Florida Cancer Specialists Summer 2017 Magazine by Florida Cancer Specialists

FCS

Summer 2017

THE MAGAZINE

Assuring Quality New Team Focuses on Improving the Patient Experience

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FC S U N I V E R S I T Y » KAT H E R I N E H O G A N » T H E A R T O F R E L A X AT I O N

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Save the Date 2017 FCS Nursing & Pharmacy Conference Date: Saturday, September 16, 2017 Time: 8 AM - 4:45 PM Registration & Continental Breakfast: 8 AM - 8:30 AM Place: Tampa Airport Marriott 4200 George J. Bean Parkway Tampa, Florida 33607 Designed exclusively for FCS RNs, LPNs and Pharm-Techs. This conference is a great opportunity to learn from expert speakers and network with colleagues within your FCS Family. Conference details and registration information will be available in the next few months. We hope to see you there!

Summer 2017

Contents

Vero Beach Office

In This Issue

DEPARTMENTS 8 FCS News 13 HR Happenings 14 Volunteer Program 30 Patient Letters 36 FCS Events

SPOTLIGHTS 34 Doctor Spotlight: Dr. Hugo Davila 40 Nurse Spotlight: Chris Sims 42 Senior Management Team Spotlight:

Katherine Hogan

Office Spotlight: Vero Beach

FEATURES 20 A Journey to Near Perfection 26 Mark Moch and FCS’ IT Department 28 FCS University 32 Leukemia & Lymphoma Society’s

Man & Woman of the Year

A Joy that Lasts: Celebrating FCS Employees’ Years of Service

Summer 2017

Editor's

Letter

FCS Leadership at COA National Conference BY BRAD PRECHTL, CEO, AND

DR. WILLIAM HARWIN, FOUNDER & PRESIDENT

FCS THE MAGAZINE PHYSICIAN LEADERSHIP PRESIDENT

WILLIAM N. HARWIN, M.D. ASSISTANT MANAGING PARTNER, DIRECTOR, EXECUTIVE BOARD

STEPHEN V. ORMAN, M.D.

DIRECTOR OF PATIENT ADVOCACY, DIRECTOR, EXECUTIVE BOARD

MICHAEL DIAZ, M.D.

DIRECTOR OF QUALITY AND MEDICAL INFORMATICS

LUCIO GORDAN, M.D.

BRAD PRECHTL: Recently, Dr. Harwin and I had the pleasure of speaking at the national Community Oncology Alliance (COA) Conference held in Washington, D.C. The meeting attracted more than 1,300 oncologists, administrators, nurses, pharmacists and patient advocates to discuss some of the most recent advancements in cancer care. FCS had great representation from physicians and leaders who were also featured speakers, including Dr. Michael Diaz, Dr. Craig Reynolds, FCS Director of Pharmacy Ray Bailey and Dr. Lucio Gordan, who served as a national co-chair for the conference. Sitting on panels post conference were Don Champlain, Associate Director of Care Management, and Sarah Cevallos, Chief Revenue Cycle Officer – plus we also had an FCS patient advocate from Sarasota attend the conference. Sharing our experiences with other community oncologists and administrators strengthens our ability to deliver innovative new therapies and services to our patients. DR. WILLIAM HARWIN: The conference theme this year was “Fueling the Cancer Moonshot,” which refers to former Vice President Joe Biden’s challenge to all of us to share cancer research data so we can see many more cures in the next decade. It was inspiring to hear the many initiatives in which researchers are involved, and especially to recognize that all of us at FCS are at the very forefront of helping to develop tomorrow’s new treatments through our Clinical Trials program. Dr. Lucio Gordan, who practices at Gainesville Cancer Center and was one of the conference co-chairs, summed it up this way: “Community oncology practices have truly taken the lead in delivering cutting-edge treatments, driving clinical research and developing innovative payment and delivery system reforms. As front-line providers of cancer care, community oncology practices understand the challenges of our current cancer care system and are dedicated to improving treatments and providing cost-effective, patientcentric solutions.”

SCIENTIFIC DIRECTOR OF CLINICAL RESEARCH, DIRECTOR, DRUG DEVELOPMENT PROGRAM

LOWELL L. HART, M.D.

DIRECTOR OF RESEARCH OPERATIONS

JAMES A. REEVES, JR., M.D.

EXECUTIVE MANAGEMENT CHIEF EXECUTIVE OFFICER

BRAD PRECHTL

CHIEF OPERATING OFFICER

TODD SCHONHERZ GENERAL COUNSEL

TOM CLARK

CHIEF MARKETING & SALES OFFICER

SHELLY GLENN

CHIEF REVENUE CYCLE OFFICER

SARAH CEVALLOS

SENIOR MANAGEMENT RICH DYSON JEFF ESHAM MICHAEL ESSIK JEFFREY RUBIN TARA RUSKA INGA GONZALEZ RAY BAILEY CHRISTY BANACH LOIS BROWN MELISA CHANDLER MELODY CHANG DAVID CURRY STEPHANIE ERTEL CLAUDIA FRENCH KATIE GOODMAN ERIC GRINDSTAFF LEVESTER JONES SUE KEARNEY MARK MOCH NICOLE PICAZIO ANNIE PIGUE LOIS POEL LYNN SAWYER LAURA SPERRY DENICE VEATCH SAMANTHA WATKINS DON CHAMPLAIN KATHERINE HOGAN ANNE RONCO

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Summer 2017

FCS

News

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Leesburg South Cancer Center Renovations Completed

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New FCS Central Business Office Opens Its Doors

Renovations to the Leesburg South Cancer Center were completed in early April. Drs. Jennifer Cultrera, Maen Hussein, Sandeep Thaper and Marays Veliz practice at the Lake County facility, which is located at 601 E. Dixie Avenue, Suite 1001. Dr. Thaper, who has practiced in Leesburg for more than 20 years, said, “Our new center was designed with our patients in mind. We are able to offer the most advanced treatments and cutting-edge technologies in a setting that is aesthetically pleasing.”

The new FCS Central Business Office, located at 2890 Center Pointe Drive in Fort Myers, opened in January. Present at the ribbon cutting in March were staff, volunteers and local dignitaries. The two-story, 50,000-plus-square-foot facility houses more than 250 Revenue Cycle department employees. “This permanent residence provides us with the ability to establish roots in order to serve our community, state network of physicians and employees. Most importantly this will permit our patients to focus on what matters most: getting better,” said Chief Revenue Cycle Officer Sarah Cevallos.

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FCS Patients Sail Away on a Voyage of Healing

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Fort Myers-Colonial Office Joins in Awareness Raising Event

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New Pathologists Join FCS Pathology Lab

More than two dozen FCS patients and their caregivers sailed away from Naples on a voyage of relaxation hosted by Sailing Heals, a non-profit organization based out of Massachusetts that operates in nine states. FCS oncologist Dr. Susan Morgan, who helped to coordinate the guests for the fourth annual event, said “Sailing Heals offers FCS patients, who are going through one of the greatest challenges in life, a chance to get away from it all and simply enjoy a healing day out on a beautiful boat and create wonderful memories with family and friends.”

In an effort to raise awareness of colorectal cancer, and as part of Colorectal Cancer Awareness Month, FCS physicians and staff at the Fort Myers-Colonial Office dressed in blue on March 3 for “National Dress in Blue Day,” a project of the Colon Cancer Alliance.

In early March, the FCS pathology lab, located in Fort Myers, added three new pathologists to its team: Surgical Pathologists Drs. Jane Bernstein and Kelly Rose, and Hematopathologist Dr. Jane McNaughton. “Our in-house pathology lab serves our entire statewide network, providing critical information to our physicians, usually within 24 hours,” said CEO Brad Prechtl. “The addition of these three excellent pathologists will enhance our ability to serve patients in the most time-efficient manner, no matter where they live in Florida.” The pathology lab in Fort Myers processes more than 20,000 samples each year.

FCS The Magazine

FCS

News

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New Office Opens in Stuart

This spring, Drs. Guillermo Abesada-Terk and Alpana Desai joined the Stuart Office of FCS, located at 301 Southeast Ocean Boulevard, Suite 102, in Stuart. “We are delighted to welcome Drs. Desai and Abesada-Terk to Florida Cancer Specialists,” said CEO Brad Prechtl. “This is our first location in Martin County and represents our commitment to serving and supporting our patients in communities, both large and small, throughout Florida. This facility will bring a wide range of treatments and services all under one roof, optimizing convenience for our patients in the Stuart community.”

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Dr. Ferdy Santiago, who joined FCS in early March, now sees patients at two locations in Collier County: the Naples West office, located at 681 4th Avenue North, and the Naples Sierra Meadows office, located at 8350 Sierra Meadows Boulevard. “Dr. Santiago comes to us with outstanding credentials and experience in clinical research,” said FCS Founder and President Dr. William Harwin. “As a highly dedicated and respected community oncologist, (Dr. Santiago) will be a great addition to our network in Collier County.”

✚ Guillermo Abesada-Terk, M.D.

Alpana Desai, M.D.

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FCS Oncologist Presents at Scripps Conference

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Dancing to Do Their Part

Dr. David C. Molthrop, a member of the FCS team who practices in the Orlando and Winter Park areas, presented information about clinical trials for HR+/HER2-metastatic breast cancer at the Scripps Conference in San Diego. Since 2000, Molthrop has served as principal investigator on trials conducted by FCS strategic partner Sarah Cannon, one of the leading clinical trial organizations in the world.

New FCS Team Member Sees Patients in Locations in Collier County

Ferdy Santiago, M.D.

FCS Physician Leader Receives Honors for 20 Years of Service

Medical oncologist Dr. Mark Rubin, who practices in the Bonita Springs location, was honored by FCS for 20 years of leadership and contributions to FCS. Dr. Rubin joined FCS in 1994; since that time, he has made immense contributions in both the development of FCS’s EMR and clinical research. “First and foremost, Dr. Rubin has consistently been an advocate for his patients, providing them with the highest level of care and access to the FCS Clinical Trials program,” said CEO Brad Prechtl. “He also has served as a principal investigator or sub-investigator on over 100 clinical research trials. As a former member of our Executive Board, Dr. Rubin’s leadership and insight have been invaluable.” “Dr. Rubin’s contributions and dedication have impacted almost every aspect of FCS physicians’ roles and have led to many physicians joining our practice,” said Dr. William Harwin, Founder and President of FCS.

On April 6, the Why Wait ‘Til the Weekend Club raised $650 for the FCS Foundation during the club’s monthly charity dance. The club holds a charity dance the first Thursday of each month at Eisenhower Recreation Center, and each month it chooses a different charity. Tickets to the dances are $10, and a portion of each ticket sale goes to the charity of the month. Almost 200 people attended the April dance, and the band that played, Flipside, also donated everything that went into its tip jar that night. (Brief written by Amber Hair, Daily Sun)

Summer 2017

FCS

News

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New FCS Oncologist Joins Palm Coast Office

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The Villages Cancer Center Reopens with RibbonCutting Ceremony

In January, Dr. Mitchell B. Weisberg, M.D., joined FCS and began seeing patients at the Palm Coast office of FCS (located at 61 Memorial Medical Parkway, in Palm Coast). “We are delighted to welcome Dr. Weisberg to Florida Cancer Specialists,” said CEO Brad Prechtl. “With more than 20 years of experience as an oncologist, he has established an excellent reputation and is a highly Mitchell B. Weisberg, M.D. respected physician with a keen interest in clinical trial research. I know Dr. Weisberg will be a great addition to our network in Flagler County.”

A new year brought a record crowd of nearly 200 people together for a ribbon-cutting ceremony to celebrate the recent renovation and expansion of The Villages Cancer Center. The center provides chemotherapy, infusion, clinical trials and radiation therapy to FCS patients. Refreshments and a tour of the center followed the ceremony.

FCS physicians and staff welcomed community leaders and patients to a ribbon cutting ceremony at the newly renovated Villages Cancer Center.

