When Organizations Join Forces
LEXINGTON VA & MCCAN UNITE WITH FOCUS
ON BETTER CANCER CARE FOR VETERANS
It was early summer in 2023 when healthcare professionals from two large organizations gathered to discuss how they could work together to provide better cancer care for Kentucky’s military veterans. There were the usual connections you’d expect among physicians, surgeons, researchers and hospital administrators, yet as the group looked around the room, they realized they shared something truly unique — each one of them was a veteran or had a family member who had served the country.
“It was remarkable to me that this was not just a bunch of people in suits making decisions about veterans. Everyone in the room had received care at the VA personally or through a family member. It was a group of veterans working to bridge the gap between a government institution and a National Cancer Institute-Designated Comprehensive Cancer Center. It was something that we had never done before,” said Sam Shepard, Lexington VA Health Care System cancer program administrator.
History is made
After nearly a year of discussions, in August 2024, the Lexington VA Health Care System joined the UK Markey Cancer Center Affiliate Network (MCCAN) in a first-of-its-kind agreement.
“We are very excited. This is a significant milestone for us,” said MCCAN Medical Director Timothy Mullett, MD, MBA, FACS, a cardiothoracic surgeon. “The VA’s desire to deliver high-quality cancer care brought them to MCCAN. Whether it’s the ability to provide care at locations closer to veterans, give guidance and assistance with Commission on Cancer accreditation, or improve access to clinical trials, this is exactly what we were created for.”
Russell Armstead, Lexington VA Health Care System executive director, agrees. “Cancer is a horrible disease. If a veteran receives a cancer diagnosis, we want that Veteran to have timely access to advanced treatments,” he said. “We are investing in our system for the nation’s veterans. This partnership with MCCAN provides a huge advantage. We are joining a network of 19 facilities, it’s a huge step forward in our commitment to provide the highest quality care to the nation’s veterans.”
The Lexington VA Health Care System, established in 1931, serves approximately 83,000 veterans at two Lexington facilities and community clinics in Berea, Hazard, Morehead and Somerset. It sees between 500 and 650 newly diagnosed cancer cases yearly, with lung cancer, prostate cancer, melanoma, bladder cancer and colorectal cancer being the most common diagnosed.
Special population with unique needs
“Much of our veteran population in Kentucky lives in rural areas,” said colorectal surgeon Avinash Bhakta, MD, a UK associate professor who is on the medical staff at the VA hospital and Markey Cancer Center. “Unfortunately, only three percent of our oncologists work in rural settings. Having a MCCAN affiliate program near the patient allows our veterans to get treated closer to home with the support and expertise of Markey and the VA.”
While the typical hospital service area has very distinct boundaries, the VA has a different challenge, explained Cheri Tolle, MAEd, CHES, administrative director of MCCAN. “Our other network sites are geographically defined. It could be five counties or 10 counties or more. But the VA’s service area is defined by population. Their service is to veterans throughout the state.”
In addition, veterans often have specific clinical needs due to their past work. Many have been exposed to chemicals such as asbestos, Agent Orange and mustard gas, or have served in areas where burn pits prevail, sending toxins into the air, water and soil. Some also have received high levels of radiation exposure.
Mullett knows first-hand about the dangers. He was diagnosed with cancer while serving as a surgeon in the Army Reserve in Afghanistan. “For me to be able to increase access to quality cancer care for our VA population is personal. Veterans are a high-risk population. I have been a provider at the VA for more than 20 years and the VA has been my provider for the last 12 years. This is an exciting opportunity to help our veteran population.”
The VA population also holds a special connection for Anna Rose, DNP, clinical nurse specialist at the Lexington VA Health Care System. “This generation is the first in my family not to have someone serve in the military since the Revolutionary War. It’s easy to get lost in the numbers, but at the center of everything is somebody’s loved one,” she said.
Markey is the only cancer center in Kentucky to be recognized for its achievements by obtaining Comprehensive Cancer Center designation from the National Cancer Institute. It is one of 57 such designated cancer centers in the country.
“It’s also through the education and training offered by MCCAN and Markey that our own researchers will become better equipped,” Armstead said. “Eventually, we hope this will encourage them to reach for grants that they otherwise might not have reached for, bringing even more clinical trials closer to where our patients live.”
Meeting CoC standards
One of the requirements of being part of MCCAN is that a hospital’s cancer program must either be Commission on Cancer accredited or be working toward accreditation. It’s a condition MCCAN put into place when it was established 18 years ago because the CoC is recognized as the gold standard for measuring quality of cancer programs at all levels, ensuring that the highest level of comprehensive, multidisciplinary care is provided.
Among today’s more than 30 accreditation standards are national evidence-based treatment guidelines, rules for cancer registries and data collection, and the requirement that facilities have a formal referral process for patients with complex cancers. MCCAN’s Dr. Mullett has been involved with the Commission on Cancer for 30 years, was state chair for six years and served as national chair from 2020 to 2024.
“The affiliation with Markey opens more doors for our patients. Markey is well known for its research and clinical trials, and this will give our population access to studies that we simply haven’t had the ability to support.”
“The VA has a huge passion for caring for their veterans. Their program is strong and we are off to a fantastic start when it comes to addressing the standards,” said Allissa Anderson, MJ, ODS-C, quality program manager for MCCAN. Quality coordinators help educate affiliates about the fine points of each standard, ensure they are capturing the essence of CoC meetings in the meeting minutes, review policies and procedures and connect affiliates that have similar issues.
While the affiliation is new, it’s a collaboration built on a lengthy history, Tolle said. “Markey and UK have deep roots with the VA,” she said. “We are even connected physically by a tunnel. I cannot say enough about the people we have worked with at the VA. They are 100 percent committed to making this a great collaboration and to make sure it is done well. We are not sacrificing quality for time. We are not just checking off boxes. We are building our relationship and a culture of quality.”
“It was remarkable to me that this was not just a bunch of people in suits making decisions about veterans. It was a group of veterans working to bridge the gap between a government institution and a National Cancer Institute-Designated Comprehensive Cancer Center. It was something that we had never done before.”
Among the organizations’ priorities are streamlining the referral process, sharing data, overcoming hurdles that are inherent with having different electronic medical records systems and providing quality care as close to home as possible for veterans. It’s a process that works both ways, with MCCAN and the VA learning from each other.
And combining forces could mean a better future for Kentucky, which has historically ranked among the worst in the nation in cancer incidence. “We have opportunities to do more around prevention. Let’s keep our veterans healthy and improve their quality of life — and, working together I’m hoping we lower the incidence of cancer in Kentucky,” Armstead said.
It’s a dream shared by MCCAN and the VA.
