Keith H. Morgenlander, MPH, Hematology/Oncology & Radiation Oncology, University of Pittsburgh School of Medicine, Iroquois Building, Suite 405, 3600 Forbes Avenue, Pittsburgh, PA 15213, 412-647-4810, morgenlanderkh@upmc.edu

A number of barriers, both real and perceived, tend to hinder patient access to cancer treatment and to participation within clinical trials. Such barriers are exacerbated for racial minorities and for both urban and rural poor. Numerous studies have documented the impact of these barriers and the resulting disparities created within health status. In order to effectively engage communities experiencing the highest level of cancer disparities and develop a trusting relationship with newly diagnosed cancer patients the western Pennsylvania-based “Radiation Oncology Community Outreach Group (ROCOG)” was created. ROCOG utilizes an organizational strategy of ”Virtual Integration”, which enables academic medical institutions, community hospitals, radiation oncologists, community agencies, faith-based and other community groups and cancer survivors to collaborate in program design, funding and implementation. Through the distribution of both governance and program responsibilities among all members, market politics and competitive healthcare forces can be neutralized, resulting in a more accurate targeting of outreach and a greater sense of ownership & acceptance by underserved communities. This collaboration (initiated in 2000), was recently awarded a five (5) year, $5 million grant from the National Cancer Institute Cancer Disparities Research Partnerships Program to enhance patient accrual and retention to radiation oncology clinical trials at a local, community level, with a particular focus upon elimination of disparities. Additional goals for the “UPMC McKeesport/ROCOG Minorities Outreach Program” include insuring that community-based radiotherapy is provided in accordance with ”best practice” medicine and measuring the impact of a comprehensive, rapid case identification & patient education mechanism upon treatment compliance.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Develop a basic understanding of the principles of "virtual integration", as compared with more traditional healthcare program organizational models;
• Understand why virtual integration can be effectively utilized in the development of collaborative partnerships between academic medicine, community hospitals & physicians, grass-roots community agencies and healthcare consumers;
• Describe the strengths and potential vulnerabilities of the UPMC McKeesport/Radiation Oncology Community Outreach Group disparities program model;
• Identify key governance and program elements and describe their relative contribution to the goal of reducing oncology disparities and increasing accrural of underserved populations to clinical trials;
• Utilize information from this presentation to evaluate other healthcare markets and disease-specific intervention opportunities for potential application of virtual integration as a cost-effective, politically acceptable organizational approach to reduce disparities and improve healthcare outcomes for medically underserved populations.

Keywords: Health Care Restructuring, Community-Based Partnership

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: UPMC McKeesport Hospital UPMC Health System Radiation Oncology Community Outreach Group of Western Pennsylvania: Jameson Hospital Mercy Hospital of Pittsburgh UPMC McKeesport Hospital Somerset Hospital Allegheny General Hospital UPMC Lee M
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment by UPMC Cancer Centers, University of Pittsburgh Cancer Institute and grant funded through NCI 1 U56 CA105486-01 awarded to UPMC McKeesport September 1, 2003.