Natalie Dickson, MD, MMHC, FASCO, FACP, of Tennessee Oncology Discusses Cutting-Edge Cancer Care Initiatives

The 2024 Community Oncology Conference from the Community Oncology Alliance took place from April 4 to 5 in Orlando, Florida. Under the theme of “Stronger Together,” discussions were centered on 3 tracks—business, clinical, and pharmacy—and came on the heels of the disruptive and destructive Change Healthcare cyberattack. Policy and reimbursement survival techniques featured in each presentation, with pharmacy benefit managers, legislative priorities, and advocacy all being topics of great interest to attendees and presenters alike.

Natalie Dickson, MD, MMHC, FASCO, FACP | Image credit: Tennessee Oncology

During the 2-day meeting, The American Journal of Managed Care®, sister publication to Evidence-Based Oncology (EBO), conducted an interview with Natalie Dickson, MD, MMHC, FASCO, FACP, president and chief strategy officer at Tennessee Oncology in Nashville, one of the largest independent practices in the country, and a presenter in the session “Operationalizing a Cellular Therapy Program in Your Community Oncology Practice.” Here she discusses several key developments at Tennessee Oncology over the past year: the launch of the McKay Institute for Oncology Transformation in October, the Greco-Hainsworth Tennessee Oncology Centers for Research in November, and the NEST (Navigated, Embedded, Supportive Care, Via Telehealth) program in February.

“Tennessee Oncology is committed to providing access to care to all patients,” Dickson emphasized.

EBO: On October 24, 2023, Tennessee Oncology launched the McKay Institute for Oncology Transformation.¹ Can you tell us more about the launch of this innovation hub? What are your short- and long-term goals?

Dickson: The inauguration of the McKay Institute was a pivotal point for Tennessee Oncology, and it marked the evolution of our ongoing efforts in innovation. The McKay Institute is a start-up company within Tennessee Oncology; it will provide the ability for our physicians and administrators to not just care for patients but also improve care delivery by helping to advance technologies and policies and to help launch new businesses within the oncology sphere.

EBO: How will McKay’s 3-pronged approach, which encompasses leadership and entrepreneurial opportunities, critical support for businesses and investment sectors, and health care delivery research, augment the cancer care that you already provide at Tennessee Oncology?

Dickson: The multifaceted approach that we have does help to provide the ecosystem of collaboration so that physicians and administrators can learn new ideas. And all these insights from research and from participating in new ventures will only enhance the quality of care that we provide.

EBO: You also recently launched the Greco-Hainsworth Tennessee Oncology Centers for Research,² which nearly doubled the number of clinic locations for research from 18 to 35. What are your current research priorities getting this initiative off the ground?

Dickson: We’re very excited to launch the Greco-Hainsworth Centers for Research. It is our commitment to ongoing clinical trials to advance the science of oncology, and it is a commitment from us to push the boundaries of research. We are leveraging our expansive infrastructure to be able to provide clinical trials to all our patients at all our clinical sites. And we are not just leveraging the number of sites that we have, but we’re partnering with other research organizations so that we have a comprehensive menu of clinical trials. Not just all the phases of drug studies but outcomes research and care delivery research as well. In our partnerships with other organizations, we have the ability to share novel ideas; this will provide the opportunity to have a greater impact. [We] will also have the ability to better understand social and health care complexities in which we can provide all these trials to our patients.

EBO: With medical and academic collaboration being a cornerstone of the Greco-Hainsworth approach, can you discuss some ways in which you will address health care disparities amid ongoing efforts to increase clinical trial diversity?

Dickson: Tennessee Oncology is committed to providing access and cutting-edge care to all our patients in our clinics and research sites. At all our centers, not just urban but at our rural centers, this indicates our commitment to help reduce disparities and improve health equity. We are leveraging technologies such as telemedicine, but we’re also engaging the local health care providers and local organizations to help us better understand what the challenges are and to bridge those gaps.

EBO: Another important priority at Tennessee Oncology is its novel NEST program.³ Just launched in February, this is aiming to improve access for patients with breast and prostate cancer. Why is it important to focus on these cancers specifically? And why is it such a need for supportive services for these rural areas?

Dickson: So, Tennessee Oncology is committed to provid[ing] access to all patients. Our NEST project is focusing on the patients [with] breast and prostate cancer, and our focus is based mainly on their prevalence and also the fact that the treatments for patients in this population tend to be very complex and they are associated with a wide array of different [adverse] effects and toxicities that can affect the patients’ quality of life and their productivity.

These patients, therefore, typically need many supportive care services. And so the NEST project is committed to finding ways to bring palliative care, psychology, and other supportive care services to this population. And we’re focusing on the rural patients because we know that rural patients have unique challenges. They are chronically underserved, and their outcomes tend to be poor [compared with] the general population.

We are leveraging community advisory boards to help us better understand what these unique challenges are. We are using telemedicine to help us provide these services, because even though we do have the largest palliative care program in independent oncology, we still have challenges to provide all the services in person, and so we’re using telemedicine to help bridge that gap.

EBO: Have you had any feedback so far from the community advisory boards?

Dickson: We are engaging the local health community, the patients, the caregivers, community advisory boards, and the health care providers. We have yet to receive any feedback from the community advisory boards, but we anticipate that their insights will be very helpful for us to tailor our solutions to the communities that we serve.

EBO: Is there anything else that you would like to share?

Dickson: We are about to launch the first community [chimeric antigen receptor] T-cell program entirely controlled by a practice. And we are hoping to be a successful example and to set best practices to help guide future endeavors in this exciting field.

References
1. Tennessee Oncology launches McKay Institute for Oncology Transformation. Tennessee Oncology. Accessed April 22, 2024. https://tnoncology.com/blog/tennessee-oncology-launches-mckay-institute-for-oncology-transformation/
2. Tennessee Oncology launches the Greco-Hainsworth Tennessee Oncology Centers for Research and appoints Dr. Ian Flinn as chief scientific officer. News release. Tennessee Oncology. November 16, 2023. Accessed April 22, 2024. https://tnoncology.com/news/tennessee-oncology-launches-the-greco-hainsworth-tennessee-oncology-centers-for-research-and-appoints-dr-ian-flinn-as-chief-scientific-officer/
3. Tennessee Oncology launches rural telehealth program to bridge digital divide for Middle Tennessee cancer patients. News release. Tennessee Oncology. February 20, 2024. Accessed April 22, 2024. https://tnoncology.com/news/tennessee-oncology-launches-rural-telehealth-program-to-bridge-digital-divide-for-middle-tennessee-cancer-patients/