Cancer care in Malaysia has been bound by uneven distribution, with most services and specialists located in the Selangor/ Wilayah Persekutuan Kuala Lumpur, and the West Coast area of the peninsula.
The implication is that the quality of care, quality of life, and survival outcomes of our patients with cancer are different depending on the part of Malaysia they reside in.
To mitigate the scarcity of service availability including consultancy service by oncologists, cancer treatment supportive care, patient navigation pathway, timely access to cancer diagnostic workup, screening, prevention, and treatment; Cancer CRI Centre (CCRIC) is now launching the initiative called East Coast Cancer Care Initiative (ECCI).
Aim:
To improve the survival outcomes, and quality of care received by patients with cancer in the east coast region.
Objectives:
1- To convert the cancer service-based model to value-based healthcare for the east coast population.
2- To improve the survival outcomes of common cancers (breast, colorectal, lung, head and neck, prostate, cervical and gynecological cancers) among the east coast population.
3- To improve the timely access to cancer screening, diagnosis, prevention, and treatment.
Outcomes / Outcome Measures:
1- Improvement in various survival outcome endpoints (example: reduction in the percentage of cancer in an advanced stage, reduction in the percentage of preventable cancer through vaccination, disease-free survival, progression-free survival, overall survival) of common cancers among the east coast population.
2- Time to a clinic appointment, time to diagnosis, and time to treatment.
3- Increased access to mammography and colorectal screening programs.
4- Increased access to HPV vaccines to prevent cervical cancer, head and neck cancer, anal cancer.
5- Improvement in quality of life (QoL) of patients measured by HRQOL / PROM metrics.
Approach:
To achieve the outline objectives and their specific outcomes, we are launching a couple of programs as a start:
1) East Coast Oncology Alliance Group (ECOAG)
The ECOAG will be a network that connects cancer healthcare workers in the east coast region. The objectives of the network:
• To provide a platform for discussion of challenges, ideas generation, cancer care integration, and fresh initiatives for patients with cancer in the east coast region.
• Through ECOAG, members would be able to discuss patients with our oncologist through the virtual telehealth program below.
We would encourage general practitioners, surgeons, physicians, radiologists, allied health workers, pathologists, and researchers to join in to create an integrated ecosystem for the east coast area. As a start, the network can be joined by filling up the google form on Cancer CRI Centre (CCRIC) website. We will then be in touch via email, and you will be added to our temporary ECOAG telegram while we build a full-fledged networking system.
2) Virtual telehealth program
We are starting a once-a-month virtual oncology telehealth clinic with hospitals and clinics in Kelantan, Terengganu, and part of Pahang. The objectives of the telehealth program are as follows:
1- To empower healthcare professionals who are not oncologists in making good oncology decisions based on oncology standards of care, taking into account patient and local factors.
2- To reduce the need for patients outside Kelantan to travel to USM for the sole reason of getting some advice on the next line of systemic treatment for their cancer.
3- To harmonize the choice of systemic chemotherapy given to patients among different hospitals on the east coast.
The virtual cancer telehealth clinic will be held the first Monday of each month, from 9 am -2 pm. The electronic booking form will be created where ECOAG can put their cases for discussion. The virtual clinic session will be between our medical oncologist and treating doctor from the individual site rather than with the patient. We would allocate 15-20 minutes of discussion and decision-making time for each case, and 15 slots per virtual clinic. The list would be finalized by the end of the third week of the previous month, and clinicians would realize that no further bookings can be made after that or when the list is full.
East Coast Cancer Care Initiative (ECCI)
