ACS CARES Invites You to End Cancer for Everyone with Dr. Bonny Morris, Senior Director for Patient Navigation at the American Cancer Society (ACS)

[00:00:01] Hey, everybody. Welcome back to the Health Matters Podcast. I'm Saul Marquez, your host for this series. And today I have the privilege of hosting Dr. Bonny Morris. She is Senior Director for Patient Navigation at the American Cancer Society.

[00:00:24] She views research and program development through a multidisciplinary lens of a clinical team member and patient advocate, considering key system and provider level factors.

[00:00:34] She's an epidemiologist focusing on rigorous study design and analyses and a behavioral scientist acknowledging the importance of community level social determinants of health and patient level factors impacting the cancer experience. Dr. Morris, thank you for joining us today.

[00:00:50] Absolutely. Thank you so much for having me on your show. I really appreciate it. Of course. And so we're going to have plenty of time to dive into the work that you and the team at the American Cancer Society are up to.

[00:01:02] Before we do, though, can you share what got you started in health care innovation? Sure. So I grew up in a very rural area. And unfortunately, rural areas are usually the last to see new technologies implemented or benefit from innovations.

[00:01:20] And it shows. So rural areas have higher overall mortality rates, higher cancer death rates.

[00:01:26] And by the time I was in seventh grade, I knew I wanted to change that. So at first I said I was going to cure cancer and then fast forward to college chemistry lab and all of my experiment compounds turned out yellow, which spoiler alert, was not the color they should have been.

[00:01:42] So I found I was much better suited for research on the patient care side. So the bedside rather than the bench. And I'm still looking, always looking for gaps, though. And what's missing? How can we make it better?

[00:01:56] How do we bring better care to more people so that we don't continue to see disparities in cancer mortality based on where we live, the color of our skin or the language that we speak?

[00:02:07] I think that's fantastic. You knew it from early on. It was clear to you and here you are doing it as you reflect on the American Cancer Society in particular, what would you say is the most unique way that the organization adds value to both health systems and patients?

[00:02:22] Absolutely. So the American Cancer Society is the only organization that then successfully combines research, patient support, advocacy to impact cancer and to do so on a national and global scale for people at risk for cancer, for those who have already been diagnosed with cancer, for their caregivers and families.

[00:02:44] And I joined ACS a year ago, and it's been really remarkable to see the breadth and the depth of the work being done. So, for example, with patient navigation, our programs span from the global arena with Beacon, which has been helping countries like Kenya and Uganda build patient navigation programs from the ground up.

[00:03:03] And then in the U.S., on the national stage, we have the incredible thought leadership of the National Navigation Roundtable, and that's a coalition of 80 different organizations united to advance the field of navigation in really a way that no single organization could do on its own.

[00:03:19] And then ACS Can, the advocacy arm of ACS, is impacting how policymakers view the importance of patient navigation, which huge win in the recent Centers for Medicare and Medicaid Physician Fee Schedule proposing for the first time to make patient navigation a reimbursable service and providing a pathway then for sustainability to do that in more places like the rural hospital near where I grew up can actually have patient navigators.

[00:03:46] And then to that end, ACS has recently committed to launching a patient navigation training and certificate program aligned to meet the requirements that are set forth by CMS so that we can expand our navigation workforce.

[00:03:59] And then at the health system level, we've been funding patient navigation capacity building grants and formed a learning collaborative to better understand how to effectively implement and grow different types of navigation programs.

[00:04:11] And then at the community level, we recently launched ACS CARES, which stands for Community Access to Resources, Education and Support.

[00:04:19] And I know we'll talk more about that, but just from this example, you can see the range and the extent of the impact that the American Cancer Society is really dedicated to making.

[00:04:28] That's really great, Bonnie. Thanks for sharing that and fantastic news on CMS reimbursing navigation. So many people struggle in this space. They don't know where to go. It's a very scary time. And to have experts be able to navigate and get compensated for it, I think will make a huge difference for many Americans faced with a cancer diagnosis.

[00:04:50] I understand the American Cancer Society develops programs and services based off what you've told me to support people with cancer and also caregivers. But with so many people impacted by cancer and with so many different needs to address, how do you approach program development?

