FirstHealth of the Carolinas is implementing strategic ways to increase access to innovative cancer care close to home. Dr. Daniel Barnes, president of FirstHealth Physicians Group, shares their journey from conception to construction, involvement of the community in design, unique longitudinal approach to oncology care that starts with prevention, and comprehensive approach to care under one roof.
By Laura Douglass, www.thepilot.com
May 27, 2021
FirstHealth of the Carolinas broke ground Thursday morning on its new $68 million comprehensive cancer center. The all-encompassing facility represents a major step forward for cancer treatment and patient care, from diagnosis to treatment, and most importantly, survivorship.
Construction of the four-story building is expected to continue through late 2022. The new structure and its adjoining parking deck on Page Road are located directly across the street from Moore Regional’s main hospital campus in Pinehurst.
Art Medeiros, chairman of Foundation of FirstHealth Board, said building the multidisciplinary cancer center was both a practical and pragmatic decision. FirstHealth has a long-standing history of providing exceptional cancer services, but has grown and expanded beyond the capacity of its current facilities.
“What we’ve got here today is a groundbreaking not just of a building. It is our community’s commitment to a line in the sand that we will fight cancer,” Medeiros said, in an inspiring message to the large crowd that included FirstHealth officials, local elected representatives, oncology staff and medical providers. “I believe we are building a haven of hope. We are building a haven of healing. We are building a haven of help.”
FirstHealth CEO Mickey Foster noted it was a “very special day,” and thanked his predecessor, former CEO Dave Kilarski, for his initial vision of the cancer center. Foster also expressed thanks to the Foundation for FirstHealth Board for their philanthropic efforts, and the FirstHealth staff for their dedication, especially throughout the challenges of 2020 and the COVID-19 pandemic.
“This will be a healthcare destination for decades to come,” Foster said.
Natalie Hawkins, executive director of Partners in Progress agreed. “I think this new cancer center that FirstHealth is building is just an incredible investment in our community. I think Mickey Foster and his leadership team have done a phenomenal job bringing first-class quality care for cancer patients here to Moore County that will benefit the entire region.”
October 23, 2020
by Laura Douglass
FirstHealth of the Carolinas has approved a key step toward beginning its $68 million cancer center, finalizing interior architectural plans.
The facility, to be built across the street from its campus on Page Road, features a four-story building and adjoining parking deck across the street from Moore Regional’s main hospital campus in Pinehurst.
“The development of the FirstHealth Comprehensive Cancer Center on the Moore Regional campus is a major step forward for patients and families in our community and surrounding areas who are facing a cancer diagnosis,” said Sherwood Blackwood, chairman of FirstHealth’s Board of Directors.
While FirstHealth has a long-standing history of providing exceptional cancer services, the current facilities have been forced to grow and expand to meet the cancer care needs of the community in a less-than-ideal fashion.
“The cancer center will bring together all outpatient cancer treatments and support services into one state-of-the-art facility offering our community the highest quality and patient-centered cancer care right here at home. On behalf of the FirstHealth Board of Directors, we’re thrilled to support this worthwhile project to allow FirstHealth to advance cancer services in our region and continue to fulfill its core purpose to care for people,” he added. “I’d like to thank the many people; staff, volunteers and donors who have helped make this dream a reality. This facility is a game changer for the thousands of people who are affected by cancer.”
FirstHealth of the Carolinas serves 15-counties in central North Carolina. While the region’s population has grown, so too has the cancer rate.
“We feel this is a good time to build a comprehensive cancer center,” said Firsthealth CEO Mickey Foster. “This brings everything together under one roof. It also gives us the space to give multidisciplinary care for our patients.”
Land clearing is already underway for the parking deck and work should be completed in May. Construction of the center itself will begin about that same time frame and should wrap up in late 2022.
Dr. Daniel Barnes, president of FirstHealth Physicians Group presented the final design to hospital trustees on Tuesday.
“This is one of the most significant things FirstHealth has done since the Reid Heart Center and FirstHealth Moore Regional-Hoke campus were built,” Barnes said. “We are starting to see the project evolve and everyone along the way is excited and looking forward to the future and what we can offer.”
