Closing the Testing Gap: Standardization of Comprehensive Biomarker Testing in NSCLC

This blog post is the fourth in a 6-part series highlighting the achievements of the 2023 ACCC Innovator Award winners before their in-depth sessions at the ACCC 40th National Oncology Conference. You can learn more about the innovations being recognized this year and those who pioneered them by joining ACCC in Austin, Texas, from October 4-6, 2023. 

In a constantly evolving oncology landscape, streamlining care delivery models has become a significant challenge for cancer programs and practices around the United States. Understanding this, Oncology Hematology Care, Inc. (OHC), has spent the last few years developing initiatives aimed at ensuring their patients continue to receive next-generation cancer care. Among their more recent endeavors was a one-year quality improvement project designed to implement and standardize comprehensive biomarker testing in patients with metastatic non-small cell lung cancer (NSCLC).

“The project ran from September 1, 2021, to August 1, 2022,” said Molly Mendenhall, RN, BSN, director of Quality and Compliance at OHC. Prior to embarking on this initiative Mendenhall and the team at OHC had the benefit of hindsight on their side. “We felt this project was going to be successful because we had run a similar project from 2018 to 2020, looking at increasing genetic testing in the breast cancer space,” she said. “That essentially became the skeleton for this project.” That experience served them well.

Engaging Healthcare Providers

Following the implementation of the program biomarker testing rates increased from 68% to 92.7%. Mendenhall credits the substantial growth to the comprehensive development of the program. “We started with adopting the NCCN [National Comprehensive Cancer Network] guidelines for the biomarking testing within the NSCLC population,” she explained. “Then we implemented a new NSCLC physician note template in our EHR [electronic health record] and created a standardized order set that accompanied that note template.”

According to Mendenhall the standardization of workflows across the entire provider set at OHC was the primary goal. To achieve this, Mendenhall and her team created 3 different YouTube educational videos that explained the purpose and importance of comprehensive biomarker testing to each provider at the program. They also created tips to show providers how to use the new NSCLC template and order set. “Our team created automated analytics report that could track every NSCLC patient that came into our office, and make sure the standardized workflow was utilized,” Mendenhall said. “This process enabled us to proactively tweak the workflow in real time, so if there were providers that needed additional information or reeducation on how to use the template and order sets, we could do that in real time.”  

Mendenhall believes that by improving workflows, the program has had a significant impact on reducing burnout among providers. “On a daily basis providers are bombarded with multiple priorities when they are seeing new patients with cancer, and they are limited with the amount of time they can truly spend with the patient,” she said. “We were striving and working to implement a strategy that could adequately streamline this process for our physicians and make it as efficient as possible.”

Looking to the Future  

Due to the success of this improvement project, Mendenhall and her team are currently working with the US Oncology Network and McKesson to scale it across the country. “The cool thing about this project is that it can be implemented at little to no cost,” she said. “There are things cancer programs and practices could do today, to roll this program out tomorrow.”

At the ACCC 40th National Oncology Conference this fall, Mendenhall will provide an in-depth analysis on how to implement a standardized comprehensive biomarker testing program for patients with NSCLC. “All of us are part the cancer care community, and it is really important that we share these best practices, so I am looking forward to attending the NOC [National Oncology Conference] for the first time,” said. “I can’t wait to go in and learn strategies that OHC can adopt to improve patient care.” To learn more about developing a program for sustainable outreach for cancer screening at your organization, including the technology and support staff needed to find success, register to attend the 2023 ACCC National Oncology Conference in Austin, Texas, from October 4-6, 2023.