[00:00:00] Adam Walker: Support for The Real Pink Podcast comes from Merck.
[00:00:06] From Susan G. Komen, this is Real Pink, a podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:00:19] Welcome to the Komen Health Equity Revolution podcast series. Each month, we invite in patients, community organizations, health care partners, researchers and policy advocates to discuss strategies and solutions that drive the health equity revolution forward for multiple populations experiencing breast health inequities.
[00:00:42] In an effort to drive systemic change, Komen partnered with ASCO and a group of health care institutions to develop and test interventions that address breast health inequities in the Black community. Here’s a peek into a success story at Parkland Hospital & Health System in Dallas, where the intervention helped connect Black cancer patients to financial coverage and ultimately improved their access to care. We are excited to speak to Maripat Hodges, Cancer Program Manager at Parkland Hospital, to learn more about this success story. Welcome to the show, Maripat!
[00:01:17] Maripat Hodges: Thank you. I’m happy to be here.
[00:01:19] Adam Walker: I’m excited. I love talking about success stories. That’s always a good, that’s a good upbeat, you know, inspiring way to get the day going. But let’s start with you. Tell us more about you and what your role is at Parkland Hospital.
[00:01:33] Maripat Hodges: So I am the Program Manager for Cancer Survivorship and Support Services. I work within the cancer program within the outpatient setting, and I implement programs and changes and quality improvements to improve our patient’s care throughout their continuum.
[00:01:51] Adam Walker: That’s kinda great, right? Your job is to help improve patient care? Like that sounds kinda awesome. So that’s nice. I like that. I feel like maybe that should be another career move for me. I’m gonna… we’ll have to talk more later. Maybe I’ll do a fourth career or something. One, one of these days.
[00:02:09] All right. All so onto our uplifting stories. So Parkland partnered with ASCO and Komen on a project to increase screening for financial coverage for black breast cancer patients. Can you tell us more about the project and why you felt it was important to work with Komen to help advance this health equity?
[00:02:30] Maripat Hodges: You know, Komen actually identified Dallas as one of these cities with big disparities for breast cancer and so we were very honored to work with them because it’s actually our community. This is who we serve. This is Parkland’s mission is to serve patients of the Dallas County. And so it was great to partner with them and to be able to go through this journey with the ASCO. So they do quality training programs. And so it helps us improve our ability to implement these changes and go through PDSA cycles and… Did it work? Did it not work? That kinda thing.
[00:03:08] And financial coverage, medical payers is confusing. It’s confusing for me. And I work in healthcare and I’ve worked in healthcare for over 12 years. So, anyone who’s not even in the industry it’s very confusing. And so being able to identify those at risk or those who may need to be connected to, we have financial counselors, and helping them get to those resources, being proactive on that so that they can get the treatment they need. That is huge. So we really wanted to start getting them connected early on.
[00:03:46] I wanna go see the financial counselor and get connected about my medical payer, things like that. You know, so it was really beneficial to be able to identify those patients that needed it.
[00:04:02] Adam Walker: Yeah. Well, I mean, let’s dig more into that, right? So Parkland set a goal to increase the rate of patients that are completing the social determinates of health screening, which is.. What is the social determinants of health screening? Before I continue this question. So like, lemme make sure I understand this, first of all.
[00:04:19] Maripat Hodges: So the social determinants of health these are, you know, socioeconomic and other factors that can I impact patients outcomes. So they’re are set of questions, right? So people who may have financial strain, people who may have food insecurity. Different things, childcare, barriers to childcare, transportation, things that may end up being barriers for them receiving their care. So we wanted to proactively screen that.
[00:04:49] Adam Walker: Okay. Right. And so, so you wanted to go from that, completing that screening from 3% to 20%, which is quite the ambitious goal, and I’m very impressed by it. And so just walk through what that full screening process looks like and why that was such an important part of this project.
[00:05:08] Maripat Hodges: So for that screening we originally didn’t really have a good workflow. So part of the quality improvement project was identifying the best people to do the screening, whose roles and responsibilities it would fall under, and then also when it would be completed. So we wanted to… we ultimately fell on our nurse navigators. We have nurse navigators for each disease group of our cancer patients. So we have a breast cancer nurse navigator, and so she would ultimately screen our new patients before their new patient visit. So she would call the patient, screen them, if they had any of these issues, maybe it’s transportation, even getting to their new patient appointment, she’s able to, you know, address those concerns right then and there.
[00:05:58] So we are able to help with the transportation assistance or figuring out what resources the patient can get to help get to the appointment. Childcare. We have partnerships with Annie’s Place with mommys in need where our patients can drop off their children, so they can come to appointments. So that way she can address any factors that may be barriers to the patient even coming to the new patient visit.
[00:06:23] Then when the patient does come to their new patient visit, she’s ready. So social work may be ready, the dietician may be ready to help address any of those additional factors that we need to kind of proactively help the patients with.
[00:06:37] Adam Walker: I love that. I love, and those you know, nurse navigators I’ve talked to many, talked to many, talked about many, I mean nurse navigators are just amazing, amazing people.So, that’s so great. So the interventions connect patients to medical coverage that can help alleviate some of those financial burdens of cancer care. Can you tell us more about what the- I guess maybe, actually ,you’ve already answered this. I was gonna ask you tell us more about what the interventions are and how they help patients, but you sort of covered that, didn’t you? So do you wanna give us any additional details to that?
