Background: The VA Hudson Valley Health Care System disease management (DM) team was developed in 2008 to coordinate recommended clinical tests, consultations, and treatments for veteran patients newly diagnosed with cancer. The team consists of 3 registered nurses who work under the auspices of the Quality Management Division rather than at a specific clinic. Before this program, coordination of components of health care delivery for our veterans were less than ideal. Local management determined that the disease case management team model, successful in the private sector, would be an appropriate solution and result in shortening the period between diagnosis and recommended treatment. This report will show the clinical impact of the Hudson Valley’s DM team on shortening the interval between suspecting a malignant diagnosis and ultimately starting a treatment regimen.
Methods: We assessed the timeline in days for veterans to get scheduled for recommended tests and consults before and after the DM team implementation. We reviewed those patients diagnosed during fiscal years 2009 to 2014. Rate of change for oncology consults and interfacility consults to DM team were calculated. Time from diagnosis to treatment intervention pre- and post-DM implementation were reviewed for colon cancers and lung cancers.
Results: Oncology consults for DM team intervention increased 62%, while interfacility consults for tests and treatments placed by the DM team increased 153%. There was a reduction in time from diagnosis to treatment intervention for colon cancer (50%) and lung cancer (47%).
Conclusion: These data show that within a VA care setting, the DM team model is feasible and contributes to reducing the time from the diagnosis of cancer to an intervention. The data show that with the introduction of the DM team, days from diagnosis to treatment declined significantly by facilitating referrals, clinical testing, and treatment initiation.