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Annual Report 2019
Hardin Memorial Health
Oncology Service Line
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 1Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 1
TABLE OF CONTENTS:
Mission, Vision, Uniqueness . . . . . . . . . . . . . . . 2
Comments from Cancer Committee Chair . . . . . 3
Comments from Cancer Liaison Physician. . . . . . 4
Meet Our Cancer Care Providers . . . . . . . . . . . . 5
2018 Data . . . . . . . . . . . . . . . . . . . . . . . . . . 6 - 7
Resource Center . . . . . . . . . . . . . . . . . . . . . . 8
Multidisciplinary Breast Cancer Care . . . . . . . . . 9 - 10
Multidisciplinary Lung Cancer Care . . . . . . . . . . 11 - 12
Clinical Trials . . . . . . . . . . . . . . . . . . . . . . . . 13
Supportive Care Clinic . . . . . . . . . . . . . . . . . . 14 - 15
Surviving Your Cancer Diagnosis . . . . . . . . . . . 15
Survivorship Clinic. . . . . . . . . . . . . . . . . . . . . 16
Psychosocial Services. . . . . . . . . . . . . . . . . . . 16
Financial Counseling Services . . . . . . . . . . . . . 17
Community Needs Assessment . . . . . . . . . . . . 18 - 20
Community Outreach . . . . . . . . . . . . . . . . . . 21 - 23
Physicians, Advanced Practice Clinicians & Staff . . 24
Hardin Memorial HealthOncology Service Line
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 2Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 2
HMH Cancer ProgramHardin Memorial Health is pleased to present its 2019 Cancer Program Annual Report. This report outlines the activities of the Cancer Program and newly diagnosed analytic cancer cases for 2018. Analytic cases are those that were either diagnosed and/or treated at our facility.
MissionTo exceed the physical, emotional and spiritual needs of our patients and their families by providing comprehensive, state-of-the art cancer treatments and therapies.
VisionTo provide hope and healing as the premier community cancer center in Kentucky.
Our UniquenessOur medical, surgical and radiation oncology specialists incorporate multidisciplinary treatments to provide advanced, cutting edge cancer expertise close to home.
Through our affi liation with the University of Kentucky Markey Cancer Center, the only National Cancer Institute (NCI) designated cancer program in Kentucky, we off er patients access to clinical trials and advanced cancer care expertise.
We are Commission on Cancer (CoC) accredited which recognizes our integrated continuum of care. Our comprehensive resources include prevention and screening, genetic counseling, nurse navigation, social work, fi nancial counseling, an onsite dedicated pharmacy, survivorship and palliative care.
We value our caring relationships with our patients and families.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 3
Comments from Donald E. Goodin, M.D.Cancer Committee Chair
At Hardin Memorial Health (HMH), comprehensive cancer care is of the utmost priority. We have access to the most current FDA approved treatment options for cancer and blood disorders as well as a broad range of support services throughout the spectrum of cancer care.
The HMH cancer program is American College of Surgeons Commission on Cancer (CoC) accredited. CoC establishes standards to ensure quality, multidisciplinary, and comprehensive cancer care delivery in healthcare settings. The HMH cancer team is in the process of obtaining American College of Radiology (ACR) Accreditation for radiation oncology. ACR accreditation is recognized as the gold standard in medical imaging. William Porter, MD has joined our radiation oncology team.
We continue to explore breast cancer accreditation through the National Accreditation Program for Breast Centers (NAPBC) and will move forward with that goal in the coming years. NAPBC is dedicated to the improvement of quality care and outcomes of patients with diseases of the breast including breast cancer.
Natalie Harper, MD, PhD has recently completed her fellowship training at the University of Kentucky and is now part of the hematology/oncology team. She will assume the role of Director of Research.
The HMH cancer program continues to enjoy a close working relationship with the University of Kentucky Markey Cancer Center Affi liate and Research Networks which allows our patients access to a wealth of cutting edge treatment and specialists as well as clinical trials.
The HMH cancer program continues to off er multidisciplinary lung and breast care. This provides an opportunity for physicians from multiple disciplines to evaluate patient specifi c treatment plans for these malignancies.
Donald E. Goodin, M.D.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 4Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 3
William Porter, M.D.
