University of Kentucky Markey Cancer Center (Kentucky)

The C4 Program’s focus is improving timely access to patients under cancer care in rural and low-income areas. In addition to a significant number of rural counties, nearly half of the state of Kentucky is designated as an Appalachian Region. The C4 Program aims to improve outcomes and enhance the quality of cancer care among these vulnerable populations in addition to others affected by barriers of social determinants or drivers of health (i.e. transportation, housing, etc).

The C4 Program includes a multilevel approach by integrating care coordination for the patient and family to support resources, providers, and the health care system and community partners. The C4 Program includes the following key strategies:

Patient and Family: The C4 Program will enhance access to care through use of digital tools, patient education and communication strategies including:

• Promote use of mobile app to enhance flow of information from patients to navigators and/or care providers
• Implement recurring remote psychosocial needs assessments monitored by care team members
• Provide ongoing patient education and connect to resources

Health Care Team: The C4 Program will promote multidisciplinary team-based care through increased education and digital dashboards. Specific strategies include:

• Automate referral intake, monitoring and tracking to ensure coordination of care while monitoring
• Monitor and report psychosocial distress elements and flagging emerging patient needs for early intervention
• Promote patient-centered communication through provider education and implicit bias training

Health Care System: Through policy development, capacity building and education, the C4 Program will deploy the following strategies at the health care system level:

• Implement distress screening to inform psychosocial care referrals and support services
• Tailor supportive services to meet individual patient needs
• Optimize staffing workflows and quality improvement protocols

Community Programs: The C4 Program will address social determinants or drivers health (SDOH) to care with the support of multisector partners from the Markey Cancer Center Research Network through the following strategies:

• Engage and promote new and existing partnerships, SDOH programming and supportive services
• Deploy community engagement strategies to inform psychosocial distress monitoring and barriers to referrals and best practices

The Markey Cancer Center will use various data sources including patient surveys and Commission on Cancer reports to measure the impact and success of the C4 Program. Key metrics will evaluate patient-centered care, communication and engagement, as well as the impact of psychosocial care and other supportive services.

In addition to C4’s evaluation efforts, the NPO will plan and implement a comprehensive cross-site program evaluation using core data elements, harmonized metrics and overall collected data. This will be used to inform future efforts and measure the impact of the initiative across grantee sites while identifying and promoting best practices.