Apply by 3/31 for career development funding to advance Learning Health System science. Learn more.

Cancer Care @ Home

Cancer Care @ Home

Safe, efficient, life-extending care in the comfort of home

Project status

Implementation
Scale

Collaborators

Penn Center for Cancer Care Innovation

Justin Bekelman, MD

Amy Laughlin, MD

Callie Scott, MSc

 

Abramson Cancer Center 

Jenn Braun, MHA, RN, BSN

Pat Higgins, MHA

David Miller, MBA

Larry Shulman, MD

Bob Vonderheide, MD, DPhil

Lindsey Zinck, RN, MSN, OCN

 

Hospital of the University of Pennsylvania 

Lu Ann Brady, MS

Donna Capozzi, PharmD

 

Penn Medicine at Home and Penn Home Infusion Therapy 

Mary Denno, MSN, RN

Joan Doyle, RN, MSN, MBA

Sarah Johnson, MBA

Sandra Jost, PhD, RN

Katherine Major, MSN, RN, CPHN

Cassandra Redmond, PharmD, MBA

 

University of Pennsylvania Health System 

Neil Crimins

Roy Schwartz, MBA

Robert Tobin

 

Division of Hematology and Oncology 

Roger Cohen, MD

Dan Landsburg, MD

Suzanne McGettigan, MSN, CRNP, AOCN

Lynn Schuchter, MD

David Vaughn, MD

Innovation leads

Funding

Innovation Accelerator Program

Penn Center for Cancer Care Innovation

Opportunity

Each year, about 1.8 million Americans are diagnosed with cancer. Historically, nearly all life-extending cancer treatment has been delivered in outpatient or hospital settings. Within a year of diagnosis, three-quarters of those with advanced cancer end up in the hospital; one in six are hospitalized three or more times. And nearly all chemotherapy is delivered in physician offices or outpatient clinics. Patients have to travel in, pay for parking, and spend hours waiting for and receiving care.

Internationally, giving cancer drugs at home has been done safely and effectively across various patient populations and treatment regimens. But it’s uncommon in the United States.

At Penn Medicine, we provide world-class cancer care to more than 26,000 new patients each year. In late 2019, a multidisciplinary team of experts, brought together by the Penn Center for Cancer Care Innovation, began to explore if home cancer treatment could, for appropriate drugs and patient populations, take the place of inpatient or outpatient administration.

Intervention 

Cancer Care @ Home (CC@H) is an evidence-based, patient-centered program that enables life-extending cancer treatment to be delivered in the home.

The program proactively identifies optimal candidates based on specific criteria agreed upon by clinical teams. Providers discuss CC@H with their patients during telehealth or in-person visits and prescribe home treatment using the electronic health record.

From there, staff from Penn Home Infusion Therapy (PHIT) obtain insurance authorization, discuss out-of-pocket cost with patients, and schedule home visits. A courier delivers the medication to the patient’s home, and an oncology-certified nurse arrives on the day of the scheduled visit to administer care. Throughout this process, the prescribing oncologist monitors the patient’s treatments to ensure coordinated care.

Impact 

Since CC@H launched in February 2020, thousands of patients with breast cancer, prostate cancer, and lymphoma have received timely, safe, and effective treatment in the comfort of their homes. In fact, CC@H has enabled patients with lymphoma to spend 25 fewer days in the hospital and patients with breast or prostate cancer to avoid up to 12 outpatient visits a year. 

CC@H patients report increased satisfaction with care, enhanced convenience and comfort, and a better overall experience. The program also benefits the health system as it increases clinic and inpatient bed capacity by decreasing infusion suite density. 

CC@H is now a standard of care at the Abramson Cancer Center, and the team is exploring opportunities to make CC@H available for more patients.

Innovation Methods

A day in the life

One of the best ways to learn more about a problem area is to experience it yourself. Immerse yourself in the physical environment of your user. Do the things they are required to do to gain a firsthand experience of...

A day in the life

The CC@H team performed contextual inquiry by observing PHIT nurses on home visits.

This afforded a deep, contextualized understanding of the existing workflows and provided insight into how cancer care delivery could be integrated into the team’s suite of available therapies.

A day in the life

One of the best ways to learn more about a problem area is to experience it yourself. Immerse yourself in the physical environment of your user.

Do the things they are required to do to gain a firsthand experience of the challenges they face. Completing a day in the life exercise will enable you to uncover actionable insights and build empathy for the people you're hoping to help.

The concierge

A concierge provides hands-on, efficient, and proactive services for customers. Similar to the concept of walking in someone's shoes, a concierge walks alongside someone and helps them get things done. Acting as...

The concierge

During early pilots, patients had access to a 24/7 concierge service. Patients could call in with questions and concerns at any time.

This helped the team identify attributes of the pilot program that could be improved and validate what was working. These insights shaped the final design of the program.

The concierge

A concierge provides hands-on, efficient, and proactive services for customers. Similar to the concept of walking in someone's shoes, a concierge walks alongside someone and helps them get things done.
 
Acting as a concierge or high-touch helper for a small sample of people will enable you to get deep into the reality of their journey and learn about the barriers they face because, like a real concierge, you'll help them navigate those barriers. You can also test solutions in real time as you explore the problem space in context.

Press