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Delivering Cancer Care in our Communities

July 26, 2023


Improved patient access, focused clinician expertise, and parity of care form the cornerstone of a new vision and strategy for growth created by the partnership of Yale Cancer Center and Smilow Cancer Hospital.

The plan is the culmination of self evaluation and planning among the entities, each guided by the same goal: to provide the best care for every patient with cancer across all 16 Smilow locations in the region.

Essential to access is a revised scheduling template designed to ensure that newly diagnosed patients with cancer are seen within three days of their referral. “Patient access is really key,” said Eric Winer, MD, Director of Yale Cancer Center and Physician-in-Chief of the Smilow Cancer Network. “When a patient has a new diagnosis of cancer—and this is by far the majority of patients coming to us—getting in to see a specialist quickly is really important and is hugely reassuring.”

"Smilow is a special place...We have a cancer hospital that delivers academic, best-in-class cancer care and access to clinical trials, but we also have a wide geographic reach." - Elizabeth Herbert

Lori Pickens, MHA, Senior Vice President of the Cancer Service Line and Executive Director of Smilow Cancer Hospital, noted that Smilow, Yale Medicine, and the Yale New Haven Health System all are intent on improving access. “Our work is aligning beautifully with what the entire health system is seeking to achieve.” At Smilow, the effort to improve access has been led by Sarah Schellhorn, MD, Associate Professor of Medicine (Medical Oncology), and Lisa Shomsky, MBA, BSN, CNML, regional director for Smilow Cancer Hospital. They have spent time holding focus groups with multiple stakeholders including physicians, RN coordinators, and intake staff. The team has also analyzed the challenges and best practices for scheduling appointments for new patients as efficiently as possible. Education and training has begun for staff who will use the new template, launching soon at all Smilow locations.

“Smilow is a special place,” said Elizabeth Herbert, Vice President for Network Services at Smilow Cancer Hospital. “We have a cancer hospital that delivers academic, best-in-class cancer care and access to clinical trials, but we also have a wide geographic reach, through sites across the state that provide close-to-home access to patients who otherwise may not have the resources to come to Smilow (in New Haven).”

The goal of Smilow’s initiatives to provide cancer specialization and regionalization of care, Ms. Herbert added, is to eliminate any distinction between the care offered at the main hospital and in the other 15 locations. “We need to provide access to subspecialty care in all sites so that patients do not have to travel or wait for appointments.”

The demand for more subspecialty care is being driven by rapid developments in cancer research that are expanding our understanding of each cancer’s complexity. This has led to new specialized technologies and treatments. “It has become increasingly difficult for one person to be an expert across all disease subtypes,” said Dr. Winer. “We need to move toward a subspecialized care model, with GI cancer doctors taking care of patients with GI cancers, breast cancer doctors taking care of patients with breast cancer, and so on.”

These transformative shifts require new models of care, said Jeremy Kortmansky, MD, Associate Professor of Clinical Medicine (Medical Oncology) and Chief Network Officer for the Smilow Cancer Hospital Network. “Patients and families want to get research-driven, multidisciplinary care from providers who are experts in their field, but they also want it to be close to home and convenient.”

Smilow physicians will begin to progress toward subspecialty expertise. To ensure that this access happens in a timely way, some specialists will practice at multiple locations. Patients will also continue to have access to clinical trials at all Smilow locations.

“The mission,” said Dr. Winer, “is to provide outstanding multidisciplinary care with the availability of cutting edge research to patients with cancer throughout the region. We want every patient at every Smilow site to receive the very best care available today, and by embracing clinical trials, we will drive improvements for future generations of people with cancer. In many ways we’re really close. We have total support in this mission from both the CEO of the Yale Health System and the Dean of the Yale School of Medicine. We have big plans for the future.”

Submitted by Emily Montemerlo on July 27, 2023