Data shows cancer patients in low resource health care settings, including rural communities, have poorer outcomes because of lack of access to the latest cancer treatments and screening technology. Shellie Ellis, PhD, is among the scientists working with these care providers on achievable solutions to close that quality-of-care gap.
Discovering a highly effective new cancer treatment is one thing. Making sure all patients, including those in more rural care settings, can access and benefit from it is another.
“You can create a therapy, a drug that is 100% effective, it cures the disease and works on every patient who gets the drug. But if doctors can’t deliver that drug to their patients, it’s 0% effective,” said Shellie Ellis, PhD, a UW Carbone Cancer Center researcher and professor of medicine at UW School of Medicine and Public Health.
“There’s a step in there that has to happen so the benefits of this great science are actually realized, and it reaches everybody it should for maximum benefit.”
Ellis is an implementation scientist focused on closing the gaps that can keep patients in rural or limited resource settings from accessing cutting-edge care that could benefit them. She is also director of the UW Institute for Clinical and Translational Science Dissemination and Implementation Launchpad. This initiative helps identify and overcome barriers to implementing proven research innovations in community health care settings in Wisconsin and beyond.
Identifying gaps in cancer care
Ellis’ research was inspired by her own upbringing in a rural community. During her graduate studies, she reviewed data on persistent gaps in getting new screening and treatment discoveries into practice in small community clinics.
“I wanted to make sure everyone was getting the same level of care,” she said. “That was very motivating for me to figure out the next challenge, which was not just to measure the gaps, but actually do something about them.”
Some of those issues include a shortage of oncologists and urologists working in rural communities. Community clinics may also be served by traveling specialists who are only available part-time. It can also be difficult for busy rural providers to stay up to date on the latest treatment research and discoveries.
Ellis engages these health care providers directly about the challenges they face, as well as ideas for practical solutions that fit their resources. She said these providers are highly motivated and eager to share their ideas for improving resources to help their patients.
“They want to provide the best care they can, and sometimes it just takes us facilitating how to work with them to integrate (new discoveries) into the care they provide,” she said.
Getting new treatments to patients
One area of focus has been the growth of precision medicine in cancer. New targeted treatments for cancer seek out specific biological features of cancer to attack, and even among two patients with the “same type” of cancer, those features can be different and the treatment won’t work.
Doing genomic testing on a tumor can help identify at the outset of treatment which patients could benefit from a targeted treatment, and which patients need a different treatment approach. However, this process can be complicated, not every patient is eligible for that testing, and the treatment landscape changes rapidly. Ellis is leading efforts to streamline genomic testing guidance and have more patients receive genomic testing at the time of their diagnosis.
“We’re trying to get standardized protocols that are updated regularly by health systems so that everybody in the health system is aware of what should be tested,” Ellis said.
Ellis said their team is also working with pathologists to automatically do genomic testing based on specified stage and grade details. The goal is to bridge communication between oncologists and pathologists and ensure all eligible patients receive this testing as quickly as possible to guide treatment.
“We’re in the midst of testing that intervention and we’ll try to scale it up across clinics that need and want it in the next year,” she said.