According to the American Cancer Society, over 1,600 people die daily in the United States from cancer. The 5-year relative survival rate for all cancers diagnosed between 2003 and 2009 is 68%, up from 49% in 1975-1977.
MD Anderson in Houston, TX arguably has the most respected of all cancer treatment programs in the United States and has not only some of the best results in terms of outcomes but some of the lowest costs per case as well. One of the reasons is the establishment of the MD Anderson Cancer Center Emergency Center which is a unique facility that provides emergent and urgent treatment for established MD Anderson Cancer Center oncology patients.
Open 24 hours every day, the Emergency Center is staffed by a team of registered nurses, patient service coordinators, patient care assistants, mid-level providers and physicians from the Department of Emergency Medicine who have expertise in the treatment of cancer related emergencies. The Emergency Center features 44 rooms including those designated for isolation, code emergencies, and gynecologic emergencies. The Emergency Center provides service to approximately sixty patient per day with cancer related conditions and is an important safety net for MD Anderson patients. Since the staff of the center is trained in handling of patients that are undergoing multiple types of treatment, they are well versed and trained in handling of conditions most often experienced by this patient population, including:
- non-urgent to emergency conditions
- treatment-related side effects
- cancer related emergencies and non-cancer related emergencies
- fluid and electrolyte replacement
- urgent blood product administration
MD Anderson isn’t the only such center. Memorial Sloan Kettering in New York has such a program also and the providers there, like in MD Anderson, are well versed in the various stages of and complications related to cancer treatment.
Oncologic Emergencies by Yeung & Escalante, reported that of all the patients presenting to the emergency center at MD Anderson in 2000, only 4% had true emergencies, 61% had conditions warranting urgent care services and 35% had non-urgent conditions. Even given these statistics however, the rate of admission was about 40%; much higher than a typical emergency room and well above any like statistics for an urgent care center. This demonstrates the difference in treatment that exist between cancer treatment patients and the typical emergency and urgent care patient.
The question is, should more cancer treatment centers have this service and what would the impact on outcomes if they did? As the focus on population health management grows and technologies advance it will make more and more sense for cancer treatment programs to facilitate enhanced support services that can continue to deliver high value, cost effective care to this and other specialty populations that may otherwise not be sufficiently serviced through the traditional delivery means.
We see the potential for an increasing number of cancer treatment programs to open their own versions of extended coverage for their patient treatment population that include telemedicine, urgent care and specific at-home treatment designed to improve outcomes, lower cost and improve the patient comfort during their treatment process.