COLON CANCER SCREENING INITIATIVE Health and Hospitals Corporation of New York City

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COLON CANCER SCREENING INITIATIVEHealth and
Hospitals Corporation of New York City

• Vivek Gumaste,MD, MRCP(I), MHCM(Harvard),
• Chief,Div of GI,Elmhurst Hospital,
• Associate Professor of Medicine,
• Mount Sinai School of Medicine.

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Colon Cancer Screening Concern

• Tremendous Increase in Volume
• No Capacity
• No resources.

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BARRIERS

• Inadequate Gastroenterologists
• Lack of Physical plant
• Lack of Finances.
• Lack of Equipment
• Lack of Endoscopy Nurses.
• Uninsured Patients

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Team BuildingColon Cancer Screening Committee

• Leadership
• Dr.B.Mojica co-chair HHC
• Dr.Vivek Gumaste co-chair-Physicians
• Mari Carlesmo- co-ordinator
• Members
• GI Chiefs
• CEOs
• CFO or rep

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FUNDING

• City Council Funding
• In FY 04 --- 396000
• In FY 05-----335000
• New York Community Trust Funding
• In FY 04---100,000 Lincoln Hospital
• In FY05---200000 Lincoln Woodhull
• Article VI
• FY 04---250000
• FY 05---250000

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Future Sources

• NIH Grants

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Total No of Colonoscopies
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No of Screening Colonoscopies

• An increase of 100

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Increase in Screening Colonoscopies
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Cancers detected

• Early Stages 0,1,2
• 60 in CY 03
• 65 in CY 04

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Adenomas

• 14 in CY 03
• 15 in CY 04.

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CRITICAL SUCCESS FACTORS

• Committement and Vision of Leadership
• DDr.Chu and Dr Frieden
• FFunding
• EEfforts of Personnel

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CHALLENGES AHEAD

• No show
• Call ahead at least 2 days
• Overbook
• Adequate Personnel
• Physicians Inability to attract personnel
• Nurses trained nurses
• Physical Capacity
• Uninsured Patients
• Equipment

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VOLUME

• 42 million people who are unscreened
• This program is going to increase demand
• Waiting Times will go up.
• Rigid Time Frame
• Catastrophic
• Collapse
• Regulate Flow
• Odd and even

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HOW CAN WE SUSTAIN THIS PROGRAM?

• There must be a commitment to reinvest the gains
  generated by the increased procedures back into
  the program
• DRIVING FORCE
• A SELF-SUSTAINING MEASURE

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GAINS

• Increased Patient Survival
• Early Stages 5 yr survival gt90
• Late Stages 5 yr survival lt8
• Fiscal Gains
• Increased Physician Revenues
• Increased Institutional Revenues
• Cost Savings- Insurance Companies

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REINVESTMENT

• Institutions
• Insurance Companies
• Government

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PATIENT INCENTIVES

• Bridges to Excellence
• Direct Patient Incentives

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• ZERO TOLERANCE
• COLON CANCER ELIMINATION ACT OF 2001 BECOMES A
  REALITY.