Comments from William Porter, M.D. Cancer Liaison Physician
At Hardin Memorial Health (HMH), the cancer committee drives program development and is responsible for the metrics supporting the mission of high quality cancer care. The Cancer Liaison Physician (CLP) reports quality metrics and drills down on data measurements for further analysis. The CLP has access to data through the National Cancer Data Base (NCDB), Cancer Patient Data Management System (CPDMS) and hospital Cancer Registry data housed in the Kentucky Cancer Registry.
The NCDB provides access to cancer data and survival outcomes and compares our program with other cancer programs. Accountability and quality improvement measures are reported to the cancer committee and action plans are developed when our metrics are outside of expected benchmarks.
CPDMS provides cancer incidence and mortality data by disease site and counties/regions in Kentucky. This comparative data supports programmatic development and planning.
The Cancer Registry data provides a breakdown of diagnoses at HMH. The detail is used to manage stage at diagnosis, where treatment is provided, etc., allowing analysis of programs to support patients in our service area.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 5
Kathryn Francescon, APRN-OCN, AANP
Specialty: Medical OncologyGraduate School: Spalding University, MSN
Cora Veza, M.D.Specialty: Hematology/OncologyMedical School: University of Santo Tomas, Manila, PhilippinesPracticing since 1985
Donald E. Goodin, M.D.Specialty: Hematology/OncologyBoard Certifi ed in Internal Medicine/Medical Oncology/HematologyMedical School: University of KentuckyPracticing since 2004
Meet Our Cancer Care Providers
Natalie Harper, M.D., Ph.D.Specialty: Hematology/OncologyBoard Certifi ed in Medical OncologyMedical School: University of KentuckyPracticing since 2019
William Porter, M.D.Specialty: Radiation Oncology Board Certifi ed in Radiation Oncology Medical School: Chicago Medical School at Rosalind Franklin UniversityPracticing since 2015
Stephen Toothaker, M.D.Specialty: Hematology/OncologyBoard Certifi ed in Medical Oncology/HematologyMedical School: DartmouthPracticing since 2008
Kelly White, APRN-OCN, CPCSpecialty: Radiation OncologyGraduate School: Spalding University, MSN
Richard Seither, M.D.Specialty: Radiation Oncology Board Certifi ed in Radiation Oncology Medical School: Louisiana State University Practicing since 1992
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 6Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 5
2018 Top 5 Diagnoses180
160
140
120
100
80
60
40
20
0
Lung Breast Prostate Colon Bladder 171 164 110 60 58
2018 Stage Breakdown: All Diagnoses
300
250
200
150
100
50
0
2018 Data
Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 Unknown75 282 121 130 173 125
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 7
2018 Case Diagnosis Location and Treatment
700
600
500
400
300
200
100
0
K E N T U C K Y
Hardin
Breckinridge
Grayson
Hart
Larue
MeadeBullitt
Nelson
Taylor
Green
AdairMedcalfeBarren
EdmonsonButler
Warren
Muhlenburg
OhioMcClean
Daviess
Hancock
Jeff erson
Spencer
Shelby
Anderson
Washington
Marion
Casey
Pulaski
Lincoln
Boyle
Mercer
Woodford
Franklin
HarrisonPerry
SpencerWarrick
I N D I A N A
52
86
442
94
139
7
72
86
29
Primary Secondary Tertiary
2018 Cases by Service Area
Diagnosed at HMH & treated
elsewhere99
Diagnosed & treated at HMH
675
Diagnosed elsewhere &
treated at HMH 117
Diagnosed in staff physician offi ce &
treated at HMH 34
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 8Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 7
On August 9, 2018, Hardin Memorial
Health (HMH) and Hardin Memorial
Health Foundation (HMHF) opened a
new HMH Cancer Care Resource Center
on Robinbrooke Boulevard adjacent to
the HMH Cancer Care Center. This facility
provides patients, family and community
members with a wide range of cancer
information and resources from treatment
options, to supportive care at no charge.
HMHF provided $28,000 to fund the construction
and furnishings of the HMH Cancer Care Resource
Center. The 2018 Purses, Pumps and Prevention
community event generated over $21,000 for
the project.
Hours for the HMH Cancer Care Resource Center are
8 a.m. – 4:30 p.m. (Monday – Friday).
A special thank you to the HMH Cancer Care Resource Center Committee that championed
construction, design and programing of the resource center as well as the generous supporting
community organizations.