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Digital Sherpa Workshops Help FCS Patients Navigate Technology

The Gladiolus Cancer Center in Fort Myers played host to two Digital Sherpa workshops in the spring. Made available by the Patient Empowered Network (PEN), the workshops, which were open to FCS patients, caregivers and friends, focused on teaching cancer patients and their families to become more tech savvy. Cancer patients in the program, referred to as “Climbers,” were paired with “Sherpas” — specially trained students from Florida Gulf Coast University who offered instruction in internet use, social media and online support community navigation, and app use (especially for ride-share services). “The more education we can provide to patients, their families and caregivers, the better equipped they are to be active participants in their own healthcare,” said Dr. William Harwin, Founder and President of FCS.

FCS The Magazine

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Leesburg Oncologist Joins FCS

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New FCS Vero Beach Facility Opens

Dr. Ram Tummala, a member of the American Medical Association, American Society of Clinical Oncology and the American Society of Hematology, joined FCS and began seeing patients at The Villages East Cancer Center (1400 Highway 441 N., Building 500, Suite 552, Lady Lake) in the early spring of this year. As Dr. Tummala has also continued to see patients at his current office in Leesburg (9832 U.S. Ram Tummala, M.D. Highway 441, Suite 101), his new tie with FCS also resulted in a new clinical location within the FCS network. “I am excited about joining Florida Cancer Specialists and being able to offer patients increased access to national clinical trials, as well as other advantages,” Tummala said.

A brand new FCS Vero Beach facility opened in March with a ribbon cutting ceremony. The state-of-the-art facility offers the latest medical treatment, including a mobile PET/CT scanner. Physicians at the Vero Beach facility include Drs. Noor Merchant, Raul Storey and Hugo Davila.

Physicians and leaders from FCS host a ribbon cutting ceremony at the new Vero Beach location. Left to right: CMSO Shelly Glenn, Dr. Hugo Davila, Dr. Raul Storey, Dr. Noor Merchant, CEO Brad Prechtl, Regional Director Lois Brown, Dr. Jennifer Byer, COO Todd Schonherz, Senior Physician Liaison Rebecca Appelbaum.

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Lynn Rasys Named Executive Director of the FCS Foundation

This spring, Lynn Rasys, former FCS Foundation Volunteer Program Manager, was named Executive Director of the FCS Foundation, a non-profit 501c3 organization that provides qualified cancer patients with financial assistance for non-medical living expenses. Regarding the change in her role, Rasys said, “I am thrilled to be a part of the great team at the Florida Cancer Specialists Foundation and (am) excited about what the future holds.”

Summer 2017

World-Class Medicine. Hometown Care.

2017 FCS Clinical Summit Ritz-Carlton Grande Lakes 4012 Central Florida Parkway Orlando, FL 32837 Accommodations at the Ritz-Carlton are limited. To guarantee your room and your meeting reservation, please register immediately!

For more information, please contact: Shelly at 770.365.6168 | SGlenn@FLCancer.com or Lynn at 941.677.7182 | LClemens@FLCancer.com

FCS The Magazine

THE TOOLS TO FIND YOUR BEST SELF Employee Assistance Program

“Life threw me a big ol’ curveball I could have never anticipated. The EAP helped me move forward with advice and resources I wasn’t able to find on my own. - Accountant/Controller

 80% of employees report reduced productivity at work due to daily stress  70% of employees who use the EAP find their stress levels improve “When life’s ‘little’ challenges suddenly became too big, the EAP helped put our family back together. We now have two daughters thriving in school and two parents finding peace at work and at home. – Hospital employee

As an employee at Florida Cancer Specialists, a big job is asked of you, and chances are, the daily demands of life don’t end when you leave work. That’s why Florida Cancer Specialists partners with New Directions to offer an Employee Assistance Program (EAP) to help you best manage your life. The free, confidential benefit provides you with the tools, whether online or in person, to tackle life’s challenges.

EAP Can Give You the Support You Need

Hard-working employees just like you use the program’s experts and resources every day to help with: • Excessive worry or stress • Relationship challenges • Substance dependence • Life-changing events • Workplace challenges • Legal or financial issues

Treatments and Resources to Find Your Best Self

The expansive list of resources, free to you and your loved ones, can be used at your style and pace:

• Dedicated helpline: Around the clock support from professionals • Assessments and referrals: In-person or telephone assessments to help match you with the resources you need to improve your health • Short-term counseling: In-person and/or telephone counseling from certified, licensed and passionate professionals • Relationship issue guidance: Around-the-clock help to find resources to deal with parenting, personal or work-related issues • Legal and financial services: Access to a network of attorneys and financial counselors prepared to provide legal expertise and advice on many issues. Download customizable legal documents for things like wills, traffic violations, asset sales and more • Health Resource library: Comprehensive collection of searchable articles, videos, self-assessments, calculators and planners for information on any health issue or topic And there’s more. For nearly any piece of your life that feels like it needs some improvement, there is support for you.

Get Started Call: 800-624-5544 or 816-237-2352 Log on: ndbh.com with passcode flcancer Request a session online at ndbh.com Online, real time, anytime: confidential care for you and your family to live with balance, health and happiness. In other words, iconic. www.ndbh.com

Summer 2017

Volunteer Program

The Art of Relaxation

Women of Hope Make Therapy Program Possible BY KIM HARRIS THACKER

FCS The Magazine

oloring books are a hot trend – and they’re not just for kids anymore. Today’s adult-market coloring books are highly detailed and are geared toward mature interests, such as world travel, history and popular culture. But if these topics don’t appeal to you, don’t fret. With all of the coloring books for adults that are out there — several of which have recently graced the top of the New York Times Best Seller list — you’re sure to find a dozen or two that pique your interest. And don’t feel guilty about being interested; like eating spinach, coloring is really good for you! In the early 1900s, psychologist Carl Jung began to prescribe the coloring of mandalas (detailed designs that are generally concentric in structure) to his patients who suffered from anxiety. Coloring allows the part of the brain that controls the fear response to relax. Today’s art therapy programs, including that which is run by the FCS Foundation, make regular use of coloring as therapy. “Women of Hope (an FCS Foundation philanthropic organization) funded our entire art therapy initiative,” said Lynn Rasys, Executive Director for the FCS Foundation. “They donated all of the supplies, as well as the pouches in which the supplies fit.” Each pouch has the Women of Hope logo on it and holds one adult coloring book, one box of colored pencils and a pencil sharpener. “Patients choose a page to color, and then they leave the rest of the book for the next patient,” said Rasys. “These bags are just one more item that volunteers can offer patients or their guests while they are in the infusion room.” Volunteer Terri Prechtl said, “The art therapy kits allow patients to be creative and expressive and to refocus their thoughts for a bit. My fondest experience with the kits was one particular morning, when nine of the 10 people in the infusion room were all coloring and smiling simultaneously! There was such a peaceful vibe in the room.” “I enjoy coloring in the books,” said Phyllis, a patient with FCS. “It takes my mind back to earlier times and helps me relax. It also makes the time go by a little faster.” But it isn’t just patients who enjoy coloring while they wait. “During our test of art therapy in a couple of clinics, we found that patients’ family members and caretakers wanted to color as well!” said Rasys. “So these pouches are distributed to them, too.” “Occasionally, as I walk through the reception/waiting room, I will see a youngster and bring them a book with a few colored pencils or washable markers,” said Volunteer John Shwiner. “It helps to keep them occupied in a creative way.” With 500 art therapy bags divided among each FCS clinic that has a volunteer program, there are plenty of coloring opportunities to go around.

Choosing The Right Colored Pencils Does this whole art therapy thing sound too good to be true? Maybe it’s time you tried it for yourself. All you have to do is invest in a coloring book and some colored pencils. Keep in mind that when it comes to colored pencils, it’s all about the core. While hard-cored, wax-based pencils are the most common colored pencils on the market, that doesn’t necessarily make them preferable. In general, hard-cored pencils keep a sharp tip, which means they last for a long time and are great for creating details, clean edges and outlines. Soft-core pencils don’t keep a sharp tip, which means you’ll go through them more quickly. But they produce vivid, smooth colors. Wax-based colored pencils tend to look light on paper. They’re great for layering or blending colors. Oil-based colored pencils are pricier than are wax-based pencils, because the colors are so intense. Each swipe of the pencil lays down a lot of color.

Women of Hope The mission of Women of Hope is “to empower and inspire women to fulfill their leadership and philanthropic potential through charitable giving that improves the quality of life for women and their children impacted by cancer.” The funds raised by Women of Hope are used to address non-medical needs, and 100 percent of all donations go directly to the patients served by the FCS Foundation.

Summer 2017

For patients with multiple myeloma after 1 prior therapy

EXTEND EFFICACY.

EXTEND THE POSSIBILITIES. EXTEND THE

The approval of the NINLARO® (ixazomib) regimen (NINLARO+lenalidomide+dexamethasone) was based on a statistically significant ~6 month improvement in median PFS vs the placebo regimen (placebo+lenalidomide+dexamethasone).* • Median PFS: 20.6 vs 14.7 months (95% CI, 17.0-NE and 95% CI, 12.9-17.6, respectively); HR=0.74 (95% CI, 0.587-0.939); P=0.012

THE FIRST AND ONLY ORAL PROTEASOME INHIBITOR NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) recommend ixazomib in combination with lenalidomide and dexamethasone as a category 1 treatment option for previously treated multiple myeloma.1 NINLARO is indicated in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy. IMPORTANT SAFETY INFORMATION WARNINGS AND PRECAUTIONS • Thrombocytopenia has been reported with NINLARO. During treatment, monitor platelet counts at least monthly, and consider more frequent monitoring during the first three cycles. Manage thrombocytopenia with dose modifications and platelet transfusions as per standard medical guidelines. Adjust dosing as needed. Platelet nadirs occurred between Days 14-21 of each 28-day cycle and typically recovered to baseline by the start of the next cycle. • Gastrointestinal Toxicities, including diarrhea, constipation, nausea and vomiting, were reported with NINLARO and may occasionally require the use of antidiarrheal and antiemetic medications, and supportive care. Diarrhea resulted in the discontinuation of one or more of the three drugs in 1% of patients in the NINLARO regimen and < 1% of patients in the placebo regimen. Adjust dosing for severe symptoms. • Peripheral Neuropathy (predominantly sensory) was reported with NINLARO. The most commonly reported reaction was peripheral sensory neuropathy (19% and 14% in

the NINLARO and placebo regimens, respectively). Peripheral motor neuropathy was not commonly reported in either regimen (< 1%). Peripheral neuropathy resulted in discontinuation of one or more of the three drugs in 1% of patients in both regimens. Monitor patients for symptoms of peripheral neuropathy and adjust dosing as needed. • Peripheral Edema was reported with NINLARO. Monitor for fluid retention. Investigate for underlying causes when appropriate and provide supportive care as necessary. Adjust dosing of dexamethasone per its prescribing information or NINLARO for Grade 3 or 4 symptoms. • Cutaneous Reactions: Rash, most commonly maculo-papular and macular rash, was reported with NINLARO. Rash resulted in discontinuation of one or more of the three drugs in < 1% of patients in both regimens. Manage rash with supportive care or with dose modification. • Hepatotoxicity has been reported with NINLARO. Drug-induced liver injury, hepatocellular injury, hepatic steatosis, hepatitis cholestatic and hepatotoxicity have each been reported in < 1% of patients treated with NINLARO. Events of liver impairment have been reported (6% in the NINLARO regimen and 5% in the placebo regimen). Monitor hepatic enzymes regularly during treatment and adjust dosing as needed.

Available at Rx To Go.

Get more information at www.NINLAROhcp.com.