[00:05:05] Sure. So my focus, both from program development and a research perspective, is how do we best leverage the power of technology and the power of people to optimize cancer care delivery and then reduce cancer disparities?

[00:05:21] So it's taking this high tech and high touch approach. And in the age of personalized medicine, the support should be personalized too. So how do we meet people where they are and provide support in a way that's right for them?

[00:05:35] So with ACS Cares, we've taken this multi-channel approach. So we developed and launched the ACS Cares app in June, which provides a person with cancer or caregiver a way to digitally navigate all of the cancer information and resources and find what will then specifically fit their needs in a way that's much more streamlined than going and searching on Google, for example.

[00:05:59] And then within the app or by calling our 1-800 number, people can talk with a trained cancer information specialist 24 hours a day, seven days a week, 365 days a year. So when they are thinking through what had happened at their recent appointment, maybe they just got a diagnosis, it's the middle of the night, you know, they have a source of support that they can call and talk with someone.

[00:06:24] And then we have a volunteer component of the program whereby people affected by cancer can receive peer support virtually within the app or in person at one of our pilot sites that launched in September. And so our goal then is way is that you can receive cancer support where and when you need it and in a way that will help you the most, whether that's in the palm of your hand or over the phone or in person.

[00:06:48] That's really great. And so it sounds like a very fantastic app. Is this app available to anybody that wishes to use it? Like how can people find it? Can they just download it and use it? Tell us more about that.

[00:07:01] Absolutely. So it's available in iOS, Android versions. You can download it in the Apple Store, Google Play. So it's readily available and we're continuing to add updates and additional features.

[00:07:15] That's amazing. That's great. And just thinking about the audience listening to our podcast today, they're probably experiencing it themselves. Maybe they have a subset of patients. How would you recommend physicians and payers and different people look at an app like this?

[00:07:30] Sure. So actually there's a feature where someone who isn't a person with cancer or a caregiver, so as a supporter can use the app and then they can go through and see themselves what information is being provided. Maybe it's a social worker at a cancer center that wants to be able to use the app to support the patients that they're meeting with.

[00:07:55] And so they can go through and answer the questions. And actually we can talk more about what you can do within the app, but it then allows them to provide this personalized information or resources when they're meeting with a patient or talking with them over the phone. And then maybe the person doesn't feel comfortable downloading the app on their own, but the social worker or the nurse or physician, whoever's working with the patient could then provide that personalized support in that way.

[00:08:21] That's amazing. Yeah, it sounds super useful and available for care teams. Maybe you could break it down a little bit more for us. Tell us more about the CARES app and then what exactly users can do within the app.

[00:08:33] Sure. So one of the foundational aspects of the app is the introductory set of questions. And so those ask user socio-demographic questions and then questions about health related social needs. And when we do this, we do it so that we can systematically identify concerns, information needs, barriers to care so that we can provide personalized support.

[00:08:54] And then after answering these questions, you're presented with an avatar or this virtual guide that's tailored to your race, ethnicity, gender identity, age range, and then a dashboard with articles and resources that are relevant to how you answer those questions.

[00:09:11] So, for example, if you said you're the caregiver of someone with metastatic prostate cancer and you're wondering about clinical trials, you're wondering about how to pay for treatment, how to get to and from treatment appointments, then your dashboard would be populated with articles on clinical trials, on information and resources to support the caregiver, on financial and transportation resources.

[00:09:36] And then there's also a search bar that you can use to search on your own for information or resources. And you have the option to connect with other resources like requesting a ride through ACS Road to Recovery or matching with a community volunteer for peer support, like I was mentioning earlier.

[00:09:52] And with that community volunteer component, this is a way that a person with cancer or a caregiver can match with someone based on a shared lived experience. And so that could be a cancer type. It could be being a caregiver and, you know, either of an adult or even someone under the age of 18, someone living in a rural area or navigating cancer from an urban area or active duty military or veteran.

[00:10:18] And so it's designed that then you can exchange these one-on-one messages with someone who's been there before and someone who can talk with you about what it's like to drive three hours to get to treatment, someone who's navigated cancer care in the VA or cared for a child with cancer.

[00:10:35] And that support's really unique and personal. And so I'm sure you can tell that our goal then when we designed this app to create this personalized experience for the person to find information, resources, and then support on the cancer journey. And we've actually we've already surpassed our first quarter goals for number of users, which is really exciting.

