Cancer Institute Implements New Outpatient Model for CAR T-Cell Therapy

By News Release


The Sarah Cannon Cancer Institute (SCCI) of HCA Healthcare has successfully established an integrated management process that safely transitioned more than 75% of HCA Healthcare’s CAR T-cell therapy patients into an outpatient setting for monitoring. The program model resulted in more than 1,200 hospital bed days saved for the first 100 patients of the program compared to historical results, and approximately 20% of patients avoided hospitalization altogether.

Piloted at four Sarah Cannon Transplant and Cellular Therapy Network (SCTCTN) sites and using new technology for at-home patient monitoring, trained outpatient clinical teams, including nurses, clinical pharmacists, advanced practice professionals, social workers and case managers, have created a model to help reduce the time patients spend in the hospital after treatment during the typical two-week monitoring period.

“Patients heal better outside the hospital if they can get these complicated therapies, which carry risk for significant complications, safely in the outpatient setting,” said Dr Navneet Majhail, physician-in-chief of blood cancers, Sarah Cannon Transplant & Cellular Therapy Network. “We have leveraged technology and developed clinical pathways to care for patients receiving CAR T-cell therapies. Our clinical teams have accomplished this by standardizing care across a network of several cell therapy programs. In addition to patient benefits, their work has helped us better anticipate and meet the increasing demand for cell therapies as we continue to innovate our care delivery models to enhance timely access for these important treatments.”

Chimeric antigen receptor T-cell therapy, also known as CAR T-cell therapy, is an immunotherapy designed to program a patient’s immune system to recognize and fight cancer. During the CAR T-cell treatment process, T-cells are drawn from a patient’s blood and genetically modified to recognize the patient’s cancer cells when reinfused. Because these oncology patients require intensive, specialized and time-sensitive care, they are closely monitored for any complications and have historically required inpatient hospitalization for up to two weeks post infusion.

In February 2023, SCTCTN, through a collaboration with Best Buy Health, launched the initiative to safely transition a substantial portion of CAR T-cell therapy monitoring into patients’ homes. Best Buy Health’s remote patient monitoring platform, Current Health, tailored for CAR T-cell therapy patients, collects continuous vital sign data and monitors symptoms through integrated wearable devices. A dedicated team triages, manages and escalates patients' needs to SCTCTN teams locally, including registered nurses, using the Current Health platform to provide 24/7 monitoring.

Colleagues from SCCI will be presenting three research abstracts on their experience with this initiative during this year’s Transplantation & Cellular Therapy Tandem Meetings of ASTCT and CIBMTR, February 21-24, in San Antonio, Texas. HCA Healthcare plans to expand this model of care to additional SCTCTN sites over the next year seeking to further improve patient and caregiver experiences nationwide.