• Embryo-fetal Toxicity: NINLARO can cause fetal harm. Women should be advised of the potential risk to a fetus, to avoid becoming pregnant, and to use contraception during treatment and for an additional 90 days after the final dose of NINLARO. Women using hormonal contraceptives should also use a barrier method of contraception. ADVERSE REACTIONS The most common adverse reactions (≥ 20%) in the NINLARO regimen and greater than the placebo regimen, respectively, were diarrhea (42%, 36%), constipation (34%, 25%), thrombocytopenia (78%, 54%; pooled from adverse events and laboratory data), peripheral neuropathy (28%, 21%), nausea (26%, 21%), peripheral edema (25%, 18%), vomiting (22%, 11%), and back pain (21%, 16%). Serious adverse reactions reported in ≥ 2% of patients included thrombocytopenia (2%) and diarrhea (2%). SPECIAL POPULATIONS • Hepatic Impairment: Reduce the NINLARO starting dose to 3 mg in patients with moderate or severe hepatic impairment. • Renal Impairment: Reduce the NINLARO starting dose to 3 mg in patients with severe renal impairment or end-stage renal disease requiring dialysis. NINLARO is not dialyzable.

• Lactation: Advise nursing women not to breastfeed during treatment with NINLARO and for 90 days after the last dose. DRUG INTERACTIONS: Avoid concomitant administration of NINLARO with strong CYP3A inducers. *TOURMALINE-MM1: a global, phase 3, randomized (1:1), double-blind, placebo-controlled study that evaluated the safety and efficacy of NINLARO (an oral proteasome inhibitor) vs placebo, both in combination with lenalidomide and dexamethasone, until disease progression or unacceptable toxicity in 722 patients with relapsed and/or refractory multiple myeloma who received 1-3 prior therapies.2 The NCCN Guidelines are a work in progress that may be refined as often as new significant data becomes available. The NCCN Guidelines are a statement of consensus of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. NE=not evaluable; PFS=progression-free survival.

Please see adjacent Brief Summary.

USO/IXA/16/0100(3)a

REFERENCES: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Multiple Myeloma T:7” V.3.2017. © National Comprehensive Cancer Network, Inc. 2016. All rights reserved. Accessed March 28, 2017. To view the most recent and complete version of the guideline, go online to NCCN.org. 2. Moreau P, Masszi T, Grzasko N, et al; for TOURMALINE-MM1 Study Group. Oral ixazomib, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016;374(17):1621-1634.

BRIEF SUMMARY OF PRESCRIBING INFORMATION NINLARO (ixazomib) capsules, for oral use 1 INDICATION NINLARO (ixazomib) is indicated in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy.

IXAZ16CDNY8151_HCP_Q3-2016_Update_BS_r6.indd 1

6 ADVERSE REACTIONS The following adverse reactions are described in detail in other sections of the prescribing information: • Thrombocytopenia [see Warnings and Precautions (5.1)] • Gastrointestinal Toxicities [see Warnings and Precautions (5.2)] • Peripheral Neuropathy [see Warnings and Precautions (5.3)] • Peripheral Edema [see Warnings and Precautions (5.4)] • Cutaneous Reactions [see Warnings and Precautions (5.5)] • Hepatotoxicity [see Warnings and Precautions (5.6)] 6.1 CLINICAL TRIALS EXPERIENCE Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The safety population from the randomized, double-blind, placebo-controlled clinical study included 720 patients with relapsed and/or refractory multiple myeloma, who received NINLARO in combination with lenalidomide and dexamethasone (NINLARO regimen; N=360) or placebo in combination with lenalidomide and dexamethasone (placebo regimen; N=360). The most frequently reported adverse reactions (≥ 20%) in the NINLARO regimen and greater than the placebo regimen were diarrhea, constipation, thrombocytopenia, peripheral neuropathy, nausea, peripheral edema, vomiting, and back pain. Serious adverse reactions reported in ≥ 2% of patients included thrombocytopenia (2%) and diarrhea (2%). For each adverse reaction, one or more of the three drugs was discontinued in ≤ 1% of patients in the NINLARO regimen. Table 4: Non-Hematologic Adverse Reactions Occurring in ≥ 5% of Patients with a ≥ 5% Difference Between the NINLARO Regimen and the Placebo Regimen (All Grades, Grade 3 and Grade 4) NINLARO + Lenalidomide and Dexamethasone N=360

Placebo + Lenalidomide and Dexamethasone N=360

N (%)

System Organ Class / Preferred Term All

Grade 3

Grade 4

All

Grade 3

Grade 4

Infections and infestations Upper respiratory tract infection

69 (19)

1 (< 1)

52 (14)

2 (< 1)

Nervous system disorders Peripheral neuropathies*

100 (28)

7 (2)

77 (21)

7 (2)

Gastrointestinal disorders Diarrhea Constipation Nausea Vomiting

151 (42) 122 (34) 92 (26) 79 (22)

22 (6) 1 (< 1) 6 (2) 4 (1)

0 0 0 0

130 (36) 90 (25) 74 (21) 38 (11)

8 (2) 1 (< 1)

0 2 (< 1)

0 0 0 0

Skin and subcutaneous tissue disorders Rash*

68 (19)

9 (3)

38 (11)

5 (1)

Musculoskeletal and connective tissue disorders Back pain

74 (21)

2 (< 1)

57 (16)

9 (3)

General disorders and administration site conditions Edema peripheral

91 (25)

8 (2)

66 (18)

4 (1)

Note: Adverse reactions included as preferred terms are based on MedDRA version 16.0. *Represents a pooling of preferred terms

(Continued on next page) 12/15/16 11:32 AM

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5 WARNINGS AND PRECAUTIONS 5.1 Thrombocytopenia: Thrombocytopenia has been reported with NINLARO with platelet nadirs typically occurring between Days 14-21 of each 28-day cycle and recovery to baseline by the start of the next cycle. Three percent of patients in the NINLARO regimen and 1% of patients in the placebo regimen had a platelet count ≤ 10,000/mm3 during treatment. Less than 1% of patients in both regimens had a platelet count ≤ 5000/mm3 during treatment. Discontinuations due to thrombocytopenia were similar in both regimens (< 1% of patients in the NINLARO regimen and 2% of patients in the placebo regimen discontinued one or more of the three drugs).The rate of platelet transfusions was 6% in the NINLARO regimen and 5% in the placebo regimen. Monitor platelet counts at least monthly during treatment with NINLARO. Consider more frequent monitoring during the first three cycles. Manage thrombocytopenia with dose modifications and platelet transfusions as per standard medical guidelines. 5.2 Gastrointestinal Toxicities: Diarrhea, constipation, nausea, and vomiting, have been reported with NINLARO, occasionally requiring use of antidiarrheal and antiemetic medications, and supportive care. Diarrhea was reported in 42% of patients in the NINLARO regimen and 36% in the placebo regimen, constipation in 34% and 25%, respectively, nausea in 26% and 21%, respectively, and vomiting in 22% and 11%, respectively. Diarrhea resulted in discontinuation of one or more of the three drugs in 1% of patients in the NINLARO regimen and < 1% of patients in the placebo regimen. Adjust dosing for Grade 3 or 4 symptoms. 5.3 Peripheral Neuropathy: The majority of peripheral neuropathy adverse reactions were Grade 1 (18% in the NINLARO regimen and 14% in the placebo regimen) and Grade 2 (8% in the NINLARO regimen and 5% in the placebo regimen). Grade 3 adverse reactions of peripheral neuropathy were reported at 2% in both regimens; there were no Grade 4 or serious adverse reactions. The most commonly reported reaction was peripheral sensory neuropathy (19% and 14% in the NINLARO and placebo regimen, respectively). Peripheral motor neuropathy was not commonly reported in either regimen (< 1%). Peripheral neuropathy resulted in discontinuation of one or more of the three drugs in 1% of patients in both regimens. Patients should be monitored for symptoms of neuropathy. Patients experiencing new or worsening peripheral neuropathy may require dose modification. 5.4 Peripheral Edema: Peripheral edema was reported in 25% and 18% of patients in the NINLARO and placebo regimens, respectively. The majority of peripheral edema adverse reactions were Grade 1 (16% in the NINLARO regimen and 13% in the placebo regimen) and Grade 2 (7% in the NINLARO regimen and 4% in the placebo regimen). Grade 3 peripheral edema was reported in 2% and 1% of patients in the NINLARO and placebo regimens, respectively. There was no Grade 4 peripheral edema reported. There were no discontinuations reported due to peripheral edema. Evaluate for underlying causes and provide supportive care, as necessary. Adjust dosing of dexamethasone per its prescribing information or NINLARO for Grade 3 or 4 symptoms. 5.5 Cutaneous Reactions: Rash was reported in 19% of patients in the NINLARO regimen and 11% of patients in the placebo regimen. The majority of the rash adverse reactions were Grade 1 (10% in the NINLARO regimen and 7% in the placebo regimen) or Grade 2 (6% in the NINLARO regimen and 3% in the placebo regimen). Grade 3 rash was reported in 3% of patients in the NINLARO regimen and 1% of patients in the placebo regimen. There were no Grade 4 or serious adverse reactions of rash reported. The most common type of rash reported in both regimens included maculo-papular and macular rash. Rash resulted in discontinuation of one or more of the three drugs in < 1% of patients in both regimens. Manage rash with supportive care or with dose modification if Grade 2 or higher. 5.6 Hepatotoxicity: Drug-induced liver injury, hepatocellular injury, hepatic steatosis, hepatitis cholestatic and hepatotoxicity have each been reported in < 1% of patients treated with NINLARO. Events of liver impairment have been reported (6% in the NINLARO regimen and 5% in the placebo regimen). Monitor hepatic enzymes regularly and adjust dosing for Grade 3 or 4 symptoms. 5.7 Embryo-Fetal Toxicity: NINLARO can cause fetal harm when administered to a pregnant woman based on the mechanism of action and findings in animals. There are no adequate and well-controlled studies in pregnant women using NINLARO. Ixazomib caused embryo-fetal toxicity in pregnant rats and rabbits at doses resulting in exposures that were slightly higher than those observed in patients receiving the recommended dose.

Females of reproductive potential should be advised to avoid becoming pregnant while being treated with NINLARO. If NINLARO is used during pregnancy or if the patient becomes pregnant while taking NINLARO, the patient should be apprised of the potential hazard to the fetus. Advise females of reproductive potential that they must use effective contraception during treatment with NINLARO and for 90 days following the final dose. Women using hormonal contraceptives should also use a barrier method of contraception.

