COEUR d'ALENE - In the ever-shifting world of community health care, teamwork can be more effective than competition.

That's why former medical foes have reached across the state line between Idaho and Washington, forming a regional cancer alliance between Kootenai Health, Providence Health Care and Cancer Care Northwest.

The alliance is not a merger or acquisition, said Jon Ness, CEO of Kootenai Health.

"It's the future of health care," he said Tuesday.

The alliance, Ness explained, includes the best of the three medical providers for the benefit of cancer patients throughout the region. The alliance will initially have 27 oncologists on board and the increased medical services will be offered within the patient's home community.

Under discussion since last autumn, the alliance is slated to go on line this October. A similar organization was started in Seattle in 1998.

"It (the alliance) is a win-win for everyone," said Dr. Kevin Mulvey, medical director of oncology services for Kootenai Health. "It will improve quality access to care and raise the bar for practicing oncology in the area. Alignment with hospitals is the best way to deliver care and it's the most logical thing to do."

"This is one of the most exciting health care opportunities we've seen," said Elaine Couture, chief executive of Providence Health Care. "The collaboration enables medical providers to advance the care and treatment of patients with cancer through a more consistent, high quality, comprehensive, multidisciplinary care approach." For example, Cancer Care Northwest and Sacred Heart are already working together to expand a program for treating patients with blood cancers including leukemia and myelomas.

"Our goal is to build regional centers of excellence in oncology that will continually provide our patients with the latest advances in cancer therapies, cutting-edge research and the most sophisticated technology," said Warren Benincosa, chief executive officer of Cancer Care Northwest. "By combining the expertise of each organization, our aim is to further expand the coordinated treatment of cancer patients, allowing them to remain close to home for their care."

Here's how it will work:

Let's say that a Kootenai County woman has been diagnosed with ovarian cancer. At present, there are no gynecological oncologists on staff at Kootenai Health - it would take a population base of a half-million people to attract such a specialty to the area, research shows. Once the alliance is in effect, however, the Kootenai patient can receive her needed treatment from one of several gynecological oncologists based at any of the three participating institutions.

But will she have to drive to Providence or Cancer Care Northwest in Spokane to confer with her specialist?

No. Under the alliance, she can stay in the community in which she is currently being served - the specialist will come to her, instead. Ultimately, the patient will be treated in the location that best serves her treatment needs.

Ness said the objective is that better coordination of services will offer patients better cancer care for less money. Other anticipated benefits of capitalizing on the strong points of the three institutions are: improved physician recruitment -physicians have historically been reluctant to move into smaller communities; enhanced patient education and prevention programs; and increased access to clinical trials.

An advisory board including two representatives from each of the organizations is in the process of being formed. The structure means voting power will be equally distributed.

The new alliance has no plans to lay off any employees. Instead, Ness said, the number of employees may increase over time.

"It is clear in today's changing health care environment that patients, medical providers, the government, insurance and health plans expect more from their health care system," he said. "They are demanding better outcomes and a more coordinated patient experience at a more affordable price... The important thing for us is finding ways to remain community-owned and independent, while still providing collaborative care."

Alliance means more clinical trials could be available

Patients with diseases that aren't remedied by current medical protocols sometimes explore the world of clinical trials, a place where new drugs and experimental treatment procedures are tested.

If accepted by an interventional study, patients may be given a particular medicine, whose outcomes are then compared with those of patients who have taken older drugs or no drugs at all.

There is a risk, of course, in taking new drugs that are still undergoing testing, but trials also offer hope to patients who feel they may have reached the end of the road. Access to drug trials is a highly desirable situation for any health community, and the larger the potential patient base, the more likely there will be a trial award.

Far greater access to clinical trials and resources is one of the goals of the cancer care alliance announced Tuesday between Kootenai Health, Providence Health Care and Cancer Care Northwest.