Bill Schmitt
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Primary care practice inside a cancer center creates an extraordinary new model to improve access to care

New “total care” model will further reduce emergency visits and help cancer patients address their non-cancer-related health needs

The Helen F. Graham Cancer Center & Research Institute at ChristianaCare is among the first cancer programs in the nation to offer patients undergoing cancer treatment the opportunity to see a primary care provider (PCP) on site if they don’t already have one of their own.

The new primary care practice builds on the success of the Graham Cancer Center’s Oncology Express Unit, a pilot program offering urgent care to cancer patients in distress during treatment. The primary care practice will see patients with non-urgent health concerns, expanding on-site services at the Oncology Express Unit to an even broader population of patients in need.

Since March 2018, the Oncology Express Unit has treated nearly 1,550 patients with acute care needs, 90 percent of whom avoided an emergency department visit.

“Our ability to offer primary care services to our patients who need them alongside a multidisciplinary roster of cancer services all under one roof is highly unusual among major cancer centers,” said Nicholas J. Petrelli, M.D., Bank of America endowed medical director at the Graham Cancer Center. “By adding a primary care provider on site, we are taking a novel approach to providing both the latest cancer treatments but also care designed to improve our patients’ long-term health.”

An informal survey among cancer patients at the Graham Cancer Center indicated that as many as 30 percent did not have a primary care provider. Having a primary care provider on site will open the doors for dialogue with the entire cancer care team so that essential patient care is not delayed.

“Our purpose is two-fold,” said Christopher Koprowski, M.D., director of Quality and Safety at the Graham Cancer Center. “We want to take care of primary care problems that may arise during treatment to reduce urgent care or emergency department visits, and, after cancer treatment, to help our patients continue to have their primary care needs addressed.”

Cancer diagnoses often happen unexpectedly, often in a specialist’s office or in the emergency department, and more than half of patients diagnosed with cancer have other ongoing health conditions such as heart disease, high blood pressure and diabetes.

“Cancer treatment can often profoundly affect these other medical problems,” said Cydney Teal, M.D., chair of the Department of Family & Community Medicine and Primary Care Service Line leader at ChristianaCare. “Having a primary care provider working in partnership with the patient’s entire cancer care team, who understands potential treatment side effects and can be responsive to the patient’s other medical needs, can make all the difference to long-term health and well-being. Having them on site creates a whole new level of convenience for our patients.”

Primary care provider Debra Delaney, RN, MSN, ACNS-BC, FNP-BC, has joined the team at the Graham Cancer Center at the Oncology Express Unit to care for patients referred by their cancer care providers. Her 20-plus years of experience at ChristianaCare include 12 years as an advanced practice nurse taking care of adult and pediatric patients in trauma and acute care settings.

Delaney has a keen interest in cancer care delivery and works closely with cancer care providers at the Graham Cancer Center, including members of each patient’s multidisciplinary disease site clinic team.

The addition of a family nurse practitioner to the cancer care team is the first step toward what could become an even broader partnership between oncology and family medicine.

“We are excited to welcome Debra Delaney as our first Family Nurse Practitioner on site at the Graham Cancer Center,” said Dr. Teal. “To our knowledge, there are no fellowships or specialty training for providers who specialize in both primary as well as oncologic care, so we also are looking at the possibility of eventually establishing a fellowship training program in cancer medicine for our family medicine providers.”

The family nurse practitioner sees patients by referral, Monday-Friday, from 8 a.m. to noon, at the primary care practice in the Oncology Express Unit, on the first floor of the Graham Cancer Center in the West Pavilion. Plans are to eventually expand practice hours.


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About the Helen F. Graham Cancer Center & Research Institute
The Helen F. Graham Cancer Center & Research Institute, a National Cancer Institute Community Oncology Research Program, is part of the ChristianaCare, one of the country’s most dynamic health systems, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. With more than 245,000 patient visits last year, the Graham Cancer Center is recognized as a national model for multidisciplinary cancer care and a top enroller in U.S. clinical research trials. In conjunction with the Gene Editing Institute, the Center for Translational Cancer Research, the Tissue Procurement Center, statewide High-Risk Family Cancer Registry and collaborations with world-renowned scientists at facilities such as The Wistar Institute in Philadelphia scientists are opening new avenues to more quickly translate cancer science into cancer medicine. For more information, visit