Grant Number:	4R37CA263936-05 Interpret this number
Primary Investigator:	Moen, Erika
Organization:	Dartmouth College
Project Title:	Improving Access to Multidisciplinary Cancer Care and Patient Outcomes By Targeting Physician Networks
Fiscal Year:	2025

Variation in health outcomes for cancer patients has garnered significant national media attention. Recent retrospective cohort studies have reported that cancer health outcomes are improved and more consistent when patients have uniform access to care, highlighting the critical clinical importance of optimizing access to cancer care. Data made available which evaluates access to cancer specialists typically determines access based on a per capita count of individual specialties, which does not adequately capture access to multidisciplinary teams of specialists. A relatively unexplored area of study is the extent to which relationships between cancer specialists can be characterized and then targeted to optimize access to cancer care and improve patient outcomes. By assessing the relationships between physicians based on patient-sharing patterns observed in administrative data, we propose to apply our team’s expertise in network analysis, health services research and cancer care to provide a framework for evaluating patient access to cancer care which recognizes the coordination across medical oncology, radiation oncology, and surgical specialists. We have developed a novel network measure– linchpin score – which identifies cancer specialists who are the only specialist of their kind among their neighbors’ ties. We have demonstrated that patients treated by linchpin oncologists are more likely to have delayed cancer treatment and often experience worse survival. This proposal will build on our prior work by examining how network-based measures of access to cancer care, including linchpin score, are associated with patient healthcare resource utilization and patient experience measures. We will also provide resources to the scientific community in the forms of an R package and an interactive dashboard of aggregate oncology workforce measures. In conclusion, this proposal uses network analysis to capture essential characteristics of access to cancer care, with the long-term goal of using network-guided strategies to improve access to cancer care and patient outcomes.




Associations of Social Deprivation and Oncology Physician Network Vulnerability With Acute Care Utilization in the SEER-Medicare Population.
Authors: Korsberg A.A. , Brooks G.A. , O'Malley A.J. , Onega T. , Schaefer A.P. , Moen E.L. .
Source: Health Services Research, 2025-11-18 00:00:00.0; , p. e70070.
EPub date: 2025-11-18 00:00:00.0.
PMID: 41255080
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A Scoping Review of Multilevel Patient-Sharing Network Measures in Health Services Research.
Authors: Korsberg A. , Cornelius S.L. , Awa F. , O'Malley J. , Moen E.L. .
Source: Medical Care Research And Review : Mcrr, 2025 Jun; 82(3), p. 203-224.
EPub date: 2024-12-30 00:00:00.0.
PMID: 40271968
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Rural Oncologists' Perceptions of Specialty Scarcity and Repercussions for Care Delivery: A Qualitative Study.
Authors: Moen E.L. , Tirrell C. , Brooks G.A. , O'Malley A.J. , Onega T. , Schifferdecker K.E. .
Source: Jco Oncology Practice, 2025-05-12 00:00:00.0; , p. OP2401065.
EPub date: 2025-05-12 00:00:00.0.
PMID: 40354601
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Associations Between Oncology Outreach and Patient-Sharing Measures of Care Coordination.
Authors: Scodari B.T. , Schaefer A.P. , Kapadia N.S. , O'Malley A.J. , Moen E.L. .
Source: Cancer Medicine, 2024 Dec; 13(23), p. e70489.
PMID: 39659048
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Surgeon and Care Team Network Measures and Timely Breast Cancer Treatment.
Authors: Ash R. , Scodari B.T. , Schaefer A.P. , Cornelius S.L. , Brooks G.A. , O'Malley A.J. , Onega T. , Verhoeven D.C. , Moen E.L. .
Source: Jama Network Open, 2024-08-01 00:00:00.0; 7(8), p. e2427451.
EPub date: 2024-08-01 00:00:00.0.
PMID: 39207756
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The Association Between Oncology Outreach and Timely Treatment for Rural Patients with Breast Cancer: A Claims-Based Approach.
Authors: Scodari B.T. , Schaefer A.P. , Kapadia N.S. , Brooks G.A. , O'Malley A.J. , Moen E.L. .
Source: Annals Of Surgical Oncology, 2024-03-27 00:00:00.0; , .
EPub date: 2024-03-27 00:00:00.0.
PMID: 38538822
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Disparities in Access to Multidisciplinary Cancer Consultations and Treatment for Patients With Early-Stage Non-Small Cell Lung Cancer: A SEER-Medicare Analysis.
Authors: Liu Y.C. , Schmidt R.O. , Kapadia N.S. , Phillips J.D. , Moen E.L. .
Source: International Journal Of Radiation Oncology, Biology, Physics, 2024-03-13 00:00:00.0; , .
EPub date: 2024-03-13 00:00:00.0.
PMID: 38490619
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Characterizing the Traveling Oncology Workforce and Its Influence on Patient Travel Burden: A Claims-Based Approach.
Authors: Scodari B.T. , Schaefer A.P. , Kapadia N.S. , O'Malley A.J. , Brooks G.A. , Tosteson A.N.A. , Onega T. , Wang C. , Wang F. , Moen E.L. .
Source: Jco Oncology Practice, 2024-02-22 00:00:00.0; , p. OP2300690.
EPub date: 2024-02-22 00:00:00.0.
PMID: 38386962
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Association between a network-based physician linchpin score and cancer patient mortality: a SEER-Medicare analysis.
Authors: Moen E.L. , Schmidt R.O. , Onega T. , Brooks G.A. , O'Malley A.J. .
Source: Journal Of The National Cancer Institute, 2024-02-08 00:00:00.0; 116(2), p. 230-238.
PMID: 37676831
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Comparison of US Oncologist Rurality by Practice Setting and Patients Served.
Authors: Cornelius S.L. , Shaefer A.P. , Wong S.L. , Moen E.L. .
Source: Jama Network Open, 2024-01-02 00:00:00.0; 7(1), p. e2350504.
EPub date: 2024-01-02 00:00:00.0.
PMID: 38180759
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Telehealth Use Following COVID-19 Within Patient-Sharing Physician Networks at a Rural Comprehensive Cancer Center: Cross-sectional Analysis.
Authors: Yu L. , Liu Y.C. , Cornelius S.L. , Scodari B.T. , Brooks G.A. , O'Malley A.J. , Onega T. , Moen E.L. .
Source: Jmir Cancer, 2023-01-17 00:00:00.0; 9, p. e42334.
EPub date: 2023-01-17 00:00:00.0.
PMID: 36595737
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Use of a Novel Network-Based Linchpin Score to Characterize Accessibility to the Oncology Physician Workforce in the United States.
Authors: Moen E.L. , Brooks G.A. , O'Malley A.J. , Schaefer A. , Carlos H.A. , Onega T. .
Source: Jama Network Open, 2022-12-01 00:00:00.0; 5(12), p. e2245995.
EPub date: 2022-12-01 00:00:00.0.
PMID: 36525275
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Rural-Urban Differences in Breast Cancer Surgical Delays in Medicare Beneficiaries.
Authors: Zipkin R.J. , Schaefer A. , Wang C. , Loehrer A.P. , Kapadia N.S. , Brooks G.A. , Onega T. , Wang F. , O'Malley A.J. , Moen E.L. .
Source: Annals Of Surgical Oncology, 2022-05-24 00:00:00.0; , .
EPub date: 2022-05-24 00:00:00.0.
PMID: 35608799
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