[00:10:55] And then, yeah, so... Congratulations on that. Thank you. We're very excited about that and seeing how it's getting out into the community and providing support. And then interestingly, there were more than 60 different cancer types among our app users.

[00:11:11] And so you can see, you know, it's not just reaching the people with the most common cancer types. It's really reaching a wide variety of people with unique needs. And then on average, users endorse 15 different health-related social needs that then we connect to resources. So again, just really showcasing that breadth and depth of support that ACS provides.

[00:11:35] Well, that's just phenomenal and so great to learn about this resource. Folks, we'll leave links to different ways you can learn about the app, download the app in the show notes of our podcast today with Bonnie. You guys are up to so many great things. What's next for ACS Cares?

[00:11:52] Well, in true nature of health and healthcare innovation, we're constantly thinking about how we can iterate and improve. And even with new programs, we want to keep things cutting edge and tackle these system and really society level barriers that are keeping people from accessing care and continue just to do better by the people we serve.

[00:12:12] So thanks to the incredible partnership with Deloitte Health Equity Institute, in 2024, we'll be able to expand from three pilot sites to 12. And so that's nine more cancer centers where we'll have highly trained, dedicated college and graduate student volunteers embedded in oncology clinics to provide that in-person level of navigation support.

[00:12:36] So our focus with these sites then is really around expanding our engagement and reach at historically Black colleges and universities, Hispanic serving institutions, community cancer centers serving more rural areas, and then cancer care for veterans. And that's just 2024.

[00:12:54] I'm very passionate about this. We won't stop until those programs nationwide so that more people can benefit from navigation support. That is phenomenal. Yeah. Oh, go ahead. Go ahead.

[00:13:05] I can tell I'm so excited about the growth this program is seeing. And then with the ACS Cares app, it was really brought to life thanks to a variety of collaborators. So our software development collaborators at Crosscom and that development was made possible through funding partners like Bristol Myers Squibb, Merck, Sanofi, Genentech, and Gilead. And again, thanks to our partnership with Deloitte Health Equity Institute, we'll be launching a Spanish version of the app in January.

[00:13:35] We're trying to support Spanish speaking people with cancer and finding high quality cancer information and resources. And there's also some known gaps with cancer care in finding and accessing clinical trials that we believe the ACS Cares app is primed to address. So really just lots of exciting opportunities that could be made possible through collaboration.

[00:13:55] Amazing. And collaboration has definitely been a key theme at the Health 2023 meeting. You guys are certainly proof of what collaboration can do. Any call outs for people listening that are curious about partnering? How do you see the program growing and how can partners help?

[00:14:12] Absolutely. So we love for continued growth and ideas. And we believe that the best way to do that is having conversations and thinking through where our strengths lie and how can we then collaborate to optimize cancer care delivery and keep things cutting edge, keep our ideas relevant to the population that we serve, and just really encouraged to have those conversations with partners.

[00:14:39] Thank you for that invitation, folks. Take Dr. Bonnie Morris up on this. There's opportunities to collaborate and make this even better. Bonnie, thank you so much for today. I'd love to just conclude our podcast with one closing thought that you'd like to share with the listeners and the best place that they could reach out to you and the team at the American Cancer Society.

[00:14:59] Sure. So I'd first like to thank you for your time with hosting me and thank your listeners then for their commitment to cancer care innovation that we know then will lead to this higher quality care and better outcomes. And I hope you'll walk away recognizing the importance of patient navigation and then how programs like ACS Cares are designed to provide the right information and resources in the right way at the right time for personalized support.

[00:15:29] And lastly, I'd just like to invite people to reach out to us at acscares.cancer.org and join us in our mission because together we can end cancer as we know it for everyone.

[00:15:41] Amazing. Bonnie, thank you so much. Your personal story is inspiring. What you've done with that spark is even more inspiring and the work that ACS Cares is just an incredible resource. So folks, as I mentioned at the beginning of the interview, check out the show notes, health matters, and you can do something about it by taking action. So explore the work that Dr. Bonnie Morris has shared today. Bonnie, thank you so much for your time.

[00:16:04] Thank you. Really appreciate it.