Nadine McCleary, MD MPH
Nadine Jackson McCleary, MD, MPH, has dedicated her career to improving healthcare quality and access for all patients. She became personally dedicated to health equity when her father was diagnosed with cancer as she was finishing her medical residency. Through her dad's cancer journey she experienced how gaps in healthcare can lead to huge financial and social burdens for patients. Dr. McCleary's nursing background taught her the importance of caring for the whole patient - not just their medical needs but how their diagnosis fits into their life outside the clinic. One of her first experiences in medicine was managing her dad's cancer care, as a student, from across the country.
Dr. McCleary earned her Bachelor of Science Nursing from University of Pennsylvania in 1998, Master of Public Health at Johns Hopkins University Bloomberg School of Public Health in 2002, and Doctor of Medicine at Johns Hopkins School of Medicine in 2003. After completing her fellowship in Hematology and Oncology at Dana-Farber/Harvard Cancer Care, she joined the Center for Gastrointestinal Oncology faculty at Dana-Farber Cancer Institute in 2009 where she is currently Senior Physician and Assistant Professor of Medicine at Harvard Medical School. Her work is funded by The Donaghue Foundation, National Cancer Institute UM1, Massachusetts Society of Clinical Oncology, Friends of Dana-Farber Cancer Institute, and a Dana-Farber Medical Oncology Grant.
Many factors contribute to health, but the social determinants of health are some of the most important, including housing security, health literacy, food security, finances, employment, and caregiving. The social determinants of health impact all phases of cancer care, from prevention and diagnosis to treatment and survivorship.
Amy Ennis was only 38 years old and a new mother when she was first diagnosed with cancer. Despite being smart and capable, she struggled to find supportive resources at the Dana-Farber Cancer Institute to help with her social determinants of health. There's a misconception that academic medical centers, especially prestigious ones like Dana-Farber, provide patients with help for every aspect of their cancer care. But while we do have resources to cover all of the social determinants of health, we ask patients to seek out the available resources themselves.
This project will develop a tool integrated into the electronic health record for patients with advanced cancer at the Dana-Farber Cancer Institute, in partnership with the resource specialist team at the Blum Family Resource Center. We will systematically screen patients for social determinants of health needs, then match patients with a resource specialist to meet their needs. This will actively bring hospital and community resources directly to patients without care team review, rather than asking patients to find resources themselves.
Amy was one of those patients that struggled to find the resources she needed when she was first diagnosed with cancer, and the burden is even greater on patients from vulnerable populations. Amy's cancer is under control, with no metastases and no new signs of growth. With courage, she is now using her cancer diagnosis to help others like her. Amy's fundraising efforts have been a huge contribution to developing RESOURCE, but to bring this program to life we need your help.
Why is this important?
Social determinants of health needs may interrupt cancer treatment, especially for vulnerable patients. Patients might have financial burdens from the cost of care or interruptions to work that make it difficult to pay rent or buy food, they might have unreliable transportation, or trouble finding a caregiver for their family. These needs can stop them from going to doctors appointments and getting their medications on time, which will impact how well they can fight their cancer. RESOURCE can help patients because it provides customized matching between patients and available resources as an integral part of cancer care.
Who will benefit?
Patients benefit by having a direct, structured way of reporting their resource needs and being automatically connected with available resources based on their specific needs. Resource specialists benefit from having a structured patient referral with a broad assessment of the patient’s needs, helping to inform the connections that they make between patients and resources. Oncology providers benefit by having social determinants of health needs identified in the medical record (giving them a more holistic view of the patient), as well as from automatic resource connections (removing the need for providers to personally assess and refer patients to resources).