Opportunity

Each year, about 1.8 million Americans are diagnosed with cancer. Historically, nearly all life-extending cancer treatment has been delivered in outpatient or hospital settings. Within a year of diagnosis, three-quarters of those with advanced cancer end up in the hospital; one in six are hospitalized three or more times. And nearly all chemotherapy is delivered in physician offices or outpatient clinics. Patients have to travel in, pay for parking, and spend hours waiting for and receiving care.

Internationally, giving cancer drugs at home has been done safely and effectively across various patient populations and treatment regimens. But it’s uncommon in the United States.

At Penn Medicine, we provide world-class cancer care to more than 26,000 new patients each year. In late 2019, a multidisciplinary team of experts, brought together by the Penn Center for Cancer Care Innovation, began to explore if home cancer treatment could, for appropriate drugs and patient populations, take the place of inpatient or outpatient administration.

Intervention 

Cancer Care @ Home (CC@H) is an evidence-based, patient-centered program that enables life-extending cancer treatment to be delivered in the home.

The program proactively identifies optimal candidates based on specific criteria agreed upon by clinical teams. Providers discuss CC@H with their patients during telehealth or in-person visits and prescribe home treatment using the electronic health record.

From there, staff from Penn Home Infusion Therapy (PHIT) obtain insurance authorization, discuss out-of-pocket cost with patients, and schedule home visits. A courier delivers the medication to the patient’s home, and an oncology-certified nurse arrives on the day of the scheduled visit to administer care. Throughout this process, the prescribing oncologist monitors the patient’s treatments to ensure coordinated care.

Impact 

Since CC@H launched in February 2020, thousands of patients with breast cancer, prostate cancer, and lymphoma have received timely, safe, and effective treatment in the comfort of their homes. In fact, CC@H has enabled patients with lymphoma to spend 25 fewer days in the hospital and patients with breast or prostate cancer to avoid up to 12 outpatient visits a year. 

CC@H patients report increased satisfaction with care, enhanced convenience and comfort, and a better overall experience. The program also benefits the health system as it increases clinic and inpatient bed capacity by decreasing infusion suite density. 

CC@H is now a standard of care at the Abramson Cancer Center, and the team is exploring opportunities to make CC@H available for more patients.