Member Spotlight: A Continuing Mission of Hope with New Focus on Value-Driven Care

As a young teen, Chris Achtien lost his father to lung cancer. The experience affected Chris deeply as he saw the ravages of cancer on the body and toll it take on loved ones. But rather than avoid the world of cancer care and research, he embraced it.

“I never thought that managing cancer centers would be my career,” Achtien says. “While I’ve always worked in health care, when I joined a cancer center in Indiana more than 17 years ago, I discovered I loved working with
physicians and clinical staff to deliver cancer care. I found my interactions with patients weren’t depressing. You hear heartrending stories, but there are also uplifting stories.”

Today, as executive director of Willamette Valley Cancer Institute and Research Center in Oregon, Achtien still finds his days are filled with much more hope than sadness. “There will always be down days for our patients as they go through their cancer journeys, but mostly I see positive and often amazing things happening!”

Achtien’s optimism and confidence about meeting the complex challenges of delivering health care today underscores WVCI’s mission of hope and patient advocacy.

Like many health-care organizations, WVCI is adapting to changes resulting from the Affordable Care Act. And that means moving from a primarily fee-for-service model to value-based contracting and payment. “Switching our focus has been huge,” Achtien says. “This means we’re not just doing procedures. Now we must evaluate what we do and how we do it, adapt, and demonstrate our value to patients and payers.”

One way WVCI is adding value to the patient experience is through a new advance-care planning initiative which was implemented in response to patient feedback. “We are responding to patients who come into the ER not knowing they have a terminal disease,” explains Achtien. “At that time, they are told by a doctor they are dying, and they are completely unprepared. What we saw was the need to help people who were completely blindsided; to facilitate their understanding of the disease and make sure they and their families are informed.”

WVCI’s “My Choices My Wishes” program provides patients, who have especially aggressive cancers, access to social workers to educate them about their disease, its prognosis, and available treatments so they and their families can fully understand the course it will likely take. A key part of the program involves helping patients make informed choices about what treatment they want, for how long, and deciding when they want to stop treatment.

While WVCI’s providers remain focused on hope and curing cancer, My Choices offers patients and their families peace of mind. In fact, Achtien notes that studies have shown that having an advance-care plan actually may enable terminal patients to live longer. Along with offering peace of mind, advance-care planning may save patients, providers, and payers money. It’s well documented that care costs at the end of life can be extremely
high, often the highest of any time during a person’s life. So Achtien and his team believe it makes sense for an oncology practice to study how many people receive chemotherapy in their final days of life and the resulting costs. “You have to ask, ‘What value do they get out of this therapy?’” Achtien says. This is why they want to make sure they help patients make their own choices based on all available information.

Results have been positive. “It’s a win all the way around,” says Achtien. “Our doctors win as this important discussion happens at the onset of treatment. It’s a win for patients and their families as our social workers have conversations at different times during the patient’s treatment, thus ensuring they have a clear plan. And it’s a win for everyone as costs are reduced and greater value is delivered.”

Focusing on the treatment of adult cancers, WVCI’s team of medical-oncologists, radiation and gynecological oncologists, treat virtually every kind of cancer, including complex blood cancers, such as leukemia and lymphoma.

WVCI sets itself apart by offering a fully integrated approach to care. In addition to providing the latest in cancer-fighting medical treatments and technologies, it also offers a wide range of support services to address the emotional, physical, and spiritual needs of patients. For example, all breast, colorectal, and lung-cancer patients receive guidance from a patient navigator who helps them anticipate, address, and overcome any challenges in the treatment process and coordinates services to improve their quality of care.

Information overload is a common problem for patients with complex diseases. So the navigators steer them to a clear understanding of their treatment course, including side effects of medication and how to deal with them, in addition to providing access to social workers, counselors, support groups, dieticians, massage therapists, and an on-site pharmacy. The goal is to ensure that the patient’s holistic needs are addressed.

A common misperception is that patients can access clinical trials and experimental treatments only in large cities or academic medical centers, but WVCI provides this at their clinics in Eugene and Springfield.

As a member of US Oncology Research, WVCI offers patients access to one of the nation's largest research networks, specializing in Phase I-III trials for a wide range of cancers. Patients also benefit from a top-notch team of clinical researchers who lead numerous national studies in immunotherapy, vaccines, targeted therapies, and radiation trials. These oncologists are conducting important work that is changing the cancer treatment landscape.

Clinical trials currently underway at WVCI include investigational therapies for cancer of the breast, kidney, lung, lymphatic system, prostate, and more.

“The caliber of physicians, breadth of cancer services, and technology we offer is world-class. It compares favorably with cancer centers in much larger areas,” Achtien says.

Clinical trials enable WVCI to differentiate itself and add value to the patient experience. They also help keep WVCI’s executive director—and many others—seeing the positive side of today’s evolving cancer care. “I know we have big challenges ahead, and there have been and will continue to be very significant changes to our model of care, but I find it stimulating,” Achtien says. “I work with bright and dedicated people who will make it better.”