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Brief Summary (cont’d) Table 5: Thrombocytopenia and Neutropenia (pooled adverse event and laboratory data) NINLARO + Lenalidomide and Dexamethasone N=360

Placebo + Lenalidomide and Dexamethasone N=360

N (%)

Any Grade

Grade 3-4

Any Grade

Grade 3-4

Thrombocytopenia

281 (78)

93 (26)

196 (54)

39 (11)

Neutropenia

240 (67)

93 (26)

239 (66)

107 (30)

IXAZ16CDNY8151_HCP_Q3-2016_Update_BS_r6.indd 2

Please see full Prescribing Information for NINLARO at NINLARO-hcp.com. NINLARO is a registered trademark of Millennium Pharmaceuticals, Inc. Millennium Pharmaceuticals, Inc. is a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. ©2016 Millennium Pharmaceuticals, Inc. NOV 2016 USO/IXA/15/0123(3) 12/15/16 11:32 AM

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Herpes Zoster Herpes zoster was reported in 4% of patients in the NINLARO regimen and 2% of patients in the placebo regimen. Antiviral prophylaxis was allowed at the physician’s discretion. Patients treated in the NINLARO regimen who received antiviral prophylaxis had a lower incidence (< 1%) of herpes zoster infection compared to patients who did not receive prophylaxis (6%). Eye Disorders Eye disorders were reported with many different preferred terms but in aggregate, the frequency was 26% in patients in the NINLARO regimen and 16% of patients in the placebo regimen. The most common adverse reactions were blurred vision (6% in the NINLARO regimen and 3% in the placebo regimen), dry eye (5% in the NINLARO regimen and 1% in the placebo regimen), and conjunctivitis (6% in the NINLARO regimen and 1% in the placebo regimen). Grade 3 adverse reactions were reported in 2% of patients in the NINLARO regimen and 1% in the placebo regimen. The following serious adverse reactions have each been reported at a frequency of < 1%: acute febrile neutrophilic dermatosis (Sweet’s syndrome), StevensJohnson syndrome, transverse myelitis, posterior reversible encephalopathy syndrome, tumor lysis syndrome, and thrombotic thrombocytopenic purpura. 7 DRUG INTERACTIONS 7.1 Strong CYP3A Inducers: Avoid concomitant administration of NINLARO with strong CYP3A inducers (such as rifampin, phenytoin, carbamazepine, and St. John’s Wort). 8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy: Risk Summary: Based on its mechanism of action and data from animal reproduction studies, NINLARO can cause fetal harm when administered to a pregnant woman. There are no human data available regarding the potential effect of NINLARO on pregnancy or development of the embryo or fetus. Ixazomib caused embryo-fetal toxicity in pregnant rats and rabbits at doses resulting in exposures that were slightly higher then those observed in patients receiving the recommended dose. Advise women of the potential risk to a fetus and to avoid becoming pregnant while being treated with NINLARO. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively. Animal Data: In an embryo-fetal development study in pregnant rabbits there were increases in fetal skeletal variations/abnormalities (caudal vertebrae, number of lumbar vertebrae, and full supernumerary ribs) at doses that were also maternally toxic (≥ 0.3 mg/kg). Exposures in the rabbit at 0.3 mg/kg were 1.9 times the clinical time averaged exposures at the recommended dose of 4 mg. In a rat dose range-finding embryo-fetal development study, at doses that were maternally toxic, there were decreases in fetal weights, a trend towards decreased fetal viability, and increased post-implantation losses at 0.6 mg/kg. Exposures in rats at the dose of 0.6 mg/kg was 2.5 times the clinical time averaged exposures at the recommended dose of 4 mg. 8.2 Lactation: No data are available regarding the presence of NINLARO or its metabolites in human milk, the effects of the drug on the breast fed infant, or the effects of the drug on milk production. Because the potential for serious adverse reactions from NINLARO in breastfed infants is unknown, advise nursing women not to breastfeed during treatment with NINLARO and for 90 days after the last dose. 8.3 Females and Males of Reproductive Potential: Contraception - Male and female patients of childbearing potential must use effective contraceptive measures during and for 90 days following treatment. Dexamethasone is known to be a weak to moderate inducer of CYP3A4 as well as other enzymes and transporters. Because NINLARO is administered with dexamethasone, the risk for reduced efficacy of contraceptives needs to be considered. Advise women using hormonal contraceptives to also use a barrier method of contraception. 8.4 Pediatric Use: Safety and effectiveness have not been established in pediatric patients. 8.5 Geriatric Use: Of the total number of subjects in clinical studies of NINLARO, 55% were 65 and over, while 17% were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified

differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. 8.6 Hepatic Impairment: In patients with moderate or severe hepatic impairment, the mean AUC increased by 20% when compared to patients with normal hepatic function. Reduce the starting dose of NINLARO in patients with moderate or severe hepatic impairment. 8.7 Renal Impairment: In patients with severe renal impairment or ESRD requiring dialysis, the mean AUC increased by 39% when compared to patients with normal renal function. Reduce the starting dose of NINLARO in patients with severe renal impairment or ESRD requiring dialysis. NINLARO is not dialyzable and therefore can be administered without regard to the timing of dialysis 10 OVERDOSAGE: There is no known specific antidote for NINLARO overdose. In the event of an overdose, monitor the patient for adverse reactions and provide appropriate supportive care. 17 PATIENT COUNSELING INFORMATION Advise the patient to read the FDA-approved patient labeling (Patient Information). Dosing Instructions • Instruct patients to take NINLARO exactly as prescribed. • Advise patients to take NINLARO once a week on the same day and at approximately the same time for the first three weeks of a four week cycle. • Advise patients to take NINLARO at least one hour before or at least two hours after food. • Advise patients that NINLARO and dexamethasone should not be taken at the same time, because dexamethasone should be taken with food and NINLARO should not be taken with food. • Advise patients to swallow the capsule whole with water. The capsule should not be crushed, chewed or opened. • Advise patients that direct contact with the capsule contents should be avoided. In case of capsule breakage, avoid direct contact of capsule contents with the skin or eyes. If contact occurs with the skin, wash thoroughly with soap and water. If contact occurs with the eyes, flush thoroughly with water. • If a patient misses a dose, advise them to take the missed dose as long as the next scheduled dose is ≥ 72 hours away. Advise patients not to take a missed dose if it is within 72 hours of their next scheduled dose. • If a patient vomits after taking a dose, advise them not to repeat the dose but resume dosing at the time of the next scheduled dose. • Advise patients to store capsules in original packaging, and not to remove the capsule from the packaging until just prior to taking NINLARO. Thrombocytopenia: Advise patients that they may experience low platelet counts (thrombocytopenia). Signs of thrombocytopenia may include bleeding and easy bruising. Gastrointestinal Toxicities: Advise patients they may experience diarrhea, constipation, nausea and vomiting and to contact their physician if these adverse reactions persist. Peripheral Neuropathy: Advise patients to contact their physicians if they experience new or worsening symptoms of peripheral neuropathy such as tingling, numbness, pain, a burning feeling in the feet or hands, or weakness in the arms or legs. Peripheral Edema: Advise patients to contact their physicians if they experience unusual swelling of their extremities or weight gain due to swelling. Cutaneous Reactions: Advise patients to contact their physicians if they experience new or worsening rash Hepatotoxicity: Advise patients to contact their physicians if they experience jaundice or right upper quadrant abdominal pain Other Adverse Reactions: Advise patients to contact their physicians if they experience signs and symptoms of acute febrile neutrophilic dermatosis (Sweet’s syndrome), Stevens-Johnson syndrome, transverse myelitis, posterior reversible encephalopathy syndrome, tumor lysis syndrome, and thrombotic thrombocytopenic purpura Pregnancy: Advise women of the potential risk to a fetus and to avoid becoming pregnant while being treated with NINLARO and for 90 days following the final dose. Advise women using hormonal contraceptives to also use a barrier method of contraception. Advise patients to contact their physicians immediately if they or their female partner become pregnant during treatment or within 90 days of the final dose. Concomitant Medications: Advise patients to speak with their physicians about any other medication they are currently taking and before starting any new medications.

COVER STORY

A Journey to Near Perfection BY ZANDRA WOLFGRAM

If FCS is not one in a million, Claudia French will have succeeded … in a manner of speaking. That’s because “Six Sigma” — the brand name of the managerial process French is implementing to improve FCS — refers to having only 3.4 defective parts per million opportunities, or one in 99.99966 percent. In other words, a measure of quality that nears perfection.

ean methods strive to eliminate waste of physical resources, time, effort and talent, while assuring quality in production and organizational processes. With 12 years of consulting experience as a Lean/Six Sigma’s “master black belt” (highest certification level), a bachelor’s degree in medical technology from Case Western University, an MBA from the University of South Florida and 25 years of experience as a senior leader overseeing laboratory medicine operations, French is well prepared to suit up as FCS’s Director of Operational Excellence (OE) and Clinical Laboratory Services. French joined FCS in August of 2016 and works out of both the corporate office and the lab. In her new role, she combines two passions: organizational management and medical operations. “What’s been fun is marrying the two — being able to do OE work in the framework of the lab,” she said. But the most satisfying aspect of this senior leader’s work isn’t found on any spreadsheet or metric — it’s the human element. “I love working with FCS, because they are people with a purpose,” French said. “They truly care about what they are doing and understand that what they are doing has an impact on people’s survival.”

Six Sigma: A Mini History Lesson

FCS The Magazine

For French, thriving in today’s competitive healthcare industry means putting patients first. “The whole paradigm is shifting to what is truly patient-centric behavior, so my goal is to work with people at FCS to begin that journey toward an even more patientcentric culture. To ask each day, ‘What can we do to make the patient experience better?’” Many would be overwhelmed with the task or not know where to start when it comes to tweaking such a fast-growing company, with 200+ physicians working with 100 labs serving nearly 100 community oncology locations. But for French, to lean in to give her all often means standing back. “The first thing you do is observe,” she said. “You can’t boil the ocean, and you can’t eat an elephant unless you take just one bite at a time; so you pick a place to start, and that is your pilot, your proof of concept.” So, one warm, late-summer morning, French did just that, arriving early at the Gladiolus office in Fort Myers. She followed a patient from the time of arrival to departure and took meticulous notes. Those notes inspired her short-list of “opportunities for improvement.”

1920s Since the 1920s, mathematicians and engineers have used the word sigma as a symbol for a unit of measurement in product quality variation.

1980s In the mid-1980s, engineers at Motorola, Inc., a global telecommunications company founded in Illinois, coined “Six Sigma” as an informal name for an in-house initiative for reducing defects in production processes, because it represented a suitably high level of quality.

The seasoned medical administrator explained that if wait time is an issue, she will look at the existing process to see what is causing a bottleneck. Is it the people? The chairs? Perhaps scheduling? “We choose one of those things, and we may make a small, incremental change,” French explained. “We do a pilot, make changes and see if that makes a difference. If so, we’ll implement that change. If not, we choose another countermeasure or opportunity.” French’s approach is to take “baby steps” to allow the process to work and to allow people time to embrace the change. “Process improvement is a journey; it’s more about instilling a culture versus simply changing things,” she says. Change doesn’t have to be big to be impactful, according to French. In fact, one of the first tweaks in the Clinical Lab, which she oversees, could fit in a mere test tube. While observing in the lab, she watched as clinicians began their process by first drawing specimens and then aliquoting into three plastic tubes. She immediately saw some room for improvement and created a test pilot program with a protocol of drawing three smaller tubes and not doing any pour-offs. It proved to save time and cut back on labeling errors. And by eliminating the “pouring off,” specimen integrity is better preserved. “It was an improvement, so in March we changed this procedure throughout all of FCS. Now we are all using small tubes and are not ‘pouring off’ anymore,” French explained. After trotting the globe to help companies realize their potential, French is happy to have found a place on the FCS leadership team. “At this point in my life, I’m exactly where I want to be,” she said. “I enjoy mentoring and training others. I want other people to be successful, so sharing what I know is important to me.”

SAVED

$750M 1991 In 1991, Allied Signal, a large avionics company, adopted the improvement process. In the mid-1990s, General Electric CEO Jack Welch did the same, and reportedly, in 1998, GE claimed that Six Sigma had saved the company over $750 million.

1990s With early adopters like GE in the mid-90s, Six Sigma became known as a successful corporate management initiative and methodology.

2000 By 2000, Six Sigma was effectively established as an industry with application for the training, consultancy and implementation of Six Sigma methodology to all sorts of industries around the world … including healthcare.

Summer 2017

Dr. Kelly Rose and Dr. Jane Bernstein consulting on a biopsy slide.

On the A-list Operational Excellence team are Analyst Mary Castellano, Project Manager Tiffany Bauman and Senior Project Manager Sierra Tomlinson. Dr. Ryan Olson, 42, has been the Medical Director of the Pathology Lab since 2011. Since then, the lab has grown manifold, from a staff of six to more than two dozen hematopathologists, technologists, managers and assistants … with a few more to come. Combined with the Central Lab, led by John Hodson, these testing facilities occupy 10,000 square feet of space devoted to state-of-the-art technology, which attracts some of the nation’s brightest minds. The Pathology Lab launched flow cytometry (laser-based cell testing) in 2010. Since that time, Olson and his medical team have expanded the lab’s testing capabilities. Today, in addition to flow cytometry, the lab has added histology (the study of the microscopic structure of tissues), managed by Kim Fortunato, and immunohistochemistry (protein expression by antibody-assisted histology). Dr. Katy Phelan along with Lisa Toomer oversee FISH (fluorescent in situ hybridization) and cytogenetics — a technique used to detect and localize the presence or absence of specific DNA sequences on chromosomes at the molecular level. Loretta Dales rounds out the team, overseeing the Regional Lab Monitors and supporting the on-site clinic labs.

