Expectations for survivorship care among hematology oncology and primary care providers.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 5-5
Author(s):  
Damien Mikael Hansra ◽  
Jeremy Ramdial ◽  
Eugene Ahn ◽  
Anthony Perre ◽  
Lauren Masar ◽  
...  

5 Background: Significant controversy exists between hem/onc & primary care providers regarding various aspects of survivorship care. Here we administer a 23 question survey to address these discrepancies. Methods: A 23 question (Q) electronic survey was created on www.surveymonkey.com and sent to providers at Cancer Treatment Centers of America, & The University of Miami Health Network. Survey included provider demographics (7Qs) and practice preference Qs (16Qs). Survey asked: who should be primary responsible for managing cardiotoxicity (CT), cardiovascular risk reduction (CRD), physical activity assessments (PA), nutrition (N), weight (W), anxiety depression panic disorder PTSD (ADPP), cognitive function (CF), fatigue (F), sexual function (SF), lymphedema (L), side effect of hormonal agents (SEH), side effect of targeted agents (SET), side effect of bone modifying agents (SEB), vaccinations (V), cancer screening (CS), sleep disorders (SD)? Answer choices were 1) Hematologist Oncologist (HO), 2) Primary Care Provider (PCP), 3) Both HO + PCP (BO), 4) Other (O). Results: 55 providers enrolled in the survey (92% physician 6% ARNP 2% other). 56% hem/onc, 7% PCP, 37% subspecialty. 56% hospital based, 20% academic, 16% multispecialty practice, 8% other. Survey results: (CT): HO 29%, PCP 5%, BO 60%, 0 6%, (CRD): HO 7%, PCP 49%, BO 36%, 8% O, (PA): HO 5%, PCP 45%, BO 38%, O 12%, (N): HO 5%, PCP 38%, BO 35%, O 12%, (W): 4%, PCP 47%, BO 31%, O 16%, (ADPP): HO 5%, PCP 33%, BO 38%, O 24%, (CF): HO 5%, PCP 33%, BO 45%, O 17%, (F): HO 4%, PCP 36%, BO 53%, O 7%, (SF): HO 5%, PCP 22%, BO 49%, O 24%, (L): HO 31%, PCP 7%, BO 36%, O 26%, (SEH): HO 62%, PCP 4%, BO 27%, O 7%, (SET): HO 69%, PCP 4%, BO 20%, O 7%, (SEB): HO 62%, PCP 4%, PCP 25%, O 9%, (V): HO 16%, PCP 42%, BO 36%, O 6%, (CS): HO 9%, PCP 38%, BO 47% O 6%, (SD): 3% HO, PCP 51%, BO 31%, O 15%. Conclusions: In our study we found that the majority of providers think PCPs should manage: CRD & SD; HO should manage: SEH, SET, SEB; BO should manage: CT, F. A minority of providers favored combined approach (BO) for: CRD, ADPP, CF, SD, L, CS in survivors.

2013 ◽  
Vol 7 (3) ◽  
pp. 343-354 ◽  
Author(s):  
Winson Y. Cheung ◽  
Noreen Aziz ◽  
Anne-Michelle Noone ◽  
Julia H. Rowland ◽  
Arnold L. Potosky ◽  
...  

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 103-103 ◽  
Author(s):  
Jonathan Sussman ◽  
Mary L McBride ◽  
Jeffrey Sisler ◽  
Grace Kim ◽  
Laura Game ◽  
...  