To help refine the Cancer Center’s initial design, CPL: Architecture erected to-scale versions of various clinical spaces inside an Aberdeen warehouse. This “cardboard city,” as it was nicknamed, let medical providers, staff and FirstHealth trustees walk-through different parts of the proposed building to better assess the functionality of each space before construction begins.
“It allowed us to come up with innovative ideas,” Barnes said. “We had a significant amount of input through the cardboard city. It helped move along the design process even further. The design really is a compilation of the input of all the various stakeholders in the process.”
The life-sized mock-up should also provide substantial cost-savings over time, he added, as fewer change orders are anticipated. The cardboard rooms were detailed all the way down to where electrical outlets would be installed.
“It is a different approach to design. We’d rather make any small changes now rather than later,” said FirstHealth’s project manager, Cindy Hetzler.
Robin Washco of CPL: Architecture said the to-scale model allowed different departments to better understand how the building would flow from one section to another.
“It is easier to envision the space this way,” she said. “Another goal was also to standardize the spaces, such as exam rooms. That works better from an operational standpoint and a budget standpoint as well.”
Foster said developing plans through the use of a cardboard city model is new for FirstHealth, but considered best practice for a modern, large construction project.
“This has to be one of the most well-thought out plans I’ve seen in my cancer center career,” Foster said.
Laura Kuzma, FirstHealth’s director for oncology support services and patient navigation, also worked closely with the architectural team and surveyed 80 FirstHealth cancer patients to help ensure the final design is also patient-friendly.
The Cancer Center’s healing garden will serve as the building’s focal centerpiece. The infusion chemotherapy area, where many patients spend long periods undergoing treatment, received particular attention. The large open-space includes private, semi-private and communal areas — most within view of an expansive glass window overlooking the healing garden.
“We wanted to create a place that met everyone’s needs, no matter where they are in their (cancer) journey,” Kuzma said.
Foster said the uniqueness of the fourth floor — set aside for patient support services — also differentiates the facility.
“There is an exercise gym for patients, a meditation space, massage spaces, community classrooms where support groups will meet, a patient resource room, palliative care, and this where the nurse navigators will be. They have one of the most important roles in cancer care.”
As a matter of convenience, the four-story adjacent parking garage will provide 500 parking spots with a drop-off area for patients. On the first floor, the new center will have a bistro cafe with healthy drinks, smoothies and other food options for patients and visitors.
Importantly, the new comprehensive cancer center will house FirstHealth’s clinical trials and research program. Initiated first in the early 1990s, the program has expanded with most trials focused primarily on breast cancer, lung cancer, colon cancer and prostate cancer.
Last year, FirstHealth made history twice: enrolling the first patient into a worldwide trial testing the efficacy and safety of immune therapies designed to battle cervical cancer, and as the first health care system in the nation to participate in a clinical study with Intuitive Surgical’s ion endoluminal system, a catheter-based, robotic-assisted technology.
In recent weeks, Moore Regional Hospital made history again as the first site to enroll a patient into a clinical trial for a new regimen to treat COVID-19 patients. Results from the study could be available by the end of the year, according to Dr. Gretchen Arnoczy, an infectious diseases physician with FirstHealth.
Earlier this year, Moore Regional Hospital was named in the top five of the state’s best hospitals, climbing from an 11th place ranking just one year ago. Perhaps more importantly, the flagship facility of FirstHealth of the Carolinas, along with Moore Regional Hospital-Hoke and Richmond campuses, was also recently ranked No. 4 for “patient picks” according to Business North Carolina magazine.
For more information about cancer clinical trials in your area, click HERE
June 4, 2020
World-class advancements in health move fast in a community known for a slower pace. In early 2019, Pinehurst-based FirstHealth of the Carolinas was chosen as the nation’s first site to host clinical trials for a robotic technology that could diagnose lung cancer earlier, more accurately and less invasively than ever before. That turned into FirstHealth becoming North Carolina’s only provider of the procedure. Then FirstHealth was designated as the world’s first site to train other doctors on the technology. All from a community hospital in the Sandhills.
Jane and Andy Sandor have been married for 56 years and finish each other’s sentences.
