Using electronic medical records system to advance cancer survivorship programs.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 65-65
Author(s):  
Megan Lanigan ◽  
Theresa M. Lee ◽  
Lisa Torp ◽  
Beth Rudge ◽  
Kit Yu Lu ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Care Delivery ◽  
Compliance Rate ◽  
Care Plan ◽  
Patient Specific ◽  
Survivorship Care ◽  
Care Plans ◽  
Medical Records System

65 Background: Survivorship care is now being increasingly recognized as an important part of cancer care. The Commission on Cancer (CoC) Standard 3.3 now recommends 100% compliance in the delivery of Survivorship Care Plans (SCP) by 2019 to eligible survivors. However, there are no systematic ways of ensuring compliance of Care Plan delivery and assessing patient eligibility. There are also no standardized methods for documentation or data collection to ensure appropriate consolidation of information from the electronic medical record (EMR) to a SCP, to assess for patient eligibility for survivorship follow up, or to appropriately report on timely delivery and follow-up with Survivorship Programs. Methods: Our survivorship team worked closely with the Cancer Registry Program, nurse navigators, and Information Technology team to optimize our institution owned EPIC electronic medical records system to populate and consolidate information automatically into patient specific care plans. By having electronic care plans, we are able to deliver plans to all members of the care team and to the patients. We also created discrete methods of flagging eligible survivors and automated data reporting and collection to ensure compliance and timeliness of care plan delivery. Results: By optimizing our electronic medical records system and our workflow process for Care Plan delivery, we were able to increase our delivery compliance rate to 100%. We are able to track patients through their care delivery and appropriately refer to our survivorship program and track care plan delivery. Conclusions: The CoC has implemented new standards to encourage appropriate survivorship care delivery and proper communication for ongoing survivorship care and follow up. With these new standards comes the challenge of developing and implementing a system for creating, delivering and evaluating the delivery of SCP. For our team to provide quality survivorship care that is measurable, we have developed data analysis and reports through our EMR with assistance from our IT department. These improvements utilizing our IT and EMR more efficiently has provided us with the ability to achieve 100% care plan delivery compliance.

Evaluating survivorship cancer care through quality improvement programs.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 112-112
Author(s):  
Guadalupe R. Palos ◽  
Fran Zandstra ◽  
Ludivine Russell ◽  
Jacklyn J. Flores ◽  
Katherine R. Gilmore ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Compliance Rate ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Full Time ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Care Plans ◽  
Improvement Programs

112 Background: The Institute of Medicine noted cancer survivors’ care may be improved by providing each with a cancer survivorship care plan (CSCP). Recently, numerous versions of CSCPs have emerged; however, evidence-based processes to evaluate their use and quality in providing personalized survivorship care have yet to be implemented. Here, we describe our efforts to use the approach recommended by the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) to track and report the compliance rate for using electronic CSCPs in our survivorship clinics. Methods: The criteria used to conduct our audit evolved from the QOPI template, which included selection of survivors seen in 7 different out-patient survivorship clinics within a specific 6-month period, identification of denominators and numerators unique to each clinic, and determination of the number of records to audit based on the number of full-time providers in each clinic. Next, we established the target condition, method(s) used for data collection, appropriate measures, and other criteria used in the QOPI. All data were obtained from our CSCPs’ mined data, institutional electronic medical records, and scheduling systems. Results: From December 1, 2011, to May 31, 2012, we conducted an electronic medical records audit to determine the compliance rate for issuing survivorship care plans in 7 clinics. The survivorship clinics included breast, colorectal, endocrine (thyroid), genitourinary, gynecology, head/neck, and melanoma. A total of 3,274 electronic medical records were reviewed. 40 providers issued a total of 2,761 electronic CSCPs within 30 days of the arrived appointment. The compliance rate per clinic ranged from 64.5% to 94.7% (X=84.5%). Conclusions: We found the QOPI process to be user-friendly and applicable to our compliance monitoring effort. All data were extracted from electronic tools, thus ensuring the processes used were reliable, reproducible, and reasonably consistent across clinics. Further examination is warranted to determine characteristics of clinics with high- vs. low-compliance rates and their impact on survivors’ outcomes as related to specific CSCP recommendations.