Cancer Care Resource Center
Committee:
Karen Blaiklock, HMH Communications/Community Relations
Kelli Bush, Community Advocate
D. Dee Shaw, Community Advocate
Jason Hart, HMH Facilities Management
Kim Jones, HMH Cancer Care
Kristina Davis, HMH Cancer Care
Renee Perry, HMH Cancer Care
Melissa Rock, HMH Cancer Care
Cathy Wilson, Community Advocate
Supporting Community Organizations:
Ange Deaton, Owner, FINE House & Garden
Empire Beauty School
Hedda Jenkins, Owner/Interior Designer, ReCreations
Louisville Bats
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 9
National Accreditation Program for Breast Centers (NAPBC)
Hardin Memorial Health supports a breast center of
excellence methodology. The multidisciplinary breast team
is dedicated to the improvement of quality outcomes for
patients with diseases of the breast through evidence-
based standards. The Breast Program Leadership Committee
under the direction of Dr. Karen Johnson Brunkhorst, Breast
Program Director, is in the process of applying for NAPBC
accreditation.
We value the importance of:
• A multidisciplinary team approach to coordinate the best care and treatment options available.
• Access to breast-specifi c information, education and support.
• Breast center data collection on quality indicators for subspecialties involved in breast cancer diagnosis and treatment.
• Ongoing monitoring and improvement of care.
• Information about participation in clinical trials and new treatment options.
“At HMH, we strive for high quality breast care and continuously benchmark our outcomes against national standards. We want to achieve the highest quality standards available. Patients will receive the same high quality care close to home.”
Dr. Johnson Brunkhorst
Breast Cancer Cases2014 - 2018
200
150
100
50
02014 2015 2016 2017 2018 139 158 134 160 164
Karen Johnson Brunkhorst, M.D. General Surgery, Breast Program Director
Multidisciplinary Breast Cancer Care
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 10Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 9
Multidisciplinary Breast Cancer Care Team
Audrey Cleaver, BSN, RNNurse Navigator
Jesse Bryant, M.D. Radiology
Laura Barkley, M.D.Radiology, Co-Medical Director Women’s Diagnostic Services
Stephen Toothaker, M.D.Hematology/Oncology
Richard Seither, M.D.Radiation Oncology
Srikala, Ramasamy, M.D.Radiology, Co-Medical Director Women’s Diagnostic Services
Jessica Clevenger, M.D. Pathology
Donald Goodin, M.D. Hematology/Oncology
Gwen Godfrey, D.O.Pathology
Cora Veza, M.D.Hematology/Oncology
Stewart Couch, M.D.Radiology
David Elliott, M.D.Pathology
Ashley Kerekes, M.D.Plastic & ReconstructiveSurgery
Karen Johnson Brunkhorst, M.D. General Surgery, Breast Program Director
William Porter, M.D.Radiation Oncology
Natalie Harper, M.D., Ph.D.Hematology/Oncology
Andrea Walker, M.D.Radiology
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 11
Multidisciplinary Lung Cancer Care
The HMH multidisciplinary lung program began in
November 2016 minimizing the number of patient
visits while providing comprehensive multidisciplinary
cancer care close to home. Patients with lung nodules,
suspicious diagnostic fi ndings or a newly diagnosed
lung cancer are seen in clinic on Tuesday afternoon
following a lung tumor board. The multidisciplinary
team is featured on the next page.
Since 2015 Hardin Memorial Health has seen an
increase in the overall number of lung cancers
that have been diagnosed. With this increase, the
proportion of stage I – III cases to stage IV cases has
changed. This means that more patients are being
diagnosed while still in a curative stage (See Exhibit A).
This change in diagnosing lung cancers earlier can be
attributed to a robust LDCT screening program, nurse
navigation and evidence-based high quality care.
Hardin Memorial completed almost 850 Low Dose CT
Lung Scans in 2018 (See Exhibit B), along with seeing
patients in our weekly Multidisciplinary Lung Clinic.
The Multidisciplinary Lung Clinic has fi ne-tuned the
population that seeks to only include patients with
lung nodules 8mm or greater. This has decreased the
number of patients being seen, however the number
of cancer diagnoses has remained steady and is on
track to increase in 2019 (See Exhibit C).
Connie Barnes, Lung Nurse Navigator states, “The
biggest impact I bring to the weekly multidisciplinary
lung program is getting those suspicious nodules into
the clinic rapidly. We average two to fi ve incidental
fi ndings per week. Not all nodules or masses are
malignant, but a good percentage will move forward
very quickly for a diagnosis and treatment.”