FCS The Magazine

This past February, the lab further enhanced its capabilities by adding Specimen Accessioning and Processing. This department receives all bone marrow and biopsy tissue specimens. Tests to be done are entered into APvX, the Lab Information System (LIS), to make sure “the right specimen gets to the right lab at the right time.” A month later, in March, nearly 600 square-feet of space within the lab was specially designed, equipped and staffed as the new Cytogenetics Lab Center. Phelan, who has a PhD in human genetics from the Medical College of Virginia in Richmond, came to FCS from Tulane Medical School in New Orleans expressly to oversee bringing the effort in-house and marrying it with the other lab specialties. Bringing capabilities on-site allows the lab to correlate results more easily. “Now we can look at Flow, FISH and Cyto all together and speak face-to-face about the results,” Phelan said, adding, “It has closed the loop in FCS, giving a fully comprehensive approach to patient diagnostics — and that, ultimately, means better service for our physicians and patients.” Over her 25-year career, French has consulted with many companies all over the globe; but she immediately saw that FCS was different. “I’ve worked with labs where all they see is a test

JoAnna Claycomb, Histotech, making slides for staining.

tube,” she said. “They connect the dots, here. They connect to patients —to someone’s life. They treat specimens with a lot more respect than I’ve seen elsewhere, and that, in itself, makes it a gratifying place to work.” French envisions FCS’s future as operationally excellent. “There are a lot more standard procedures in place; quality is being monitored and improvement is happening, reducing errors and improving patient flow, as well as increasing patient satisfaction through enhanced turn around, higher quality and less waittimes,” she said. “And we are beginning to standardize our 100plus clinic labs!” That sounds, indeed, like near perfection.

Johnny Flores, Cytogenetics Tech, harvesting cells for analysis.

DMAICT is the Six Sigma process defined as:

Define opportunity Measure performance Analyze opportunity Improve performance Control performance and optionally Transfer best practice

(to spread the learning to other areas of the organization)

Summer 2017

Sci en ce . Progre ss. Ca re . Together, Seattle Genetics and Takeda Oncology are leading the way to a better understanding of the pathogenesis of classical Hodgkin lymphoma and the critical role CD30 plays in malignant HRS cell survival. Advancing innovation continues, which is why we are driving forward science that can help answer questions regarding the underlying biology of Hodgkin lymphoma. We are deeply committed to improving upon current standards of care for all patients with Hodgkin lymphoma. With more than 50 clinical trials across multiple lines of therapy, including 2 large, randomized, phase 3 company sponsored studies, and recent 5 year long-term data, Seattle Genetics and Takeda Oncology are providing unparalleled support for Hodgkin lymphoma clinical research to improve outcomes for patients globally. This commitment extends to improving the patient experience as well with our intense focus on education and support of patients with Hodgkin lymphoma during treatment and beyond. We will continue to pioneer new opportunities in partnership with advocacy organizations in an effort to broadly support research and patient education initiatives.

Seattle Genetics and Takeda Oncology are at the forefront of science, progress, and care for patients with Hodgkin lymphoma. To learn more, visit us at takedaoncology.com and seattlegenetics.com Follow us @TakedaOncology and @SeattleGenetics

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GON/NON/15/0050a (1) USP-COR-2015-0102 (2)

We Support the Health of your Practice With the Same Dedication that You Support Your Patients Your number one priority is the health of your patients. With the changing healthcare landscape, our number one priority is the business health of your practice. Dedicated exclusively to the viability of community oncology, ION Solutions provides contracting, technology, education and advocacy support that ensures you have the tools to run your practice both efficiently and effectively. With the practice support of ION Solutions, you can navigate this changing environment and focus on providing quality care for your patients.

To learn how ION Solutions enables community oncology practices to improve operational efficiency, financial performance and quality of care, contact your Strategic Account Manager or visit IONonline.com. To experience ION Solutions advocacy support, visit ourcommunitycounts.org.

Feature

Mark Moch Employs IT in Advancing FCSâ&#x20AC;&#x2122;s Goals BY AUDREY POST

FCS The Magazine

Pictured First Row, Seated (L-R): Jelle Jordaans, Andrea Sarotte, Mark Moch, Todd Schonherz, Aileen Osterhout, Dave Rude, Rita Bentley Pictured Second Row, Standing (L-R): Troy Joyal, Jude Charles, Edwin Rogers, Jason Price, Ahmed Aly, Randy Mason, Charles Ezelle, Pete Bennett, Alisia Gill, Christopher Sulfridge, Charisse Coventry, William Keeney, Ivan Torres, Phil Clark, Ken Sundstrom, Marshall Williams, Scott Harrington, Peniel Adolphe

or Mark Moch, technology works best when it stays in the background. “We don’t want the technology to interrupt the work,” said Moch, Vice President of Information Technology for Florida Cancer Specialists. “It’s important to understand how someone does his or her job using technology, and their expectations and their needs.” Moch took on a big job when he was hired as IT Director for FCS in late 2016. For starters, integrating technology upgrades at nearly 100 locations throughout Florida can be challenging. In addition, the people using the technology — be they physicians, clinical or administrative staff— often don’t speak the same language, when it comes to technology, as the people who are building and maintaining it. Fortunately, Moch can bridge the divide because his background gives him not only the technology knowledge, but also the communication skills to explain it to diverse audiences. Moch has a master’s degree in literature and was teaching in his native Poland when he won a lottery for a U.S. green card 15 years ago. A year after he and his wife, Iwona, immigrated to the United States, he got a job in maintenance at a South Florida hospital and began taking courses to gain certification in IT specializations related to his job. “That’s when I knew I wanted to move into the IT world,” he said. He shared his goal with his supervisor, who liked his work ethic and helped him get a transfer to an IT position. “I started at the help desk, and I took a lot of classes in more advanced IT. I learned from the ground up,” Moch said. Over the years, he worked his way up the management ranks, becoming Network Administrator, Director of IT and, ultimately, Vice President of IT for an LTAC multi-hospital system, which included 18 hospitals and two skilled nursing facilities. “I feel like my experience helps not only with building my team, but also with talking to people about the tech side of the business,” Moch said. “When I go in front of a group of doctors, I can translate the technical terms and explain what the technology will do.”

It is critical to Moch that the technology aligns with the goals of the company. For FCS, that goal is always to provide the best patient care possible. To achieve that objective, IT must be built on a platform that serves as a base for growth. “I want to change the culture of how IT is done,” Moch said. “It shouldn’t be just buying another piece of equipment, another server or another switch. It has to be driven by anticipating a business’s needs and buying what we need now to prepare us for what we will need in the future.” Since he joined FCS, Moch has increased the size of the IT staff and restructured its functions. He was met with a list of 100 pending IT projects when he started his job; 80 percent were completed within five months. “I try to visit the clinics, to see where the biggest needs are and what’s creating extra steps,” he said. “With close to 100 locations, we have a pretty big footprint. And I’m still wrapping my head around some of it. There are a lot of similarities between hospitals and clinics, but there are differences, too.” Sarah Cevallos, Chief Revenue Cycle Officer for FCS, said IT operates much more smoothly since Moch arrived, calling him, “a breath of fresh air.” “He has brought a lot of very positive approaches to IT, including an ability to collaborate with the business side,” she said. “The reliability of our infrastructure is so critical to patient care.” That infrastructure covers everything from accessing a bill quickly, so the patient who called with a question doesn’t have a long wait on hold, to doctors or nurses being able to check a patient chart rapidly for medication history. Like almost everyone else at FCS, Moch has lost family members to cancer and feels a personal stake in its mission. “We have all these tools and all this great technology, and it’s important to put it where it’s needed, to help people,” he said. “Once the background is done, it can produce better results.”

Summer 2017

Feature

Class Is in Session FCS University Enrolls Eager Students BY REBECCA PADGETT

FCS The Magazine

FCS

t has proven true, time and again, that the saying, “You learn something new every day,” is accurate. Often, that daily dose of learning doesn’t fully satisfy the hunger for knowledge. FCS set out to satiate their employees’ appetites for continued learning with the launch of FCS University. The virtual university was implemented as part of a learning management system that allows FCS staff to expand their skills and

knowledge through online courses. There are up to 1,000 courses available, ranging from “Getting Started with Excel” to “Targeted Therapies and Immunotherapy: General Principles” (oncology) to “Leadership Essentials: Building Your Influence as a Leader.” Classes are accredited, and selected titles offer continuous education units. “In an effort to continually offer quality care and service, we should also make sure our patients have the best experience, which begins with focusing on our employees by allowing them to further learn and develop their skills,” said Sara Jones, Manager of Customer Experience and architect of the FCS University Training Administration. Jones explained that this educational addition to FCS was developed to ensure that employees have access to tools that will further enhance their current positions or prepare them for roles they would like to pursue within the company. Jones, alongside the Clinical Directions Team, headed by Diane Cope, PhD, ARNP-BC, AOCNP, and Human Resources Manager Francine Ulrich, researched a variety of catalogues and companies in order to select curriculum that fit the needs and desires of employees. When making decisions, the suggestions of the nurses and staff were of the highest consideration. “I loved hearing what the staff wanted and being able to actually provide it to them and watch it come to fruition,” said Jones. The first wave of classes is being offered to nurses. The curriculum was designed to build and maintain these individuals’ baseline knowledge and skills as well as introduce new concepts. The nursing curriculum consists of 30 courses, but not every position has a required track. The coursework is completed online and in a variety of forms, from demos to testing, and sessions take anywhere from 15 to 60 minutes. For orientations and special events, an instructor is present to facilitate. Jones will continue to lead and grow the learning landscape as FCS endeavors to assist employees in providing quality care and service to patients. Jones emphasized that the employees are not being charged for the classes, thanks to the generous physicians and administrative leaders who have invested in their development. “This is a great opportunity that the physicians and administrative leadership have provided,” she said. “I hope FCS University becomes ingrained in our culture and that you will be able to recognize someone from FCS because of the training they have received.” Jones is excited for the opportunity to witness clinical team members learning cutting-edge health techniques, office managers expanding their customer service knowledge and the administrative team becoming even more influential as leaders. “As the architect who was able to put this program together, I mostly worked behind the scenes to make sure FCS University had everything we needed,” said Jones. “Now, my hope is that the staff will gain more skills and knowledge and that, as a whole, the organization will gain a stronger group of employees who will be upto-date with the latest in health care and be able to provide the best service to our patients.” There is no doubt that the online university’s engaging coursework will help to maintain the gold standard of service for which FCS is known.

Summer 2017

FCS

Patient Letters

m eive letters fro c re to ys a lw a ind us It is gratifying nd words rem ki ir e h T . ts n e ati d inspire appreciative p in medicine an rs e re a c r u o se om why we cho have a letter fr u yo If . rk o w est us to do our b lished, like to see pub ld u o w u yo t a g at a patient th FCS Marketin to il a -m e ia v it please submit Cancer.com. marketing@FL

To Dr. Andy Lipman and Staff, I cannot thank you all enough for the care and comfort you gave my wife while she coped with the ravages of lung cancer. At least five days a week, she was in the office at 4th Avenue North, receiving chemotherapy treatment, or receiving an injection for blood clots, or being hydrated, etc. From a patient’s point of view, the first people we saw on arrival were the two valet parking guys, Noel and Victor, who greeted us with a smile each and every day. It is important to remember that these two men were the official greeters, and how she enjoyed them. In terms of the office personnel and administrative staff, you couldn’t have been more accommodating. To everyone in the infusion center, there were no weak links. Everyone who had an interface with her was professional, kind and truly caring about her condition. You are a great team with tremendous professionalism, which made my wife feel fulfilled every time she was receiving a treatment. My wife is in a better place now, but I wanted to let everyone know that she passed away very peacefully. Other than the fentanyl patch on her back, she was taking no other pain medication. Near the end, she told me she wanted to have a talk with her mother who passed away five years ago. I asked to close her eyes and try to find her mother. She went into a deep sleep and never awoke again. To all of you in the building, our family extends its sincere thanks for taking care of my wife in the only way you knew how. With great caring, compassion and a level of unsurpassed medical professionalism that I have never seen before! Thank you all! A patient’s husband in Naples West

FCS

Patient Letters Dear Mr. Prechtl, It is with great pleasure and joy that I am so motivated to write you about my life saving experience and exceptional treatment administered to me at your Clearwater, FL. location.