Measuring impact of survivorship care plans on head and neck cancer patients.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 73-73
Author(s):  
Bridgett Ann Harr ◽  
Joanna Bodmann ◽  
Shlomo A. Koyfman ◽  
Tobenna Igweonu Nwizu ◽  
Nikhil Purushottam Joshi ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Survivorship Care Plan ◽  
Patient Specific ◽  
Survivorship Care ◽  
Care Plans ◽  
The Impact ◽  
Over Time

73 Background: At our institution, patients who have completed treatment for a locoregionally confined head and neck cancer are followed in a multidisciplinary head and neck survivorship clinic initiated by the administration of a formal, patient specific survivorship care plan (SCP). We sought to assess the impact of these SCP visits on patient understanding of their disease, its treatment, and potential late effects and follow up plans. Methods: An IRB approved survey was administered by an uninvolved third party, to an unselected sequential series of head and neck cancer survivorship patients at the time of a regularly scheduled follow up visit. The survey focused on the knowledge recalled from the SCP, and whether this changed over time. We analyzed two cohorts of patients, based on whether the SCP had been given to them within the last 18 months or not. Results: Preliminary results from the first 20 patients surveyed are presented. These patients received their SCP 3-27 months before being surveyed. Primary tumor sites included oropharynx (16) and larynx (4) and most patients had been treated with intensity modulated radiation therapy (19) and concurrent cisplatin (11). Conclusions: Although patients’ recall about receiving a formal SCP appeared to diminish over time, the information provided by this SCP plan and subsequent survivorship visits was retained. Whether this reflected the SCP itself, or the reinforcement of continued close follow up survivorship visits cannot be determined, but merits further investigation. [Table: see text]

Perceived value of cancer survivorship care among Asians and Native Hawaiian/Pacific Islanders.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e22522-e22522
Author(s):  
Jared David Acoba ◽  
Sharon Tamashiro ◽  
Marci Chock
Keyword(s):  
Cancer Survivors ◽  
Racial Differences ◽  
Cancer Survivorship ◽  
Native Hawaiian ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

e22522 Background: Numerous studies have evaluated the impact of cancer survivorship care. However, no study to date has focused on Asian or Native Hawaiian/Pacific Islander (NH/PI) cancer survivors. It has been well documented that Asian and NH/PI patients often suffer from inferior cancer outcomes compared to White patients, and differences in their experience with cancer survivorship care could contribute to this disparity. Methods: Surveys were sent to 1410 cancer survivors who were treated at a community cancer center with curative intent and who had received survivorship care plans between Jan 2014 and June 2018. The 26-item questionnaire evaluated patients’ perception of various aspects of their survivorship care plan and follow-up physician visits. All responses were anonymous. Results: Of the 360 patients who responded, 24% were White, 54% Asian, and 13% NH/PI. Compared to Whites, Asian and NH/PI patients were younger (p = 0.004), less educated (p = 0.004), and reported a lower income (p < 0.0005). Among all patients, 62% reported that the survivorship care plan was “very helpful” and 86% rated their satisfaction with physician follow-up visits as “very good” to “excellent.” There were no racial differences in satisfaction with either survivorship care plan or physician follow-up. In a multivariate binary logistic regression, Asians and NH/PI patients were significantly more likely to rate ongoing survivorship care as helpful compared to Whites, OR 4.08 (95%CI, 2.13-7.82). Conclusions: There were no racial differences in patient satisfaction with their survivorship care plans and follow-up care. However, Asian and NH/PI patients valued ongoing cancer survivorship care follow-up significantly more than White patients. Whether more extensive survivorship care would lead to improved outcomes among Asian and NH/PI cancer patients should be investigated further.

A feasibility study of an electronic interface between Internet-based survivorship care plans and electronic medical records (EMR)/tumor registries.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 9589-9589
Author(s):  
Christine Hill-Kayser ◽  
Linda A. Jacobs ◽  
Steven C Palmer ◽  
Margaret K. Hampshire ◽  
Carolyn Vachani ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Feasibility Study ◽  
Medical Records ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Tumor Registries ◽  
Electronic Interface

Integrating the primary care physician into cancer follow-up.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 102-102 ◽  
Author(s):  
Andrew L. Salner ◽  
Deborah Walker ◽  
Amanda Seltzer ◽  
SarahLena Panzer ◽  
Carrie Stricker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Primary Care Physician ◽  
Care Physician ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Plans ◽  
Follow Up Care

102 Background: After a diagnosis of breast cancer, it can be difficult for patients to understand the role their primary care physician (PCP) should play in their follow up care. Methods: 65 women (mean age 60 years, SD = 10) with breast cancer (stage 0-III) were seen by a nurse practitioner for a 60-90 minute consultative survivorship visit and received a treatment summary and personalized survivorship care plan (SCP) utilizing Carevive Care Planning Systems software. The Carevive system incorporates patient-reported and clinical data to create tailored care plans with personalized recommendations for follow up care and supportive referrals, including direction to follow up with primary care for specific care and health maintenance activities. Approximately 6 weeks following their survivorship care visit, patients completed a survey assessing their use of and satisfaction with the SCP. Patients were advised that the SCP would be mailed to their referring oncologist and primary care physician. Results: Out of 65 sent, 35 surveys have been completed to date. Survivors were diagnosed approximately 10 months prior, and all were within 6 months following completion of treatment. All patients (100%) reported that they read, or planned to read, their survivorship care plan packet carefully. While all care plans included a recommendation to follow up with their PCP, only (71%) of survivors remembered receiving this recommendation. Of those who did, most (74%) had either seen or scheduled an appointment with their PCP. Patients who reported higher anxiety at the time of the survivorship visit were more likely to report that the follow up care plan helped them take action about seeing their PCP (p = .03). Conclusions: Coordination between primary and oncology care providers has previously been shown to improve the quality of care for cancer survivors. SCPs that emphasize the importance of and activities to be undertaken in primary care may help to improve this coordination. Continuation of this research will help to better understand how to integrate the primary care physician into cancer follow up care. Updated data will be shared at time of presentation.