“We moved here in 2001,” Andy starts “to be near a great hospital,” Jane finishes. That turned out to be a wise move when the unthinkable happened and nonsmoker Jane was diagnosed with lung cancer in March 2020.
A new technology offered by FirstHealth enabled her to get an early diagnosis — resulting in a greater ability to treat and cure it. The Ion endoluminal robotic bronchoscopy platform is a robotic-assisted, catheter-based technology designed to access hard-to-reach areas of the body through natural openings, like the mouth. When applied in the lungs, it aims to enable early lung cancer diagnoses by accessing and sampling tissue from small nodules in difficult-to-reach areas.
Jane Sandor was the 100th patient at FirstHealth to be diagnosed using this groundbreaking technology.
In early 2020, Jane had the flu, followed by a pain in her side. Her primary care physician was suspicious of a kidney stone and ordered a computed-tomography scan (CT scan) of her abdomen. Jane’s scan indeed found a kidney stone — and more.
Abdomen scans often capture the lower portions of the lungs, and Jane’s scan showed a nodule in her lung. A subsequent CT scan of the entire chest revealed the need for a biopsy to see if it was lung cancer. Although she had never smoked, she previously lived in an area with high levels of radon gas, a known carcinogen.
Jane’s primary care physician referred Jane and Andy to Michael Pritchett, D.O., MPH, a pulmonary specialist at Pinehurst Medical Clinic and director of the Chest Center of the Carolinas at FirstHealth.
“My doctor mentioned that Pritchett has a special way to see and test for cancer with robots,” Jane says. “She said he’s also a good listener, and I appreciated that.”
Using the Ion endoluminal system, Pritchett and his team performed a robotic navigation bronchoscopy to reach, see and snip a sample of Jane’s lung nodule to test it.
To be sure, Pritchett performed the procedure — not a robot — but a robot assisted him to see deep inside the lung and reach the nodule to biopsy it.
Specifically, he inserted a catheter with a tiny camera and instruments into Jane’s mouth and steered the scope robotically all the way out to the nodule. He controlled the instruments’ movements through a console right beside Jane and saw all activity through a high-definition monitor.
“The catheter that the instruments and camera go through is only 3.5 millimeters wide and can easily fit into some of the smallest airways in the lung. More than 70 percent of lung cancer is in the farthest reaches of the lung, so this technology allows us to reach nodules we never could before — and without invasive tactics,” he says.
Before robotic navigation bronchoscopy, Pritchett says to test Jane’s lungs he would have either used traditional navigation bronchoscopy, which may not have reached as far in the lungs, or perhaps refer her to get a CT-guided needle biopsy in which “a needle is inserted from the outside, between the ribs and into the lungs. This has a high rate of lung collapse and we didn’t want her to go through that.”
Also, before this technology, Pritchett says there was no minimally invasive and reliable way to find and biopsy small lesions that often represent early-stage lung cancer — a most frustrating ordeal for both patients and physicians.
“Imagine a doctor telling you that through a CT scan he found a 10-millimeter nodule that is likely early cancer, but he has no way to accurately test it right now, so you’ll have to wait another three months until it gets bigger,” says Pritchett. “That’s absolutely excruciating. But now we don’t have to wait.”
Immediately after Jane’s biopsy — as in right in the operating room with Jane — Pritchett diagnosed her nodule as lung cancer in a protocol called “rapid on-site pathologic examination.”
Armed with that information, he conducted a second procedure, an endobronchial ultrasound, to see if the cancer had spread to her lymph nodes.
“Both of these procedures were completed on the same day under the same anesthesia,” says Pritchett.
After the short procedure, Jane reported a mild sore throat and minor cough, but that was the extent of her discomfort.
Also, the same day, Andy and Jane were able to learn Jane’s initial diagnosis—Stage 1 lung cancer that had not spread to the lymph nodes.
“I was able to share our findings with Jane and Andy that same day and get started on her next steps,” says Pritchett.
Becoming a World Leader
A tremendous amount of talent and work comprise the events leading to Jane being named FirstHealth’s 100th patient to receive a robotic navigation bronchoscopy using the Ion robotic system.
The Ion robot is produced by a California-based company called Intuitive. When the Ion’s development was at the stage of testing on patients, Intuitive contacted Pritchett.
