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Duke Oncology Network. Overview of Affiliated Programs. Public Affairs and Marketing Network. May 6, 2008. Duke University Health System. Duke University Health System Long history of Reaching Out. 1939 American College of Surgeons Cancer Program Accreditation.

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Duke Oncology Network

Overview of Affiliated Programs

Public Affairs and Marketing Network

May 6, 2008

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Duke University Health SystemLong history of Reaching Out

1939 American College of Surgeons Cancer Program Accreditation

1972 Duke Designated by the NCI as a Comprehensive Cancer Center

1974 Duke University Medical Center Clinical and Education Affiliations Established

1989 Duke Comprehensive Cancer Center Affiliations Program Established

2001 Integration of Cancer Affiliations between Cancer Center and Health System Initiatives


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Duke Oncology Network Rationale for Developing Affiliate Relationships

  • Is consistent with Duke’s goal of becoming an internationally recognized leader in oncology medicine.

  • Enhances treatment options, outcomes, and the quality of life for members of the local community.

  • Generates funds in support of its academic mission.

  • Provides the opportunity to develop new markets and new sources of patients (in DUHS Service Area).

  • Enables Duke to maintain its pre-eminent position in research and education by adding sites for additional training opportunities and clinical research.

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Duke Oncology NetworkMission Statement

Providing state-of-art cancer care to patients in the communities we serve;

Providing and promoting cancer prevention, screening, diagnosis and treatment through clinical research;

Offering educational opportunities to healthcare practitioners and the community at large; and

Enhancing the effectiveness and efficiency of cancer care delivery through performance improvement and outcomes measures.

The mission of the Duke Oncology Network is to provide an array of oncology related services in a regional network of community cancer programs that have made a commitment toward excellence in cancer care. The Duke Oncology Network seeks to support and strengthen the mission of the affiliated organizations by:


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Duke Oncology NetworkSites of Service

Memorial Hospital of Martinsville & Henry County

Oncology & Hematology of Southwest Virginia Associates

St. Mary’s Hospital

Maria Parham Medical Center

Granville Medical Center

Durham Regional Hospital

Durham VA

Duke Raleigh Hospital

Comprehensive Cancer Care, PA

Columbus County Hospital

First Health Moore Regional

Southeastern Regional Medical Center

South Carolina Oncology Associates

Beaufort Memorial Hospital

Community Memorial Healthcenter

Virginia Oncology Associates


Memorial Hospital


Medical Center






Johnston Memorial Hospital

Phoebe Putney

Medical Center



Oncology Research Programs

Bone Marrow Transplant Programs

Oncology Program Development

CALGB Affiliates

Clinical Medical Oncology Practices

Palm Beach

Cancer Institute

Clinical Radiation Oncology Clinics


Consultative Clinics

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Duke Affiliations

Anchor Communities

DUMC Affiliated Counties




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Duke Oncology Network

Linda Sutton, MD

Medical Director

Duke Oncology Network

Paul Lindia

Associate Vice President

Clinical Program Development

Julie Clayton

Staff Specialist

Community PDC


DON Med Onc

Renee Muellenbach


Duke Oncology Network



Rusty Anderson, MD

Kaushik Sen, MD

Brianne Buchanan, PA

Lena Carver

Staff Assistant

Rhonda Bergey

Staff Specialist

Gail Leget, MD

Beth Moore, , PA

Ivy Altomare, MD

Sharon Taylor, MD


Monica Roberson

Program Coordinator

Kelvin Raybon, MD

Gina Vaccaro, MD


Melanie Watson


Marty Polovich

Associate Director

Financial Analyst III

Nursing Director &

Associate Director

Remote Mkt Affil

Ahmad Mahmood, MD

Assoc Dir

Clinical Trials

Onc Clin Ops

and Ed Programs

Yuri Fesko, MD

Angela Latta

Medical Secretary

Primary Responsibilities:

1) Affiliated program operations (admin operations/ interface with Hospital)

2) Program development

3) DON operations

4) Clinical trials (operations)

5) Education programs (logistics)

6) Contracting

7) Planning

Linda Owen, PhD

Clinical Trials Manager

Primary Responsibilities:

1) MD practice oversight/ faculty development

2) Clinical care (MD and nursing)

3) Clinical trials (clinical aspect)

4) CME (clinical content)

5) Program development

6) Planning


Clinic Supervisor

Johnston Cancer Center

Annie Langley, RN

Research Nurse

Primary Responsibilities:

1) Affiliated program operations (QA, nursing oversight, etc.)

2) Program development

3) Clinical care

Chris Marino, RN

Research Nurse

Beth Clapp CCRP, AAS

Regulatory Specialist

Administrative (DUHS): 14.8 FTEs

Clinical Providers (SOM): 6.2 FTE’s

May 6, 2008

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Network Services Divisions

Clinical Planning


Market Research

Duke Heart Network

Specialty Outreach Programs/Contracting Services

Affiliations and Market Development



14 Admin/Support FTEs

6 DUHS Clinical FTE

4 PDC Physicians

Duke Network Services

Total FTEs ~ 40

Corporate Relations/DHD

Duke Oncology Network

Physician Recruitment

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How Elements Work Together

  • Clinical Planning

    • Identify opportunities and strategies for clinical differentiation and new program growth

