Download - myriad presentation feb 2012 grant project
Kathryn Murray, MS, CGC Center for Genetics
February 2012
541-349-7600
Community Cancer Risk Assessment
Project
We have such a great community of
Providers and Families
ITS versus Referral Models
Referral – Weaknesses
Bottlenecks are created.
Significant PT fallout from referral to visit.
Lack of ownership.
Referral HCP level of cancer syndrome education.
– Strenths Quality of counseling process.
Unaffected family member testing.
Identify rare forms of hereditary cancer syndromes.
Independent Testing Site (ITS) – Weaknesses
Rarer syndromes not identified.
Family members rarely tested.
Quality of counseling process.
– Strengths Ownership.
Convenience for patient.
Less bottleneck.
HCP may have a higher level of understanding for the cancer syndrome being tested for.
HCP: Cancer
Genetic Counseling
HCP: PCP
HCP: OB/GYN HCP: Out of Area
Community Risk Assessment Model
can maximize the strengths and minimize
the weaknesses
of both of the other models
(Referral VS ITS)
How do we do this???
• Meet with the different practices.
• Determine their level of interest.
• Identify the Champion(s) in the Office.
• Determine their educational needs.
Assessment:
Average Risk Moderate Risk High Risk
Colonoscopy
beginning
@ 50 years,
no polyps
every 10 years.
NCCN Version 2.2011
1st degree relative CRC
> 60 yrs.
Colonoscopy
beginning
@ 50 years,
no polyps
every 5 years.
Mutation Carrier.
Colonoscopy
beginning
@ 20-25 years,
repeat every
1- 2 years.
Other extra-colonic
screening
recommended.
How do we do this???
• Provide Education.
• Provide Support.
• Build a Community of Providers that are interested in
seeing these patients and triaging their care.
Integration:
How do we do this???
• What works for each practice – may be different.
• How can we expand the circle?
Evaluation:
HCP: Cancer
Genetic Counseling
HCP: PCP
HCP: OB/GYN HCP: Out of Area
Genetics
Providing
Cancer Risk Assessment.
Providing
better management.
GI Oncologist
Surgeons Pathology
Genetics
Providing
Cancer Risk Assessment.
Providing
better management.
HCP: PCP
GI Oncologist
Surgeons Pathology
OB/GYN Out of Area
Conclusion:
• We can develop an integrated model that will
minimize the weaknesses of both referral and ITS
models while maintaining both of their strengths.
• We can serve more patients by providing a more
individualized medical management plan.
• In the end, I believe we can reduce morbidity and
mortality.
Kathryn Murray, MS, CGC