg Medicine is working with AllianceChicago to deploy the 4R intervention to several community health centers across the city of Chicago. Patients from Howard Brown and Near North Health Service Corporation have been recruited to join the Feinberg intervention.
Facts and Figures
- According to the most recent census, there are 2,716,450 people living in Chicago
- 3% of the total population is white, 30.9% is black or African American, 29.1% Hispanic or Latino, 6.1% Asian.
- 7% of the population lives in poverty
About Northwestern University Feinberg School of Medicine
Northwestern University Feinberg School of Medicine is a research-intensive medical school that fosters powerful collaborations on a thriving academic medical campus. Feinberg is driven by its mission to transform the practice of medicine and profoundly impact human health beyond the individual patient, making a genuine commitment to meeting the needs of the diverse neighborhoods and populations it serves. Its community engagement efforts allow Feinberg to provide unique and valuable training experiences, strengthening research and improving outcomes for patients and communities.
AllianceChicago’s mission is to improve personal, community and public health through innovative collaboration. Their efforts are focused in three core areas: health care collaboration, health information technology, and health research and education. AllianceChicago is committed to providing essential guidance that informs policy, health care delivery design and clinical services to improve health, increase relevance and accessibility of health care, and eliminate disparities.
About Near North Health Service Corporation
Near North Health Service Corporation, a non-profit Federally Qualified Health Center (FQHC), is one of the largest providers of community-based primary health care in Chicago. They provide medical services, social services, and nutrition education to medically indigent and uninsured individuals and families. Approximately 65% of their patients live below 100% of the federal poverty level.
About the Alliance to Advance Patient-Centered Cancer Care
The Alliance to Advance Patient-Centered Cancer Care, a multi-site initiative funded by the Merck Foundation, works to increase timely access to patient-centered care and reduce health disparities among under-served populations in the United States. The Alliance includes the following organizations: Georgia Cancer Center for Excellence at Grady Health System, Johns Hopkins University School of Medicine, Massachusetts General Hospital (MGH) Cancer Center, Northwestern University Feinberg School of Medicine, The Ohio State University Comprehensive Cancer Center, The University of Arizona Cancer Center, and University of Michigan School of Nursing, which serves as the National Program Office (NPO). For more information, visit the Alliance to Advance Patient-Centered Cancer Care’s website at https://cancercarealliance.org/.