By Michael LeCompte, MS
The Committee of Health Equity, Diversity, and Inclusion (CHEDI) of ASTRO developed the Minority Summer Fellowship (MSF) as an opportunity to introduce medical students from backgrounds that are underrepresented in medicine to the field of radiation oncology. The program provides a framework for medical students to gain meaningful early exposure to the specialty that both encourages interest and provides mentorship within the field. MSF awardees work with a mentor on a research project and are required to submit their work for presentation at the subsequent ASTRO Annual Meeting. For the 2020 cycle, four students will be offered a package of $5,000: a $4,000 stipend for the eight-week training program and a $1,000 grant toward travel to the 2021 ASTRO Annual Meeting.
I first learned of the MSF through my school’s Student Affairs office. At this point, I had previously shadowed within the Wake Forest Department of Radiation Oncology and had collected data for a few residents’ research projects. I had a basic understanding of certain elements within radiation oncology and was fascinated by all I had seen thus far. Radiation oncology allows physicians to help patients process the uncertainty associated with a cancer diagnosis and build actionable, evidence-based treatment plans. This blend of social support and scientific application resonated with what I was looking for in a specialty, and the MSF was the avenue that would permit me to explore this specialty further.
The MSF allows the recipient to design a research project with a mentor to be completed over the eight-week training program. I was fortunate to find mentors who empowered me to identify my own research questions. Through conversations with Dr. Karen Winkfield and Dr. Michael Chan, we found ways to leverage my prior knowledge within diabetes research and investigate topics I was already personally interested in. This allowed me to more easily take an active role in designing our research project. We investigated the impact of diabetes mellitus and anti-diabetic drugs on the clinical outcomes of brain metastasis patients treated with stereotactic radiosurgery. The research completed through this experience was presented at the 2018 ASTRO Annual Meeting and has been published in the Red Journal.
The MSF training program may last for just a summer, but the connections I made during this experience continue to influence my career plans. I was able to make lasting connections with mentors both inside and outside my home institution. During the training program, I continued shadowing Dr. William Blackstock, who has always been there to offer advice and guidance along my path in medicine. Under the guidance of Dr. Chan, I have continued my research in clinical outcomes of brain metastasis patients, specifically the study of the concept of brain metastasis velocity. My project with CHEDI served as a stepping stone to a research experience that has seen me present at the inaugural Conference on Brain Metastases sponsored by the Society of Neuro-Oncology.
CHEDI also provides MSF awardees a liaison. For me, that person is Dr. Christian Okoye of St. Bernards Cancer Center, who has been there to check in on my progress in medical training and offer encouraging words. Other members of CHEDI have also served as mentors. I have been able to discuss my research and career plans with members of CHEDI over phone calls and in person at national meetings. Through mentorship, the MSF helps medical students further develop their career goals and grow toward their true potential.
This experience affirmed my fascination with the specialty and ultimately helped me in choosing to apply for residency in radiation oncology. I cannot express how appreciative I am to the members of CHEDI for offering me this wonderful opportunity, and I encourage others to apply. The application for the 2020 cycle is currently open with a deadline of Friday, February 7, 2020.
Michael LeCompte, MS, is a fourth-year medical student at Wake Forest School of Medicine. He was one of two recipients of the 2017 ASTRO Minority Summer Fellowship Award.
Posted: November 19, 2019
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By Corbin Johnson, MD, CUAC chair, and Nikhil Thaker, MD, CUAC vice-chair
As radiation oncology heads into 2020, are you worried about whether your practice has its coding compliance in order and is up to speed on new coding rules? ASTRO, the authority on radiation oncology coding, is rolling out an updated ASTRO Radiation Oncology Coding Resource and hosting a Coding and Coverage Seminar to help practices get off to the right start in the new year.
ASTRO’s Code Utilization and Application Committee (CUAC) works throughout the year to ensure that the radiation oncology (RO) community has access to comprehensive tools that assist with consistent application and interpretation of the Current Procedural Terminology (CPT®) code set most commonly used in RO. The CPT system, developed by the American Medical Association (AMA), is a highly technical process. New codes are developed, redefined and revalued every year for physicians and other qualified health care providers to report services provided in a universal manner to institutions, private and government payers, researchers and other interested parties. ASTRO actively provides input to the AMA and other groups that update the CPT coding system to ensure that CPT coding accurately reflects the clinical logic and level of effort that is required in RO.