“Based on the work that we have previously done in the lung cancer space and at the recommendation of a friend, Dr. Tom Gildea, with the Cleveland Clinic, FirstHealth caught the eye of Intuitive and they asked us to conduct clinical trials here,” Pritchett says.
Applying to be a clinical trial site is no easy task. However, bringing the latest technology to patients in the Sandhills is a top priority for FirstHealth and the team worked together to make it happen quickly. “FirstHealth’s amazing clinical trials team was able to gain approval of the protocol and finalize contracting issues in record time,” says Pritchett, resulting in FirstHealth being the nation’s first clinical trial site for the Ion.
Additional clinical trial sites included Massachusetts General Hospital, Beth Israel Deaconess Medical Center, MD Anderson Cancer Center, the Mayo Clinic and Henry Ford Hospital. Dr. Pritchett completed the first procedure in the U.S. on March 29, 2019.
“The clinical trial was also important because it helped us determine if we wanted to purchase the Ion system for FirstHealth after the trial ended — and we did,” says Pritchett.
To date, FirstHealth is the only health care system in North Carolina offering this technology.
Because FirstHealth got a head start on using the Ion, Pritchett has completed more robotic navigation bronchoscopy procedures using this system than anyone else in the world. As a result, Intuitive selected FirstHealth as the world’s first Ion mentor site.
Since August 2019, Pritchett has trained more than 50 physicians from 15 hospital systems across the nation.
“It is such an honor to work with these talented physicians to expand the use of this technology,” he says. “I’m eager to see the positive outcomes we can achieve together for our patients.”
Next Steps for Jane and Others
Jane’s left upper lobe was removed on April 2 by cardiovascular and thoracic surgeon Peter Ellman, M.D., and she was back at home with Andy by April 5.
“A final pathology report proved her cancer was Stage 1, which suggests she has the best possible chance for a cure,” says Ellman. “The fact that Dr. Pritchett was able to reach and biopsy Jane’s nodule so it could be tested at such an early stage made all the difference.”
Pritchett says he and Ellman had many conversations about whether it was the right time to proceed with Jan’es surgery given the current pandemic.
“In the end, cancer doesn’t care about pandemics,” he says. “We at FirstHealth are dedicated to aggressively and safely treating our cancer patients, even in light of this pandemic. Additional safety precautions were taken for the patient as well as for staff. While elective procedures were placed on hold, we don’t consider treatment for an aggressive form of cancer to be elective; therefore, we decided the benefits outweighed the risks and chose to proceed.”
For the next 100 patients and beyond for whom Pritchett uses this technology, he says his goal is to have a fully integrated platform with Ion that works in harmony with additional advanced technologies owned by FirstHealth, including the daVinci robotic-assisted surgery system, also by Intuitive, and the Philips cone-beam CT system.
“Beyond the ability to scope and biopsy lung cancer with this device, in the near future we also expect to be able to treat lung cancer for patients who are not candidates for surgery,” Pritchett says.
FirstHealth is already at the front lines of such therapies, as one of his patients, Sanford resident Terri Cook, was the first American in a clinical trial in which a flexible probe is inserted through the mouth, routed directly to the cancerous lesion and “zapped” with microwave energy. Now more than a year after the procedure, Cook is doing well, and scans reveal no cancer.
FirstHealth’s early adoption of advanced technologies means that “residents of the Sandhills can stay right at home and receive the most advanced care possible,” says Pritchett. “In particular, with FirstHealth’s position at the forefront of lung cancer diagnosis worldwide, patients can receive more advanced care here than they could at a large, academic medical center.”
The Sandors agree.
“It’s scary for cancer to have it hit home, but I feel that I am in good hands here,” says Jane. “People say I should go to Duke or UNC-Chapel Hill, but I politely decline, saying we feel very confident in the doctors and capabilities here at FirstHealth. Yes, Duke and UNC have good doctors, but so do we.”
When Pinehurst-based FirstHealth of the Carolinas opens its one-stop shop cancer center in 2022, the 15-county medical network will have a centralized diagnosis and care center, a headquarters for its clinical trials and a check mark on the to-do list of priorities set by new CEO Mickey Foster.
