Latest / Becker’s Healthcare Podcast / Dr. Theodoros Teknos, President and Scientific Director of the University Hospitals Seidman Cancer Center at University Hospitals Cleveland Medical Center and Deputy Director of the Case Comprehensive Cancer Center

Transcript

Dr. Theodoros Teknos, President and Scientific Director of the University Hospitals Seidman Cancer Center at University Hospitals Cleveland Medical Center and Deputy Director of the Case Comprehensive Cancer Center · Becker’s Healthcare Podcast

• 0:02
  The most important health care decisions don't happen
• 0:05
  in isolation.
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  They happen when leaders come together.
• 0:08
  Becker's sixteenth annual meeting brings together more than
• 0:11
  3,500
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  hospital and health system executives this April in
• 0:15
  Chicago.
• 0:16
  With 800 speakers from Ascension,
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  Cleveland Clinic, CommonSpirit and more, the conversations get
• 0:22
  real. Leaders will share how their scenario planning
• 0:24
  for policy shifts, breaking through value based care
• 0:27
  barriers, and building clinical teams that translate
• 0:43
  Well, hello
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  Well, hello everyone, and welcome to the Becker's
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  Healthcare Podcast.
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  I'm Mackenzie Bean, associate vice president and managing
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  editor of Becker's Hospital Review.
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  Today, I am truly so thrilled to be
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  joined by doctor Ted Technos,
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  who is the president and scientific director of
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  the University Hospital's Seidman Cancer Center at University
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  Hospital's Cleveland Medical Center.
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  He also serves as deputy director of the
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  Case Comprehensive Cancer Center.
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  Doctor Technos, welcome to the podcast today. Thank
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  you so much for joining us.
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  Thank you so much for having me, Mackenzie.
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  It it's such a pleasure. I'm excited for
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  our conversation today.
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  But before we dive in, I was hoping
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  I could turn it to you just to
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  share a little bit more about your yourself
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  and your background.
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  Sure.
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  So I am trained as an otolaryngologist
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  head and neck surgeon. So I still practice
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  head and neck, cancer surgery as well as
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  reconstructive
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  surgery
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  following,
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  head and neck cancer ablations.
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  I've been,
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  at several institutions throughout my career,
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  and have been here at University Hospitals as,
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  president and scientific director of the cancer program
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  since 2017.
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  Wonderful.
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  Excited to tap your rich perspective today.
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  I wanna start off by looking at
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  health systems' efforts to grow and differentiate their
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  cancer programs.
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  Where do you see the biggest strategic misalignments
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  between
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  those cancer center ambitions and then perhaps broader
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  health system priorities,
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  and how can leaders
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  close those gaps?
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  Yeah. This is a this is a very
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  important question. And, really, the biggest misalignment
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  between
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  health systems
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  and cancer programs
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  isn't money. It's really language
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  and time horizon. So cancer programs, you know,
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  we talk
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  in aspiration.
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  You know, the the latest treatments, finding new
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  discoveries. So we we're really about aspiration and
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  hope, whereas our health systems really talk in
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  execution.
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  You know, the gap really closes when oncology
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  strategy
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  is framed not just as prestige
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  and, academic success, but also as one of
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  the systems'
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  most powerful engines for sustaining growth,
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  and differentiation as well as value. So I
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  think
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  the mistake a lot of cancer leaders make
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  is after they, you know, they chase relentlessly
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  after academic proceed, which is really important.
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  But I think as leaders, we also need
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  to be able to
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  just as equally be facile in talking about
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  margin,
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  access,
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  volumes,
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  cost of care,
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  and all of those things that really are
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  aligned goals, but I think oftentimes get,
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  sort of,
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  at odds with each other.
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  So I think, you know, the best way
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  for cancer center leaders to really,
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  interface and close that gap is to really
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  translate a cancer center's ambition
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  into system relevant outcomes. And what do I
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  mean by that? I mean that,
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  really,
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  in addition to leading with prestige
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  and excellence, cancer center leaders should also focus
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  on, you know, the the other metrics that
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  are really important to the system,
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  reducing leakage of cancer patients to other systems,
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  you know,
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  documenting
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  our our downstream
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  revenues, what our site of care cost differentials
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  are,
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  and then really,
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  differentiating
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  us ourselves with payers. And then strategy for
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  cancer centers also
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  really needs
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  to center around where care happens. I think
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  winning systems
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  centralized
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  only what really needs to be centralized, things
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  such as complex
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  surgeries, bone marrow transplants,
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  phase one clinical trials,
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  and any of those other things that do
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  not have to be centralized can be decentralized,
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  such as infusion services, imaging
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  to lower cost settings. And I think that
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  aligns
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  the cancer center's growth with the system growth
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  as well.
