Transforming cancer treatment and patient care experience in Seattle

Published May 23, 2018

Christine Swanson’s might be the first face patients see when they step off the elevator at the Seattle Cancer Care Alliance (SCCA). She’s the new patient liaison at SCCA, a nationally renowned cancer treatment center that brings together researchers and cancer specialists from local institutions including Fred Hutch, Seattle Children’s and UW Medicine.

Swanson works for Premera Blue Cross (Premera BC), one of the area’s major insurers, but she’s embedded on the team at SCCA. Her role is unique when it comes to patient navigators, who often work exclusively for either a hospital or an insurer. She bridges the two worlds to improve the patient care’s experience.

She can troubleshoot insurance issues–a task doctors and patients are used to taking on themselves. She can follow a patient’s treatment plan and upcoming appointments. And she stays connected to patients throughout their experience. That information helps her anticipate a patient’s needs and ease any burdens, which could entail everything from offering help understanding treatment costs to finding a meal delivery service for patients too exhausted to cook. To do that, she taps into big data from both organizations.

In the patient’s corner    

Setting aside what can sometimes be a sensitive relationship between health insurer and healthcare provider, Premera BC and SCCA began working together in 2016 to come up with ways to improve their patients’ experiences. They agreed to keep the field wide open for ideas. It was during a brainstorming session that a new concept began to bubble up: why not provide a kind of “Mary Poppins” solution for patients, someone who could enter a patient’s life when needed, pull resources out of her toolkit to help address almost any need, and then pull away when no longer needed.

After weeks of collaboration and brainstorming about how it might work, the patient liaison project was born.

“Just taking some of the responsibility off the patients, to navigate through their insurance coverage, what’s being paid, what isn’t being paid, is very helpful, in addition to the many other things she’s able to do for you,” says Elizabeth Stohr, clinic manager for thoracic and head cancers at SCCA. But Stohr says the liaison isn’t just an insurance problem solver. “She’s also this patient advocate. She’s identifying any roadblocks patients might be facing, she’s bringing them back to our working group and then we’re trying to work through those together.” 

For patients, cancer can be a battle for their lives and a full time job

“Patients face an onslaught of information and choices after their initial diagnosis,” says Miranda Meyer, strategic relationship manager for Premera BC. They have to understand their disease, weigh treatment options, think about payment and review what their insurance might or might not cover.  

Through it all, patients face the challenge of keeping up with work, family and finances. They might be in pain. They may need counseling to deal with the emotional impacts of cancer. All of this can make taking care of even day-to-day responsibilities feel overwhelming.

This is where Swanson comes in.

Every day, Swanson, a former social worker, runs a report to find out whether any Premera BC patients are coming to SCCA for a first appointment. She calls them before they arrive to explain her services. “I offer to meet people in the lobby so that, hopefully, I am one of the first people they see when they step off the elevator,” she says. Swanson also offers to accompany patients to their first appointment, and to take notes so the patient can listen closely to what doctors are saying. But she’s more than a welcoming committee. She’s a keen observer of a patient’s experience.

Swanson says she pays a lot of attention to any stressors a patient might be experiencing. She asks about work, family and finances. “It deeply impacts your stress to have the burden of how am I going to afford this care, how am I going to afford this for my family, can I work?” says Swanson. “So one of the huge parts of my job is, as early as possible, assessing for stress around finances: how is it for you paying your co-pays?  Are you having to cut back on your work hours to go to radiation?” 

Swanson can help patients find solutions to those problems, as they come up. She’s found assistance affording co-pays for some patients, counseling services for others and more.

Collaboration supports improved patient experience 

Healthcare is already a complex system, so why add more complexity to the experience? 

Bill Akers, senior vice president for Premera BC’s Washington market group sales, says Swanson is there to improve that experience. As Akers sees it, healthcare faces four major challenges. “One being that it costs too much. The second being that too often people get things they don’t need and third they don’t get what they do need,” says Akers. “Finally, the experience can be confusing, with many rules around insurance and coverage,” says Akers, adding that patients may feel as though no one’s in their corner.  But, Akers says, this partnership aims to change that.