Annual Coding and Coverage Seminar and Resource
CUAC’s primary responsibility is to understand the impact of these changes on coding for radiation oncology services. This includes providing membership with educational programs and materials that include the most recent and up-to-date coding guidance. One of the most popular educational programs that ASTRO offers to the RO community is the annual Coding and Coverage Seminar. This two-day seminar held at ASTRO headquarters provides a comprehensive overview of the many factors that affect the complex and ever-changing aspects of coding in clinical practice. The seminar is geared to make clinical coding easier to understand and applicable to those new to coding as well as for those with experience who are looking to hone their skills. This year’s seminar will take place on December 6 and 7 in Arlington, Virginia. Registration is currently open on the ASTRO website.
In addition to the seminar, CUAC also produces the ASTRO Radiation Oncology Coding Resource. The Coding Resource is designed as an orientation and reference document to assist physicians, their practice administrators and their staff to develop accurate coding and documentation procedures to support billing for RO services. The ASTRO Radiation Oncology Coding Resource is an essential coding reference for all radiation oncology practices, and ASTRO strongly encourages all coding/billing professionals to utilize this resource in their daily practice. This resource is updated twice a year to ensure that it reflects the most up-to-date information on CPT coding, rules and regulations related to radiation therapy. Coding and Coverage Seminar attendees will receive a copy of the updated Coding Resource as part of their registration.
Additional ASTRO coding resources
In addition to the comprehensive ASTRO Coding Resource and annual Coding and Coverage Seminar, ASTRO provides the RO community with coding education through regularly updated coding FAQs, Coding Guidance Articles and Coding Updates on the ASTRO website. If ASTRO members have coding questions that are not answered through these various resources, or if further clarification on a nuanced topic is needed, they are encouraged to submit the question through the ASTRO Coding Question submission form. The questions submitted through the Coding Question submission form are processed through CUAC during their monthly meeting, and members are provided an answer to their questions via email. While providing individualized coding guidance to members, this question form also enables CUAC to keep track of frequently asked questions and topics that may have significant importance to the membership at large.
It's important to remember that correct coding encourages efficiency, reduces audit risk and claim rejections and facilitates efficient reimbursement. Additionally, accurate coding and proper supporting documentation demonstrate an understanding of the process and delivery of patient care. While correct coding reflects the process of care, it is vital to acknowledge that coding does not drive the process of care. Selection of codes should not be based on reimbursement but rather on the services provided by the physician that are considered medically necessary while caring for the patient. The physician of record is held responsible not only for all aspects of patient care but also for all codes and documentation submitted in his or her name. Arming yourself with a thorough understanding of these key elements and taking advantage of ASTRO’s educational resources can lead to successful practice management.
Corbin Johnson, MD is a radiation oncologist at Vanderbilt University Medical Center. Dr. Johnson currently serves as chair of ASTRO’s Code Utilization and Application Subcommittee in addition to playing a vital role as a member of ASTRO’s Code Development and Valuation Subcommittee.
Nikhil Thaker, MD, is a radiation oncologist with The Arizona Oncology Associates of Tucson and currently serves as vice-chair of ASTRO’s Code Utilization and Application Subcommittee, as well as serving on the Code Development and Valuation Subcommittee.
Posted: November 13, 2019
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By Sabin B. Motwani, MD
Communications Committee Chair
November has arrived, signaling Fall, and the one-year anniversary of the new and improved ROhub! ASTRO’s official online community continues to serve as a place for collaboration and networking. During the summer of 2018, ROhub was moved to a more user-friendly platform and relaunched in November 2018 welcoming the Open Forum, ASTRO’s all member community, ASTRO event communities and specialty communities such as Locum Tenens.
To celebrate its one-year anniversary, ASTRO is conducting an online scavenger hunt on ROhub during the month of November. At the beginning of each week, a new activity will be posted in the Open Forum for members to complete. Those who complete all posted activities will be entered into a drawing and five individuals will win $50 each in ASTRO cash, which can be used toward ASTRO products.
Let’s take a moment to look back at this invaluable resource. When ROhub launched last year, expectations were open and benchmarks were not set. Looking back over the course of a year, ROhub has received overwhelmingly positive feedback from members and other committees. The Communications Committee was particularly excited with what ROhub brought to the table as a resource that we were missing at ASTRO. Over the course of the year, ROhub has totaled 231,000 pageviews, 8,500 unique logins, 300 plus unique contributors and more than 900 discussion posts generated by ASTRO members.
