2020 ACCC Innovator Awards: Creating a Community-Based Cardio-Oncology Clinic

This blog is the second of an eight-part ACCCBuzz series highlighting the achievements of the 2020 ACCC Innovator Award Winners. You can learn more about the innovations being recognized this year and the people who pioneered them by joining us at the upcoming ACCC 37th [Virtual] National Oncology Conference, September 14-18. 

In 2016, Vijay Rao, MD, PhD, was working as a cardiologist at Franciscan Health in Indianapolis, Indiana, when three of his female patients in treatment for breast cancer all suffered heart failure. Newly committed to proactively addressing the link between oncology treatments and cardiotoxicity, Dr. Rao sought to provide better preventive care for at-risk patients. Subsequently, he and Kerry Skurka, a cardio-oncology nurse navigator, created the Franciscan Health Cardio-Oncology Clinic. 

“The clinic developed out of a need to help cancer patients navigate their potentially cardiac-toxic therapies,” explains Dr. Rao, director of Franciscan Health’s Cardio-Oncology Program and co-director of its Heart Failure Program and Anticoagulation Clinic. 

The Franciscan Health Cardio-Oncology Clinic educates patients with cancer about the potential risks to heart health posed by oncology treatments and provides support and surveillance should any cardiotoxicities occur. “Our goal is to prevent the cancer survivor of today from becoming the heart failure patient of tomorrow,” explains Dr. Rao. 

Dr. Rao says the clinic’s success ultimately depended on obtaining buy-in from the health system’s administrators and medical oncologists. “I think in starting any program, you need to have a champion,” says Dr. Rao. “For this effort, we needed a cardiology champion.” Dr. Rao assumed this role and began to include medical oncologists from the Franciscan Health Cancer Center in conversations about combining oncology and cardiac care into one multidisciplinary clinic. He explains that he wanted the oncologists to understand that his mission was not to stop patients’ chemotherapy, but to offer cardio-oncology as a supportive service in the cancer center. “That was probably the hardest and most important obstacle to overcome,” recalls Dr. Rao. 

To further make his case, Dr. Rao brought an oncologist with him to the Global Cardio-Oncology Symposium held by the International Cardio-Oncology Society to better understand the essential role cardiology care can play in cancer care. “I got him to understand and appreciate that this is a real field and that it can impact patients,” Dr. Rao explains. “Once he did that, it really helped us move the program forward.”  

In August 2016, the Franciscan Health Cardio-Oncology Clinic was launched, and Kerry Skurka was hired as the clinic’s first cardio-oncology nurse navigator. Skurka brought her own experiences in cardiology and administration, and she worked with and educated the cancer center’s clinicians and staff daily. Dr. Rao credits the nurse navigator model for establishing a much-needed link between medical oncology and cardiology. Skurka identified patients in real time who might benefit from visiting the cardio-oncology clinic. The team could then review patients’ treatment plans, identify any toxic effects that may occur, and triage patients according to their individual needs. 

The clinic grew, incorporating key members of the cancer care team, including pharmacists. In time, a second dedicated cardio-oncology nurse navigator was hired, and a scheduler was added to help manage incoming patients. “Our team grew because more people became aware of the clinic as we educated them,” explains Skurka.  

Since the creation and implementation of Franciscan Health Cancer Center’s Cardio-Oncology Clinic four years ago, it has grown from a virtual patient service into a bi-weekly in-person clinic housed in the Franciscan Health Cardiology Clinic. “The difference this clinical service can make for cancer patients is astounding,” says Skurka.  

Dr. Vijay Rao and Kerry Skurka will deliver an in-depth presentation on the development and implementation of the Franciscan Health Cardio-Oncology Clinic at the ACCC 37th [Virtual] National Oncology Conference, September 14-18, 2020. To gain insight into how this two-person team obtained the buy-in necessary to bring the clinic to life, register for "A Nurse Navigator-Led Community-Based Cardio-Oncology Clinic."

Attend the ACCC 37th [Virtual] National Oncology Conference to learn about the accomplishments of the other 2020 ACCC Innovator Award winners on topics ranging from the creation of a 3D educational tool that reduces patient distress to onboarding experienced non-oncology nurses to address staffing shortages.