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Fulcrum Best Practices Lay the Foundation for Comprehensive Cancer Center

Background: The Base Realignment and Closure (BRAC) Act necessitated the closure of all services at Walter Reed Army Medical Center and the realignment of those activities to (primarily) the Walter Reed National Military Medical Center (WRNMMC) and Fort Belvoir Community Hospital. The transition presented an opportunity for the Military Health System (MHS) to re-evaluate how to effectively and efficiently support a medically ready force and provide world-class cancer services to military personnel.

The project was led by our Program Manager with extensive cancer center management experience and a broad knowledge of budget, contracting, personnel, and logistical support of clinical activities within the DoD. Our task was to assist the Implementation Team (consisting of civilian and military cancer treatment and research experts) with drafting the guiding principles, Concept of Operations, and Operation Plan for a Comprehensive Cancer Center (CCC) at Walter Reed. In addition, Fulcrum conducted a gap analysis to determine the current capabilities available in the National Capital Region compared to the requirements to become a National Cancer Institute-designated CCC. Fulcrum devised a three-phased approach to full operating capability that put the CCC on the path to become the DoD’s only NCI-approved Comprehensive Cancer Center.

Impact: The Murtha Cancer Center, as it was named in December of 2012, is now operational as a tri-service, multidisciplinary cancer care delivery system and translational cancer research center. Fully integrated within WRNMMC operations, the Center has more than 330 military, civilian, and contract personnel and $44 million in operations, training, and research funding. The Center’s integration of basic and translation research, along with the application of more effective treatments and enhanced clinical services, is expected to lead to a decrease in cancer morbidity and mortality among patients. The Center has attained designation as a DoD Cancer Center of Excellence attention within the Military Health System (MHS).

Because of Fulcrum's Gap Analysis, recommendations are in place for measuring the investment of time, funds, and human resources required to achieve NCI-designated Comprehensive Cancer Center status after a three-phased approach to the proof of concept. Collaborations are in process with the Joint Pathology Center (JPC), the NCI, USU, and other federal and local cancer entities to foster synergies that will provide the highest quality of cancer care for military beneficiaries in the National Capital Region.

Quotes: In short, [Fulcrum’s staff member] support has literally “touched” virtually every facet of the School of Medicine’s curricular reform effort, often volunteering weekend and off-duty times to help meet key deadlines. There is absolutely no question that many of the successes that we’ve been able to celebrate have been directly related to behind-the-scenes efforts. For all these reasons and more,[staff member] epitomizes the very best attributes of a truly exemplary support staff member, and exceedingly cordial demeanor, uncommon dedication, and outstanding work ethic make an exceptionally well deserving of this year’s Faculty Senate Outstanding Staff Award.




Eliminating Trouble Ticket Backlog and Reducing Costs for the Defense Health Clinical Systems (DHCS)

Background: As the destination for all Tier III tickets for the DoD worldwide EHR, Defense Health Clinical Systems (DHCS) recognized the need for an additional Tier of service that could provide analysis, triage, and routine solutions resolution without reaching the more expensive application development vendor. Despite the initial cost savings, costs on this new contract continued to escalate. When DHCS put the contract out for re-compete they needed a vendor who could provide Defense Health Clinical Systems (DHCS) e the patient safety analysis, patient and provider merge and unmerge operations, and theater data reconciliation at significantly lower costs.

Impact: Upon award, Fulcrum worked with DHCS to begin the scheduled six-week transition. Due to budget issues, DHCS halted the incumbent’s work two weeks into the transition. Fulcrum was asked to take over full performance of the contract immediately. At that time, the incumbent held a backlog of 6900 open trouble tickets with an average ticket age of 60 days. Within 3 months of start-up, Fulcrum had eliminated the entire backlog of tickets and reduced the average ticket age from 60 to 12 days. All of these efficiencies were achieved with an overall cost reduction of over 35 percent to the government. Today, Fulcrum provides same day service on the trouble tickets/action items and maintains the shortest time for resolution possible.