A University of Tennessee Health Science Center (UTHSC) research team is poised to make a real-world impact on vulnerable cancer patients, thanks to new support from the State of Tennessee.

Led by David Schwartz, MD, chair of the Department of Radiation Oncology in the College of Medicine, and founding director of the UTHSC Center for Health Equity, the team received $2.75 million from the Tennessee Department of Health for a project that marries an automated informatics strategy with a personalized patient-support system to tackle interruptions to radiotherapy in at-risk patients. Altha Stewart, MD, senior associate dean for Community Health Engagement at UTHSC and associate professor and chief of Social/Community Psychiatry, is a co-investigator.

The grant is part of the first round of funding released from the Tennessee Department of Health’s Healthcare Resiliency Program. The program, announced in November 2022, awards competitive grants in two categories – Capital Investment, and Practice Transformation and Extension (PT&E). Dr. Schwartz’s project answers the PT&E category, whose purpose is to encourage innovations in the delivery of health and healthcare services that foster improved health outcomes.
The project is the result of several years of multidisciplinary preparation at UTHSC focused on using population health data to automate individualized, high-touch patient support to improve cancer treatment access. All members of the project leadership team led large-scale public health responses to COVID-19 in Memphis and/or collaborated on the UTHSC-led COVID-19 data warehouse for Shelby County. “This funding program is a special opportunity to pilot our vision to meaningfully (and inexpensively) lower social barriers for Tennessee cancer patients who had the hardest time accessing care during the pandemic,” Dr. Schwartz said.

The project focuses on radiotherapy interruptions. Cancer mortality in Tennessee has historically been high (currently 6th worst in the United States), particularly in disadvantaged areas. Radiotherapy is used to cure cancer in over half of patients, but is not like other cancer treatments. Time is a make-or-break driver of its effectiveness. While surgery or chemotherapy can be pushed back several days without much issue, delaying as few as two appointments during a several week course of radiotherapy can threaten cure. Radiotherapy interruptions occur more often in vulnerable populations of low socioeconomic status. The researchers have found interruption disparities in Memphis are defined by patient race, insurance coverage, and neighborhood-level income, including home address in historically poor areas. The COVID-19 pandemic has further highlighted need for strategies to secure equitable radiotherapy access. COVID-19 has impacted poorer, socially vulnerable Americans disproportionately, in part due to underlying social factors contributing to high baseline cancer and COVID-19 risk. Dr. Schwartz’s team published the first U.S. report to describe institutional radiation treatment referral volume and interruption patterns during the first year of the pandemic. Patient presentations to his clinic from high poverty areas never fully recovered from the initial decline seen during the early pandemic for over a year.

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