Rapid diagnosis and treatment for suspected inpatient malignancies: The MVP CAN clinic.

271 Background: Patients in North Philadelphia face cancer care disparities due to social determinants of health (SDOH), including poverty, poor healthcare access and low health literacy. It is known that patients who present at Temple University Hospital-Broad St (TUH-B) are diagnosed at later stages and are less likely to receive timely treatment. At TUH-B, we identified an unmet need for patients presenting in the inpatient setting with signs of malignancy that required further outpatient workup, leading to missed or delayed treatment. Here we present a targeted intervention with the Multi Visit Patient Cancer Clinic (MVP CAN) model to facilitate expedited workup and treatment of patients with suspected cancers. Methods: MVP CAN was established to address disparities in cancer care by creating infrastructure and providing navigation to reduce delays in evaluation for patients with suspected malignancy discovered in the inpatient setting. Inpatient providers order a referral to MVP CAN for findings suspicious of malignancy. A subspecialist reviews the case via e-consult and provides recommendations. Post-discharge, an internist and navigator coordinate outpatient workup, subspecialty visits, and follow-up, while addressing SDOH barriers, with both in-person and virtual components. A no-show protocol with a real-time dashboard assists in tracking missed appointments. Utilizing index date of initial suspicious finding, we evaluated time to specialist visit (e-consult 63% Black, 20% Hispanic). 44% were diagnosed with cancer, 36% referred to oncology-directed treatment, 26% required active surveillance, and 13% lost to follow up. For the subset of patients diagnosed pathologically with malignancy, the average time to specialist e-consult was 6 days (range 1-29), diagnosis was 20 days (0-203), outpatient specialist visit was 31 days (4-113), and treatment was 53 days (0-162). 86% of patients with malignancy referred to oncology received treatment. Conclusions: MVP CAN clinic is a thoughtfully designed navigation model that provides cancer care in an expeditious timeline for underserved patients by dismantling barriers for diagnostics and treatment planning. We will further validate this approach by examining patients who underwent traditional diagnostic and treatment pathways pre-MVP CAN and depending on findings, may further validate in a randomized clinical trial.