Dr. Peter Yu, the new physician-in-chief at the Hartford HealthCare Cancer Institute, is a recognized expert in the cancer field with more than 30 years’ experience as a researcher and physician leader. After starting his career as a research fellow at Memorial Sloan Kettering Cancer Center, Dr. Yu later became director of cancer research at Palo Alto Medical Foundation in California.
A past president of the American Society of Clinical Oncology, Dr. Yu also was among the team of cancer experts who consulted with former U.S. Vice President Joseph Biden on his “Moonshot” initiative to accelerate the effort to find a cure for cancer. (Dr. Yu assumed his new role as the clinical leader of the Hartford Health- Care Cancer Institute in June 2016.) Here, he reflects on his first eight months on the job:
Q: What are some of your impressions of the HHC Cancer Institute since joining as physician-in-chief?
A: First, that the Cancer Institute is just one of several institutes being launched at HHC. Each has a different disease focus and draws upon unique strengths, but all the institutes can learn from each other and the physician and administrative leadership are now meeting regularly.
Second, there are multiple needs and opportunities for growth in the Cancer Institute as we respond to two imperatives. One of those is positioning our health-care providers and the hospitals for the changing economic environment of alternative payment reform coupled with the need to demonstrate that our patients experience superior health outcomes.
In short, what is called the Triple Aim of better patient experience with their healthcare, improved population health and more affordable healthcare. The other prime objective of the Cancer Institute is to help develop the Memorial Sloan Kettering Cancer Alliance by successfully recruiting patients to clinical trials and helping to define guidelines and best practices that lead to better patient outcomes. The importance of recruiting patients to clinical trials is self-evident; it is how we will bring precision medicine and immuno-oncology to HHC patients and contribute to the national cancer Moonshot efforts. But less often mentioned is the opportunity for HHC, working through the MSK Cancer Alliance, to help build the next generation of practice guidelines.
Typically, oncologists and nurses rely on the professional guidelines produced from the American Society of Clinical Oncology, the National Comprehensive Cancer Network, the Oncology Nursing Society and others. But these guidelines begin as best practices of the cancer centers, through quality improvement initiatives and consensus opinions of experts, who now include our HHC providers.
Q: What are some of the main challenges or barriers you feel are important for the Cancer Institute to overcome to be successful?
A: Finding the right people for the work at hand. Some of those people are already here, but are engaged in other work. Will they be willing to change focus and redefine their careers? In other situations, we will need to recruit new talent.
With the right vision and forethought we can articulate a message that will bring to bear the best talent. The right people need to be supported to succeed. To me that means that what they are trying to accomplish and why that is important needs to be both clearly articulated and accepted by our community. Change management is key and the changes we are speaking of are disruptive. But to stand still is to fail.
We are living in an information world and for providers to take the best care of their patients, for administrators to make the right business decisions and for us to learn how to improve, we need the capacity for data analytics and reporting. That can only happen if we can collect and organize cancer data so that we understand it and build a data architecture that allows information sharing among the HHC oncology ecosystem. This is no trivial task and I would say that no institution that I am aware of has accomplished this to date.
However, several organizations have made progress and I would like to see the Cancer Institute be at the forefront in this area.
Q: Conversely, what are some of the attributes of the Cancer Institute that make it well positioned to meet those challenges?
A: The Cancer Institute is fortunate to have superior talent among its administrative leadership. Vice President of Operations Donna Handley and her three regional directors — Abbi Bruce, Kris Popovitch and Fred Bailey — really center the Institute.
On the physician side, our team of medical, radiation and surgical oncologists are inquisitive and self-determined to succeed. In all disciplines including oncology nursing, pharmacy, cancer registrars, genetic counselors, palliative care and others, we have people passionate about their work and their patients. When I was a fellow at Memorial Sloan Kettering, I was told that with the tremendous resources available at MSKCC, success was expected.
It feels the same way here at HHC. You work closely with physicians in your new role.
Q: What are some of the important messages you try to convey to them?
A: We are living in a period of medicine where unprecedented and disruptive forces are relentlessly forcing themselves upon us and changing our profession. Physician burnout is leading senior physicians to consider earlier retirement and younger physicians to ask questions about the quality of their lives, both professionally and personally.
Ignoring this is foolhardy. Much of what is happening is frankly unpredictable and uncontrollable; witness the recent national elections. Some of this is under our control through our professional medical societies such as ASCO, the American Society for Radiation Oncology, the College of American Pathologists and the American Society of Hematology and I encourage physicians to be actively involved with their professional society as I have done.
Some of it is under our control through healthcare systems such as HHC and within HHC the Cancer Institute is where we educate, support and provide a mechanism to get involved in determining your future, such as our Disease Management Teams and leadership structure. Payment reform will most definitely impact our physicians. It will drive us to shared accountability for the health outcomes our patients experience and for the economic outcomes of our decisions on treatment. By shared I mean collective responsibility for team-based care involving primary care, specialists, hospitalists and diagnostic and supportive specialties such as radiologists and pathologists.
Our incomes will be linked to the health and economic outcomes of individual patients and populations of patients.
Q: Where would you like to see the Cancer Institute 10 years from now?
A: Ten years from now, the Cancer Institute will be seen as a national model for a community healthcare system that consistently exceeds expectations. We will have a clearly articulated strategy that is well grounded on our mission and vision, and achieved operationally through respect for and alignment of the interests and preferences of our constituencies including patients, healthcare providers and administrators. We will be at the forefront in the sustainable and scalable implementation of precision medicine, immuno-oncology and science in patient care through our clinical trials and care delivery systems.
Q: It can be a challenging time to be in the health-care field. Why do you continue to be excited and passionate about the work that you do? How do you respond to challenging times? Do you see yourself as a victim or as an innovator who can envision new models and build the team around that?
A: As president of ASCO, I spent a good deal of time thinking about the future state of cancer care. Working with the ASCO Board of Directors and our staff of over 300, we prepared a vision of cancer care that will transform patient lives and healthcare.
At HHC, I feel that we have the opportunity to see that happen and to be part of that exciting future.