Clinical Component

Navigating the Clinical Component

The practice is outpatient medical oncology with a light, shared inpatient consultative component. Clinic sits inside the new Lake Nona cancer center, a dedicated medical office building next to the hospital where medical oncology, breast surgery, urology, general surgery, infusion, and radiation oncology are all under one roof. The physician's day is built around clinic; infusion patients are managed in the chairs by Cancer Institute advanced practice providers, and hospitalists admit and manage inpatients with oncology consulting.

Patient Population and Case Mix

• Adult solid tumor oncology with a genitourinary emphasis. Prostate cancer is expected to represent roughly 80 percent of early GU referrals, with bladder, kidney, and testicular cancers making up the balance
• General hematology/oncology during ramp-up, narrowing toward 80 to 90 percent GU as Dr. Patel's surgical volume and community referrals build
• Benign hematology remains a small share of any Institute practice and is the first work handed to the practice APP once one is added
• No pediatrics
• Patients drawn from the Lake Nona and southeast Orlando market, an area with no other AdventHealth medical oncology or infusion site and the region's fastest residential growth

Clinic Environment

No surgery is performed in the cancer center building. Robotic and open cases run in the adjacent hospital.

Infusion Center

• 16 chairs at opening, with shell space built out to reach 41 chairs as volume grows
• Cancer Institute APPs manage patients during infusion. The physician is contacted only about their own patients when a clinical question arises, and receives an annual oversight stipend for that availability
• Infusion pharmacists perform a clinical review of every order two to three days ahead of treatment, with a second verification on the day of treatment
• Inpatient chemotherapy is reserved for cases where urgency requires it and is reviewed by a campus committee; outpatient infusion is the default
• Transfusions are coordinated through the Orlando blood bank: type and cross drawn on day one, blood delivered and administered the following morning

Radiation Oncology and Surgical Partners

• Radiation oncology on site at Lake Nona on a separate floor of the cancer center, following the Institute's standard build with surface-guided radiation therapy, treatment mapping, and open-face mask systems used at the Celebration and Winter Garden centers
• Vipul Patel, MD, robotic prostatectomy, splitting his practice between Celebration and Lake Nona. The Lake Nona surgical suite is being built around the newest da Vinci platform and configured for the tele-surgery cases he has performed internationally
• Urology clinic located in the same building as medical oncology
• Breast surgery moving to Lake Nona from the Narcoossee medical office building

Inpatient Coverage and Call

Oncology is a consultative service across all AdventHealth Orlando campuses. Hospitalists admit; oncology sees new consults and existing patients when treatment decisions are needed. The Institute's target is a consult seen within 24 hours.

Advanced Practice Providers

Two APPs are planned for the Lake Nona practice, added as each physician reaches roughly the 65th to 70th percentile in wRVU production. The physician participates in interviewing and hiring the APP who will report to them. APPs in the Institute manage independent panels of 17 to 19 patients a day: benign hematology, toxicity checks, chemotherapy education, and follow-up visits. All Institute APPs come through an oncology APP fellowship or arrive with experience, and complete specialty training modules through Thrive AP. Every APP has a dedicated MA.

Tumor Boards and Clinical Pathways

• Disease-site tumor boards across the Institute, including a molecular tumor board
• Pharmaceutical medical science liaisons routinely attend, which supports early trial and drug access
• Elsevier ClinicalPath pathways in use for eight years and being integrated directly into Epic. At diagnosis entry, the system surfaces open clinical trials the patient may qualify for and shows evidence-based regimen options with efficacy and cost

Clinical Trials and Research

Lake Nona opens as a clinical practice. Dedicated research time is not part of this position at the outset, and the Institute is explicit that it wants a physician who builds the practice first.

Research access is still immediate through the network:

• Guru Sonpavde, MD, Medical Director of GU Oncology and of the Phase I Clinical Research Unit and Christopher K. Glanz Chair for Bladder Cancer Research, based at Celebration, formerly Bladder Cancer Director at Dana-Farber. He is the designated clinical mentor for this position
• Carlos Alemany, MD, breast and GU medical oncologist at the Orlando main campus, who leads the clinical GU program
• Patients eligible for a trial not open at Lake Nona are referred to the campus running it, and the physician's quality incentive rewards trial referrals
• Research coordinator support at Lake Nona is expected to follow shortly after opening
• A phase one unit at Lake Nona, operating as an extension of the Celebration unit, is planned within the Institute's next three to five year strategic cycle. Lake Nona is intended to become a research hub for the south market and the likely anchor for a future destination and international cancer program, given its proximity to Orlando International Airport
• The Institute has hosted its own ASCO-sponsored annual review meeting for 15 years, drawing more than 350 attendees

Teaching

• AdventHealth launches a hematology/oncology fellowship at the Orlando campus in 2027
• The Institute runs an oncology APP fellowship that rotates through its campuses

Supportive Care and Navigation

• Nurse navigation and patient education provided through the Cancer Institute
• Social work embedded in the practice
• Eden Spa services (wigs, prosthetics, lymphedema care) on the Lake Nona campus
• On-site oncology pharmacy expected in the cancer center
• Lyra mental health services and financial counseling available through AdventHealth

Referral Pattern

Bone marrow transplant, malignant hematology requiring transplant evaluation, and any lab or transfusion work the satellite sites do not run are referred to the Orlando main campus. Everything else in GU and general solid tumor oncology is managed at Lake Nona.