Construction on the four-story, $60 million cancer center on Page Road North, near Moore Regional Hospital, will begin in 2021 following completion of a four-story parking garage. The target opening date is November 2022. Foster estimates about $30 million for the 120,000-square-foot center will be raised through a philanthropy campaign launching in January. However, people have already been donating to the project since November.
“The rates for cancer in our 15 counties is expected to grow, so we need to build a comprehensive cancer center,” says Foster, who joined FirstHealth in July after serving as president of Moses H. Cone Memorial Hospital in Greensboro. “I have had the opportunity to oversee several cancer programs in my career, and there is a need to have all the support services under one roof. It creates a one-stop shop for care for all of our cancer patients.”
Foster joined FirstHealth with three main goals: “First, we want to be the best place to work in the county. We are in the top 4% nationally [according to Hospital Consumer Assessment of Healthcare Providers and Systems], so we want to create the best culture. Second, we want to be a health system that is a zero-harm organization. There are still too many harm events in health care. We want to be a system with zero: no falls, no injuries, no infections. Third is to build a destination for cancer care.”
Informal talks about a centralized cancer center began four years ago but weren’t concrete until last summer.
“We have outstanding services, but they’re spread out across our campus,” says Dan Barnes, president of FirstHealth’s physicians group and vice president of oncology services. “This [new center] allows patients to be seen from diagnosis to treatment to survivorship and be patient-centered and patient-focused. It allows us to bring physicians and treatment under one roof and increase support services such as financial counseling and palliative care.”
The project received full support from the Pinehurst Village Council and the Village of Pinehurst, Foster says. Space will be reserved for meditation and support groups, as well as rooms designated for exercise. “We want to create a more healing and natural setting that will differentiate us from other places,” he says. “It’s a game changer for cancer care in this region.”
One floor will house research and clinical trials, such as those headed by pulmonary specialist Michael Pritchett, director of the Chest Center of the Carolinas at FirstHealth and an employee of Pinehurst Medical Clinic. Last April, Pritchett was the first in the world to demonstrate work with a robotic-assisted catheter-based device to collect samples for lung cancer diagnosis. Pritchett performed his first procedure last March and as of mid-November, he had seen about 60 cases.
“We have the pathologist sitting in the room, so they put it on a slide, and we get immediate feedback as to whether it’s malignant or not,” he says. “So when I wake you up, we will tell you what we found. We can biopsy multiple lesions, so it’s really a game changer for us.”
The future cancer center’s central location is imperative in reaching the 15-county area beyond the 16,000 people of Pinehurst, Pritchett says. “We don’t want them to drive past us and have to go to Duke or UNC.”
Pritchett isn’t the only one working on research at the new cancer center. On the same floor in the building, gynecologic oncologist Michael Sundborg will continue administering a Gynecologic Oncology Group Foundation trial to assess a chemo treatment for advanced cervical cancer.
Sundborg has two patients enrolled in the six-month trial designed to prompt the immune system to seek and destroy cancer. The GOG Foundation chose FirstHealth to test the therapies in a hybrid trial, meaning it’s sponsored by the National Cancer Institute and is an industry trial, so the medication is free. “We’re shooting smart missiles. We’re a sniper,” Sundborg says. “This is the evolution of cancer therapy.”
Sundborg says Moore County has seen a 7% increase in cancer diagnoses annually, compared with a national average of about 3%. It’s the leading cause of death, according to the 2018 State of the County Health Report. He attributes it to the region’s relatively older population and patients in nearby rural coastal areas without access to care. “But we’re doing something for them. We’re changing life spans.”
Both Sundborg and Pritchett have begun their research in their current roles, but the new cancer center will make “a substantial footprint” in care, Sundborg says.
Foster did not detail the number of jobs that may be created with the completion of the center but anticipates recruiting additional physicians, nurses, support staff and medical-office assistants for the new center. Health care and social assistance are listed by the N.C. Department of Commerce Labor & Economic Analysis Division as the top employers in the county with 9,457 workers, or 26.2% of the total workforce.
“I have plenty of offers all the time to go other places, and I have no desire to go anywhere,” Pritchett says. “I can do all these things, [including] publish research, right here in my own community.”