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New Directions

Issue: Winter

Patients Benefit from Improved Access to Cancer Treatment, Research

Drs. Susan Stinson, Stephen Greco and Laurie Herscher have joined the Johns Hopkins radiation oncology department as full-time attending physicians. Their practice remains based at the Suburban Hospital Outpatient Medical Center in Bethesda.
Imagine an elderly man with prostate cancer who wants to enroll in a potentially life-saving clinical trial at The Johns Hopkins Hospital. Because he lives in Bethesda, however, he doubts that he and his wife can make the weekly drive to East Baltimore for radiation treatments. If that same trial were offered at nearby Suburban or Sibley Hospital, he would likely participate without hesitation.

The department of radiation oncology at Johns Hopkins Medicine is close to offering him that option as part of JHM’s initiative to integrate clinical trials and services across its expanded health-care delivery system. The groundwork is now being laid to integrate clinical operations for radiation oncology at Sibley Memorial Hospital and Suburban Hospital, both located in the Washington metro area.

“We’re trying to blend the best of academic medicine and community medicine in a way that improves the care and process of care for the community,” says Brian Gragnolati, senior vice president for the Johns Hopkins Health System and Suburban Hospital President and CEO.

While similar integration efforts are also underway in surgery, geriatrics, primary care and perinatal, radiation oncology is the most advanced in the process. Instead of attempting to oversee separate operations at three hospitals, designing one large department has the opportunity to create a “seamless” system of care for patients and academic research.

Since restructuring began earlier this year, teams of radiation oncologists have begun to standardize quality assurance measures, compliance and safety and treatment protocols. Institutional review boards, charged with examining the safety of research projects that involve human subjects, are in place. Hopkins is purchasing new treatment equipment for the community hospitals.

Three physicians from Suburban Hospital — Drs. Stephen Greco, Susan Stinson, and Laurie Herscher — have joined the Johns Hopkins radiation oncology department as full-time attending physicians. This arrangement provides stability to what doctors do and it allows the system to be consistent in how it monitors patient safety and measures physician performance across the Johns Hopkins Health System. It also allows doctors to gain an understanding of the kind of patients they are serving.

 All three hospitals will share the same system to record, verify and evaluate patient treatment plans. They will also use the same type of linear accelerator, a device that delivers high-energy precision x-rays to target tumors.

 In their positions as clinical associates, the doctors from Suburban Hospital will help develop research protocols, participate in Hopkins’ educational conferences and provide instruction to resident physicians in addition to treating patients.

 Dr. Stephen Greco, co-medical director of Suburban’s radiation oncology center, says his patients are becoming more aware of the clinical integration.

“Although the care at Suburban is comparable to any you’ll find at major university centers, our community [of patients] has a certain comfort level knowing the relationship between Suburban and Johns Hopkins is very open in terms of information and treatment,” he says. “What they may not realize yet is that the true benefit will be the translational research and the trials that can be extended to the community.”

He mentions a recent visit from Dr. Richard Zellars, an associate professor in radiation oncology, who explained a clinical trial that decreases the duration of a standard breast cancer therapy —chemotherapy followed by radiation after lumpectomy — from five to six months to less than two.

Expanding clinical trials to include patients at Sibley and Suburban will accelerate research and make advances in cancer care more accessible to patients in the greater DC region.

Note: Excerpted from a story by Linell Smith in the October 2011 edition of the Johns Hopkins Medicine Dome newsletter.

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