In the U.S., care deserts exist across specialties and geographic areas. Represented in a variety of ways, cancer care deserts arise when patients are unable to access appropriate treatments, screenings and clinical trials.
Rachel Wagemann, vice president of operations for South Dakota-based Sanford Health's Sioux Falls market, spoke to Becker's about how the largest rural health system in the U.S. ensures its patients have access to cancer care.
Editor's note: Responses have been lightly edited for clarity and length.
Question: How is Sanford Sioux Falls addressing access to cancer care?
Rachel Wagemann: This year we expanded our diagnostic mammography services so that they can be done remotely, meaning we're able to provide diagnostic mammography services with the physician located in Sioux Falls and the patient located in a small community hospital. This helps to reduce transportation and lodging barriers that otherwise would have prevented patients from receiving care.
Our mobile mammography looks to provide preventative and screening services throughout rural South Dakota. It is also available in our more urban communities that are otherwise underserved or have difficulties finding transportation.
Our Cancer Community Outreach Coordinator works with a variety of nonprofit organizations throughout the state to reach underserved communities, non-English-speaking communities, and other groups of patients that often find themselves without access to basic information on screening and prevention. She's even been known to personally drive patients to their appointments with their oncologists.
Both our medical oncology and radiation oncology practices provide outreach and virtual appointment services, seeing patients from across the state and surrounding states.
We've partnered with the American Cancer Society on critical key grants to support patients through lodging and transportation funding to help eliminate this barrier to treatment, as well as provide short-term housing assistance for patients that are receiving longer courses of treatment on campus.
Sanford Sioux Falls is committed to providing phase 1 clinical trials to our portion of the Midwest. As new and novel treatments become available for patients navigating a cancer diagnosis, ensuring they have access to these treatments close to home is a top priority.
Q: What is unique about the Sanford Sioux Falls community in terms of barriers to accessing care?
RW: Our Sioux Falls community is growing rapidly, not only in size but in diversity as well. The state of South Dakota has resettled more than 280 refugees in fiscal year 2024. Our ability to connect with these communities, educate on the importance of cancer screening, prevention and treatment, as well as build trust with the healthcare system has been a large focus of our community outreach programs.
Q: Are cancer care deserts a new phenomenon, or is it an issue that has been going on for a long time?
RW: Cancer care deserts have existed to some extent but have worsened as we see changes in community hospitals and availability of medical oncologists. Changes to telehealth have allowed some expansion to oncology care, but there are still needs for on-site infusion and radiation treatment centers to truly provide comprehensive cancer care.
Q: What are the biggest challenges or opportunities for growth in improving access to cancer care?
RW: Recruitment for medical oncologists and other oncology specialists continues to be one of the biggest opportunities with growth, as well as scaling services and establishing new pathways for virtual services to be provided safely. This includes continued advocacy for payment reform for telehealth services and partnering with industry and grant leaders to expand clinical trial services in nontraditional ways. Continuing to reduce barriers to lodging, transportation and food insecurities through community partnerships and grants is also a key strategy.
Q: What does the future of cancer care look like to you?
RW: Like most of healthcare, the future of cancer care is timely access to screening, prevention, and treatment services. As the socioeconomic barriers continue to increase in our patient populations, we'll be expanding our social work services in 2025 as a priority to meet these needs. Sanford Sioux Falls will continue to expand our virtual and outreach services, and focus on supporting our oncology workforce.