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  And then I think, finally, we just need
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  to align incentives,
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  you know, between cancer center leaders
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  and, our system leaders. So what that really
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  means is that rather than being a separate
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  siloed leader to lead the cancer program, cancer
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  center leaders really need to be system executives,
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  and their
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  their goal should be
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  closely aligned with the system goals as well.
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  And they should be accountable
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  for each, both system leaders for cancer center
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  goals and then cancer center leaders with system
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  goals.
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  I think that's the way that, you know,
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  we can really close the gap between expectations
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  of of of both
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  different components of a health care system.
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  Mhmm. That shared accountability. And that's so interesting,
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  what you said about, you know, the the
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  aspiration versus
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  execution. So it sounds like cancer center leaders
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  really need to be adept at sort of
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  translating,
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  you know, their own aspirations or clinical discoveries
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  or efforts really into,
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  the concrete terms of how is this going
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  to also support system wide outcomes.
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  I'm curious, is there a specific,
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  real world example you can point to of
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  maybe a decision,
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  or an effort on the cancer side that
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  you,
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  you know, really had to translate for,
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  the system wide perspective?
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  Yeah. I think, you know, examples of this
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  may be, you know, for us when we,
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  we have a centralized
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  academic medical center and a and a freestanding
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  cancer hospital, one of just 13 in the
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  nation. But then we also have 17 sites
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  in the region.
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  And I think, you know, what we did
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  is look specifically
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  at and as I mentioned, you know, what
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  actually has to be
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  on the main campus. That's the highest cost
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  place to deliver cancer care. And what can
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  we do in the region? So a lot
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  of what we decided to do
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  was actually focus our clinical trial efforts, our
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  really complex surgery on the main campus.
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  And then even if patients are evaluated on
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  the main campus, if they can receive standard
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  of care therapy closer to home, which is
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  a lower cost setting, we allow patients to
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  do that. So we not only meet patients'
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  needs where they are and where they're at
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  close to home, but we also then free
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  up capacity in the main hospital for us
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  to do more complex
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  care. So that
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  both,
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  you know,
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  achieves our goal to get the maximum access,
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  but then also optimizes
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  our ability to
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  to,
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  create revenue both on the main campus as
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  well as off, the main campus sites. And
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  payers like it because they
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  see that we are actually trying to defray
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  cost and bend that cost curve by not
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  necessarily requiring everybody to be at the highest
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  cost setting.
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  Mhmm. I appreciate that example. I think it's
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  a,
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  you know,
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  very relevant,
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  discussion that so many organizations are having as
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  they think about
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  sort of the structure of their service lines
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  or those specialties.
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  Let's look ahead to this upcoming year now.
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  From your perspective,
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  what shifts do you see coming in how
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  academic cancer centers
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  translate discovery into standard clinical care?
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  Do you feel like hospital or health systems
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  are overestimating or perhaps underestimating
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  the operational lift that will be required to
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  do that?
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  Yeah. This is a this is a great
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  question. So I think,
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  you know,
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  discoveries
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  and and and,
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  translation is coming at us fast and furious.
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  So I think, you know, the biggest trends
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  that we're facing in 2026
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  really are how do we integrate
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  precision medicine
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  and system biology into our clinical workflows?
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  How do
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  we how do we,
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  in essence,
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  use all these technologic
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  accelerations such as
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  artificial intelligence and digital twins
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  to make decisions
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  for our patients?
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  And then how do we accelerate clinical trial
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  accruals using some of these really remarkable,
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  machine learning algorithms? So, you know, there's no
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  question
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  that all of these require
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  a tremendous amount of planning and operational
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  expertise for for cancer center leaders to be
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  able to to make them a reality.
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  And I do think that there is an
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  underestimation
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  of what this will take to really implement,
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  into,
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  into our workflows.
