Multidisciplinary team improves patient care coordination

April 20, 2020

A team of radiation oncologists, medical physicists, dosimetrists, and analysts from Winship's Department of Radiation Oncology and Simpler Consulting have joined forces to use a series of initiatives to improve patient scheduling and coordination between the Emory Proton Therapy Center (EPTC) and Emory University Hospital Midtown (EUHM) when insurance approval for proton therapy is pending or denied.

The team, dubbed the "RIE (Rapid Improvement Event) Team," recognized the need for patients seeking proton therapy to have a concurrent photon treatment start date at EUHM to ensure a seamless continuation of care while insurance authorization is pending.

The team first identified the various individuals in the process, their roles, and the time needed to complete their tasks.

Next, the team determined the method of communication. The EUHM radiation oncology team was using different communications channels than the proton center. After identifying the communications barrier, both sides began using Powerchart, a tool used to assist with scheduling patients.

The final step was to institute a policy enforcing a set start date for photon treatment at EUHM, regardless of proton insurance coverage, ensuring that EPTC patients have concurrent photon and proton treatment start dates. These start dates, called the "no-later-than-date," signals that no matter what a patient's insurance company decides, treatment will start on a specific date.

This "no-later-than-date" is scheduled at the end of a 21-day "care path" which starts when a potential EPTC patient completes a treatment planning simulation, which is a pre-treatment imaging appointment that is used to map out a potential radiation treatment plan.

The first 14 days are allotted for the insurance company to review proton treatment coverage. After this time, seven days before the "no-later-than-date," if a patient's insurance is still pending, then the EUHM radiation oncology team begins preparing for the patient to receive photon treatment. The patient will be notified prior to their start date which treatment they will receive.

"Because of the communication flow established in the project, both modalities -- proton and photon -- make preparations in parallel in order to receive the patient for treatment. And, at the conclusion of the simulation appointment, the patient will walk away with an appointment time,” says Director of Radiation Therapy Maxine Washington, who championed this project.

The project team also included Amy Breakstone, a clinical operations administrator and project champion, project leads Colton Gartin, RT and Anya Matthews, RT, and fellow team members Beth Bradshaw Ghavidel MS, DABR, Nikki Stafford, RT, Erica Banda, Virginia Jones, Quang Dang, CMD, and Simpler Consultant Katy Wurmann.