[00:07:10] Maripat Hodges: But we actually had another system in place as well. So we actually had our, you know, operation side, our schedulers and everyone were reviewing the appointments ahead of time and seeing which patients maybe their insurance is expiring. Maybe they are on a charity insurance or something. And they needed to be connected with the financial counselor.
[00:07:38] So there were certain criteria that they looked at that we helped, we worked on with our patient financial services and they would call the patient ahead of time, do you have any changes in your insurance? If you don’t, do you need an appointment with a financial counselor? Cuz then that financial counselor can really help the patient even further and really has that financial knowledge.
[00:07:58] Adam Walker: Okay. Okay. That’s great. I love that. I love that. All right, so. So what were the outcomes of this project? Was it a success? And if so, why or why not?
[00:08:10] Maripat Hodges: So I consider all of our project successes.
[00:08:14] Adam Walker: That’s the way to go. I mean, listen, if I were in your shoes, like, if you improve one patient’s life, then that’s a success, right? So I think that, I think, and for sure you’ve done that but give us more detail.
[00:08:26] Maripat Hodges: So not only were we able to screen more patients, but then by screening these patients, we actually are able to identify what’s going on with our patients. I think that is gonna help us continue to grow and figure out what areas really would benefit more attention by us and help us grow those programs, grow those resources, grow those partnerships within the community. And so unless we know from the patients from these screenings, we don’t. So it’s a success to be able to say. Wow, this is really a patient driven thing that we need these resources, that we need to figure out how to connect our patients more to these things.
[00:09:07] Adam Walker: I mean, I love that you’re screening the patients and it sounds like you’re learning quite a bit from them. And I think, you know, our mistake as oftentimes as professionals in particular, is that we think we know, you know, we think we know what people need or whatever. And I don’t we don’t know anything… like, you know, we just, there’s just, there’s so much to know. And I think if we don’t know, if we don’t ask. And it’s, I love that you’re doing that.
[00:09:32] Maripat Hodges: Well, you know, I think our, you know, our program has really focused on that patient-driven and data-driven when we’re looking at planning out our strategic plan. And so we have a patient family advisory council that we turn to for a lot of things to get their input. We have, you know, we want the data as well to say, you know, this- to show what the impact is and how many patients it’s happening to. And that way we can really help all these patients. So we really wanna make sure that we’re driving in the right direction.
[00:10:06] Adam Walker: That’s great. Well, so I wonder if you can kind of put a face on this for us, in a sense. I mean, do you have a, do you have a story about how patients benefited from the project that you could share?
[00:10:18] Maripat Hodges: I have a lot of stories.
[00:10:21] Adam Walker: Well give us give us a good one or two or however many.
[00:10:26] Maripat Hodges: One in particular. It really helps the nurse navigator identify, wow, this patient’s gonna have a lot of barriers. Getting to appointments, getting their treatment when she filled out that social determinants of health.
[00:10:37] And so with that connection at the very beginning, our nurse navigator was able to help that patient through, and I actually talked to this patient and her husband, and she was just so thankful to be able to have such an advocate on our side and someone who really understood all the barriers, and we really wanted to take care of the whole patient.
[00:11:00] We want to, you know, cancer is one thing, but that cancer is affecting everything in her life, and so it really helped us kind of address getting her through the treatment, getting her everything she needed. And her and her husband were just so grateful that we were able to really direct her to whatever resources she needed.
[00:11:20] Adam Walker: That’s great. That’s great. And that’s what it’s all about. That’s right. That’s what it’s all about. So what did Parkland learn from the project that you think might be able to serve as a model for other healthcare systems and that can possibly help patients in the future?
[00:11:35] Maripat Hodges: I know something that’s been really helpful for us is who is completing the social determinants of health, kind of identifying the right person so that way it can be addressed properly.
[00:11:48] That was something that we definitely learned. But also I think taking on some of these things is difficult, but it’s definitely doable. So in really identifying some of these patient issues, we really are trying to address the whole patient and I think that’s something that a lot of places can- are working towards and striving towards. And I think that is, that’s wonderful.
[00:12:12] So we communicate, our team actually has a lot of friends out into different cancer centers and you know, we’re all sharing best practices all the time. So I know a lot of them are also trying to address these similar issues and all of us have different issues and we think. Just because we’re the safety net at Dallas, it’s, this is the same issues that other people at other places are having. So I think there’s a lot we all can learn from each other.
[00:12:39] Adam Walker: Yeah. There is, there’s a lot we learn from each other. And two things I think that I learned from this conversation is one, to attempt to address the whole patient. I love how you say that because there, there’s so many things going on aside from just cancer. And then two, which is the listening side. I mean, just listen, ask questions because that’s how you know how to help. And I think that’s so important when we’re dealing with people that are dealing with some- with illnesses.
[00:13:06] So, wow. Maripat, this is fantastic. Thank you for the work that you’re doing. Thank you for the job role that you have. That sounds kind of amazing. And thanks for joining us on the show today.
[00:13:17] Maripat Hodges: Thank you so much. I really appreciate it.
[00:13:20] Adam Walker: Thank you for joining another episode of the Komen Health Equity Revolution podcast series. We will continue to galvanize the breast cancer community to support multiple populations experiencing breast health inequities to advance and achieve breast health equity — for all. To learn more about health equity at Komen, please visit https://komen.org/HealthEquity. Thanks to Merck for supporting the Real Pink podcast.
[00:14:02] Thanks for listening to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit RealPink.com. For more on breast cancer, visit Komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam, you can find me on Twitter @AJWalker or on my blog, AdamJWalker.com.