SALT LAKE CITY — Tom Kurrus is not afraid to die.
"I have no qualms about the fact that I have a fatal diagnosis," he says. "But I'm not into suffering."
While his approaching death from cancer doesn't fill him with dread, "I just don't want to be there when it happens," he quipped.
Kurrus, a retired internal medicine and infectious disease physician who worked in the field for 43 years, learned in September he had a brain tumor called a glioblastoma. His doctors from the Huntsman Cancer Institute believe he could live anywhere from three months to about a year.
"Everybody expects I know what's going down with this," Kurrus said in an interview Friday. "(But it's) new to me. It's the first time I've had cancer."
For patients like Kurrus, carefully protecting both quality and longevity of life is top of mind. For him, that means enjoying the comforts of his home in the Avenues section of Salt Lake City, while also seeing to it that his symptoms are aggressively managed.
"I would much rather be here than looking out the window of an extended-care facility, and it's a whole lot cheaper to be here than an extended-care facility," Kurrus said. "There's no question home is where you want to be. Home is where you are more in charge."
It is with that flexibility and affordability in mind that the Huntsman Cancer Institute has debuted a new program designed to help cancer patients leave the hospital sooner and receive more comprehensive care inside their own home. The program aims to essentially bring the full arsenal of its resources to meet the patient where they are, rather than having them make the trip.
"We're trying to keep the patient where they are, if that's appropriate," said Karen Titchener, director of the new initiative, called Huntsman at Home. "It's all about the right care in the right place."
Huntsman at Home launched in August and has already served 145 patients.
"We were very busy very quickly," said Titchener, who is also an assistant professor of nursing at the University of Utah.
Titchener said Huntsman at Home is unique because it melds the comprehensive treatment options and 24/7 availability of hospital care with the convenience and personability of traditional home health and hospice care.
"The basis behind the whole program is that there was … a gap in care between …when patients were sitting in an acute ward and transitioning in to home health," Titchener said. "There was this definite gap in care at (an intermediate) level."
Many patients may be able to manage their illness outside of a hospital, but the "complexity of the needs" they have are "too great to transfer to normal home health," explained Titchener.
As Kurrus sees it, the program allows him and other patients to "go back and forth between radiation, part therapy, no therapy and hospice," depending on the progression of his cancer and his unique needs at any given time.
Titchener said the design of Huntsman at Home challenges the intuitions of the fee-for-service revenue model.
"We are providing care that isn't necessarily reimbursable all the time," she said. "That's really forward thinking and innovative in the fee-for-service world."
Huntsman at Home is currently limited in scope, Titchener said, as she works to demonstrate its effectiveness for patients as the basis for eventually expanding the program. Currently, only patients within 20 miles of Huntsman Cancer Institute are eligible.
"By year three, we hope to be statewide," she said.
Kurrus hopes more patients will think to take advantage of Huntsman at Home and that it will stay in operation long term.
"If anybody else is concerned about this being some sort of experimental program — this is patient-based. And it's a comfort situation," he said. "And I would not like to have (this) be a program that starts and fails because lack of cooperation from a patient standpoint."
Titchener said Huntsman at Home offers the flexibility, or what she terms "transitions of care," needed for patients to keep seeing the same medical providers after officially moving to hospice. As a result, she said, they are able to avoid changes to their relationship with providers that many hospice patients deal with and which can be jarring to someone navigating the final period of their life.
"You just have that unified care and you're working with the patient at the center of that. That's really kind of the whole ethos of this program, that it's patient-centered and family-centered."
Kurrus said he has been grateful for the "extraordinary responsiveness" of the staff who visit his home and the "seemless transition" in terms of how they have adjusted his care over time. It is that kind of care that has helped him regain his bearings as he adjusts to a new reality, he said.
"It became quite obvious to me I was in new territory, I had no idea what the heck I was doing," Kurrus said. "I was most pleased with the fact that people were very honest and straightforward with what we're doing."1 comment on this story
Titchener noted that those with terminal diagnoses are not the only type of cancer patient Huntsman at Home will benefit; many others with less-advanced cases may fully recover while using the services.
Huntsman Cancer Institute spokeswoman Debby Rogers noted Titchener is a highly sought after expert in providing comprehensive care for patients in their own homes, having previously debuted such a program in Great Britain.
Rogers also said the "research underlying" Huntsman at Home was made a reality with the support of the Huntsman Cancer Foundation and the National Cancer Institute.