Ramachandran, Venkataramanan, Pradhan, Akash, Kumar, Abhishek, Sarvepalli, Bharat, Rao, Sripriya, Oswal, Kunal, Kommu, Raja, Sharma, Manish, Pathak, Sarika, Kunnambath, Ramdas, Kuriakose, Moni Abraham, Rengaswamy, Sankaranarayanan, Alajlani, Mohannad and Arvanitis, Theodoros N. (2022) A distributed cancer care model with a technology-driven hub-and-spoke and further spoke hierarchy : findings from a pilot implementation programme in Kerala, India. Asian Pacific Journal of Cancer Prevention, 23 (9). pp. 3133-3139. doi:10.31557/APJCP.2022.23.9.3133 ISSN 2476-762X.

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Abstract

Background: The technology enabled distributed model in Kerala is based on an innovative partnership model between Karkinos Healthcare and private health centers. The model is designed to address the barriers to cancer screening by generating demand and by bringing together the private health centers and service providers at various levels to create a network for continued care. This paper describes the implementation process and presents some preliminary findings. Methods: The model follows the hub-and-spoke and further spoke framework. In the pilot phases, from July 2021 to December 2021, five private health centers (partners) collaborated with Karkinos Healthcare across two districts in Kerala. Screening camps were organized across the districts at the community level where the target groups were administered a risk assessment questionnaire followed by screening tests at the spoke hospitals based on a defined clinical protocol. The screened positive patients were examined further for confirmatory diagnosis at the spoke centers. Patients requiring chemotherapy or minor surgeries were treated at the spokes. For radiation therapy and complex surgeries the patients were referred to the hubs. Results: A total of 2,459 individuals were screened for cancer at the spokes and 299 were screened positive. Capacity was built at the spokes for cancer surgery and chemotherapy. A total of 189 chemotherapy sessions and 17 surgeries were performed at the spokes for cancer patients. 70 patients were referred to the hub. Conclusion: Initial results demonstrate the ability of the technology Distributed Cancer Care Network (DCCN) system to successfully screen and detect cancer and to converge the actions of various private health facilities towards providing a continuum of cancer care. The lessons learnt from this study will be useful for replicating the process in other States.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions:	Faculty of Science, Engineering and Medicine > Engineering > WMG (Formerly the Warwick Manufacturing Group)
Library of Congress Subject Headings (LCSH):	Cancer -- Early detection -- Kerala, India, Breast -- Cancer -- Diagnosis -- Data processing -- Kerala, India, Diagnostic imaging -- Data processing, Artificial intelligence -- Medical applications, Medical screening -- Kerala, India
Journal or Publication Title:	Asian Pacific Journal of Cancer Prevention
Publisher:	Asian Pacific Organization for Cancer Prevention
ISSN:	2476-762X
Official Date:	30 September 2022
Dates:	Date Event 30 September 2022 Published 11 September 2022 Accepted
Volume:	23
Number:	9
Page Range:	pp. 3133-3139
DOI:	10.31557/APJCP.2022.23.9.3133
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	25 October 2022
Date of first compliant Open Access:	27 October 2022

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