Use of telemedicine in the delivery of survivorship care plans among breast cancer survivors: Lessons learned at Kaiser Permanente East Bay.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 77-77 ◽  
Author(s):  
Pamela Kim Washington ◽  
Heather Tews ◽  
Dan-Thanh Nguyen ◽  
Leeina Wade ◽  
Trang Phan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Lessons Learned ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Kaiser Permanente ◽  
Care Plans ◽  
Follow Up Care

77 Background: Beginning in 2015, the National Accreditation Program for Breast Centers (NAPBC) requires accredited facilities to provide Survivorship Care Plans (SCP) to breast cancer patients treated with curative intent. Here we describe lessons learned with the use of telemedicine in the delivery of SCPs at Kaiser Permanente East Bay. Methods: SCP implementation followed a two-step process: patients who are diagnosed and complete treatment in 2016 are given a SCP at their last surgical or medical oncology appointment (YTD, n=8); 2) patients diagnosed in 2015 who completed treatment in 2015-2016 were contacted by a physician assistant and offered an appointment by telephone or in-person to deliver the care plan (n=152). Both clinic and telemedicine appointments consist of a detailed review of treatment received, post-treatment follow-up care, discussion of health education resources, and provision of referrals as appropriate. Patients also have the opportunity to ask questions about treatment and follow-up care. Results: Among patients diagnosed in 2015 who were offered a TAV or in-person visit, 44.0% preferred a telephone appointment. Actual appointment duration ranged from 10 to 30 minutes. Lack of co-payment and fees associated with transportation as well as loss of income due to taking time off work were the primary factors cited choosing telemedicine over in-person clinic appointments. Interestingly, no differences in member satisfaction scores for in-person vs. telephone visits were observed. Conclusions: Findings suggest telemedicine may be effective in the delivery of SCPs. Similar to rural settings, use of telemedicine in urban settings has a unique capacity to increase service to breast cancer patients.

scholarly journals The Potential of Survivorship Care Plans in Primary Care Follow-up of Minority Breast Cancer Patients

2009 ◽  
Vol 24 (S2) ◽  
pp. 467-471 ◽  
Author(s):  
Mary Ann Burg ◽  
Ellen D. S. Lopez ◽  
Amy Dailey ◽  
Mary Elspeth Keller ◽  
Brendan Prendergast
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Patients ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Care Plans

Systematic development of a a breast cancer survivorship program at a small independent oncology practice.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 52-52 ◽  
Author(s):  
Cynthia Rogers ◽  
Shailesh R. Satpute
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Data Entry ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care Plans ◽  
Full Time ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Care Plans

52 Background: It is widely accepted that providing survivorship care plans leads to improvements in outcomes for cancer survivors. Treatment summaries are now part of ASCO and NCCN survivorship guidelines. We faced a unique challenge of implementing the survivorship care plan at the Jones Clinic as a small independent practice. The Jones Clinic consists of three full time physicians and two full time nurse practitioners. We see approximately 850 new patients per year. Methods: As a part of ASCO’s quality training program, we focused on the stage I – III (early stage) breast cancer patients who completed their initial therapy. We formed a team, identified the barriers, created a flow diagram of the process, assigned roles for each individual member and finally implemented the process. Results: The major issues identified were lack of provision in the electronic medical record (EMR) system for survivorship and lack of standardized data entry process. We created a system in the EMR for survivorship data entry and extraction of such data in a document. Since July 2015, one hundred percent of breast cancer patients completing adjuvant therapy at the Jones Clinic have received a survivorship treatment summary and a plan of care. The care plan is also shared with their primary care provider. Importantly, creating a survivorship document required less than 10 minutes of the provider’s time. Conclusions: We are now able to provide our patients with a survivorship care plan and address survivorship issues within thirty days of completion of therapy. Creating the care plan requires minimal time from the providers. Our new process meets ASCO guidelines for survivorship care plans and no additional staffing was needed. We now plan to provide a survivorship care plan to all oncology patients treated with curative intent.

Variations in recommended surveillance in colorectal cancer survivorship care plans.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 13-13
Author(s):  
Alaina Chodoff ◽  
Katherine Clegg Smith ◽  
Aishwarya Shukla ◽  
Amanda L. Blackford ◽  
Nita Ahuja ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Risk ◽  
Controlled Trial ◽  
Center Frequency ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Follow Up Care