Exhibit B Number Of Low Dose CT Scans
1250
1000
750
500
250
02017 2018 2019
Projected
100
80
60
40
20
0
Exhibit A Lung Cancer Diagnoses By Stage
2015 2016 2017 2018
Stage I-III Stage IV
600
400
200
0
New Pulmonology Oncology Cancer Patients Visits Visits Diagnoses
Exhibit C Lung Clinic Data
2017 2018 2019 Projected
594
848
1150
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 12Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 11
Multidisciplinary Lung Cancer Care Team
Navin Kaini, M.D.Pulmonary/Critical Care
Kelli Mathew, D.O.Pulmonary/Critical Care
Aaron Mulhall, M.D. Pulmonary/Critical Care
Jordan Miller, D.O.Cardiothoracic SurgeryUK HealthCare
Richard Seither, M.D.Radiation Oncology
Connie Barnes, MSN, RN, OCNNurse Navigator
Gwen Godfrey, D.O.Pathology
Ronald Wurth, M.D. Radiology
Jesse Bryant, M.D. Radiology
William Cundiff , D.O. Pulmonary/Critical Care
Jessica Clevenger, M.D. Pathology
Donald Goodin, M.D. Hematology/Oncology
Stewart Couch, M.D. Radiology
Cora Veza, M.D.Hematology/Oncology
Stephen Toothaker, M.D.Hematology/Oncology
William Porter, M.D.Radiation Oncology
Natalie Harper, M.D., Ph.D.Hematology/Oncology
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 13
HMH Clinical Trial ParticipationThe mission of the clinical research program is to reduce the impact of cancer by increasing awareness of new evidence, trends and practice standards. It is our goal to increase the involvement of those in the community to participate in cancer research activities creating more opportunities for community based research services.
University of Kentucky Clinical Trial Opportunities• Hardin Memorial Health is a member of both the research and affi liate
networks of the University of Kentucky Markey Cancer Center, the state’s only National Cancer Institute (NCI) designated cancer center. HMH participates in the NCI’s National Cancer Trials Network through the University of Kentucky, allowing access to both national clinical trials and advanced cancer expertise.
• The Molecular Tumor Board (MTB) is a forum of expert clinicians and scientists that analyzes tumor genotypes and molecular abnormalities from next generation sequencing test results in order to recommend patient-specifi c targeted therapies. The MTB provides a gateway for Markey researchers to learn more about which genetic mutations cause certain cancers in patients throughout the Commonwealth. Knowing which mutations are found in Kentucky’s cancer population can help with developing or recruiting targeted clinical trials for patients. Through this observational study, Markey is able to create a rich molecular database connected to the Kentucky Cancer Registry, providing researchers with a wealth of information for drug development as well as population-based studies.
Clinical Trial Volumes
In 2018, clinical trial accrual again exceeded accreditation requirements of 4% for a comprehensive community cancer program (see chart below). We exceeded our goal of 36 by 28% accruing 50 trial participants.
2018 Clinical Trial Accrual
Kentucky Lung Education Awareness Detection and Survivorship (LEADS) 17
Optimization of Smoking Cessation Strategies (MOST) 4
University of Kentucky Molecular Tumor Board 8
NCI Trials 11
Referrals to other programs 12
Total (28% Increase) 50
Clinical Trial Accrual by Year 2015 - 2018
50
25
0
2015 2016 2017 2018 16 21 39 50
HMH also participates in the National Radiology Data Registry (NRDR) dedicated to low dose CT screenings. This research project builds on the ongoing screening of patients age 55-77 with a 30-pack year smoking history, who either currently smoke or quit within the past 15 years. This rich data will be used to learn more about lung cancer. Our participation increased by 66% from last year from 300 patients to over 500.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 14Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 13
Supportive Care Clinic
In December of 2017, HMH Cancer Care, in partnership with Hosparus of Louisville, implemented a provider
driven Supportive Care Clinic. Dr. Cory Lucas (Palliative/Hosparus Provider), Jeanette Settle (RN), and Kristina
Davis (Oncology Social Worker), see patients every Friday.