S-Venice eciation to FC pr ap re ce n si ess my is past year. I want to expr n me over th ve gi e av h ey care th , but they Island for the r was difficult ce n ca h it w ed d Being diagnos comfortable an make me feel to le ib ss po in g ginn g did everythin one for me, be ve ti si po a as ry visit w reassured. Eve t desk staff. efficient fron d an ul rf ee ere eased by with a ch g treatment w in iv ce re t en ort and The hours I sp g to offer supp in ill w s ay w nurses, al ings about smiling, happy gh say good th ou en t n’ ca I ey were t. And Jackowski. Th encouragemen e yc Jo , er on ti d nurse practi e most l. They are th Dr. Gonter an fu h ut tr d an rned, thorough ever met. always conce sionals I have es of pr of p caring grou I had a friendly and ttle, I felt that ba y m g n ti gh was fi We are Even while I alongside me. t gh ri g n ti gh fi llow soldiers ity. squadron of fe our commun in them here e av h to d se bles Respectfully, orth Port A patient in N

I have so many staff members to thank spearheaded by Dr. Jose Alemar. Dr. Alemar’s brilliant assessment of my condition and ongoing tweaking led me to a successful journey and cure. For him I owe my eternal gratitude and proudly hail him to so many of my friends and acquaintances. Additionally, I salute Dr. Alemar’s assistant, Ms. Nataya Francis for her guidance as well. Leading the chemo team is RN Michelle Manias and her warm and caring staff. From the inception of my treatments to its conclusion, I hail the wonderful and caring Nurses who helped me to my successful recovery. They always were so consistent in greeting me and gave me the courage to conquer my disease. I will always have a warm spot in my heart for them. Let me also praise the help rendered to me by your shot lab teams led by Donna and Mary Jo. Their infectious smiles and expertise always raised my enthusiasm level. Concluding, my gratitude is further directed to Cindee McClaren for all her cheerful and helpful assistance over the years. Further I wish to thank Marilyn at your front desk and all her teammates for the upbeat greetings I received each and every time coming to Florida Cancer Specialists. Mr. Prechtl, I thank you and your corporate staff for your diligent efforts in hiring such a brilliant staff. They are all “SUPERSTARS,” and I hope they are all recognized and adequately compensated for the many people they touch and

Special FCS Colleague Recognition!

nurture to a better life. God Bless all of you that served us and may the Bright Lights always shine on all of you and your families. Respectfully,

A patient in Clearwater NP, AR e, Pric .) (T.C I would like to recognize Teressa service. g din stan out her for , Bonita Springs st cancer surgery and infection T.C. was out recovering from brea the child neighbor’s child drowned, and complications. At this time, her knew that nsive! The mother of the child was lifeless – blue and unrespo to her. T.C.’s home and gave her child T.C. was a RN, and ran over to back to ediately, bringing the little boy T.C. started performing CPR imm s. The sign water and was crying – all good life. The child threw up a lot of the e, utes later. Had T.C. not been ther EMS team arrived about 10 min ht rnig y admitted the little boy for ove child would surely have died. The of ther mo next day. T.C. saved a life! The observation, and went home the ent artm a Civil Award and the Fire Dep the child also nominated T.C. for as well.

, Bonita Springs Deborah Thompson, FCS Lead MA

Feature

Looking for the Knockout Punch FCS Physician Liaison Manager is Leukemia & Lymphoma Society’s Woman of the Year BY KIM HARRIS THACKER

n 2014, Maria Ramos-Person’s mother was diagnosed with breast cancer. Two weeks later, Maria began her employment with Florida Cancer Specialists. Right away, she learned about the Leukemia & Lymphoma Society (LLS), which is dedicated to finding a cure for blood cancers and providing support to patients and families who are personally affected by blood cancers. Although her mother had breast cancer, not a blood cancer, Ramos-Person felt compelled to participate in the LLS’s annual Man and Woman of the Year campaign, which helps to raise funds for the LLS’s mission — because to her, a cure for any type of cancer is a step toward knocking out all cancers. Shelly Glenn, FCS’s Chief Marketing and Sales Officer, explained how the campaign works. “Every year, an outstanding roster of nominees accepts the challenge to engage in a spirited competition to raise funds for blood cancer research and to earn the coveted title of Man or Woman of the Year.” The competition lasts for 10 weeks and, in its way, is as intense as any athletic competition. “As the 2014 LLS Suncoast Chapter’s Woman of the Year and the incoming chair of the Suncoast Chapter board, I know how challenging the nominees’ campaigns are, and how important they are to our community,” Glenn said. “But thanks to the efforts of those individuals who work so hard to raise funds … the lives of blood cancer patients are being saved every day.” Nominees for the title of Man and Woman of the Year compete on a national scale as well as in their individual LLS chapters. This year, the Suncoast Chapter named Ramos-Person as their candidate for Woman of the Year. Collectively, 12 candidates participated in the Man & Woman of the Year (MWOY) campaign raising nearly $380,000. In the course of 10 weeks, Ramos-Person raised more than $108,000 with help from her campaign team and campaign managers Sandy Brooks, Shelly Glenn and JoLynn Wright; in early June, she was awarded the title of 2017 Woman of the Year. “What a tremendous blessing to be named Woman of the Year,” she said at the LLS Grand Finale Event, where she received her title. “With such great support from FCS friends and colleagues, and my family and friends, we were able to move one round closer to knocking out blood cancers!” FCS CEO Brad Prechtl praised Maria’s achievement, stating that it reflects the philanthropic spirit shared by many FCS physicians, clinicians and staff.

FCS The Magazine

2017 Man of the Year former Tampa Bay Buccaneers Player Anthony Becht and 2017 Woman of the Year Maria Ramos-Person, along with Boy and Girl of the Year.

2016 Man and Woman of the Year Award Winners Dr. Julia Cogburn LLS Suncoast Chapter Woman of the Year • Raised $152,000 for the LLS • Practices in Tampa and Brandon Dr. Meera Iyengar LLS North & Central Florida Chapter Woman of the Year • Raised $100,000 for the LLS • Practices in Clermont and downtown Orlando Dr. Vipul Patel LLS North & Central Florida Chapter Man of the Year • Raised $56,000 for the LLS • Practices in Inverness and Ocala

Past Man and Woman of the Year Award Nominees and Winners

About the Leukemia & Lymphoma Society About “LLS is the leading source of free, highly specialized blood cancer information, education and support for patients, survivors, families and health care professionals… We advocate for blood cancer survivors and their families, helping patients navigate their cancer treatments and ensuring they have access to quality, affordable and coordinated care… LLS is dedicated to removing barriers to care.” Mission “Cure leukemia, lymphoma, Hodgkin’s disease and myeloma, and improve the quality of life of patients and their families.” Purpose “LLS exists to find cures and ensure access to treatments for blood cancer patients.” Research Agenda “LLS drives research in areas of unmet medical need and helps to bridge the gap between academic discovery and drug development.” Information provided by LLS website

Central Florida: Dr. Jennifer Cultrera (Woman of the Year), Danielle Spears (Woman of the Year) and Dr. Lee Zehngebot (Man of the Year) Suncoast/Greater Tampa: Dr. Mary Li, Dr. Gregoire Bergier (Man of the Year), Shelly Glenn (Woman of the Year) and Dr. Anjan J. Patel West Palm Beach: Dr. Shachar Peles, Dr. Todd Gersten, Dr. Beth Byron and Dr. Augustin Schwartz From left to right: Jeff Rubin, Anna Marie Zambito, Shelly Glenn, Maria RamosPerson, Kristina Sparacino, JoLynn Wright and Jimmy Khun

Summer 2017

FCS The Magazine

DOCTOR SPOTLIGHT

Dr. Davila

A Urologist with a Passion for Technology BY DANA BARFIELD

hen Hugo Davila, M.D., is asked what prompted him to practice medicine, his answer is simple: “I was always exposed to medicine, because my grandfather was a nephrologist. My dad still practices as a urologist. I remember from a very early age, that at the dinner table, we were talking about medicine.” With this early preparation as a child in Caracas, Venezuela, it was an easy choice to attend Central University of Venezuela School of Medicine, where he decided that surgery — and, more specifically, urologic surgery — would be the focus of his career. The influence of his father might have guided Davila to this particular specialty, but when asked what kept his interest, it’s clear that the technology had a lot to do with it. His enthusiasm is contagious. “In urology, we are always looking into new technology, and that’s something I’m captivated by,” he says. “We use lasers, we use robotic equipment, we use high definition cameras and 3-D cameras. I found that was what I wanted to do for a living.” When he was 24, Davila left Venezuela and completed his internship and residency at University of South Florida Health in Tampa. Several fellowships followed, including a Clinical Research Fellowship in Endourology at Cornell University and New York Presbyterian Hospital, a Postgraduate Research Fellowship in Urology at the University of California and Los Angeles Center of Health & Sciences, and a Research Fellowship at the University of South Florida in the Sexual Medicine Program. This in-depth education and experience gave Davila the background he needed to provide the highly specialized care he’s become known for at the offices of Florida Healthcare Specialists (FHS), an affiliate practice of FCS, in Sebastian and Vero Beach. “I work with a great staff — about 35 members in both oncology and urology,” Davila says. “Having a staff that shares the same values that you have for your patients is very important, because that allows you to grow. And I’m very lucky to say that FHS allows me to recruit the best and keep the best.”

Davila is also enthusiastic about the advanced technology and procedures he’s able to offer his patients at the FHS offices, such as a “pacemaker” for the bladder in the treatment of patients with overactive bladder and MRI ultrasound fusion technology in the identification of patients with an aggressive type of prostate cancer. However, the success of advanced technology depends on first establishing the most important factor in the doctor/patient relationship: trust. “It’s the same trust we have when we fly,” Davila says. “Once you gain (a patient’s trust), you can take that trust through the standards of care to ensure you always do the right thing for your patient.” During his career as a urologist, Davila has been deeply affected by many of his patients. He tells one particularly touching story about a young man who was involved in a car accident. While receiving care in the ER, doctors discovered that the man had kidney cancer. All at once, his family was faced with helping him through neurological problems from the accident along with cancer treatments — all while his wife was pregnant with their second child. “It’s one of those stories about how, in one second, everything can change so much,” Davila says. “Slowly but surely, we were able to see a full recovery.” Recently, Davila ran into the family at Publix and was able to share hugs and rejoice with them. The patient has been cancer free for almost a year, with no neurological affects from the accident, and the family is celebrating the new baby. Davila is a dedicated family man, himself, having been married for sixteen years to his wife, Maria, who is an architect. They have two sons, Hugo (10) and Samuel (7), and the family is rounded out by their Goldendoodle, Elsa. For the last three years, they have made their home in the Vero Beach area and are very happy with their choice. “It’s a small community. It allows you to spend more time with your family and patients,” Davila says. “You have that small town charm but with good restaurants, access to a beautiful beach and good education. We have found all that we were looking for, here.”

Summer 2017

FCS

Events 1A.

1B. 3.