13 Background: Survivorship care plans (SCPs) outline pertinent information about a cancer survivor’s treatment and follow-up care. We describe the content of colorectal cancer (CRC) SCPs, completed as part of a randomized controlled trial of SCPs, and evaluate whether follow-up recommendations are guideline concordant. Methods: We analyzed 74 CRC SCPs from an academic and community cancer center. Frequency distributions and descriptive statistics were calculated for the entire cohort and separately by recruiting site. Follow-up recommendations were compared to American Cancer Society (ACS), American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines (Table). Results: Content routinely provided in SCPs (>80%) included patient demographics, cancer diagnosis, treatment details (surgery, chemotherapy, radiation therapy) as well as treatment-related side effects. SCP content specified less frequently included cancer stage, cancer risk (predisposing conditions), and recommendations for genetic counseling/testing and health promotion. Nearly all SCPs from the community site provided uniform, guideline-concordant follow-up. At the academic site, on average, more than 15 follow-up recommendations were listed for each surveillance modality, except colonoscopy. Among the SCPs that specified the frequency of follow-up care, the rate of guideline-concordant recommendations was 15/42 (36%) for follow-up visits, 29/43 (67%) for imaging, 12/45 (27%) for laboratory and 39/39 (100%) for colonoscopy. Conclusions: SCPs consistently provided information about CRC diagnosis and treatment, but often omitted information about cancer risk, staging and prognosis. There was considerable variation between cancer centers in the follow-up recommendations suggested for CRC survivors. Future work to improve the consistency of SCP follow-up recommendations with guidelines may be needed. Clinical trial information: NCT03035773 . [Table: see text]

scholarly journals Survivorship care plans for breast cancer patients: understanding the quality of the available evidence

2017 ◽  
Vol 24 (6) ◽  
pp. 446 ◽  
Author(s):  
V. D'Souza ◽  
H. Daudt ◽  
A. Kazanjian
Keyword(s):  
Breast Cancer ◽  
Stress Reduction ◽  
Knowledge Synthesis ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Emotional Challenges ◽  
Care Plans ◽  
Methodologic Quality

Aim The overall goal of the present study was to contribute to consistency in the provincial approach to survivorship care planning through knowledge synthesis and exchange. Our review focused on the research concerning the physical and emotional challenges of breast cancer (bca) patients and survivors and the effects of the interventions that have been used for lessening those challenges.Methods The psychosocial topics identified in bca survivorship care plans created by two different initiatives in our province provided the platform for our search criteria: quality of life (qol), sexual function, fatigue, and lifestyle behaviours. We conducted an umbrella review to retrieve the best possible evidence, and only reviews investigating the intended outcomes in bca survivors and having moderate-to-high methodologic quality scores were included.Results Of 486 reports retrieved, 51 reviews met the inclusion criteria and form part of the synthesis. Our results indicate that bca patients and survivors experience numerous physical and emotional challenges and that interventions such as physical activity, psychoeducation, yoga, and mindfulness-based stress reduction are beneficial in alleviating those challenges.Conclusions Our study findings support the existing survivorship care plans in our province with respect to the physical and emotional challenges that bca survivors often face. However, the literature concerning cancer risks specific to bca survivors is scant. Although systematic reviews are considered to be the “gold standard” in knowledge synthesis, our findings suggest that much remains to be done in the area of synthesis research to better guide practice in cancer survivorship.

scholarly journals Exploring Interactive Survivorship Care Plans to Support Breast Cancer Survivors: Protocol for a Randomized Controlled Trial

10.2196/23414 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e23414
Author(s):  
Akshat Kapoor ◽  
Priya Nambisan
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Self Management ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Survivorship ◽  
Care Plans ◽  
The Impact

Background Breast cancer is the most common form of cancer among American women, accounting for 23% of all cancer survivors nationally. Yet, the availability of adequate resources and tools for supporting breast cancer survivors has not kept up with the rapid advancement in treatment options, resulting in unmet supportive care needs, particularly among low-income and minority populations. This study explores an alternative means of delivering breast cancer survivorship care plans (SCPs), with the aim of improving survivor morbidity, patient knowledge, and self-management of treatment-related symptoms, as well as addressing inconsistencies in follow-up care visits. Objective The overall goal of this study is to improve the uptake of SCP recommendations via an educational intervention for breast cancer survivors, to improve treatment-related morbidity, patient knowledge, self-management, and adherence to follow-up visits. The specific aims of the study are to (1) evaluate the feasibility of the online SCP, and (2) assess the impact of the online SCP on survivorship outcomes. Methods We will enroll 50 breast cancer survivors who have completed initial breast cancer treatment into a 2-armed, randomized, waitlist-controlled pilot trial, and collect data at baseline and 6 months. For the first aim, we will use mixed methods, including surveys and personal interviews among the intervention group, to determine the feasibility of providing an online, interactive SCP (called ACESO) based on the survivors’ online user experience and their short-term adoption. For the secondary aim, we will compare the 2 groups to assess the primary outcomes of survivor knowledge, self-efficacy for self-management, perceived peer support, and adherence to SCP-recommended posttreatment follow-up visits to oncology and primary care; and the secondary outcomes of treatment-related morbidity (body weight, fatigue, depression, anxiety, sexual function, distress, and sleep quality). We assess these outcomes by using measurements from validated instruments with robust psychometric properties. Results We have developed and refined the online breast cancer survivorship plan, ACESO, with consultation from breast cancer oncologists, nurses, and survivors. Approval for the study protocol has been obtained from the Institutional Review Board. An advisory board has also been established to provide oversight and recommendations on the conduct of the study. The study will be completed over a period of 2 years. Conclusions The results of this pilot study will inform the feasibility and design of a larger-scale pragmatic trial to evaluate the impact of an online breast cancer SCP on treatment-related morbidity and self-efficacy for self-management. International Registered Report Identifier (IRRID) PRR1-10.2196/23414

