QIM22-202: Cancer Diagnostic Center: A Response to the COVID-19 Pandemic to Improve Access to Diagnostic Testing

INTRODUCTION: During the COVID-19 pandemic, data suggests there was a significant decrease in the volume of cancer screening tests and number of cancer diagnoses made compared with historical trends. Given the association of late stage cancer with increased mortality, ensuring early diagnosis is critical. As a response to COVID-19’s impact on cancer screening and timely symptom evaluation, The James Cancer Diagnostic Center (JDC) was opened to provide patients with direct, expedited access to diagnostic testing at a time when access to these services was declining. Methods: The JDC is an Advanced Practice Provider-led clinic that is open 5 days/week with same or next day appointments available. In person or telemedicine visits are offered. JDC referrals may be provider- or self-initiated for any symptom, physical exam, laboratory, or radiographic findings worrisome for cancer. Subspecialty oncologists were initially engaged to develop clinical algorithms for appropriate referral placement. Each JDC appointment includes a comprehensive review of the sign or symptom eliciting concern, tailored diagnostic services to evaluate for malignancy, followed by detailed result review, counseling, and general or specialty service referral, as needed. Results: The JDC opened on June 15, 2020. Since opening, the clinic has seen 506 new and 243 return patient visits. The majority of referrals received are internal (45%); 29% external and 26% self-referral. Clinical algorithms for appropriate placement have grown from 2 to 6. The average time from referral receipt to new patient visit completion is 1.5 days. 69% of visits are conducted in person; 31% via telemedicine (video visit or telephone encounter). A total of 6,310 discrete laboratory studies, imaging, or procedures have been completed. Over 47% of newly evaluated patients are referred for subspecialty evaluation after initial consultation. Conclusion: As a direct response to the COVID-19 pandemic and its impact on cancer diagnosis, our institution deployed a successful and novel clinical model to ensure prioritized access to cancer diagnostic services. The JDC is distinguished by rapid access coupled with comprehensive diagnostic service provision, robust clinical support, and specialty service linkage. The JDC promotes early diagnosis and accelerated deployment of cancer-directed therapies, which may not only impact patient survival, but may also lower treatment morbidity and improve quality of life.