The Challenges of the Integration of Cancer Survivorship Care Plans with Electronic Medical Records

2015 ◽  
Vol 31 (1) ◽  
pp. 73-78 ◽  
Author(s):  
James R. Zabora ◽  
Sage Bolte ◽  
Drucilla Brethwaite ◽  
Saundra Weller ◽  
Carrie Friedman
Keyword(s):  
Electronic Medical Records ◽  
Cancer Survivorship ◽  
Medical Records ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

A model for delivering survivorship care: Integrating the oncology and the primary care setting—An Italian experience.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. e275-e275
Author(s):  
Elena Lorenzi ◽  
Lucia Morello ◽  
Rita Mazza ◽  
Isabella Garassino ◽  
Raffaele Cavina ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Early Stage ◽  
Care Delivery ◽  
Care Plan ◽  
Disease Stage ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Early Stage Disease

e275 Background: The population of cancer-survivors faces different lifetime health risk. Thus, models for high-quality and personalized care delivery are strongly needed. ASCO provides different models for survivorship care delivery but there is not an agreement on what is the best in meeting patients’ needs and in terms of cost-effectiveness. In our institution we started a program that tries to integrate survivors’ health care provided by the oncologist and by the Primary Care Physician (PCP). Methods: We included patients (pts) aged more than 18 yrs-old at the time of diagnosis, affected by hematologic or solid tumors. Pts had no evidence of disease from at least 5 yrs from the diagnosis. They are referred to the PCP with the following documents: Survivorship Care-Plan, Survivorship Care-Program, letter to the PCP. Recurrence rate, death rate, treatment related serious clinical events will be calculated after 12 months from the start of the project. Results: We includedin our program 269 cancer-survivors (60% of pts referred to our survivorship-clinic from April to July 2015). The median age was 67 yrs, they were mainly females. The different cancer types were: breast (157), colorectal (36), hematologic (30), gynecologic (11), gastric (9), melanoma (6) lung (5), genitourinary (5), head/neck (3), sarcoma (3) and others (4). 189 of pts had an early stage disease (stage I-II) at diagnosis. 234 of pts underwent surgical treatment and 161 received chemotherapy with different schedules based on tumor types. 59% of pts received anthracycline-based-chemotherapy, 78% at a cumulative dose > 240 mg/m2 . 154 of pts underwent radiation therapy (90% in thoracic field) with a median dose of 60 Gy. We observed 11 cases of secondary cancer after a median of 2.7 yrs from the first diagnosis. The median observation time from the diagnosis to the inclusion in our program was 10 yrs (range 2-31). Conclusions: The observation period from the beginning of the program is too short to provide follow-up data. A high percentage of pts present a high risk of cardiologic late toxicities, therefore they need a more intensive cardiologic follow-up. We will present the first follow-up analysis of this cohort of pts in April 2016.

Implementation of survivorship care plans in the pediatric oncology clinic.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 55-55 ◽  
Author(s):  
Christine Moore Smith ◽  
Barron L. Patterson ◽  
Debra L. Friedman
Keyword(s):  
Pediatric Oncology ◽  
Standard Of Care ◽  
Primary Care Providers ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Cancer Center ◽  
Survivorship Care ◽  
Care Providers ◽  
Care Plans

55 Background: Quality survivorship care and follow up have been well described in the pediatric oncology population to improve overall health of cancer survivors. Typically, a key component is the delivery of a survivorship care plan (SCP) in a dedicated survivorship program. Creation of an SCP in the immediate post-treatment period has not been commonly adopted. To address the Commission on Cancer's (CoC) requirement to provide SCPs within six months of ending therapy, our pediatric oncology clinic has used quality improvement (QI) methods to incorporate SCPs into clinic workflow with subsequent survivorship program referral. Our aim is to meet the CoC’s benchmark of 50% of eligible patients receiving SCPs by December 31, 2017. Our secondary goal is to improve the timeliness of delivery to patients, families, and primary care providers (PCP). Methods: Registry data from our cancer center was utilized to identify eligible patients. Upcoming appointments were then identified for a panel of eligible patients using the electronic medical record (EMR). Providers use a standardized SCP template which includes the components required by the CoC. The SCP is then reviewed with families, electronically sent to the PCP, and saved in the EMR. Evaluation of the process included subjective feedback from providers and Plan-Do-Study-Act cycles. Based on this feedback and cycles, iterations of the template have been progressively streamlined and the EMR panel has been updated. Results: Care plan creation and delivery is ongoing. At baseline, 28% of eligible patients had SCPs previously created in the survivorship program. After implementation of our QI methods, to date, we have increased the proportion of eligible patients with an SCP to 40.3%, approaching our goal of 50% by December 31, 2017. We have also decreased the time from end of therapy to delivery of a care plan from 22.9 months to 14 months. This is expected to further improve as the process continues. Conclusions: The QI process has been successful in implementing a new standard of care for delivery of SCPs. Ongoing use of QI methods will increase compliance with the CoC standards and result in improved survivorship care.

