Alison Andre enjoys solving puzzles. Crossword, Sudoku, Rubik’s Cubes, all kinds. As the executive director of Compass Oncology, she approaches health care today like a giant puzzle.
“Like many of us, people important to me have been touched by cancer,” she says. “That makes it personal. If I can use my talents to support a phenomenal group of providers in caring for cancer patients, the journey is worthwhile.” She and her team operate on the principle of “Cancer Care Built Around You.”
Compass Oncology is the largest independent cancer and hematology treatment practice in the greater Portland, Oregon/Vancouver, Washington metro area (population: 2.35 million people). Its 38 specialty-trained and board-certified physicians and 14 advanced-practice providers at five cancer treatment centers include gynecologic oncologists, radiation oncologists, breast surgeons, cancer pathologists, palliative-care physicians, and genetics counselors. Collectively, they treat every type of cancer, including rare malignancies.
TOP-NOTCH PHYSICIANS ARE KEY STRENGTH
Their strength is seen in physicians such as Lucy Langer, who has performed genetic research at Columbia University and UCLA, and is the national medical director for the U.S. Oncology Genetic Risk Assessment and Treatment (GREAT) Program, and David Smith, a leading national investigator for the U.S. Oncology Network’s participation in Gene Related to Anergy in Lymphocyte (GRAIL) clinical studies. GRAIL seeks to develop a blood test to detect cancer early before symptoms appear.
“It is moving to me that many of the Compass team members are themselves cancer survivors,” says Andre. “They know well what our patients need, what they are feeling, and the compassionate care they deserve.”
It was that empathy that compelled many of the 380 Compass employees to the meaningful work of supporting others with cancer.
A SURVIVOR’S PERSPECTIVE
Jen Steen-Reavis is a breast-cancer nurse navigator. A nurse navigator’s primary role is to focus on patients, as well as on their families and support members. Knowledgeable in breast cancer, the navigator encourages the patient to be proactive and to participate in their own care and treatment plan. The navigator helps to identify and remove any barriers to care, is a strong source of education for the patient and his or her family, and follows patients through their journey from diagnosis through survivorship. “We live in a day and age in which cancer is now considered a chronic disease or illness.” According to the U.S. National Center for Health Statistics, a chronic disease is one lasting three months or more. “In the past, when people were given a diagnosis of cancer, they believed they would die of the disease," says Steen-Reavis. “Many times they would.” Now, she says, the National Cancer Institute reports there are over 3.1 million breast cancer survivors in the U.S., and the five-year survival rate for all breast cancers is nearly 90 percent. “We are curing people of breast cancer every day. Our screening is better, our treatment is better, and many women are living a long time, even with metastatic disease," she says. “I am hopeful people will start to see breast cancer as more of a chronic condition, rather than a death sentence.”
Having survived cancer herself, Steen-Reavis says that her patients appreciate the perspective and empathy she brings to their care. “When I was diagnosed 10 years ago, I shared in the same panic that anyone has when dealt the ‘cancer card,’” she says. “I have learned through time, treatment, and survivorship that life really is all about what we make it, and not what has been handed to us. I am a better version of myself because of the experience. I live differently now, and I know what’s important.”
Andre’s team of puzzle-solvers saw 4,221 new cancer patients in fiscal year 2018. They saw a few thousand more who do not have cancer but receive other services, such as those with a hematologic diagnosis or who seek genetic counseling.
LOCATIONS: Five cancer treatment centers in the
Portland, OR/Vancouver, WA metro area
MEDICAL STAFF: 38 specialty-trained and board-certified physicians,
including gynecologic oncologists, radiation oncologists, breast surgeons,
cancer pathologists, palliative care physicians, and genetic counselors
PHYSICIANS INSURANCE MEMBER: Since 2010
A COMMITMENT TO COST-EFFECTIVE CARE
In the majority of cases, notes Andre, free-standing community-based centers like Compass provide cancer care at a lower cost than hospital outpatient facilities. “Our team-based care model helps us provide services without unnecessary redundancy, for instance in the ordering of duplicate scans or lab work," she says. “Also, a private practice does not have the overhead that most hospitals do, such as an emergency department. In most cases, chemo treatment is considerably less expensive at a community-based cancer center than at a hospital.”
