Lung cancer patient care - The Conference Board of Canada cites the Quebec Heart and Lung Institute as a model even as its labs are threatened

MONTREAL, March 17, 2021 /CNW Telbec/ - The Quebec Heart and Lung Institute at Université Laval is a model of care according to the Conference Board of Canada, which conducted a study for the Quebec Cancer Coalition on optimizing lung cancer care for better patient outcomes. The conclusion was clear: The Institute's approach is more effective and quicker, thereby optimizing the lung cancer patient care pathway and potentially improving survival rates. Because its process is more efficient, it is also less costly to the health system compared to non-specialized centres. By optimizing pathology, the Institute drives value in health care.

The Conference Board study describes the impressive results obtained by the Institute's performance measures during the 2002–2016 period. However, this was before Quebec's Ministry of Health and Social Services (MSSS—Ministère de la Santé et des Services sociaux) initiated the OPTILAB project to centralize medical laboratories in 2017, which will completely dismantle the Institute's specialized laboratories by 2024. Yet this pathology lab testing and research is a critical part of the Institute's successful treatment approach.

Rapid and Optimal Care
The Conference Board just published this report, which showcases the Institute's optimized approach to diagnosis and molecular testing of lung cancer as consistent with international best practices and recommendations, thus serving as a model to be spread to and scaled up in other jurisdictions in Canada based on its speed and efficacy.

Because of its supra-regional model and concentrated expertise, the IUCPQ-UL approach can significantly reduce patients' waiting times from time of referral to treatment. Specifically, with its efficient approach, patients receiving care at the Institute can be offered treatment within 26 days,compared to the provincial average of 56 days. The IUCPQ-UL model also reduces lab costs. For example, the Conference Board estimates overall savings of $57 per biopsy at this specialized centre, 36% less than the system average. Technical costs alone are 45% lower ($50 les per biopsy).

For patients with cancer, faster access to care can make all the difference. This means the Institute's optimized care can truly impact patients' survival and quality of life. The Conference Board's report highlights the Institute's unparallel expertise, tools, and workflows for improving patient outcomes and health care efficiencies for lung cancer patients. The Conference Board recommends that this model be spread and scaled up in other jurisdictions in Canada to improve the efficiency and quality of lung cancer diagnostics and enable optimal patient care including timely access to first-line treatments.

A World-Class Centre of Expertise
The Institute is a world-class centre of lung cancer expertise. Lung cancer is the most common cancer in Canada and the leading cause of cancer death for both genders, with the lowest survival rate of all cancer types. And Quebec is the province with the highest incidence of lung cancer in the country (Source: Canadian Cancer Society, Lung Cancer Statistics, August 2020).

Quebec's health care system would therefore do well to capitalize on the Institute's expertise in patient care to fight the deadliest cancer, which kills more than 6,700 Quebecers every year.

The Institute's success factors include:

• Cutting-edge expertise and a high volume of lung cancer patients in the same hospital
• Optimized prioritization of specimens with in-house interdisciplinary teams (pulmonary oncologists, pathologists, surgeons, radiologists, and nurses) to speed up analyses and results
• Standardized protocols, consistent practices, and continuous improvement processes
• Specific time slots for imaging, bronchoscopies, and biopsies
• Specialized nurses to document follow-up

The report's findings have been praised by many doctors and lab managers in Quebec's health network and from other Canadian provinces.

Concerns About the Future of this Cancer Care Model
Although the Institute is a world-renowned centre of expertise, it has lost autonomy over patient care due to the dismantling of its lab through the MSSS's OPTILAB centralization process. The Quebec Cancer Coalition has serious concerns about the impact the loss of this lab will have on cancer patients.

The Quebec Cancer Coalition doesn't oppose laboratory reorganization. However, this must not occur at patients' expense. Access to tests and quick, reliable, and effective diagnoses must remain a priority. Though OPTILAB's intent is laudable, implementation has proven ineffective. Performance has been subpar, and patients are paying the cost of this failed reorganization. Centres of excellence and expertise such as the Institute should continue to provide the highest level of service, like Sainte-Justine Hospital, which has maintained its autonomy.

Today, ultraspecialized doctors who are among the best in the country can no longer perform the diagnostic tests they need for their practice and research projects. The centralized laboratory system has also increased wait times, impacting patients with several types of cancer. In this era of personalized medicine, patients across Quebec will suffer if this supraregional centre cannot conduct the tests required to offer optimal care.

Quotes
"Just like Sainte-Justine Hospital, the Institute has a special status that must be preserved. It has created a process that considerably decreases wait times for treatment, which is critical in the fight against cancer since speed promotes access to precision drugs and improves survival rates. It's unacceptable that this 'crown jewel' of Quebec's public health system is losing its autonomy for purely political reasons. We've been worried that patients will pay the price, and unfortunately, this is already starting to happen."

-  Eva Villalba, Executive Director, Quebec Cancer Coalition

"Health care systems around the world are facing higher cancer care costs and increased pressure to deliver value in terms of patient outcomes and system efficiency. Optimizing the lung cancer diagnostic process and biomarker analysis provides an incredible opportunity to improve patient outcomes while reducing costs. The Institute's pathology model could be extended to other centres and jurisdictions, along with funding to support the necessary infrastructure and capacity building in training and expertise."

-  Dr. Monika Slovinec D'Angelo, Director of Health at the Conference Board of Canada

Some of the Institute's standout features from the Conference Board report

• 71% lower than average rate of insufficient samples for biomarkers
• Total savings of $57 per biopsy (36%) to diagnose lung cancer
• 45% lower technical costs
• 21% lower pathologist fees
• Pathology reports available more quickly to treat patients
• Biopsy reports in 2.1 days versus the MSSS target of 7 days
• Surgery reports in 2.4 days versus the MSSS target of 12 days
• Biomarker reports in 2.2 days versus the MSSS target of 10 days

To consult the report summary: https://www.conferenceboard.ca/insights/featured/health/optimizing-lung-cancer-care-for-better-patient-outcomes

About the Quebec Cancer Coalition
The Quebec Cancer Coalition (CPCQ) was founded in 2001 to give a strong voice to people affected by cancer. We are made up of more than 60 non-profit organizations from all over Quebec, representing all cancer types and stages. We aim to improve Quebec's health system for the good of those affected by cancer and defend the rights and interests of patients, survivors, and caregivers. For more than 20 years, our members have shared the vision of a healthier Quebec.
www.coalitioncancer.com

About the Conference Board of Canada
The Conference Board of Canada is the foremost independent non-profit applied research organization in Canada. We provide Canadians and key decision makers with insights and expertise in three main areas: economic trends, public policy, and organizational performance. We work across disciplines and bring together people from all sectors to solve the complex problems that have the greatest impact on the future.

SOURCE Quebec Cancer Coalition

Mélissa Bradette, TACT, 418 540-0324, [email protected]