The Open Forum has served as an inaugural place for members to discuss a wide range of topics and allows members to interact with staff on a more personal and private level compared to other platforms. This discussion forum has also given the Communications Committee and ASTRO staff invaluable feedback on areas to focus on or what ASTRO can do to better serve its members. From topics like prior authorization, RO-APM and rural practices, discussion has spurred on and encouraged a number of members to jump in and participate in these timely topics. The Communications Committee posted a discussion about the changes we were making to the patient education material and found the feedback extremely valuable. We will continue to do this to help our members shape the work we do.
What’s next for ROhub?
Additional features and large initiatives have been going on behind the scenes for some time now in ROhub. At this very moment the Communications Committee and I are testing a document versioning system similar to Google Docs that will be hosted on ROhub called WorkSpace. WorkSpace will greatly enhance the efficiency of ASTRO committee work and will eliminate the need for so many emails flooding our inboxes or several users at once making changes on a document. Workspace, for example, has features that will allow users to “lock” documents as they are making edits in draft mode. We are confident that this will bring a much-needed reprieve from Google Docs.
Working with the ASTRO Rural Task Force, we will soon launch a peer-to-peer matching system. This new platform will match interested radiation oncologists for the purpose of virtual physician to physician peer review of patient cases.
With the growing expansion, I can’t wait to see what emerging ideas, points of discussion and progress will be accomplished by the 2nd anniversary of ROhub! To those of you who may have wanted to jump in on a thread or have had a question you wanted to pose to the rest of the membership, I encourage you now to go online to rohub.astro.org and post those questions in the Open Forum.
I encourage you to feel comfortable to voice your opinions and ask your questions in this members only environment. Don’t forget to upload your headshot! It’s always appreciated to associate a post with a friendly face so others can introduce themselves to you at maybe…#ASTRO20. It’s never too late to start a conversation or create a new connection today on ROhub. Learn more about how to post in the ROhub.
Posted: November 6, 2019
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By Anna Lee, MD, MPH, and Valerie Powell, RT Patient
Social media provides a platform for people and organizations to share information, opinions and expertise. It also serves as a news source, a networking tool and a pivotal communications channel for millions of people around the world. As radiation oncology experts, it’s important that we share our voice and raise the profile of our field and one area of focus for ASTRO is social media. For this year’s Annual Meeting, ASTRO asked nine attendees to serve as Social Champions, including, for the first time, the voice of an RT patient. Here, two #ASTRO19 Social Champions share their experiences from the meeting.
Anna: Last year I created a Twitter account in preparation for ASTRO’s Advocacy Day in Washington, D.C. While I participated in social media through Facebook and Instagram, these were primarily for personal use and I found the public platform of Twitter to be daunting. Why would people even care what I thought? What would be the purpose of having a professional account? These sentiments were alleviated after watching the social media webinar prior to Advocacy Day. I quickly learned different ways to increase visibility and how to use the platform to put my voice out there and get people’s attention.
Once I joined the #SoMe (social media) community, I was floored to see so many radiation oncologists on Twitter! I immediately felt welcomed and learned so much from discussions (some can be intense) and hot-off-the-press papers. I quickly developed new friendships that have crossed over #IRL (in real life) and have been offered opportunities to collaborate on projects including to be one of the nine #ASTRO19 Social Champions.
The #ASTRO19 meeting in Chicago this year was one of the busiest but most exciting I’ve attended. I felt more engaged because I wanted to synthesize information from the talks and share it on #SoMe. As a current trainee in proton therapy, I wanted to share my perspective as someone still early in her career and excited about the increased utilization of protons for our patients. Even though my task was to interact and engage through tweets, I met and spoke #IRL with so many dedicated ASTRO members. I came home exhausted but grateful to have had an enriched conference experience and to be part of a larger network that helped me to better understand both the field and the people in the field.
Valerie: I was giddy to get to Chicago. The opportunity to attend such an influential and informative conference with the opportunity to be an #ASTRO19 Social Champion and stand in for other RT patients was something I never imagined I would do. So, I assigned myself a few goals: Be present. Be professional. Be transparent. And, be myself.
As a non-clinician and former RT patient attending #ASTRO19 for the first time, my initial steps into the main ballroom made me nervous. My face had been promoted all over Twitter and was published throughout the convention center. Whether anyone recognized me or not was one thing, but the idea of potentially being way out of my realm of understanding was a whole different thing.