103 Background: Primary care providers (PCPs) have an important role in the provision of survivorship care. While there is evidence to support the feasibility and safety of PCP-led survivorship care, there are gaps in knowledge about how to best integrate providers to support transitions, enhance quality of care, increase system efficiencies, and improve patient and provider satisfaction. Methods: A pan-Canadian study comprised of three projects has been initiated to address three key aspects of care integration, based on a previously described system performance framework. Functional integration will be studied through the evaluation of electronic survivorship care plans using a prospective cohort of breast and colorectal cancer patients with pre and post measures of knowledge, care coordination, and satisfaction. Vertical integration will be evaluated through a series of descriptive case studies to document structures and processes that are currently in place to support PCP re-referral to regional cancer centres. Clinical integration will be studied through the development and evaluation of an interspecialty survivorship training curriculum for oncology and family medicine trainees. Results: Functional integration: Development of an electronic platform for care plan outputs is complete. Two sites in Ontario (ON) and one in British Columbia (BC) have been selected to study the impact on 200 patients and their providers. Vertical integration: Using a study-specific interview guide, 48 semi-structured key informant interviews have been successfully conducted in ON; 15 interviews are planned for Manitoba (MB) and 15 for BC. Clinical Integration: a National Advisory Committee was established and needs assessments were performed with postgraduate program directors, cancer survivors, and trainees using online surveys and focus groups. A blended learning curriculum is being piloted in MB, ON, and BC in 2015. Conclusions: Integrating primary care and cancer care in survivorship requires a collaborative approach that begins in residency, supports PCPs with clear mechanisms for re-entry, and optimizes communication. This study will inform approaches to enhancing provider integration and survivorship care.


2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 23-23
Author(s):  
Jennifer R. Klemp ◽  
Carol Bush ◽  
Ashley Spaulding ◽  
Hope Krebill ◽  
Gary C. Doolittle

23 Background: Advances have been made in elevating cancer survivorship as a public health priority and defining elements needed to deliver high-quality follow-up care to survivors. However, a lack of research on how best to care for survivors and the most effective and efficient strategies for delivering survivorship care in the community setting still exists. We report our assessment of the current state of practice, knowledge and professional development, and plan to increase access to care of urban and rural practices across the state of Kansas. Methods: In 2014, the Midwest Cancer Alliance (MCA), a membership-based outreach arm of The University of Kansas Cancer Center, convened an educational summit and survey to assess the survivorship landscape in Kansas. Post-summit, individual interviews were conducted. Survey and interviews included questions regarding health records, treatment summaries, survivorship care plans (SCP), availability of survivorship programs and resources, access to primary care and specialists, distress screening, community support, and educational needs. Results: Ten MCA member health systems were invited to participate and 7 indicated interest in participating in the project. Only one organization provided an SCP to survivors. Barriers included lack of an integrated approach and knowledge. A majority of survivorship care could be delivered close to home, however, services including fertility preservation, genetic counseling, oncology rehab, sexual health, and second opinions, required travel of more than 50 miles. Identified educational needs focused on comprehensive survivorship care across the health care team. Conclusions: Survivorship care remains fragmented across the state of Kansas. Based on this project, we have secured a CDC survivorship grant that will facilitate clinical and technical assistance related to process improvement and electronic health record integration focused on survivorship care and delivery of an SCP. Next steps include engaging primary care providers and survivors to assure the SCP meets the needs of stakeholders. This work will focus on a translational process to meet the growing needs of the survivors and complex health care organizations.


2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 61-61
Author(s):  
Pamela Jane Vetter

61 Background: The Institute of Medicine (IOM) report From Cancer Patient to Cancer Survivor: Lost in Transition, noted cancer patients often lacked the ability to successfully navigate the transition from patient to survivor (2006). To assist patients with understanding their disease and follow up, managing side effects and connecting with resources, the IOM recommends a survivorship care plan (SCP). The Commission on Cancer (CoC) is requiring accredited cancer programs provide SCPs to curative patients while giving them full discretion on structuring these programs. Methods: After researching survivorship components, a consultative model serving the adult cancer patients curatively treated at my facility was chosen. My goals included increasing patient satisfaction and connection to resources, fulfilling accreditation requirements, as well as financial benefits. I secured champions and procured budgetary approval. An assessment tool was created, a SCP program chosen, and a schedule created with IT. I gathered resources, reviewed side effect management, chose evaluation metrics and created educational materials and a tracking system. Results: 235 patients were seen in the first year of the clinic. Through nine months of 2017, 67.9% of eligible patients were provided with a SCP. Downstream revenue included patients changing to an Aspirus Primary Care Provider and referrals to various providers. Patients were connected to community and facility resources. Side effect assistance given; multiple medical issues addressed; additional Advanced Care Plans completed. Patients and Primary Care Providers are complimentary of the service. Conclusions: Successful start to survivorship clinic; will meet CoC accreditation. Many eligible patients who did not receive a SCP were seen at an unaffiliated Urology clinic. Moving forward, plan to work with their clinic to provide SCPs. Other challenges included time spent tracking patients, which should ease with a newly implemented electronic medical record.