The purpose of the clinic is to discuss goals of care, symptom management, advanced care planning and
spiritual counseling for patients with late stage cancers. Patients being treated with palliative intent in
radiation oncology and medical oncology are off ered a referral to the Supportive Care Clinic. The goal is
to establish a patient in the Supportive Care Clinic early in the journey to support and complement the
prescribed treatment plan.
Below is a graph of referrals to the Supportive Care Clinic through August 2019. The Supportive Care Clinic
team is currently collaborating with our oncology providers and leadership to increase the number of
referrals to the Supportive Care Clinic and improve the timeliness of these referrals.
January - August 2019 Supportive Care Referrals
7
6
5
4
3
2
1
0JAN FEB MAR APR MAY JUN JUL AUG
4 6 1 3 1 3 4 3
Jeanette Settle, BSN, RN, OCNSurvivorship Nurse Navigator
Cory Lucas, MDPalliative Care/Hosparus Provider
Kristina Davis, MSW, CSWOncology Social Worker
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 15
Surviving Your Cancer DiagnosisAt HMH, patients completing curative treatment receive a survivorship care plan and treatment summary.
This information provides the patient with detail about their treatment, information on follow up
recommendations, and ongoing screening.
“As the survivorship nurse navigator, it is my responsibility to connect with patients, providing a contact for
ongoing support. Patients appreciate the personal contact and often reach for ongoing care,” says Jeanette
Settle, Survivorship Nurse Navigator.
January - August 2019 Supportive Care Clinic
7
6
5
4
3
2
1
0JAN FEB MAR APR MAY JUN JUL AUG
4-3 6-4 1-1 3-2 1-1 3-2 4-2 3-1
# of Patient Referrals # of Patients Seen
In the next graph, a comparison is shown between referrals and patients seen through August 2019 . The goal is
to close the gap between referrals and patients seen through earlier referrals to the Supportive Care Clinic. Often
patients are not referred until end of life when a Hosparus admission or death occurs prior to the visit.
Jeanette Settle, BSN, RN, OCNSurvivorship Nurse Navigator
2015 - 2018 Survivorship Care Plan Distribution
400
300
200
100
02015 2016 2017 2018 13 28 324 299
Plan
s G
iven
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 16Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 15
Survivorship ClinicIn 2018, a Survivorship Clinic was established. A nurse practitioner evaluates the
patient’s current versus pre-treatment status and develops strategies to improve
conditioning and healthy lifestyles (e.g. Physical Therapy, Nutrition, Alternative
Therapies), and assists in scheduling screening for other cancers. Patients
are scheduled in the clinic after the last curative treatment appointment. A
survivorship care plan is also presented at this time. The next appointment is with
the physician for specifi c diagnosis follow up.
HMH is excited to provide this best practice as a high-quality service for our
patients.Kelly White, APRN,ONC, CPCMedical Oncology
Psychosocial ServicesTo address psychosocial issues experienced by patients with cancer, the HMH
Cancer Program performs distress screening for all new cancer patients, as
needed during treatment, and at survivorship appointments. Our oncology
social worker, Kristina Davis, assesses psychological, social, fi nancial and
behavioral issues that may interfere with a patient’s treatment plan and
adversely aff ect treatment outcomes.
Kristina meets with cancer patients in radiation oncology, the infusion center
and multidisciplinary clinics to address barriers to care that arise after the new
patient appointment. “At the fi rst appointment, my time is spent on emotions
dealing with the diagnosis. Often, it is
when treatment is in process that barriers
to care with transportation and cost arise,”
states Kristina.
This year, the top interventions requiring
actions were emotional support, fi nancial
assistance, transportation assistance, and
support groups.
Kristina Davis, MSW, CSWOncology Social Worker
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 17
Financial Counseling ServicesThe HMH Cancer Program off ers all cancer patients access to fi nancial counseling services. The cost of
treatment can be prohibitive due to expensive co-pays and out-of-pocket expenses for services.
Through a recent assessment of cancer patients in active treatment, most have limited income with
33% of our patients at or below poverty level. Patients indicated cost of medication as the reason for not
refi lling prescriptions.
Hanna Price provides fi nancial counseling services at any time during a patient’s treatment. Most patients
are identifi ed at the new patient appointment by the oncology social worker through the distress
screening tool. The oncology social worker refers the patient to Hanna to collect information to support
drug assistance, charitable options, and other services that support patient adherence to the prescribed
treatment regimen. This team oriented approach to patient care closes the gap on missed appointments
and decisions not to go forward with treatment.
