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Applying the unattainable triangle in cardio-oncology care: Balancing cost, quality, and time
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Abstract
John Hoverson1, Chirag Buch1, Juan Ulloa-Rodriguez1, Samuel Governor1, Stella Pak1 and Prince Otchere1
1 Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
Correspondence to:
Stella Pak, | email: | [email protected] |
Keywords: cardio-oncology; quality improvement; cardiology; oncology
Received: November 26, 2024 Accepted: May 30, 2025 Published: June 04, 2025
ABSTRACT
The unattainable triangle, also known as the iron triangle or triple constraint, traditionally applied in business as a model for balancing time, cost, and quality, offers valuable insight into the field of cardio-oncology. Cardio-oncology merges cardiovascular care with cancer treatment, addressing the growing risk of cardiovascular complications in cancer patients. Similar to the business model, this specialty faces the challenge of providing timely, high-quality, and cost-effective care. The urgency of cancer treatment often strains cardiovascular assessments, while comprehensive care increases costs due to advanced diagnostics and specialized teams. Establishing a cardio-oncology center of excellence, where oncologists and cardiologists collaborate in real-time, can help balance these demands, enhance care coordination, and manage resource utilization effectively. This article explores how the specialty of cardio-oncology could deliver comprehensive, timely, and affordable patient care by applying the unattainable triangle method.

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