    • Extend service line vision across health system entities and network

  • Affiliations and Market Development

    • Identify opportunities for new business and new market development

    • Relationship management with CEOs and MDs in key referral markets

    • Physician sales and customer service

  • Oncology and Heart Networks

    • Build volume and share for affiliates and DUHS

    • Maintain involvement when care translates to local setting

      • Program design, development and operations

    • Advance clinical research and education

  • Affiliations Contracting

    • Off- site clinical activities and selected GME rotations

  • Outreach Clinics

    • Specialty programs in local communities

    • Advance education

  • Corporate Relations/ Duke Health Direct

    • Relationship management and sales for regional employers

  • Physician Recruitment

    • Servicing DUAP, CPDC, DUHS and selected SoM divisions

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Defining Value of Network Services

  • Grow targeted referral volumes

    • DUH, PDC, DHRH, DRH, affiliated programs

  • Generate income from clinical activities

    • Specialty clinics and affiliated programs

  • Advance academic priorities

    • Clinical trainees and clinical trials

  • Improve access to Duke health care

    • New services to priority medical communities

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Duke Oncology Network Affiliations

  • Tiered Affiliation Structure

    • Research Affiliation

    • Clinical Program Staffing and Management

    • Program Development Affiliation

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Duke Oncology Network Qualifications for Affiliate Relationship

  • Patient care and the delivery of high quality services must be first and foremost.

  • Commitment from medical staff and administrative staff to work as partners and provide resources for the delivery of oncology services and to participate in clinical trials

    • Appropriate staffing

    • Adherence to regulatory requirements (IRB, etc.)

    • Senior administrative time and support

    • Information Systems

  • A long term agreement

  • Affiliate will maintain resources to support an ongoing, collaboratively developed QA/PI plan

  • Maintain JCAHO accreditation and ACoS designation

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Research AffiliationsKey Research Functions

  • Access to clinical trials

    • In-house studies

    • National cooperative groups

    • Pharmaceutical industry

    • Collaborative research

  • Offer opportunities to be recognized in publications

  • Offer opportunities to participate in grant funding

  • Provide education and training of clinical trials staff

  • Provide assistance in the establishment of a Protocol Office

  • Provide current regulatory and IRB updates and support to facility-based IRB

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Research AffiliationsKey Educational Functions

  • Participation in Tumor Boards by Duke faculty

  • Assistance in clinical training

  • Liaison with academic medical center physician colleagues

  • Recommendations for Faculty appointments

  • Coordination of medical and nursing symposia

  • Continuing nursing education for research nurses

  • Rotation for learners

  • Liaison with pharmacy contacts

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Research AffiliationsKey Research Development Functions

  • Assessment of needs

  • Opportunities for telemedicine conferences

  • Assistance in cancer control initiatives

  • Assistance with the development of Quality Improvement Programs

  • Assistance with physician referral services

  • Access to other clinical program development efforts within the Duke Comprehensive Cancer Center and Oncology Network

  • Assistance with research policy and procedure development

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Strength through communication

The Duke Comprehensive Cancer Center partners with Duke Oncology Network affiliates to produce a co-branded newsletter highlighting research and patient care initiatives at Duke as well as news and events from the affiliate.

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Strength through communicatione-newsletter for referringphysicians

  • Bi-monthly e-newsletter

  • Distributed to referring physicians

  • Highlights new trials or trials having difficulty accruing

  • Links to cancer.duke.edu for a complete listing of trials

  • Features a different cluster in each issue

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Supporting the Duke Oncology NetworkAffiliations and Market Development

  • Establish and maintain relationships with medical communities in the DUHS service area

    • Serve as the central point of contact for DUHS clinical program development and outreach activities

    • Primary market intelligence

  • Grow targeted referral volumes

    • Practice (>1500/yr) and Hospital ( > 100/yr) Visits in Targeted communities

    • Marketing Materials Hand Delivered (> 1000 sites/yr)

    • New Appointments – (personally facilitated)

    • Admissions – (personally facilitated)

    • New physicians identified

  • Identify opportunities for clinical program development that create “win-win” situations between DUHS and community providers

    • Planning process used

  • Liaison between referring physicians and DUHS to improve patient outcomes and expedite care

    • 24/7 customer service for referring physicians

      • Troubleshoot access problems

  • Market new and existing DUHS programs to referring physician

  • Promote education of community physicians and other healthcare providers.

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Develop Services



Outreach Programs and Clinical ContractsMission / Role

Provide Oversight in the establishment of clinics and/or contract management process to clinicians, business managers, DUHS and SoM staff

Annually ensure alignment with DUHS and SoM strategic plans, renegotiate and/or terminate contracts for the provision of services


Coordinate implementation of outreach clinics and contract review process with

  • Clinical Providers

  • Operational Managers

  • Legal Counsel

  • Risk Management

Monitor and oversee outreach clinics and contracts to ensure compliance with regulatory requirements and contractual obligations with DUHS, DU and PDC administration, clinical care providers and sites

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Duke Oncology Network ServicesDefining Value

  • Grow targeted referral volumes

    • 32 services in 25 communities

    • 4 CPDC, 3 PDC medical and 3 radiation oncology physician practices

  • Generate income from clinical activities

    • Net Income to DUHS from DON

    • ~50% of Oncology patient volume from Greater Triangle and Anchor regions

  • Advance academic priorities

    • 10 med onc fellows at 5 community sites, generates funds for DOM fellowship activities

    • Numerous self-supporting CME symposia and CME lectures (unrestricted educ grants)

    • Patient accruals to clinical trials

    • Funds to Duke through CALGB accruals

  • Improve access to Duke health care

    • Duke Raleigh Hospital – Medical and Radiation Oncology

    • Durham Regional Hospital – Radiation Oncology

    • Affiliated medical and radiation oncology sites