In 2019, 177 applications were approved for co-pay assistance, 46 applications were approved for free
medication, and 115 Financial Assistance Program applications were completed.*
“The majority of my time is spent processing applications. If there is a program available, I want to
make sure our patients are enrolled. Often the thought of the fi nancial obligation weighs as heavy as
the diagnosis. The last thing I want to hear is a patient does not move forward w ith treatment or stops
treatment due to cost. That’s where the oncology social worker and I step in, and work together to fi nd a
program or solution to ensure our patients receive the care they deserve,” states Hanna.
Hanna PriceOncology Financial Navigator
* Applications processed through December 1, 2019.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 18Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 17
Community Outreach
Prevention Prevention Goal:
Prevention, Refl ect, Assess, You (P.R.A.Y.) Breast Cancer
Awareness Program
In 2019, our goal was to educate more underserved area residents about personal breast health. This was accomplished through business and industry clients, health fairs, Wellness On Wheels (WOW) van visits and or church events. We additionally established an African American advocate to support awareness for breast education and worked to improve tracking of race/ethnicity for outreach opportunities.
Hardin Memorial Hospital partnered with First Baptist
Church in Elizabethtown to provide a Breast Cancer Awareness event, P.R.A.Y. Women
were educated on the importance of mammograms by Dr. Andrea Watson. Pre and
post-tests were completed to assess the attendees’ compliance with mammography
screening.
WOW counseled 63 clients, distributed information to 38 women (2 African Americans,
1 Hispanic, and 60 Caucasian) and provided follow up phone calls with 11 clients on
mammograms. Additionally, one African American health fair was scheduled, with 100
attendees and 9 surveys were completed.
P.R.A.Y.
Survey Event Results
of women hadmammograms in
the last 2 years
69%completed yearly
clinical breastexam
89%plan to
schedule amammogram
40%motivated to schedule as aresult of the
program
26%undeterminedon whether to
schedule amammogram
57%
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 19
Tobacco Prevention Program
During 2019, implementation of Botvin Life Skills tobacco reduction pilot program
continued at the Larue County Middle School. Tobacco prevention is a top strategy and
community need for Hardin Memorial Hospital patient population. Smoking incidence,
lung cancer incidence and mortality are high for patients in our regional counties. Botvin
Life Skills tobacco reduction evidence-based prevention program cuts tobacco use for
middle school students by up to 80% with eff ects lasting up to 6 years.
In School Year 2018/2019, Larue County Middle School, 205 students attended 4
sessions; 190 students attended 3 sessions; and 193 attended 2 sessions. 172 students
took the post-test. After completion of the 9 education sessions over 3 school years,
3% of the eighth grade students, indicated, “Defi nitely would not say “no” to accept a
tobacco product.” 69% indicated, “Defi nitely say “no” to accept a cigarette.”
20182019 BOTVIN POST TEST 8TH GRADE
How likely would you be to say “no” Defi nitely Would Probably Would Not Sure If I Probably Would Defi nitely Wouldwhen someone off ers you a cigarette. Say “No” Say “No” Would Say “No” Not Say “No” Not Say “No”
69% 16% 8% 4% 3%
Screening Goal:
Prevention, Refl ect, Assess, You (P.R.A.Y.) Breast Cancer Awareness Program
Increase the number of service area underserved populations participating in screening
mammography.
In our service area, breast cancer is the 2nd highest diagnosis. In Hardin County, the
African American population is 12% of the residents. Incidence and mortality from
breast cancer is higher for underserved populations, specifi cally African American. A
review of mammograms for 2018 indicates less than 7% of African Americans complete
an annual screening.
As demonstrated on p. 20, year-to-year data from 2018 to 2019 comparing Q.1 and Q.2,
indicates more African American clients completed a screening mammogram.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 20Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 19
Colorectal Cancer - FIT Kits
Increase the number of service area residents reached for Fecal Immunochemical Test (FIT)
testing through business and industry clients and underserved populations participating
in health fairs, WOW van visits and or church events.
51 FIT OC Light kits were distributed from 1/17/2019 to 10/31/2019 within 9 counties.
Following ACS guidelines for screening protocol, various venues were utilized to reach our
community: 4 health fairs, 1 church, 15 WOW regional visits.