scholarly journals Strategies for Successful Survivorship Care Plan Implementation: Results From a Qualitative Study

2018 ◽  
Vol 14 (8) ◽  
pp. e462-e483 ◽  
Author(s):  
Sarah A. Birken ◽  
Alecia S. Clary ◽  
Shampa Bernstein ◽  
Jamiyla Bolton ◽  
Miriam Tardif-Douglin ◽  
...  
Keyword(s):  
Care Plan ◽  
Survivorship Care Plan ◽  
Future Research ◽  
Survivorship Care ◽  
Care Providers ◽  
Improvement Program ◽  
Care Plans ◽  
Follow Up Care ◽  
Oncology Practice

Introduction: Care for US cancer survivors is often fragmented, contributing to poor health outcomes. Care and outcomes may improve when survivors and follow-up care providers receive survivorship care plans (SCPs), written documents containing information regarding cancer diagnosis, treatment, surveillance plans, and health promotion. However, implementing SCPs is challenging. As such, we sought to identify strategies for successfully implementing SCPs. Methods: We measured SCP implementation using performance data from cancer programs participating in the American Society of Clinical Oncology Quality Oncology Practice Initiative, an oncologist-led quality assessment and improvement program. We used semistructured interviews with cancer program employees (eg, physicians) to identify strategies for successfully implementing SCPs by comparing approaches in cancer programs that, according to Quality Oncology Practice Initiative performance indicators, developed and delivered SCPs to a relatively small proportion of eligible survivors and their follow-up care providers (ie, low performers; n = 6 participants in five programs) with approaches among programs with better performance (ie, moderate performers; n = 15 participants in nine programs). Results: Ten of 14 cancer programs developed SCPs for ≥ 50% of eligible survivors; two of 14 delivered SCPs to any survivors; and eight of 14 delivered SCPs to ≥ 25% of follow-up care providers. We found that moderate performers proactively addressed SCP requirements, leveraged requirements to improve survivorship care, set internal targets, automated implementation, had active leaders and champions, and tasked appropriate employees with SCP implementation. Conclusion: SCP implementation remains challenging. We identified strategies for successfully implementing SCPs. Future research should examine how cancer programs have achieved these strategies; findings could contribute to an understanding of the changes needed to implement comprehensive survivorship care.

scholarly journals Reversing Frailty Levels in Primary Care Using the CARES Model

2017 ◽  
Vol 20 (3) ◽  
pp. 105-111 ◽  
Author(s):  
Olga Theou ◽  
Grace H. Park ◽  
Antonina Garm ◽  
Xiaowei Song ◽  
Barry Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Frailty Index ◽  
Community Dwelling ◽  
Care Plan ◽  
Pilot Phase ◽  
Clinical Frailty Scale ◽  
Positive Effect

BackgroundThe purpose of this manuscript was to evaluate the effectiveness of the Community Actions and Resources Empowering Seniors (CARES) model in measuring and mitigating frailty among community-dwelling older adults.MethodsThe CARES model is based on a goal-oriented multidisciplinary primary care plan which combines a comprehensive geriatric assessment (CGA) with health coaching. A total of 51 older adults (82 ± 7 years; 33 females) participated in the pilot phase of this initiative. Frailty was measured using the Clinical Frailty Scale (CFS) and the Frailty Index (FI-CGA) at baseline and at six-month follow-up.ResultsThe FI-CGA at follow-up (0.21 ± 0.08) was significantly lower than the FI-CGA at baseline (0.24 ± 0.08), suggesting an average reduction of 1.8 deficits. Sixty-one per cent of participants improved their FI-CGA and 38% improved CFS categories. Participants classified as vulnerable/frail at baseline were more responsive to the intervention compared to non-frail participants.ConclusionPilot data showed that it is feasible to assess frailty in primary care and that the CARES intervention might have a positive effect on frailty, a promising finding that requires further investigations. General practitioners who participate in the CARES model can now access their patients’ FI-CGA scores at point of service through their electronic medical records.

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