1. CONGRAULATIONS TO ROZ SENATUS & FIORELLA TRULLEN

2. NEW PORT RICHEY SPRING FLING & PATIENT APPRECIATION BBQ

Roz Senatus, PSS Team Lead at Sierra Meadows, and Fiorella Trullen, PSS Team Lead at Naples West, have taken the oath to become United States citizens. Fiorella has worked for FCS for nine years, and Roz for 14 years. They studied many hours to take the citizenship test in addition to working at their offices during a busy season. Congratulations on this wonderful accomplishment, Roz and Fiorella!

3. HAPPY RETIREMENT TO VAL VANCE. THANK YOU FROM THE FCS TEAM!

1A. Pictured: Fiorella Trullen 1B. Pictured: Roz Senatus

Submit your recent event photos to FCS Marketing at marketing@FLCancer.com.

FCS The Magazine

Pictured (L-R): Shelly Glenn, Maria Ramos-Person, Val Vance, Irene Nathanson and Lynn Clemens.

FCS

Events 4.

6. S AV E

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PinkDay! the n i us n i o

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5. All proceeds benefit

4. HOPE, HEALTH AND SUNSHINE FOUNDATION DONATE BAGS Justin Doyle, founder of the Hope, Health and Sunshine Foundation, donated more than 200 patient bags to the FCS Largo clinic. The customized drawstring bags were filled with a puzzle book, pen, socks, eye mask, snack bar, Chapstick, hand sanitizer and lotion. Mr. Doyle and his wife selected the Bardmoor location in honor of Dr. Don Luong. Pictured (L-R): Jeff Rubin, Shawndra Albritton, Justin Doyle, Dr. Don Luong, Michelle Reinhard. 5. FCS MARKETING TEAM DINNER IN FORT MYERS The team met for tours, training and meetings at Rx To Go, the Pathology Lab and Corporate HQ. 6. PINK DAY Pink Day is a designated fundraising day for the FCS Foundation held in October during Breast Cancer Awareness month. On Pink Day, team members are encouraged to develop fun ways to raise monies for the FCS Foundation including raffles, T-shirt sales, etc.

7. 2017 WOMAN & MAN OF THE YEAR Congrats to Maria Ramos-Person, MBA, on winning the 2017 Man & Woman of the Year Campaign from the Leukemia & Lymphoma Society - Suncoast Chapter and to Shelly Glenn for being awarded the 2017 Leadership Team Chair Award.

Summer 2017

FCS

Events 8A.

8B2. 8B3.

8A2.

8C.

8B1. 8. RELAY FOR LIFE

8B: The Naples event was held at Gulfview Middle School.

8A. The Hernando FCS booth had sunscreen, lip balm, FCS bags and sunglasses, all of which were a hot item with attendees. Many patients who have completed, or currently are on treatment, and their family members stopped by, and all could not give enough praise to the FCS staff and physicians. Relay for Life also hosted a food drive and donated all items to the FCS pantry.

Pictured (L-R): 1: Sara Fernandez, Dr. Lipman and his wife. 2: Maria Damiani-Johnson, PSS, Damaris Soto, FC, Crystal Briscoe, Office Manager. 3: Participants in the â&#x20AC;&#x153;Survivor Lap.â&#x20AC;? 8C. Cape Coral staff pictured (L-R): Bill Snyder, Sue Ruth, Amanda McDonough, Heather Ronevich, Nicole Steinke, Michele Herman, Debbie Wiseman, Peggy Sweigert and John Herman.

FCS The Magazine

FCS

Events 9.

11.

10A.

12.

10B.

9. 2017 W.R.E.C. HEALTH FAIR

11. GOOD DEED

Pictured: Brett Hipsley, Physician Liaison of Alachua, Citrus & Marion Counties.

The Vero Beach office assisted a patient undergoing oral chemotherapy who could not afford food to be taken with his treatment, nor had family nearby to support. The patient was so appreciative and the story is truly heartwarming. And, only half of the groceries are shown in the photo!

10. PRODUCTS OF ONCOLOGY EDUCATION FAIR (10A AND 10B) Medical and pharmaceutical companies exhibited at an educational fair hosted by FCS at the Tampa Cancer Center. Healthcare professionals from various oncology disciplines including medical oncologists, nurse practitioners, physician assistants and oncology nurses attended the event. Exhibit fees were donated to St. Judeâ&#x20AC;&#x2122;s Childrenâ&#x20AC;&#x2122;s Research Hospital.

Pictured (L-R): Suzanne Boudreau, Tabitha Steady, Angela Jones, Tiffany Bullock, Kathy Bruce, Briana Muti, Cecelia Summers, Cynthia Shelton, and Andrea Bheer. 12. CHARLOTTE STONE CRABS CHARITY NIGHT Charlotte Stone Crabs Charity Night Benefitting the FCS Foundation Pictured (L-R): Volunteer Beth Goodwin, Jessica McIntyre, Terri Gagliardi, Jimmy Khun and Kristina Sparacino.

Summer 2017

FCS The Magazine

NURSE SPOTLIGHT

Chris Sims’ Calling

Serving Oncology Patients with Specialized Care and Plenty of Empathy BY DANA BARFIELD

s Head Nurse of the FCS Bradenton East practice, M. Christine “Chris” Sims is used to caring for patients who have had their world turned upside down. When asked what is the most important quality of a good nurse, she answers without hesitation. “Empathy,” she says. “These patients are unique in that they’re dealing with a potentially life-threatening disease. Most of us go through our whole lives maybe not ever really thinking of mortality. Can you imagine what it feels like to be faced with that?” It’s a role that comes naturally to her. Volunteering as a candy striper at the age of 15 in Durham, North Carolina, Sims knew what she wanted to do with her life. She wanted to help people. It wasn’t a difficult decision to follow her dream to Duke University School of Nursing, where Sims’ personal style of nursing began to take shape. As part of an independent study, Sims spent several months developing a new perioperative role for nurses. She chose to work at the local VA hospital with head and neck patients, often with conditions that required complex surgeries which resulted in significant changes in body image and the ability to communicate. “I saw that those patients needed an advocate both before surgery and after their surgery,” says Sims. “The concept of following patients and being with them through a process became a trademark of my personal career.” After graduation from school came marriage, children and various nursing roles. In 1990, she moved to the Washington, D.C., area, where she got a job at a multi-specialty clinic and honed her skills as an oncology nurse — a unique role that requires an in-depth understanding of complex disease processes, complicated treatment regimens and the symptom management that comes with both disease and treatment. “We also need to be aware of how and to what extent patients understand their disease and treatment,” says Sims. “We need to be aware that many patients seek information from the Internet. All of this needs to be managed with sensitivity and tact. We are teachers, translators, diplomats, advocates and shepherds, all at once.” After a few years, Sims joined a small oncology practice and, as the only nurse, found herself involved in the business side of the practice.

She monitored drug purchasing and learned the ins and outs of insurance billing. These skills broadened her ability to address any needs a patient might have, be they practical concerns about finances or emotional concerns surrounding mortality. “It’s a privilege to cross paths with people at that point in their lives,” she says, “and it’s incumbent on us to recognize that they didn’t get to choose whether or not to have cancer, and that people handle this in different ways. As oncology nurses, we meet patients where they are and walk with them through their cancer experience, meeting their individual needs as we go. It’s almost spiritual, when you think about it.” It’s a career that many may find too difficult to handle emotionally; but Sims disagrees. “People ask me if it gets depressing. It really doesn’t. I want to help people,” she says. “When people die, they leave us, physically, but they don’t leave us in an emotional sense. We’ll always have a memory. We’ll always be able to say we did the best we could to help these people through a rough time in their lives. Our patients inspire us and that trumps being depressed by caring for them.” In 2005, when Sims moved to Bradenton with her second husband, retired oncologist Jim Dangelo, she brought with her these caring sensibilities. After a brief foray in the restaurant business, Sims returned to nursing in 2007, this time at FCS. She became an Oncology Certified Nurse (OCN) in 2009. Now, as Head Nurse, Sims brings to the practice that empathy and sensitivity she has cultivated since her first days at Duke University and helps her patients deal with the new, often unexpected challenges that face individuals with cancer. Outside of oncology, Sims’ life with her husband, an avid military historian, is quite full. The couple is looking forward to the publication of his first book, which she helped him edit, as well as the impending first birthday of a new grandbaby. Sims is also passionate about playing the flute for several groups, including the Tampa Bay Flute Choir. When one suggests that such a hobby must be very therapeutic, she laughs. “It can also be extremely nerve-wracking,” she says. “But it’s a release. I’ve been doing it so many years I can’t imagine my life without it.”

Summer 2017

Katherine Hogan Leading the Rx To Go Way BY TISHA CREWS KELLER

FCS The Magazine

SENIOR MANAGEMENT SPOTLIGHT

ver the course of a 30-year career in pharmacology, it seems all of her experience has built up to this. Katherine Hogan is the eight-year veteran Assistant Director/Pharmacist in Charge (PIC) of Rx To Go, the in-house specialty pharmacy at FCS. Her job is to maintain a pharmacy practice with high-touch, patient-focused services — but also to make the most of its business opportunities and clinical aspects. Hogan’s resume encompasses nearly every portion of the segmented pharmacology industry—and these silos each require specialized skills and clinical considerations. Her years of experience include home infusion therapy, hospital clinical pharmacy and retail pharmacies, both high-volume and independent. This unique blend of skills provides a business acumen and understanding of clinical and patient needs that is hard to match. Rx To Go is licensed both as a retail and as a community pharmacy; but it’s a specialty pharmacy, in practice. The business has a very close relationship to FCS: As an ancillary, it treats only FCS patients, and it provides oral and a few sub-cutaneous chemotherapy drugs that are mailed directly to patients at home. Rx To Go doesn’t mix or compound any of the oral therapies they provide, but they do handle much of the prescription management and patient financial services that drugs whose worth totals $8,000$12,000 per month necessarily require. In contrast, FCS clinic-based pharmacies mix and dispense intravenous and injectable infusion therapy for immediate use. Due to Rx To Go’s distribution model, which uses direct mail to out-of-state and in-state FCS patients, Hogan has the distinct achievement of being a licensed pharmacist in 15 states — and is intimately familiar with the pharmacology laws in each of those states. That means that snowbirds, who are part-time FCS patients for a few months of the year, or split-resident Florida-based patients, who migrate to other regions for extended periods, can keep their prescriptions at one pharmacy. For Hogan, they are all her FCS patients and they all deserve special care. It’s the Rx To Go way. The advantages for patients who use Rx To Go are many. For instance, Rx To Go’s pharmacists have immediate access to patient records and physicians, so they are able to provide faster, superior service. Medications can be delivered to patients’ homes or to their doctor’s office, and Rx To Go specialists are trained to provide assistance with insurance qualifications and co-pays, making it easier to navigate paperwork and meet insurance requirements. Because fighting cancer is a costly project, Hogan’s on-staff patient assistance professionals seek financial relief through co-pay cards, financial assistance programs available through community foundations and even through the drug companies themselves. Nowadays, almost 35 percent of all cancer drugs are available in pill form, including the newer targeted therapies. Although oral medications offer more convenience to patients, it is critical that these drugs be delivered on a timely schedule and that

patients are closely monitored to ensure compliance in taking their medications. This is called “patient adherence.” Hogan’s Clinical Manager maintains a robust patient adherence policy that monitors individuals to ensure their access to the drugs and makes sure patients know how to take them and what to expect in terms of side effects. This program greatly increases patients’ compliance and persistency on therapy which in general contributes to a better patient outcome. “What we’re really doing,” Hogan explains, “is continuing the relationship that the patient has already established with FCS, their clinic, their doctor and their nurse.” Using phone conversations for patient education and monthly followup, Rx To Go Pharmacists discuss drug/drug and drug/food interactions and monitor for tolerance and treatment changes, among other general considerations during long-term chemotherapy treatment. Hogan oversees the operations and compliance for a rapidly growing pharmacy, which grew from just six people in 2009 to a staff of 90 today. This explosion in growth is mainly due to the exponential expansion of FCS itself, which integrates more practices each year. However, the increasing availability of targeted oral chemotherapies — perhaps 50-60 new drugs just since 2001 — makes the convenience and comfort of home-based treatment more viable than ever before. Rx To Go is so successful, in fact, that they are shipping medications to about 4,000 patients per month and getting anywhere from 20–50 new patient referrals per day. Fortunately, the company has been able to maintain a great turnaround time that compares positively to any other national mail-order pharmacy. “Rx To Go’s success is due to my incredible and dedicated Management Team and staff,” says Hogan. Born and raised in Fort Myers, Hogan still lives in the places she loves most in the world. She moved to Gainesville briefly, for college and pharmacy school at the University of Florida, but settled back into the beach landscape where her parents, brother, niece and nephew anchor her. She loves to travel and has visited several countries worldwide, with a special devotion to Central-Eastern Europe. A self-described foodie, she can go on about the Italian and Mediterranean influence in Croatian cuisine — one of her favorites. But what really gets Hogan talking is how Rx To Go — which she considers the culmination of her three decades in pharmacology — has really made a solid impact on the lives and care of FCS patients. As she describes it, the Rx To Go business model is perfectly suited to its goals: getting patients the prior authorization/payments they need, access to the information and care, and the convenient dispensation of life-extending oral cancer therapies. “Improving patient adherence is our biggest impact,” she says. “We’ve really enhanced patient care and made it a continuation of clinical care. We work to get our patients the drug access they need and help keep them on those drugs for as long as it takes.”

