Kaiser Permanente (KP) recently launched an innovative Cancer Expert Review Program (the Program) aimed at bridging the gap between oncologists and cancer subspecialists within the organization. The program, conducted from October 2022 to June 2023, facilitated virtual consults for a wide range of cancer types, including breast, gastrointestinal, genitourinary, sarcoma, thoracic, hematology, central nervous system, melanoma, head & neck, and gynecologic oncology, as well as cases necessitating molecular/genomic testing. The results of the program were presented in an abstract at the 2023 ASCO Quality Care Symposium in Boston, Massachusetts. 

During the pilot phase of the program, medical oncologists from Hawaii, Georgia, and Southern California utilized HealthConnect, KP’s EPIC electronic health record system, to request virtual consults from designated cancer subspecialists. The consulting physicians had immediate access to comprehensive patient records, including pathology and imaging, ensuring a thorough and informed assessment of each case. The Program’s primary objective was to provide timely consultation and ensure that patients received the best possible care within their local health care setting.

The results from the pilot were promising, with a total of 164 consults processed during the pilot period. Of these, 108 consults (67.5%) were handled by individual subspecialists, whereas 22 consults (14%) involved multiple experts or a multidisciplinary team. Notably, 87.5% (140) of the consults were completed within 2 business days, demonstrating the efficiency and effectiveness of the Program in providing timely expert guidance.

Feedback from the participating oncologists underscored the success of the initiative. A survey revealed that 85% of physicians expressed satisfaction with the service, and 75% of them said the advice received contributed to the development of the treatment plan. Approximately 50% of the respondents reported that the advice provided prompted alterations to the original treatment or approach. The survey also indicated that in the absence of this internal program, half of the physicians would have referred their patients to non-Kaiser Permanente providers for consultation, highlighting the crucial role of the Program in retaining patients within the Kaiser Permanente network.

The success of the pilot sheds light on the feasibility of integrating virtual consults into a national cancer care framework. By combining the expertise of subspecialists with the continuous care provided by the patient’s primary oncologist, the Program effectively ensures that patients receive comprehensive and specialized care tailored to their individual needs while staying within the familiarity of their local health care system. The positive outcomes of the pilot emphasize the potential for similar integrated systems to provide high-quality care in a timely and patient-centric manner.

While the initial results are promising, the study authors stress the need for further research to comprehensively understand the long-term implications and quality outcomes of such programs. 

Kolevska T, Brasfield FM, Kotak D, Presti J, Harzstark A, Carney JF et al. Implementation of a national cancer subspecialist virtual consult pilot in an integrated health system. Presented at: the 2023 ASCO Quality Care Symposium; October 27-28, 2023; Boston, MA, and virtual; Abstract 143