Feasibility of group follow-up visit for breast cancer survivors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19603-19603
Author(s):  
C. O. Ruud ◽  
K. Francis ◽  
C. Stephens ◽  
M. H. Rajab
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Social Worker ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Group Visit ◽  
Follow Up Care

19603 Background: The ASCO 2006 guidelines specify that regularly scheduled follow-up care of breast cancer survivors should be the standard. Follow up care is a “teachable moment” to train survivors in positive habits. A group visit model at the Cleveland Clinic proved feasible and improved patient satisfaction for other diseases. Our objectives include assessing the feasibility of an adapted group follow-up visit for the care of breast cancer patients and patient satisfaction. Methods: A feasibility study targeting breast cancer patients who completed primary therapy and were scheduled for a routine appointment. We mailed letters inviting patients to a follow-up group visit. Patients were divided into 3 groups, each scheduled for a separate (90–120 minute). During the first half of the visit, participants were divided into three groups; 5-minute physician exam, nurse review of medications and vital signs, and instruction by a social worker. Groups were rotated. During the second half the doctor, nurse, and social worker met with all participants in one room starting with an educational presentation about fatigue and exercise. Each participant was subsequently interviewed by the physician in the presence of their peers. Shared complaints were investigated first. Patients rated their satisfaction with the different parts of the visit on a scale of 1–5. Participants were surveyed pre- and post- education session and asked if they would participate again. Participants were allowed to bring a family member or friend. Results: 29 (29.6 %) out of 98 consented and 22 (22.5%) attended;10 in first visit, 5 in second visit and 7 in last visit. Average age 61±8, ranged from 46–72 years. Most participants were satisfied with all parts of the group visit, except two in the first group were less satisfied with the check in process and moving between rooms. Comparing the pre- vs. post- educational session surveys showed an improved understanding of the importance of fatigue or exercise. 17 (77%) out of 22 participants agreed to participate in another group visit. Conclusion: Group visit format is feasible and provides patient satisfaction. No significant financial relationships to disclose.

Do nurse-navigated TSSCPs improve treatment and follow up compliance in underserved populations?

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 72-72
Author(s):  
Camille Manoukian ◽  
Maria Altamirano ◽  
Kimlin Tan Ashing ◽  
Ann Falor Callahan ◽  
Virginia Sun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Underserved Populations ◽  
Statistical Significance ◽  
Clinic Visit ◽  
Treatment Recommendations ◽  
Breast Cancer Patients ◽  
Care Plans ◽  
Number Of Patients

72 Background: Multiple cancer organizations advocate for the use of treatment summaries and survivorship care plans (TSSCPs) in cancer patients. To better quantify the benefits of a nurse-navigated, culturally and linguistically responsive TSSCP in underserved breast cancer patients, we compared rates of compliance with treatment and follow up in 26 patients who were treated with TSSCPs to 38 similar controls who were treated without TSSCPs. Methods: We prospectively enrolled 26 consecutive, newly-diagnosed breast cancer patients who were given nurse-navigated TSSCPs under an IRB-approved protocol. At their first clinic visit, a trained nurse educated and assisted the patient in the use and completion of the TSSCP. Nurse-navigated TSSCPs were completed at each subsequent visit through 12 months of surveillance. Rates of compliance with treatment and follow up guidelines were compared to 38 similar control patients using a two group Fisher’s exact chi-square test. Statistical significance was set at p-value < 0.05. Results: All patients were treated under Medicaid insurance and 47% were racial and/or ethnic minorities. Time from diagnosis to treatment and time from initial clinic visit to treatment were similar across groups. The rate of compliance with first treatment recommendations was 96% (25/26) in the TSSCP group compared to 79% (30/38) in the non-TSSCP group (p = 0.07). The number of patients compliant with all follow up visits was similar: 22/25 (88%) of TSSCP patients and 22/30 (73%) in non-TSSCP patients (p = 0.31). Of the recommended total follow up appointments, 6/67 in the TSSCP group and 25/120 in the no TSSCP group were “no shows” (p = 0.04). Conclusions: Although the use of nurse-navigated TSSCPs may not improve time to treatment in medically underserved patients, adherence to first treatment recommendations and follow up appointment attendance shows some improvement in patients who participate in nurse-navigated TSSCPs. Further study is needed to fully assess the role of nurse-navigated TSSCPs in improving treatment and surveillance compliance rates and how these rates impact clinical outcomes. Acknowledgement: Funded by a Community Grant from the Los Angeles County Affiliate of Susan G. Komen.

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