Each year, Kaiser Foundation Health Plan of Washington cares for thousands of patients with cancer in Washington state. True to the organization’s integrated care model, clinicians are committed to understanding the full picture of a patient’s health, including medical, social, emotional, and psychological health. Oncology teams work closely and collaboratively with primary care teams so the patient’s total health can stay front and center.
Dr. Tracy Sherertz, who grew up in the Pacific Northwest, sat down recently to describe what makes Kaiser Permanente’s multidisciplinary approach to cancer care unique. She also talked about the efforts she’s leading, along with her colleagues, to bring new advancements to their patients.
Partnering with the patient
When a patient is diagnosed with cancer, Kaiser Permanente takes a unique comprehensive approach to treatment. Each patient’s primary care team is already integrated with specialty care and diagnostics in the same network, so the patient doesn’t have to face the hurdle of preauthorization to get the care they need at a critical time.
An entire team of specialists is engaged, including surgeons, medical oncologists, radiation oncologists, oncology nurses, nurse navigators, social workers, nutritionists, and geneticists. Using the latest protocols and technologies, this team reviews, assesses, and develops a personalized treatment plan for each patient.
“It’s very important to have multiple eyes on a cancer case,” says Dr. Sherertz. “There’s a lot of coordination between oncology teams and the patient’s primary care team. The emphasis is on total health and aligning with a patient’s goals.”
Kaiser Permanente is deeply committed to providing highly coordinated care during the patient’s health journey, says Dr. Sherertz. “Our integrated system allows for seamless coordinated care, from the primary care team to diagnosis, treatment, surveillance, and throughout survivorship.”
What happens when a patient with cancer also has a chronic condition, such as diabetes?
It’s not uncommon for patients with cancer to be dealing with other health challenges, says Dr. Sherertz. Kaiser Permanente’s integrated model lets doctors optimize care for patients who need a careful balance of treatment for multiple chronic and acute health issues.
“Cancer care is highly individualized, and the emphasis is on total health,” she says. “We strive to take all of the patient’s needs into account. This might mean working with our colleagues in social work, primary care, nutrition, and our community resource team to come up with a personalized plan for each patient.”
This model means that the 1,000-plus doctors at Kaiser Permanente Washington can confer with more than 23,000 doctors who practice with the organization nationwide. In 2020, there were over 62,000 consults across medical teams.
Brachytherapy: How Kaiser Permanente is expanding access to state-of-the-art oncology care
When Dr. Sherertz joined Kaiser Permanente in 2018, she set out to establish a state-of-the-art, image- guided brachytherapy program. Brachytherapy is a form of internal radiation that allows oncologists to implant high doses of radiation to deep-seated tumors in the body, often those that can’t be taken out safely with surgery.
During external radiation therapy, radiation is directed into the body from a machine outside the body using high-energy X-rays. Certain forms of cancer, such as gynecological cancers, require a higher dose of radiation than can be delivered safely with external radiation. These cancers need a more targeted form of internal radiation in the form of brachytherapy.
With brachytherapy, treatment is often shorter and may have fewer side effects. Though this internal radiation has been available for many years, it’s evolving and becoming more personalized to the patient.
“One of the most recent advances in brachytherapy is image guidance,” says Dr. Sherertz. “We use MRI imaging that is acquired with the implant in place to create the most accurate mapping of the tumor and the patient’s anatomy.” This requires close coordination with the radiation oncology, anesthesia, and radiology departments.
The high-dose-rate (HDR) brachytherapy program created by Dr. Sherertz and her team allows for MRI guidance because these care teams are all under one roof at Kaiser Permanente’s Capitol Hill Campus. The opportunity to expand access to advanced treatment options is deeply rewarding for Dr. Sherertz.
“Radiation oncology is always evolving and improving,” she says. “Our ability to use the most high-tech advancements to improve our techniques is so gratifying.”