Partnering with the Kentucky Cancer Link, follow up phone calls and letters were placed to
fi nd the following results: 3 positive, 33 negative, 1 invalid kit (replacement was mailed), 15
noncompliant and 1 invalid colonoscopy status after positive, 1 was moving out-of- state
and would share with new MD; 1 declined assistance and requested to share info with MD;
1 was returning to MD for shared decision; and unable to be reached after that.
The campaign covers 14 counties by off ering the kits during wellness coaching on the
WOW, 2 African American events, with the addition of community festivals and off ering FIT
kits in conjunction with fl u immunizations at business/industries.
Although the focus of the goal was prevention through screening, the topic of colorectal
cancer awareness is a subject matter we continue to creatively investigate approaches to
reach clients to encourage early detection.
SCREENING MAMMOGRAMS AT HMH DIAGNOSTIC CENTERS
2018 CY 2019 CY
Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2
American Indian or Alaska Native 1 2 0 1 1 2
Asian 41 29 51 47 39 38
Black or African American 196 216 202 241 240 250
Other 8 9 15 31 20 8
White 2,909 3,051 3,048 3,347 3,420 3,182
Total 3,155 3,307 3,316 3,694 3,720 3,480
or Alaska Native 1 2 0 1 1 2
Asian 41 29 51 47 39 38
Black or African American 196 216 202 241 240 250
Other 8 9 15 31 20 8
White 2,909 3,051 3,048 3,347 3,420 3,182
Total 3,155 3,307 3,316 3,694 3,720 3,480
or Alaska Native 1 2 0 1 1 2
Asian 41 29 51 47 39 38
Black or African American 196 216 202 241 240 250
Other 8 9 15 31 20 8
White 2,909 3,051 3,048 3,347 3,420 3,182
Total 3,155 3,307 3,316 3,694 3,720 3,480
or Alaska Native 1 2 0 1 1 2
Asian 41 29 51 47 39 38
Black or African American 196 216 202 241 240 250
Other 8 9 15 31 20 8
White 2,909 3,051 3,048 3,347 3,420 3,182
Total 3,155 3,307 3,316 3,694 3,720 3,480
2018 CY 2019 CY
or Alaska Native 1 2 0 1 1 2
Asian 41 29 51 47 39 38
Black or African American 196 216 202 241 240 250
Other 8 9 15 31 20 8
White 2,909 3,051 3,048 3,347 3,420 3,182
Total 3,155 3,307 3,316 3,694 3,720 3,480
or Alaska Native 1 2 0 1 1 2
Asian 41 29 51 47 39 38
Black or African American 196 216 202 241 240 250
Other 8 9 15 31 20 8
White 2,909 3,051 3,048 3,347 3,420 3,182
Total 3,155 3,307 3,316 3,694 3,720 3,480
or Alaska Native 1 2 0 1 1 2
Asian 41 29 51 47 39 38
Black or African American 196 216 202 241 240 250
Other 8 9 15 31 20 8
White 2,909 3,051 3,048 3,347 3,420 3,182
Total 3,155 3,307 3,316 3,694 3,720 3,480
Barriers to reaching additional African American members and churches were due to
scheduling confl icts for Fall 2019, but several organizations reached out after the pilot
P.R.A.Y. event requesting similar events for 2020.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 21
Other Prevention AndScreening Initiatives
National Colorectal Cancer Awareness MonthThe Incredible ColonMarch 9, 2019
During the month of March, HMH educated clients about colorectal cancer and the importance of early
detection screenings. The attendees had the opportunity to explore the Incredible Colon, a 20 foot infl atable
interactive medical model at the event. Registered nurses with HMH Cancer Care Center and Endoscopy ser-
vices were present to engage participants in a discussion regarding risk factors, prevention tips and screening
guidelines for colorectal cancer. 150 community members visited the display in the Towne Mall center court
and completed a colon cancer screening survey.