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  Yeah. That that's so interesting. I think it's
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  gonna be a a helpful perspective for listeners
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  as they're thinking about this at their own
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  systems.
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  You know, we're also seeing
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  health systems, cancer centers operating in a difficult
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  environment.
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  There's, capital workforce pressures. We're seeing research dollars,
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  being taken away in some cases.
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  How can health system executives strategically decide where
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  to invest in cancer care over, say, the
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  next three to five years?
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  And is there anywhere where you think restraint
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  might be more important and valuable than expansion?
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  Yeah. This is a this is a a
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  challenge that all of us face.
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  You know, there
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  are limiting, you know,
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  limited resources and, you know, with some of
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  the governmental changes coming both in Medicaid, Medicare,
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  all of you know, the average health system,
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  about two third
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  of our patients in the cancer program
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  are on
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  are government insured. So we really are, in
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  some in some ways, held captive to
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  some of the CMS changes that are coming,
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  you know, with regards to our,
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  reimbursements. But then also, as you mentioned, NIH
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  dollars, you know, are are harder and harder
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  to come by. By last estimate,
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  you know, only the top 4%
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  of grants are being funded, even though the
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  NIH budget was expanded. So it's it's really
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  a tough environment. So I think as cancer
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  center leaders,
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  you know, we really
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  need to focus
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  on, you know, how we
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  how we spend those dollars in a very,
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  you know, in a very strategic way. So
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  I think the ways that a really effective
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  cancer center leader can do that is to
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  anchor
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  their strategy under these,
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  you know, constrained,
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  times
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  to really focus on value
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  and cost effectiveness. So, you know, we need
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  to prioritize investments that deliver high value for
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  our patients and the system
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  rather than just, you know, acquiring the expensive
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  leading edge technologies
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  that provide us with marginal gain. So what,
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  you know, what we are focusing on is
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  how do we implement evidence based
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  interventions and clinical protocols, you know, so that
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  we can standardize pathways?
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  How do we develop value based models
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  in cancer care?
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  And then how do we
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  essentially evaluate these outcomes? You know? Before we
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  embark on a high cost therapy, we do
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  very thorough,
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  cost benefit analysis to make sure that it's
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  good for the patients and also good for
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  the system.
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  The other thing I think we really need
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  to do
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  in constrained times
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  is really double down on early detection, screening,
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  and navigation.
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  So we all know that if we detect
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  cancers earlier,
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  we find them at earlier stages, they have
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  better outcomes, and it costs the system less.
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  So we have really invested
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  significantly in our
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  early cancer detection, whether it be mammography, lung
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  cancer screening, other screening modalities,
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  and implemented population based screening programs and predictive
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  analytics. And we've really moved the needle,
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  especially in our lung cancer care to earlier
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  stages
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  with lower cost. And then I the other
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  part that I think is really important is
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  we can't continue to build a bigger and
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  bigger system. So we really have to partner
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  under constrained capital
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  with
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  our networks, with local providers so that we
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  can expand our reach,
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  you know, reach more patients without actually,
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  having to do more brick and mortar acquisition.
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  And then the last thing
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  that I think is really important is we
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  need to leverage technology,
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  And whether that's AI and machine learning to
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  help with
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  triage, clinical decision support,
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  or even reducing, you know, the administrative and
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  cognitive burden for physicians
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  is really important for us, you know, to
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  be able to become more efficient and deliver
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  care that,
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  you know, that is best for our patients.
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  And then finally,
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  you know, I think,
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  we really have to use very robust data
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  to
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  to determine which investments are
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  are gonna
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  be viable, you know, when in in a
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  three to five year period rather than over
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  a decade, which is what typically,
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  we as cancer center directors
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  are looking at.
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  And especially as we acquire
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  very expensive high cost research platforms,
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  equipment.
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  So we really need to see that ROI
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  in a shorter time horizon rather than a
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  longer time horizon.
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  Mhmm.
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  So, really, we almost outlined, like, a a
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  a five pronged approach of having a relentless
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  focus on value for both patients in the
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  system of standardizing care pathways, value based models,
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  early detection, screening, and navigation, like you said,
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  increasingly looking at partnerships with local providers, other
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  networks,
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  of course, continuing to lean on technology and
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  then,
• 15:03
  that very robust data to help really determine
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  what are the viable
• 15:07
  investments. Is is that a fair summary?
