26 Nov Cover Story: New local venture fights tumors with tech
Erich Mounce has a vision for OneOncology — equal parts leveraging technology, creating operational scale, and improving cancer patients’ “care journey.”
In an interview with Memphis Business Journal after being named COO of OneOncology, Mounce detailed the opportunities and challenges in the venture that he calls a “game changer” for community cancer treatment.
A majority of cancer patients in the U.S. currently receive care and treatment in community oncology clinics and centers — a care model that Mounce and OneOncology’s leadership believe best for their patients. But, practicing oncology in a community setting is not without its challenges.
“The shifting and shrinking community cancer care system reduces access to cancer care, inflates spending at the more expensive hospital setting, and is a disservice to patients, their caregivers, and support networks,” said Dr. Jeff Vacirca, CEO of New York Cancer & Blood Specialists. “Patients deserve accessible and affordable cancer care in the communities where they live and work. Community oncology practices provide that now, and they do it exceedingly well.”
Vacirca’s practice is one of the OneOncology founding members, and he is president of the national nonprofit Community Oncology Alliance (COA). His remarks accompanied the release of the COA’s 2018 Community Oncology Practice Impact Report in April.
Some trends are working against community-based oncology, as clinics close and hospitals acquire oncology practices, the COA report said. More than 1,600 community oncology clinics and practices have closed, have been acquired by hospitals, or struggled financially over the past decade.
While OneOncology is entering a challenging environment, its new partnership — with Memphis-based West Cancer Center, Nashville-based Tennessee Oncology and New York Cancer & Blood Specialists as founding members — has technology and scale on its side as it forges ahead to create a new cancer care model.
Growing with tech
Small community oncology practices might not have the resources to invest in technologies that have the potential to proactively alter treatment plans and make cancer treatment regimens easier on patients. But, at the same time, technology can help practice networks such as OneOncology become more efficient.
“[Cancer] is becoming more of a chronic disease, but I don’t think cancer providers are set up for that,” Mounce said. “That’s one of the things that OneOncology will let us start to invest in, especially technology.”
An infusion of $200 million by private-equity firm General Atlantic jump-started OneOncology. While that capital will be spread across all three practices, West Cancer Center will receive its share, and its leaders feel local patients will be the beneficiaries.
“Having a capital partner here for a physician-led organization is a really good mix where it will allow us to invest capital in technology, in growing the organization … [and] investing in the entire cancer trajectory,” said Dr. Lee Schwartzberg, executive director of West Cancer Center.
OneOncology’s ability to have a large data warehouse is key to creating more tailored drug regimens and care plans, Mounce said. Such a large collection of data allows providers to see how all patients across OneOncology’s practices respond to drugs and treatments.
The end result is to find what drugs and treatments work best for cancer patients.
Beyond improving patient care, technology is also a major component in OneOncology growing its member practices. Smaller oncology practices often don’t have the scale to participate in research trials and new treatment programs or to implement new software.
“OneOncology is attempting to bring that kind of support to smaller practices — and take the best practices of big practices to help them become more efficient and more technology-driven,” Mounce said.
At its core, OneOncology is a management company. That allows the founding practices and future additions the opportunity to retain a local brand and the idiosyncrasies of each practice while benefiting from being part of a larger organizational structure.
“We felt that by sharing management, infrastructure, and technology, we could build for the needs of patients in an increasingly complex environment going forward,” Schwartzberg said.
Leveraging data, informatics, and best practices could be the right mix to improve quality, cost, outcomes, and patient experiences through OneOncology’s integrated platform.
With new drugs coming out daily that are more successful with less toxicity, cancer patients are living longer. But, to support cutting-edge treatments, practices need “robust” electronic medical records and pharmacy systems, Mounce said.
The payoff for that investment is better outcomes for patients. West Cancer Center’s chief of staff, Dr. Kurt Tauer, noted that he sees patients who are 10 to 20 years removed from a cancer diagnosis and who, 15 years ago, would have been terminal.
With the newest drug and treatment regimens comes a need for training and an emphasis on safety.
While recently in Nashville meeting with OneOncology leadership, Mounce said that they discussed putting together a clinical committee to review all drug regimens that go into the electronic records system. Training through online education, podcasts, and other electronic means will keep all staff updated in real time on new drugs, techniques, and any changes or reactions.
Two years ago, West Cancer Center launched a new safety program based on recommendations from a Federal Aviation Administration consultant. The program took about a year to implement and involves daily “safety huddles,” an incident reporting system, and a reward system for those catching errors.
“If you had a 1 percent error rate in the aviation industry, you would have a lot of people dying in plane crashes,” Mounce said. “On the health care side, you know that there’s a much larger event of errors, and nobody seems shocked by that.”
The new safety program resulted in a decrease in potential errors and the ability to catch issues before patients are even close to being affected.
“[West had] a total change in our culture, that it’s okay to report a mistake or an error. That’s how we figure out the root cause and fix it,” Mounce said.
Tennessee Oncology, one of OneOncology’s founding members, has started doing safety huddles; the New York clinics plan to, as well.
When Mounce came to West Cancer Center in 2010 as CEO, patient care followed a pattern of going to one place for surgery, then another for radiation, physical therapy, and bloodwork. All of that added up to a less-than-ideal situation for an already tired and ill cancer patient.
The integration of all those components is one strength West brings to the OneOncology partnership. The goal is for care at all OneOncology practices to have the same level of integration.
“At some point, if you go to a OneOncology practice, the care you will receive in Paris, Tennessee, [will be] the same you will receive in Memphis, Nashville, or New York,” Mounce said.
OneOncology plans to eventually add more practices beyond the current three founding organizations. Mounce has ambitious goals for the group.
Over the next three to five years, he wants OneOncology to become the preeminent community oncology group in the U.S., with 1,500 to 2,000 physicians.
Mounce has already overseen significant changes and seized opportunities for West since moving to Memphis in 2010. While CEO, West Cancer Center began an affiliation with Methodist Le Bonheur Healthcare in 2012, which coincided with the start of an upward growth trend in the number of physicians, locations, and employees.
OneOncology signifies the further evolution of West Cancer Center. Next year, a new breast cancer center, radiation oncology center, and dedicated surgery center are planned, adding about 50 new jobs. And in 2020, plans involve doubling the size of West’s integrative oncology program and adding a full cancer center site, creating another 25 new jobs.
Beyond these local investments, the ultimate goal for OneOncology is to add likeminded practices regionally and nationally. West, Tennessee Oncology, and New York Cancer & Blood Specialists are already on the same electronic medical records and billing systems, which helps with expenses in combining operations. But, future practices joining may not be as aligned on the technology side.
“If we brought a new practice in … to our delivery model, I expect it to take six months to a year for practices to come up, get on the new technology platform, integrate in with a new care model, and then learn how to do it within their practice,” Mounce said.
OneOncology intends to be selective about practices it adds in the future and knows that what makes a practice unique can be a strength.
“We want to have practices that are innovative, here for the long haul, committed to patient-centered care, and to building all the components that entails,” Schwartzberg said.
“We’re not trying to create a cookbook kind of process,” Mounce said. “We are trying to create a standardized flow and technology.”