National Cancer Control MonthPurses, Pumps and Prevention: A Cancer Awareness Social April 25, 2019
Recognizing April is National Cancer Control Month, Hardin Memorial Health held a community
cancer prevention awareness program featuring a fashion show, dinner and educational program
for participants to learn about breast, colorectal, cervical, skin and lung cancer prevention. Cancer
prevention educational handouts were provided in addition to local support and resources. Participants
were encouraged to recognize cancer prevention screening recommended guidelines and seek
appropriate medical assistance.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 22Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 21
Skin Cancer Screening May 6, 2019
In recognition of National Skin Cancer Detection and Prevention Month, a free skin
cancer screening was provided: 43 community members were screened following the
American Academy of Dermatology (AAD) screening guidelines with the assistance
of 2 local dermatologists. Educational materials from the American Academy of
Dermatology and National Cancer Institute were distributed to promote skin cancer
prevention. Demographics below:
Average Age: 52
Participants
Participants completed a screening evaluation noting: 49% of the participants stated
they regularly use sunscreen; 54% perform monthly self-preventative skin check
examinations; and 88% indicated they will start checking their skin monthly for
changes. Follow up phone calls were conducted by a registered nurse to the 9 referring
participants reaching 4 clients.
5 38
• 9 referred for follow-up (1 male and 8 females)
• 2 ruled out basal cell carcinoma
Social Media
Various platforms of social media, including Facebook, Internet hmh.net, and YouTube
were utilized to help our regional community learn more about cancer prevention,
education and various cancer support group opportunities.
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 23
Skin Cancer Prevention Education and Awareness:
Utilizing the Environmental Protection Agency (EPA) Sun Safety program “SunWise,” the
program reached over 422 community members at community festivals and summer
school programs from April-July. Sunscreen and education regarding UV radiation was
shared and distributed throughout our regional service area.
Additionally, 92 community clients who visited the WOW mobile health unit during
regional visits, were counseled regarding skin cancer prevention based upon their risk
factor. 59 of the 92 received educational information and 15 clients received follow up.
Breast Cancer Awareness MonthOctober 2019
During the month of October, Hardin Memorial Health participated in community
outreach through the following activities: Tails & TaTas and Judy Walden 5K.
Community members participated in raising funds to support the HMH Cancer
Resource Center. They also received educational information on the importance of
early detection through mammography screenings.
Tails and Ta Ta’sBreast Cancer Awareness 5K Run/WalkOctober 12, 2019
Judy Walden 5KOctober 26, 2019
Submitted by: Karen G. Blaiklock, MS, RN Communications & Community Relations Director, HMHCommunity Outreach Coordinator, Cancer Committee
Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 24Hardin Memorial Health | Oncology Service Line 2019 Annual Report | Page: 23
Physicians, Advanced Practice Clinicians & Staff
521 Robinbrooke BlvdElizabethtown, Kentucky 42701
www.hmh.net
Medical Oncology:
Donald Goodin, MDNatalie Harper, MD, PhDStephen Toothaker, MDDan Martin, PT, MPT – AVP of Oncology and Rehabilitation ServicesMelissa Rock, BSN, RN, OCN – Director of OperationsMorgan Gerage, BSN, RN, OCN – Clinical ManagerRocky Hardesty, RN, OCNDiane Drobny, BSN, RN, OCN, CCRPJeanette Settle, BSN, RN, OCNSara Robinette, BSN, RN, OCNAnna Akins, RN, OCNPaula Bray, RN, OCNDebora Kirby, CPCJoyce Williams, BSN, RN, OCNPamela Dodd, BSN, RN, OCNMary Harned, MSN, RNConnie Barnes, MSN, RN, OCNKathryn Francescon, APRN, OCNDeborah Lemons, RN, OCNRhonda Judd, CMARenee Griner, RRT, BSN, RNAudrey Cleaver, BSN, RNJameka Milton, BSN, RNKristen Boone, BSN, RNMegan Smith, MA
Kimberly Jones, BSN, RNBrandon Thompson, RNAbby Henderson, MAJames Taylor, RN
Pharmacy:
Jackee Clark, PharmD, BCPSMike Senay, PharmD, RPhJessica Smith, CPhTMegan Mier, CPhT
Radiation Oncology:
William Porter, MDRichard Seither, MDKelly White, APRN, OCN, CPCMelissa Hardin, BSN, OCNCharity Johnston, BSN, OCNPhyllis Raymer, SecretarySara Stivers, CPC, SecretaryJohn Sena, RT(R)(T), CMDNathan Thompson, MS, DABRMary Ann Squires, RT(R)(T)Eyvette Fisher, BSRT(R)(CT)(T)Amanda Smith, BSRT(R)(T)Amber Robey, BSRT(R)(T)Scott Goodman, BSRT(R)(T), MBA-HCM