Implementing a focused IO service line: 3 key takeaways

Establishing an interventional oncology (IO) service line at a quaternary cancer center can make a significant impact, according to a recent study published in the Journal of the American College of Radiology.

In July 2013, researchers from the department of radiology at Vanderbilt University Medical Center in Nashville, Tenn., developed a patient-centered IO service line at their facility’s cancer center. Time was built into clinicians’ schedules to attend tumor boards, and all new patients were scheduled to be seen in the IO clinic. Patient care was managed by the service line “from initial consultation through follow-up.”

“Our primary hypothesis in this report was that development of an IO-specific service line ... would significantly increase both clinic and procedure volumes,” lead author Daniel B. Brown, MD, and colleagues wrote. “We also hypothesized that any increases resulting from development of the IO service line would exceed national trends.”

The authors analyzed data from before implementation (July 2012-June 2013) and after implementation (July 2013-June 2014), tracking both procedure volume and the number of clinic visits.

Were the team’s hypotheses correct? These are three important findings from the team’s research:

1. Total clinic visits increased from 9 to 193 after implementation

“Development of a focused interventional oncology service line led to increases in patient referrals, with clinic visits growing by over 2,000 percent in a single year,” the authors wrote.

Brown et al. also noted that a whopping 88 percent of visits were by new patients, and the number of clinic visits increased in each quarter the IO line was open.

2. Procedure volume increased from 60 to 239 procedures

This statistic represents an increase of almost 300 percent, the authors said, and volumes increased at least 150 percent for each subtype (transarterial chemoembolization, mapping, and others.)

3. The distribution of procedure type changed from 2013 to 2014

In 2013, transarterial chemoembolization made up 60 percent of the center’s procedures, but that dropped from 38 percent of its procedures in the following year, when the IO line was fully up and running.

Brown and colleagues also noted a change in the center’s “range of treated pathology,” with hepatocellular carcinoma (HCC) still remaining the most commonly treated tumor but by a much smaller margin.

“The percentage of non-HCC cases rose from 27 percent to 40 percent, including growth beyond neuroendocrine and colorectal cancer,” the authors wrote.

Overall, the center’s focused IO service line resulted in significant changes, but other groups will need a little bit of help to follow the research team’s own example.

“Acquiring dedicated staff requires capital support,” the authors wrote. “Given that most IRs report suboptimal support in the procedure suites, getting staffing comparable to surgical or medical oncology is a challenge. We hope that other IO service lines and IR divisions can use these data to demonstrate value.”