2015 ◽  
Vol 11 (3) ◽  
pp. e329-e335 ◽  
Author(s):  
SarahMaria Donohue ◽  
Mary E. Sesto ◽  
David L. Hahn ◽  
Kevin A. Buhr ◽  
Elizabeth A. Jacobs ◽  
...  

Survivorship care plans were viewed as useful for coordinating care and making clinical decisions. However primary care physicians desired shorter, clinician-oriented plans that were accessible via EHR and located in a standardized manner.


2012 ◽  
Vol 25 (5) ◽  
pp. 635-651 ◽  
Author(s):  
T. Salz ◽  
K. C. Oeffinger ◽  
P. R. Lewis ◽  
R. L. Williams ◽  
R. L. Rhyne ◽  
...  

2021 ◽  
Vol 28 (5) ◽  
pp. 3408-3419
Author(s):  
Dominique Tremblay ◽  
Nassera Touati ◽  
Karine Bilodeau ◽  
Catherine Prady ◽  
Susan Usher ◽  
...  

Risk-stratified pathways of survivorship care seek to optimize coordination between cancer specialists and primary care physicians based on the whole person needs of the individual. While the principle is supported by leading cancer institutions, translating knowledge to practice confronts a lack of clarity about the meaning of risk stratification, uncertainties around the expectations the model holds for different actors, and health system structures that impede communication and coordination across the care continuum. These barriers must be better understood and addressed to pave the way for future implementation. Recognizing that an innovation is more likely to be adopted when user experience is incorporated into the planning process, a deliberative consultation was held as a preliminary step to developing a pilot project of risk-stratified pathways for patients transitioning from specialized oncology teams to primary care providers. This article presents findings from the deliberative consultation that sought to understand the perspectives of cancer specialists, primary care physicians, oncology nurses, allied professionals, cancer survivors and researchers regarding the following questions: what does a risk stratified model of cancer survivorship care mean to care providers and users? What are the prerequisites for translating risk stratification into practice? What challenges are involved in establishing these prerequisites? The multi-stakeholder consultation provides empirical data to guide actions that support the development of risk-stratified pathways to coordinate survivorship care.


Cureus ◽  
2020 ◽  
Author(s):  
Sukesh Manthri ◽  
Stephen A Geraci ◽  
Kanishka Chakraborty

2019 ◽  
Vol 35 (6) ◽  
pp. 1219-1226 ◽  
Author(s):  
Emily M. Geramita ◽  
Ira R. Parker ◽  
Jill W. Brufsky ◽  
Brenda Diergaarde ◽  
G. J. van Londen

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 8-8
Author(s):  
Talya Salz ◽  
Erin Onstad ◽  
Mary S. McCabe ◽  
Shrujal S. Baxi ◽  
Richard L. Deming ◽  
...  

8 Background: The Institute of Medicine advised that cancer survivors and their primary care providers receive survivorship care plans (SCPs) to summarize cancer treatment and plan ongoing care. However, the use of SCPs remains limited. Methods: Oncology providers at 14 National Cancer Institute Community Cancer Centers Program (NCCCP) hospitals completed a survey regarding their perceptions of SCPs, including barriers to implementation, strategies for implementation, the role of oncology providers, and the importance of topics in SCPs (diagnosis, treatment, recommended ongoing care, and the aspects of ongoing care that the oncology practice will provide). Results: Among 245 providers (70% response rate), a minority reported ever providing an SCP or any of its components to patients. The most widely reported barriers were personnel to creating SCPs and time (69% and 64% of respondents, respectively). The most widely endorsed strategy among those using SCPs was the use of a template with pre-specified fields; 94% of those who used templates found them helpful. For each topic of an SCP, while 87%-89% of oncology providers felt it was very important for primary care providers to receive the information, only 58%-65% of respondents felt it was very important for patients to receive the information. Further, 33%-38% of respondents had mixed feelings about whether it was oncology providers’ responsibility to provide SCPs. Conclusions: Practices need additional resources to overcome barriers to implementing SCPs. We found resistance toward SCPs, particularly the perceived value for the survivor and the idea that oncology providers are responsible for SCP dissemination.


Sign in / Sign up

Export Citation Format

Share Document