Summer 2017

OFFICE SPOTLIGHT

Teamwork Makes the Dream Work

Vero Beach Office Places Emphasis on Friendliness BY KIM HARRIS THACKER

FCS The Magazine

ero Beach is a community that puts the “treasure” in Florida’s Treasure Coast. Birders flock to the area, as do surfers, anglers, foodies, art lovers and botanical garden enthusiasts. This scenic locale is definitely a place to heal the soul, but it’s also a place to heal the body. The Vero Beach office of FCS is located on 37th Street, in what is known throughout the community as the medical/hospital district. Put aside any notions you might have of impersonal medical facilities, however; the Vero Beach office, which opened in December 2016, is all about friendliness and quality care. Twenty-three individuals work at the Vero Beach clinic, including a world-renowned urologist and two preeminent, visionary medical oncologists. But it’s not the kind of place where one employee carries more importance than another. “We all realize that each department plays an intricate role in making the office operate efficiently,” says Vero Beach Senior Office Manager Katrina Thompson. “If one area is struggling, then we all are. If we are doing great, it’s as a team.” The office’s motto, “Teamwork makes the dream work,” reflects that philosophy.

Vero Beach Who’s Who • 2 Medical Oncologists (Drs. Noor M. Merchant and Raul E. Storey) • 1 Urologist (Dr. Hugo Davila) • 2 Nurse Practitioners • 6 Medical Assistants • 4 Patient Service Specialists • 1 Surgery Scheduler • 1 Pharmacy Technician • 1 Head Nurse • 3 Registered Nurses • 1 Financial Counselor • 1 Office Manager

“Everyone here knows what is expected, as far as the atmosphere in the office goes,” Thompson says. “When things get hectic, we come together to talk about issues and to solve problems. Unity, not division, is our goal.” Staff members build positive relationships with one another in formal settings, such as during monthly staff meetings, as well as in informal settings. “We do an exercise called ‘You’ve Been Mugged,’” Thompson explains. “The employees select another employee to recognize, and that employee will receive a mug filled with candy, pens, etc. The ‘mugged’ employee then mugs another person the following week, until every employee has been mugged. It has really boosted morale in the office and has brought us together. It’s a way for the staff to recognize one another and their accomplishments.” Another way in which employee accomplishments are recognized is through the annual Employee Appreciation Dinner, held each June. The center’s physicians host the dinner, and Thompson and other leaders at the Vero Beach office facilitate. “We put together (the dinner) for the staff to show how much we value them and what they give to our company and our patients,” Thompson says.

“We usually have random gift card drawings and gifts for each employee, and we end it with a team building exercise. The staff looks forward to it each year.” The unity that is felt among the employees at the Vero Beach office affects the patients who seek cancer treatment at that location. A “snowbird” from Connecticut recently stopped Thompson to tell her that the care she has received in Vero Beach has been the best she has ever had. “She said that everyone, from the front staff to the Medical Assistants to the RNs, made her feel very comfortable and treated her like family,” Thompson says. “She was very afraid before she came here, but because of her encounters with the staff, her fears were put to rest.” Thompson explains that one reason she is able to run a cooperative office is that the physicians she works with are supportive of her and allow her to do what she thinks is necessary to create a positive work environment for the office’s other employees. “I am very fortunate to work with such a supportive group of physicians as well as with my regional director, Lois Brown, who has been an amazing mentor,” Thompson says. “I could not do any of this without them. Our team is great!”

Summer 2017

A Joy that Lasts

Medical Assistant Completes 30 Years of Work with FCS

BY KIM HARRIS THACKER

rom the moment Deborah Thompson began working with FCS Founder and President Dr. Bill Harwin at the “old Broadway office,” he recognized that she was particularly good at helping his patients relax. Her naturally sunny disposition soothed, calmed and also cheered patients. “She always had a bright smile on her face,” he says. “She was always teasing me. That’s just her personality. She makes everyone happier.” Thirty years have passed since Thompson began working with FCS, and while a few things have changed — the organization has expanded dramatically from its original, single office with three doctors and 13 employees, for example — she remains as cheerful as ever. When asked how she feels about having worked for FCS for so many years, Thompson, who is now the Lead Medical Assistant at the Bonita Springs office, quips, “I can’t believe it’s been 30 years — especially since I’m only 32!” Humor has helped Thompson get through the difficult times that are an inherent part of her work. “I’m honored to care for patients at the most vulnerable time of their lives — through their journey back to good health,” she says. “On a daily basis, I am reminded how important our jobs are; but more so, how our laughter, love and care impacts patients’ lives in more ways than we may realize.” Thompson’s ready laugh and infectious smile affects everyone she meets — and in her line of work, she meets a lot of people. “I have made many lifelong friends here,” she says. “I have worked in many locations with different doctors, and I’ve been able to meet and care for many new patients.”

Longtime Members of the FCS Family The following 46 individuals have celebrated or will soon celebrate at least 15 years with FCS: 35 years Naomi B. Poston, Head Nurse 30 years Joan F. Schaffer, Head Nurse Deborah Thompson, Lead Medical Assistant 25 years Steve A. Longenecker, Radiation Therapist Jocelyn Melnyk, EDI Specialist Helga K. Von Greiff-Cobian, Senior Office Manager 20 years Tara M. Boyd, Medical Assistant Deidra Brown-Brinson, ARNP – Clinic Cecilia Garcia, Senior Office Manager Joann D. Dresch, Patient Services Specialist Cristina Duque-Weidenfeller, Business Office Supervisor

FCS The Magazine

Amy Ensell, Medical Assistant Jenean C. Fletcher, Office Manager Marilyn J. Frystak, Senior Office Manager Sandra J. Hetz, LPN Maria C. Hightower, Office Manager John Hodson, Clinical Lab Manager Donna Kamp, LPN Suzanne McCarty, Credential Coordinator Debra A. Vogel, Lead Clinical Database Specialist Debra Wiseman, Office Manager 15 years Kellie A. Ackernecht, RN OCN Lynn Bentz, Senior Research Coordinator 3 Elise T. Bingham, Radiation Therapist Virginia Cook, Registration Coordinator James Davis Jr., Patient Services Specialist Joyce Davis, Research Pharmacy Coordinator Bobbi Diaz, Patient Services Specialist

Adam Feikert, Clinical Medical Technician Sarah J. Gulotta, Research Data Coordinator Erzsebet Hadady, Patient Services Specialist Taiwanna L. Jackson, Medical Assistant 2 Teresa K. Kastor, Patient Services Specialist Rebecca L. Loomis, LPN Gina M. Losardo, LPN Staisy Maldonado, RCH Clinical Assistant Alma Medina, Financial Counselor Donna J. Milam, Head Nurse Monica Peterkin, Medical Assistant 2 Anedra W. Sherman, Medical Assistant 2 Terri L. Smith, Medical Assistant 2 Kathy A. Still, Clinical Lab Technician Christine E. Stokes, RN OCN April C. Watkins, Lead Medical Assistant Marcia Weis, Senior A/R Specialist Rx To Go Tracy L. Wuerth, Regular Clinical Pharmacy Technician Trainer

Thank You for Your Continued Support of the FCS Foundation! The FCS Foundation fulfills a unique purpose for cancer patients who are struggling to pay their everyday living expenses. Imagine cancer patients who can’t make car payments leaving them without transportation to their physician’s office; or patients who can’t pay mortgage or rent and are facing eviction while they are fighting for their lives. The Foundation pays for non-medical expenses such as mortgage, rent, utilities and car payments, so that patients can concentrate on recovering from cancer.

What Separates the FCS Foundation from Other Charities? Florida Cancer Specialists pays the overhead, which means that 100% of all donations go directly to help cancer patients in need! The FCS Foundation provides help for the entire family, as well, by relieving some of the stress cancer patients and their family members face on a daily basis.

You Can Make a Difference. Volunteer. The Florida Cancer Specialists Foundation is seeking volunteers to provide non-medical support and comfort to patients undergoing treatment for cancer at Florida Cancer Specialists clinics. Duties include offering a pillow, warm blanket, snack or beverage to the patient, sharing a magazine and providing companionship. Applications are available at Foundation.FLCancer.com/Volunteer or send email inquiries to: VolunteerProgram@FLCancer.com

5204 Paylor Lane, Sarasota, FL 34240

For more info or to donate, call (941) 677.7181 or visit Foundation.FLCancer.com Summer 2017

Operational Exc On behalf of our Executive Board, Physicians and Executive Management Team, it gives us great pleasure to recognize our 2016 Operational Excellence Award winners. Each year we receive hundreds of nominations from patients, staff and physicians who share remarkable stories of our team members who go above and beyond in demonstrating our C.A.R.E. Values. We truly appreciate the hard work, effort and unyielding compassion that each of you exhibit every day on behalf of our patients. Todd Schonherz Chief Operating Officer

FCS The Magazine

ellence Awards Award Winner

Job Title

Home Office

Peggy Sweigert

Lead Medical Assistant

Cay West

Roselyne Senatus

Patient Services TM LDR

Naples Sierra Meadows

Kimberly Horner

Medical Assistant 2

Venice Islands

Tracy Richolson

Patient Services Spec

Lakewood Ranch

Katrina Mack

Financial Counselor

Mease

Javarius Philon

Medical Assistant

Tampa Cancer Center

Corrine Demeulenaere

Patient Services TM LDR

Sun City

Denise Anderson

LPN

New Port Richey West

Veda Payne

Financial Counselor

Lecanto

Anedra Sherman

Medical Assistant 2

Gainesville

Linda Marin

EDI Team Lead

Fort Myers, Corporate

Claire Wise

RN OCN

Atlantis

Melissa Rivera

Financial Counselor

Orange City

Jacqueline Gamache

Tavares

Francine Nelson-Archie

Pharm Tech

Villages East

Krisie Moore

Patient Services TM LDR

Villages North

Rosemary Bennett

RN OCN

Palm Coast

Erynn Schneider

Patient Services Spec

Ormond Beach

Amanda Tennison

Patient Services Spec

Sebastian

Tonya Tucker

Lead Medical Assistant

Winter Park

Zulma Katz

Patient Services TM LDR

Winter Park

Summer 2017

Operational Exc

FCS The Magazine

ellence Awards

Summer 2017

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