Nancy Keating

Last updated
Nancy Lynn Keating
Born
Alma mater Virginia Tech
University of Chicago Pritzker School of Medicine
Harvard T.H. Chan School of Public Health
Brigham and Women's Hospital
Scientific career
InstitutionsBrigham and Women's Hospital
Harvard Medical School

Nancy Keating is an American physician who works at the Brigham and Women's Hospital and is a professor at Harvard Medical School. Her research considers the factors that influence quality care for people suffering from cancer.

Contents

Early life and education

Keating grew up in Maryland. She attended Fallston High School. [1] Keating was an undergraduate student at Virginia Tech, where she majored in biochemistry. [2] She was a medical student at the University of Chicago Pritzker School of Medicine [3] and completed her internships and residency at the Brigham and Women's Hospital. [4] She was a medical clinical fellow at the Harvard Medical School. [3] Alongside her fellowship in health care policy, Keating was a student in the Harvard T.H. Chan School of Public Health where she earned a Master's in public health and specialized in clinical effectiveness. [3]

Research and career

Keating was appointed to the faculty at the Harvard Medical School in 1998.[ citation needed ] She was awarded the Society of General Internal Medicine Outstanding Junior Investigator Award in 2005, [5] and promoted to Professor in 2014. Her research considers healthcare equity and improving access to quality cancer care. [3] [6] [7]

Keating is a member of the National Cancer Institute Cancer Care Outcomes Research and Surveillance (canCORS) consortium. CanCORS examines the treatment pathways and outcomes of patients with colorectal cancer. She analyzed the quality of cancer care for people in the Veterans Health Administration. [8] She considered how geography, ethnicity and age impacted veteran health outcomes. She showed that cancer-related imaging was lower in the Veterans Health Administration than in the fee-for-service Medicare. [9] She also showed that Black veterans were considerably less likely to receive surgery for early stage lung cancer or appropriate radiotherapy than their white counterparts. [10] [11]

Keating is interested in end-of-life care for people who experience advanced cancer. [12] She showed that variations in the intensity of end-of-life treatment have less to do with patients' wishes than they do with treatment availability and a physician's discomfort in speaking about end-of-life choices. [12] Keating is committed to oncologists providing appropriate and correct information to people with cancer. She has shown that very few people with fatal cancers have an accurate understanding of their illness, with almost half not every talking to their parents about their life expectancy. [13] She has examined variations in the cost and quality of cancer care across Massachusetts. [6]

Keating is evaluating the Oncology Care Model of the Centers for Medicare & Medicaid Services. [14] [15] The Oncology Care Model provides a new approach to delivering oncology services, using new financial incentives and appropriate levels of care across the United States. [16]

Awards and honors

Selected publications

Personal life

Keating was married in 2003. [2]

Related Research Articles

Internal medicine, also known as general internal medicine in Commonwealth nations, is a medical specialty for medical doctors focused on the prevention, diagnosis, and treatment of internal diseases in adults. Medical practitioners of internal medicine are referred to as internists, or physicians in Commonwealth nations. Internists possess specialized skills in managing patients with undifferentiated or multi-system disease processes. They provide care to both hospitalized (inpatient) and ambulatory (outpatient) patients and often contribute significantly to teaching and research. Internists are qualified physicians who have undergone postgraduate training in internal medicine, and should not be confused with "interns", a term commonly used for a medical doctor who has obtained a medical degree but does not yet have a license to practice medicine unsupervised.

Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.

Prescription drug list prices in the United States continually are among the highest in the world. The high cost of prescription drugs became a major topic of discussion in the 21st century, leading up to the American health care reform debate of 2009, and received renewed attention in 2015. One major reason for high prescription drug prices in the United States relative to other countries is the inability of government-granted monopolies in the American health care sector to use their bargaining power to negotiate lower prices, and the American payer ends up subsidizing the world's R&D spending on drugs.

A medical error is a preventable adverse effect of care ("iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, infection, or other ailments.

<span class="mw-page-title-main">Medical guideline</span> Document with the aim of guiding decisions and criteria in healthcare

A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. Such documents have been in use for thousands of years during the entire history of medicine. However, in contrast to previous approaches, which were often based on tradition or authority, modern medical guidelines are based on an examination of current evidence within the paradigm of evidence-based medicine. They usually include summarized consensus statements on best practice in healthcare. A healthcare provider is obliged to know the medical guidelines of their profession, and has to decide whether to follow the recommendations of a guideline for an individual treatment.

Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately.

Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.

The American Society of Clinical Oncology (ASCO) is a professional organization representing physicians of all oncology sub-specialties who care for people with cancer. Founded in 1964 by Fred Ansfield, Harry Bisel, Herman Freckman, Arnoldus Goudsmit, Robert Talley, William Wilson, and Jane C. Wright, it has nearly 45,000 members worldwide.

<span class="mw-page-title-main">Oncology</span> Branch of medicine dealing with, or specializing in, cancer

Oncology is a branch of medicine that deals with the study, treatment, diagnosis, and prevention of cancer. A medical professional who practices oncology is an oncologist. The name's etymological origin is the Greek word ὄγκος (ónkos), meaning "tumor", "volume" or "mass". Oncology is concerned with:

James L. Gulley is an American cancer researcher and the Director of the Medical Oncology Service at National Cancer Institute.

William K. Oh, is an American medical oncologist, academic and industry leader and expert in the management of genitourinary malignancies, including prostate, renal, bladder and testicular cancers.

Unnecessary health care is health care provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending in 2012.

<span class="mw-page-title-main">Peter Bach</span> Medical researcher

Peter B. Bach is a physician and writer in New York City. He is the Chief Medical Officer of DELFI Diagnostics and was previously an attending and researcher at Memorial Sloan-Kettering Cancer Center where he was the Director of the Center for Health Policy and Outcomes. His research focuses on healthcare policy, particularly as it relates to Medicare, racial disparities in cancer care quality, and lung cancer. Along with his scientific writings he is a frequent contributor to The New York Times and other newspapers.

Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.

<span class="mw-page-title-main">OpenNotes</span> American healthcare research initiative

OpenNotes is a research initiative and international movement located at Beth Israel Deaconess Medical Center.

Financial toxicity describes the negative impact medical expenses can have on patients in terms of their health-related quality of life. It leads to negative mental and physical effects as well as, in some cases, bankruptcy, loss of job or income, or even homelessness.

Elliott S. Fisher is a health policy researcher and advocate for improving health system performance in the United States. He helped develop the concept of accountable care organizations and championed their adoption by Medicare. The development of the Affordable Care Act was influenced by his research on disparities in healthcare spending and utilization across the United States. He has strongly supported a rapid transition from fee-for-service to pay-for-performance models in the U.S. healthcare industry. He is a tenured faculty member at Dartmouth College, where he teaches in the Masters in Public Health program.

The Oncology Care Model (OCM) is an episode-based payment system developed by the Center for Medicare and Medicaid Innovation. The multipayer model is designed for discrete instances of care, especially those involving chemotherapy, which triggers the six-month episode. The program combines fee-for-service (FFS) payments for established services, monthly payments for additional care under a structured guideline, and performance-based payments weighed against quality metrics and benchmarks.

Brain Tumor Social Media (#BTSM) is a patient and care partner-run, grassroots Twitter community. The Twitter account @BTSMchat hosts bi-monthly tweet chats for the #BTSM community and consistently trends among the top 15 of disease-related tweet chats. A study published in 2020 revealed the hashtag was most commonly used by brain tumor patients (33.13%), along with patient advocacy organizations (7.01%), care partners (4.63%), and clinicians (3.63%) and researchers (3.37%) specializing in brain tumors and brain cancers.

Kimmie Ng is a physician at Dana–Farber Cancer Institute who is known for her work on colorectal cancer in young patients.