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  Absolutely. Yeah. I mean, I think more than
• 15:11
  ever, you know, it's gonna require a lot
• 15:14
  of,
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  you know, very thoughtful decision making,
• 15:18
  and, you know,
• 15:20
  and great stewardship of the of the limited
• 15:22
  capital dollars that are out there.
• 15:24
  Mhmm.
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  I think, you know, you hint on this
• 15:27
  a a bit, but I'd love you to
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  elaborate.
• 15:31
  As we look ahead even perhaps beyond three
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  to five years,
• 15:34
  what organizational capabilities do you think will most
• 15:37
  determine whether a health system's cancer strategy succeeds
• 15:40
  or stalls, whether that's, you know, research, governance,
• 15:44
  data, access, and more. I'd love to hear
• 15:46
  your take on that.
• 15:48
  Yeah. I mean, I think, you know, ultimately,
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  the systems that are gonna succeed in the
• 15:53
  future
• 15:54
  are gonna be the ones that really think
• 15:56
  of on oncology as an enterprise wide portfolio
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  and not, you know, just a, you know,
• 16:02
  a simple service line. So, you know, those
• 16:05
  systems and ours is an example of this
• 16:07
  where,
• 16:08
  you know, cancer is looked at as
• 16:12
  not delivered only on the main campus, but
• 16:14
  is a component of the entire system. So
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  in general,
• 16:18
  cancer programs
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  ultimately are about 25%
• 16:23
  of the revenue of the entire health system
• 16:25
  and over a third of the margin.
• 16:28
  So it really needs to be embedded in
• 16:30
  system strategy.
• 16:31
  So the key is the systems that succeed
• 16:34
  are gonna have a, a very cohesive
• 16:38
  strategy across their entire portfolio. They're gonna use
• 16:41
  a lot of data
• 16:43
  to make informed decisions.
• 16:45
  And most importantly, they really need to align
• 16:50
  the physicians because physicians really are the drivers
• 16:53
  in cancer care. So beyond just employing the
• 16:56
  physicians, we really need to engage them. We
• 16:59
  need to engage them in in helping us
• 17:02
  devise our our workflows and helping us implement
• 17:05
  them,
• 17:06
  in a much more robust way.
• 17:08
  And then we need to partner. We need
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  to partner with with,
• 17:12
  regional
• 17:13
  practices. We need to partner with other health
• 17:15
  systems and joint ventures.
• 17:17
  You know, the systems that are not gonna
• 17:19
  do well, I think, in the future are
• 17:22
  the ones that expand facilities,
• 17:24
  do a lot of brick and mortar building,
• 17:28
  faster than they expand their, you know, their
• 17:30
  workforce
• 17:31
  capabilities.
• 17:33
  Also, the ones that don't have a cohesive
• 17:35
  structure
• 17:36
  going throughout the system, and they have sort
• 17:38
  of little fiefdoms of cancer care delivered in
• 17:41
  their regional hospitals that compete
• 17:43
  with the main campus or or fragment care.
• 17:47
  And then I think, ultimately,
• 17:50
  you know, the systems that
• 17:52
  invest in,
• 17:54
  you know, really long term,
• 17:57
  platforms of innovation
• 17:59
  that are frankly hit or miss sometimes,
• 18:02
  are gonna have a hard time in this
• 18:04
  new sort of model of care that's that's
• 18:07
  coming,
• 18:08
  based on, you know, the the economic challenge
• 18:11
  that we see
• 18:13
  in cancer care and health system delivery.
• 18:18
  Well, doctor Technos, this has truly been just
• 18:20
  such a enlightening discussion. I so appreciate you
• 18:22
  taking the time to join the podcast
• 18:24
  and and share your insights about how you're
• 18:27
  thinking about,
• 18:28
  you know, growth,
• 18:29
  innovation,
• 18:30
  value to patients,
• 18:32
  and more. So thank you again. We really
• 18:34
  appreciate it.
• 18:36
  It is my pleasure, and I really appreciate
• 18:38
  that the opportunity, Mackenzie.
• 18:40
  Yeah. Always happy to have you. Thank you
• 18:42
  so much.
• 18:43
  You're very welcome.