I arranged my conference schedule to include topics I was interested in but also topics that I had some familiarity with. While I am not clinical in my marketing and communications work at University of Alabama, Birmingham’s (UAB) radiation oncology department, I tend to poke my head in as many different areas of our department that I am allowed. Of course, going through treatment for head and neck cancer in 2017 taught me quite a bit about radiation oncology too.
During each #ASTRO19 session I attended, I kept the overall topic in mind and listened closely. If something struck a particular chord in me, I quickly wrote it into my phone and gave myself a few seconds to process why it impacted me. Sometimes it came from a past experience. Other times it might have come from clinical perspective that I learned while working in research at UAB and more recently in marketing and communications.
At that point, I had to make a decision about how what I had to say was going to come across to a very practical and data-driven audience. It was crucial for me to stay relevant in this venue and provide quick and valid thoughts or I would inevitably fall behind the other Social Champions.
Overall, being a Social Champion definitely gave me a feeling of inclusiveness, especially coming in as a total outsider and not knowing what to expect. I came with purpose and a story and ASTRO gave me a platform to share those things and hopefully improve care for future patients being treated with radiation therapy.
Even though the Annual Meeting is behind us, there are many opportunities to use social media in radiation oncology. If you are not currently on social media, you can start with a Twitter account. There’s an easy how-to video on ASTRO.org. If you don’t want to start posting right away, you can follow the conversations until something strikes your interest.
Anna Lee, MD, MPH, graduated from residency at SUNY Downstate Medical Center and is currently completing a one-year proton therapy fellowship at Memorial Sloan Kettering Cancer Center.
Valerie Powell is a radiation oncology marketing professional at the University of Alabama at Birmingham and a previous head and neck cancer patient. She is married to her husband of five years, K.T. Powell, and they have two dogs, Fox and Stella.
Posted: October 30, 2019
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By Gita Suneja, MD, MS, and Malika Siker, MD
As the field of radiation oncology continues to make tremendous biomedical advancements in patient care, we know that these breakthroughs are not reaching all patients equally. We are aware of the outstanding research documenting the disparities that exist in the field, both in terms of patient care and the composition of our work force. It is critical that we focus on improving health equity to devise new and innovative solutions to bring change to the field. To this end, the ROI has issued a new request for proposals (RFP), “Improving Diversity and Inclusion in Radiation Oncology,” to award research grants focused on developing and testing practical applications that will help change the current state of affairs for radiation oncology professionals and their patients.
This new funding opportunity from the ROI will support innovative ideas to:
- Reduce disparities in patient care.
- Increase participation of underrepresented groups in clinical trials.
- Improve diversity in the radiation oncology workforce.
The proposed research must also focus on one or more of the topics that make up the ROI’s research agenda: communication, quality and safety, toxicity management, comparative effectiveness and value of radiation therapy. The grants typically will be approximately $50,000 to be paid over two years, but budgets of up to $100,000 will be considered for projects with a large scope of work. We encourage all interested, eligible applicants to submit a Letter of Intent (LOI) by 5:00 p.m. Eastern time, October 28, 2019, on the ROI portal on proposalCENTRAL. Full proposals will be due at the end of January for invited applicants only.
The ROI and ASTRO’s Committee on Health Equity, Diversity and Inclusion (CHEDI) are excited to be partnering on this new grant opportunity to ensure that the ROI is supporting the highest priority research that will address some of the most pressing challenges to improve equity, diversity and inclusion in radiation oncology. Our collaboration began with the development of the RFP and will continue through the review of the LOIs and proposals, when members of CHEDI will serve as guest reviewers. We are hoping to see many proposals for groundbreaking initiatives to improve recruitment and inclusion of underrepresented minorities into cancer clinical trials, one of CHEDI’s top priorities for the year, in response to this RFP.
We are proud to support this new funding opportunity that could help transform the field. We invite all members of the radiation oncology community to review the complete RFP and propose your best ideas for how to improve health equity and ensure that all patients have access to the lifesaving and quality-of-life benefits of radiation therapy.
Gita Suneja, MD, MS, is chair of the ROI Research Committee and vice-chair of CHEDI, and Malika Siker, MD, is chair of CHEDI, a member of the ROI Development Committee and chair of its Communications Subcommittee.
Posted: September 25, 2019
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