References

  1. "FHS Class of 85". www.geocities.ws. Retrieved 2022-01-06.
  2. 1 2 "WEDDINGS/CELEBRATIONS; Nancy Keating, Brian Kinney". The New York Times. 2003-07-27. ISSN   0362-4331 . Retrieved 2022-01-06.
  3. 1 2 3 4 5 6 7 "Nancy L. Keating". hcp.hms.harvard.edu. Retrieved 2022-01-06.
  4. "Nancy Lynn Keating, MD - Brigham and Women's Hospital". physiciandirectory.brighamandwomens.org. Retrieved 2022-01-06.
  5. "Alumni". Harvard Medical Scho. Retrieved 2022-01-06.
  6. 1 2 "Quality Questions". www.cancertodaymag.org. Retrieved 2022-01-06.
  7. "Nancy L. Keating, MD, MPH - DF/HCC". www.dfhcc.harvard.edu. Retrieved 2022-01-06.
  8. 1 2 "The American Society for Clinical Investigation" . Retrieved 2022-01-06.
  9. McWilliams, J. Michael; Dalton, Jesse B.; Landrum, Mary Beth; Frakt, Austin B.; Pizer, Steven D.; Keating, Nancy L. (2014-12-02). "Geographic variation in cancer-related imaging: Veterans Affairs health care system versus Medicare". Annals of Internal Medicine. 161 (11): 794–802. doi:10.7326/M14-0650. ISSN   1539-3704. PMC   4251705 . PMID   25437407.
  10. Samuel, Cleo A.; Landrum, Mary Beth; McNeil, Barbara J.; Bozeman, Samuel R.; Williams, Christina D.; Keating, Nancy L. (Sep 2014). "Racial disparities in cancer care in the Veterans Affairs health care system and the role of site of care". American Journal of Public Health. 104 (Suppl 4): S562–571. doi:10.2105/AJPH.2014.302079. ISSN   1541-0048. PMC   4151900 . PMID   25100422.
  11. Stirling, Rob G. (2014-12-01). "Clinical Quality Registries: Engaging Effectiveness Data for Quality Improvement". American Journal of Public Health. 104 (12): e10. doi:10.2105/AJPH.2014.302319. ISSN   0090-0036. PMC   4232116 . PMID   25320882.
  12. 1 2 "Physicians' beliefs may override cancer patients' wishes for end-of-life care, study finds". STAT. 2018-07-09. Retrieved 2022-01-06.
  13. Szabo, Liz (2017-06-12). "'How Long Have I Got, Doc?' Why Many Cancer Patients Don't Have Answers". Kaiser Health News. Retrieved 2022-01-06.
  14. Zheng, Qing; Christian, Thomas; McClellan, Sean; Glass, Roberta; Keating, Nancy; Brooks, Gabriel; Hassol, Andrea (2021). "Impact of the Oncology Care Model on End-of-Life Care". Health Services Research. 56 (S2): 18. doi:10.1111/1475-6773.13742. ISSN   1475-6773. PMC   8441259 .
  15. Brooks, Gabriel A.; Jhatakia, Shalini; Tripp, Amanda; Landrum, Mary Beth; Christian, Thomas J.; Newes-Adeyi, Gabriella; Cafardi, Susannah; Hassol, Andrea; Simon, Carol; Keating, Nancy L. (2019-10-01). "Early Findings From the Oncology Care Model Evaluation". Journal of Oncology Practice. 15 (10): e888–e896. doi: 10.1200/JOP.19.00265 . ISSN   1554-7477. PMID   31393807. S2CID   199508135.
  16. Keating, Nancy L.; Jhatakia, Shalini; Brooks, Gabriel A.; Tripp, Amanda S.; Cintina, Inna; Landrum, Mary Beth; Zheng, Qing; Christian, Thomas J.; Glass, Roberta; Hsu, Van Doren; Kummet, Colleen M. (2021-11-09). "Association of Participation in the Oncology Care Model With Medicare Payments, Utilization, Care Delivery, and Quality Outcomes". JAMA. 326 (18): 1829–1839. doi:10.1001/jama.2021.17642. ISSN   1538-3598. PMC   8579232 . PMID   34751709.
  17. 1 2 "Excellence in Mentoring Awards Past Recipients". The Office for Diversity Inclusion and Community Partnership at Harvard Medical School. Retrieved 2022-01-06.
  18. "Paying It Forward". hms.harvard.edu. Retrieved 2022-01-06.
  19. "Nancy Keating Elected to Association of American Physicians". hcp.hms.harvard.edu. 14 March 2017. Retrieved 2022-01-06.
  20. "Health Affairs In 2018: Editor's Picks | Health Affairs Forefront". www.healthaffairs.org. 2019. doi:10.1377/forefront.20190110.783396 . Retrieved 2022-01-06.