Dr. Randy Oyer: Nik, you’ve been with us since before the ABBCI opened, and you’ve accomplished a lot! On our seventh anniversary, we’d like to hear your thoughts on some of our top milestones, your biggest concerns and challenges, and the future of the ABBCI.
Nik Buescher: First, a big thank you to all of the employees who are here from the early years of ABBCI (or even pre-ABBCI), as well as those who have joined us along the way. You all have been a big help as we grow and improve step by step each year. Our highly functioning care model and excellent outcomes have attracted national attention because of our “secret sauce.” In the past three years, we’ve hosted visits from the Medicare Oncology Care Model team, the White House Cancer Moonshot team and Memorial Sloan Kettering (MSK even came back a second time), who all wanted to learn more about our care model. For those of us who have worked at other cancer centers, ABBCI is clearly special, thanks to talented people, great teamwork, our specialized disease teams and a strong focus on providing loving care for our patients.
I see three big challenges for ABBCI: growth (without careful planning), competition and payment reform. And I see even more exciting opportunities that will continue to set us apart: proton therapy, CAR-T and cellular therapy, clinical trials and continued improvement of personalized care and patient experience.
RO: What is your educational background, and how did you choose cancer care as a career?
NB: I studied public health, economics and health-care management at Johns Hopkins, and still occasionally teach MHA classes there as member of their faculty. My mother was diagnosed with breast cancer when I was in the fourth grade. I knew by the time I was in high school that I wanted to go into the medical field, and that working in oncology was a dream. What I didn’t expect was an offer to lead a cancer center in Minneapolis that came in 2005, on the anniversary of her death. Hard to refuse a sign like that!
RO: To get the ABBCI up and running in 2013, you participated in designing processes, hiring staff, writing policy and building new programs. Please share some of the features of our model of care that were new and designed especially for the ABBCI.
NB: Some of you who have been here from the beginning might remember the early work, which was considerable:
- Getting all oncology departments on Epic and developing new ABBCI workflows for us to work seamlessly together
- Developing a new billing system for ABBCI
- Creating a new scheduling and registration system allowing universal registration for all hospital outpatient and physician office care in one location.
- Before opening ABBCI, we created over 30 new positions that needed to be interviewed and hired.
- ABBCI presented an opportunity to experiment with new technologies, such as kiosks, VOIP phones, patient tracking systems, virtual tumor boards and the patient entertainment system in infusion.
- The Image Recovery Center, and our initial challenges in obtaining a cosmetology license
- ABBCI also marked the start of sub-specializing and developing our disease teams.
RO: COVID-19 has been a tremendous strain for so many people in so many ways. What went through your mind in early March? A lot has happened since then. How do you think we are doing?
NB: It’s hard to remember all the way back to March, even though it wasn’t that long ago, but there were a lot of competing thoughts. We faced a lot of unknowns. Unlike everything else we have done that was new, this time there were no early pioneers or researchers pointing the way for us. Guidelines changed as the clinical evidence became more refined. It took a few months before COVID data became more available, and we continue to learn more about it.
Our early and ongoing priorities included:
- Getting important new information out to staff as quickly as possible
- Updating our processes immediately when guidelines change
- Developing our screening process
- To the greatest extent possible, keep screening outside, so ABBCI can live up to its goal of being a welcoming, peaceful, reassuring place as soon as patients walk through the door.
As for how are we doing, our main focus now is on figuring out how to make our COVID work sustainable long-term, as it becomes clear the pandemic is not going away anytime soon.
We do face some challenges. Extreme temperatures in the summer and winter, along with inclement weather, make it difficult to work outside with the current setup. Also, 30 percent of our clinic visits were converted to virtual earlier in the spring. In-person visits are now returning to a more normal volume, which means increased need for screening of patients, staff and visitors. And with the extreme global demand, we must ensure that we continue to maintain adequate supplies of PPE and other necessities.
RO: You are known for looking at the big picture and long-term outcomes. What do you see in store for the ABBCI over the next three years?
- Improving our patient experience. We will focus on:
Providing enhanced service to referring providers
- Facilitating quick access for new patients
- Helping patients who call us to reach the right person right away
Offering an advanced level of care
- Promoting the quality of our care to those in the region who have not yet experienced it. Unfortunately most people we survey don’t have an opinion on who provides the best cancer care in our area.
- Enhancing processes that make it easy for providers to send patients here
- Increasing availability of cancer treatment clinical trials
- Major scientific advances in Radiation Oncology
- Expanded genetic and molecular diagnostics
RO: Thank you, Nik, that’s really exciting! In closing, we’d like to thank you for your leadership and your devotion to our staff, patients and the ABBCI business.