Healthcare uncertainties retard efforts to expand cancer 'compassionate care'

The uncertain future course of national health care is retarding fledgling efforts to expand what's known as "compassionate care" for cancer patients as hospitals in Seattle and elsewhere are proving reluctant to launch new cancer programs that drain rather than enhance revenue.

Matt Loscalzo, who helped develop the concept of "psychosocial" programs as the underpinning of "compassionate care" for cancer patients and their families, laments that major hospitals around the country have been reluctant to incorporate it into their treatment programs.

But Loscalzo. executive director of the Department of Supportive Care Medicine at the respected City of Hope in Duarte, east of Los Angeles, is careful not to criticize the major hospitals, including those with highly touted cancer-care programs, for failing to move toward psychosocial treatment programs.

"All hospitals and institutions are holding their collective breath over the challenges they face," Loscalzo says. "These hospitals represent a lot of good people under a lot of stress. First they have to keep the lights on, then attract good people, then meet a tremendous amount of regulation, insurance challenges and Medicare cutbacks."

Loscalzo is a pioneer nationally in the development of  psychosocial programs and he has guided development of a touchscreen tablet that allows cancer patients to deal with the mental and emotional issues beyond their medical problems.

The device, called SupportScreen, is a cornerstone of City of Hope's leading-edge focus on compassionate care. The device, which is programmed specifically for each patient, is designed to electronically record distress levels, through answers on touchpads, by asking cancer patients to identify and rate their practical, social and emotional problems along with medical information.

Patients reveal concerns that might otherwise go unrecognized, such as mental health imbalances, stresses over personal finances or insurance coverage concerns, or suicidal thoughts.  The information, which the patient knows will be shared with the entire healthcare team, allows that team to immediately provide integrated treatments and crises interventions.

And because of the efforts of a philanthropic couple who maintain residences in both Los Angeles and Seattle, visibility for SupportScreen will be coming to Seattle and, with it, a heightened awareness of what compassionate care actually means to cancer patients' outcomes.

Loscalzo's other role at City of Hope is as administrative director of the Sheri and Les Biller Patient and Family Resource Center, created nearly four years ago through the vision and financial support of the Billers to create an international model of compassionate care. His psychosocial program, including, the touchscreen tablet, is a major part of the Biller Center's unique offerings.

The reach and influence of the Billers has given Loscalzo's efforts a major boost. Sheri is chair of the City of Hope board and Les is retired vice chair of Wells Fargo and current board chair for Spokane-based Sterling Savings.

Loscalzo's goal is to move the psychosocial program concept, complete with the SupportScreen, into the mainstream of cancer care, expanding its reach well beyond the handful of cancer hospitals where the program is now being introduced. The only other one in the West, in addition to the City of Hope, is the Huntsman Cancer Institute in Salt Lake City, which Loscalzo describes as "a fairly new center that is really trying to get is program up and running."

"The number of cancer survivors nationally is nearing 12 million and for them, psychosocial is going to be a part of the rest of their lives," Loscalzo says. "There are humanistic and financial costs for ignoring the psychosocial needs of patients and their families, as well as of cancer survivors."

In the nearly four years since their philanthropy allowed the Biller Center to open, the Billers have made the City of Hope's focus on compassionate care, including the SupportScreen, their cause.

It was because of a friendship with the Billers and a personal interest in the cancer initiatives there that I was able to get a first-hand look late last year at the programs of City of Hope and its almost unique focus on compassionate care. thus I had a chance to meet key players there, including Dr. Michael Friedman, who is president an CEO, and Loscalzo.

Because the Billers are givers, they share the willingness of all practiced philanthropists to also be askers, tapping friends, colleagues and associates to support their cause with personal involvement and financial support.

For three years, Sheri Biller's "ask" has been on behalf of a team of what she calls "Resource Racers" in an all-women's half marathon in New York City to raise money to augment the basic support for the Biller Center at City of Hope that's provided by the Biller Family Foundation.

This year, the call has gone out from both Sheri and Les Biller for "generous" contributions to her Resource Racers, including men as participants for the first time, for the Rock 'n Roll Marathon/Half Marathon in Seattle in late June. The donations this year will go specifically to expand the use and the number of SupportScreens available to City of Hope's cancer patients.

That may well bring visibility for the first time to cancer-care supporters in the Northwest, who may legitimately ask "why not here," given the cancer-care reputations of major hospitals in Seattle and Portland.

Meanwhile, Loscalzo's vision is to develop a touchscreen specifically aimed at children suffering from cancer. But that may be a ways off.

"We want to incorporate things like animation into the software of the SupportScreens we develop for youngsters," Loscalzo says. "A rough estimate is that we'll need about $1 million for development of those children's screens."