e-Consults for Immune-Related Toxicities Improve Patient Access and Reduce Costs

Between 4% to 15% of patients with cancer who are treated with a class of medications called immune checkpoint inhibitors experience immune-related adverse events (irAEs), including hypothyroidism, hyperthyroidism, and insulin-deficient diabetes. Delayed access, diagnosis, and management of irAEs are often causes of preventable hospital admissions in cancer patients.

At Duke Cancer Institute, the implementation of electronic-consults for patients experiencing endocrine irAEs improved patient access and reduced healthcare utilization. Time to appointment and hospitalizations were reduced from 61 days to 39 days and from 11% to 2%, respectively. To propel integration and scalability, the next step is to ensure adequate reimbursement from payers for these types of e-consults.

Guest:

Afreen Shariff, MD, MBBS

Director, Duke Endo Oncology Program

Associate Director, Cancer Therapy Toxicity Program, Center for Cancer Immunotherapy

Duke Cancer Institute

Durham, North Carolina

 “I’ve been a strong advocate to fix the effort and reimbursement mismatch because these are very different from traditional e-consultative services…the acuity of patients is different. The level of expertise that is needed to triage and give recommendations to patients is different…the reimbursement we get through third party-payers is what I call the ‘coffee and bagel’ consult because it really doesn’t do justice to the kind of service we provide.”

This podcast is part of a special series with the 2023 ACCC Innovator Award winners. For a deeper dive into this and other content that will help your team reimagine how care is delivered at your cancer program or practice, register today for the ACCC 40th National Oncology Conference, Oct. 4-6, in Austin Texas.

Resources:

Managing irAEs into Post-Treatment Survivorship

Working with Rheumatologists to Manage irAEs

Adverse Event Management in the Community-Based Immuno-Oncology Clinic

Virtual Toxicity Team Cleveland Clinic

Perspective on Managing Immune-related Adverse Events

Working with Rheumatologists to Manage irAEs