Further demonstrating that Compass Oncology is serious about making cancer therapies more affordable, the group joined the Oncology Care Model (OCM) when it began two years ago. The OCM Medicare demonstration project is focused on providing higher-quality, more highly coordinated oncology care at the same cost as Medicare, or lower.
A concerted focus on cost-effective care is, in part, why in 2017, after more than 20 years, Andre left Duke Cancer Center and her job as Assistant Vice President, and moved to the Pacific Northwest. “Health care is a rapidly changing landscape. I saw in Compass Oncology an organization committed to providing the best possible cancer care in a cost-effective manner. And I saw that Compass physicians play a part in defining the future of cancer care through participation in clinical trials, which ensure that our patients have access to the latest therapies available.”
“It is moving to me that many of the Compass team members are themselves
cancer survivors. They know well what our patients need, what they are feeling,
and the compassionate care they deserve.”
Executive Director, Compass Oncology
The team’s involvement in cancer research is another reason Andre joined Compass, where physicians have played an important role in the development of 60 cancer therapies. These include Durvalamab, a recently approved drug for patients with unresectable, stage 3, non-small-cell lung cancer, and Apalutamide, an approved drug for non-metastatic, castration-resistant prostate cancer.
Compass providers are no strangers to innovation—they were the first to introduce the Paxman Scalp Cooling System to patients in the Portland-Vancouver region. The system greatly reduces chemotherapy-induced alopecia. Compass surgeon Toni Storm-Dickerson is known for her innovative work in advancing breast surgery, such as using magnets to help pinpoint lesions in the breast.
FOUR PILLARS OF PATIENT CARE
This type of leading-edge success has helped bring Compass Oncology approximately 30 percent of market share in the region. So have the four pillars of patient care that drive their work:
Patient questions are encouraged. Educational opportunities are plentiful, as are an array of support groups, including groups devoted to journaling, nutrition, exercise, and stress reduction through the practice of Reiki. Special attention is given to “co-survivors,” the relatives and close friends who accompany the cancer patient on his or her journey.
Andre says transparency is key in a patient’s care. Cross-disciplinary sharing of a patient’s progress is an important part of that. “The care team holds huddles in which key information is shared with the physician, nurse practitioner or physician assistant, medical assistant, social worker, nutritionist, and other team members to improve our care and ensure that the needs of the patient are met.”
Cancer has been called “the disease of moving parts,” an ever-changing puzzle that,
as it grows and morphs over time, so do the types of personalized treatment that are most beneficial.
VARIETY IS THE SPICE OF LIFE
One of the joys of Andre’s job is rarely doing the same thing two days in a row. The variety includes positioning Compass for the future and developing a strategic plan; searching out the best locations for care; holding open forums with staff to hear their perspectives; working with the finance team; interfacing with the larger medical community on comprehensive strategies to benefit shared patients; and keeping on top of the health-care payment landscape.
Born in California, raised in Louisiana, and having lived much of her adult life in Virginia and North Carolina, Andre is smitten with the natural beauty of the Pacific Northwest. Originally drawn to the region by its natural resources, she says she is kept here by the people and their friendly and independent spirit.
“Oregon and Washington are trailblazers in many areas of health policy,” Andre says. “I am learning much from the work done here.”
She, her husband Jeff, and their two children fell in love with the local foodie culture. They also skied Mount Hood this winter, and plan to raft the Deschutes River, hike the Columbia Gorge, and explore as much as they can.
But it is Compass's operational principle to help patients find a clear path to hope and healing that drives her. “In the two years since we joined OCM, we have demonstrated agility by implementing changes to our practice in order to leverage the expertise of each team member to provide the best possible care,” she says.
Cancer has been called “the disease of moving parts,” an ever-changing puzzle that, as it grows and morphs over time, so do the types of personalized treatment that are most beneficial. Alison Andre and her team of puzzle solvers at Compass Oncology stay on top of the complexities for those who rely on them, ever mindful that “as every cancer is different, so is every patient.”