An innovative approach to manage cancer patient information for care coordination and monitoring using a digital health platform for a nonprofit tertiary cancer care institute in India.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14102-e14102
Author(s):  
Sharon Hensley Alford ◽  
Rishi Kumar Gupta ◽  
Nayan Sonawane ◽  
Srishti Mahatma ◽  
Shilpa Mahatma ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Medical Information ◽  
Early Stage ◽  
Digital Health ◽  
Ease Of Use ◽  
Cancer Information ◽  
New Delhi ◽  
Non Profit ◽  
Treatment Information

e14102 Background: In India, most patients maintain a personal copy of their medical record in paper form which is hard to manage and collate. Newly diagnosed cancer patients and their doctors have an insurmountable task of consuming and using that information. Making this information available in an easy to consume format as well as recording a patient’s cancer experience is a technical challenge. We piloted an innovative mobile application to address this pain point. Methods: A pilot engagement was performed with 100+ cancer patients visiting a non-profit oncology center between March 2019 and January 2020 in a suburb of New Delhi, India. Systematic medical information was captured on stage, TNM, molecular markers, tumor size, tests, and treatments. We assessed the utility of a digital health application for the purpose of cancer information management and ease of use by the medical team. Results: Data for a total of 65 patients with a single cancer and diagnosis and treatment information was captured. Patients were between the ages of 23 and 78, mean age 49. Of these patients, there were 21 (32%) early stage cases ( < Stage 3), 23 (35%) late stage cases ( > Stage 2), and 21 (32%) cases with missing stage. Overall, 39 (60%) received a chemotherapy only regimen, 2 (3%) radiation only, 6 (9%) surgery only, 6 (9%) received chemotherapy and radiation, 11 (17%) received surgery and chemotherapy, and 1 (1%) patient received surgery, chemotherapy, and radiation. Clinic staff reported that the application was easy to use and helpful. We continue to enhance the application with staff feedback. Conclusions: We demonstrate the feasibility and value of moving to a next generation digitized mobile platform circumventing the need for a traditional EMR system at a busy non-profit oncology clinic in the suburbs of New Delhi, India. Using the pilot, we make a case that this type of technology has the ability to transform cancer care for rural and low-resource cancer centers. We also demonstrate that it is easy to capture patient longitudinal data using this innovative platform.

Using a bi-directional digital health platform for cancer care coordination and monitoring to enhance the cancer care continuum between patients, clinicians and caregivers.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14105-e14105
Author(s):  
Sharon Hensley Alford ◽  
Shilpa Mahatma ◽  
Rohit Mahatma ◽  
Sagar Amode ◽  
Rupal Sethia ◽  
...  
Keyword(s):  
Medical History ◽  
Cancer Patients ◽  
Treatment Planning ◽  
Care Coordination ◽  
Cancer Care ◽  
Medical Records ◽  
Digital Health ◽  
Innovative Technology ◽  
Non Profit ◽  
Case Summary

e14105 Background: It has been recognized that current electronic medical record (EMR) systems detract from the patient-provider relationship and that an innovative technology is needed to re-center medical encounters on the patient-provider engagement. This is especially important in oncology during new patient onboarding, care coordination in between medical visits and survivorship planning. Methods: We built a HIPAA compliant role-based digital health platform to support providers in patient engagement and care coordination. In this pilot at a non-profit oncology center in India, nurse navigators onboarded the patients using the mobile application. The technology was used to digitize past medical records and parse the clinical history. In addition, self-reported patient past medical history, family history, as well as social, reproductive and surgical history was collected as needed. The system collated the information into an easy to consume case summary for the oncologists. The system was tested with 3 clinicians and consented cancer patients. Results: Nearly 200 cancer patients participated in the pilot study. Patients’ medical records were digitized by oncology nurse navigators. The summarized longitudinal view of the patient’s medical history was used by oncologists for diagnosis and treatment planning. Participating clinicians noted that the digital case summary saved time and effort in treatment planning. In addition, it was noted that collaboration between nursing staff, medical oncologist, surgical oncologist and radiation oncologist was substantially improved. Conclusions: We demonstrate the value of using digital health technology to support the care coordination of cancer patients in a low-resource, non-profit clinical center in India.

Cancer Patients' Information Needs across the Cancer Care Continuum: Evidence from the Cancer Information Service

2005 ◽  
Vol 10 (sup1) ◽  
pp. 15-34 ◽  
Author(s):  
Linda Squiers ◽  
Lila J. Finney Rutten ◽  
Katherine Treiman ◽  
Mary Anne Bright ◽  
Bradford Hesse
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Information Needs ◽  
Information Service ◽  
Cancer Information ◽  
Cancer Information Service ◽  
Care Continuum ◽  
Cancer Care Continuum

scholarly journals “To learn what cancer is, press 1”: A Descriptive study of the Implementation of an Interactive Voice Response (IVR) System for Cancer Awareness in Uganda (Preprint)

2020 ◽  
Author(s):  
Johnblack K Kabukye ◽  
Onaedo Ilozumba ◽  
Jacqueline EW Broerse ◽  
Nicolette de Keizer ◽  
Ronald Cornet
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Information Needs ◽  
Interactive Voice Response ◽  
Healthcare Providers ◽  
Cost Of Care ◽  
Cancer Information ◽  
Free Access ◽  
Cancer Awareness ◽  
Voice Response

BACKGROUND Cancer awareness is crucial for effective and satisfactory cancer care and prevention. However, cancer awareness in Uganda is low, and access to cancer information is limited. OBJECTIVE In this paper we describe an mHealth intervention in the form of an Interactive voice response (IVR) system for addressing the low cancer awareness in Uganda. Specifically, we (i) describe cancer information needs, (ii) describe the development of the cancer awareness messages and the IVR system for disseminating these messages, and (iii) explore user acceptance and usage of the IVR system. METHODS We conducted interviews and focus group discussions with cancer healthcare providers, cancer patients, caregivers and survivors, administrators and lay citizens, to understand the cancer awareness situation in Uganda (perceptions, beliefs, information needs and challenges to accessing cancer information), and opinions about IVR. We then developed an IVR system to address the cancer awareness needs, tested the system with cancer patients, caregivers and survivors during co-creation workshops, and then implemented and evaluated the system through qualitative telephone surveys and quantitative analysis of system usage data (call records). RESULTS The cancer messages cover general topics such as what cancer is, what causes it (risk factors), cancer screening and diagnosis, and cancer treatment. They also provide practical information on what to expect during cancer care (e.g., duration and cost of care), address myths and misconceptions that were identified, and information on COVID-19 which was added following the outbreak. The IVR system is accessible through a multi-channel toll-free telephone line. In addition to the pre-recorded voice messages, the system allows callers to leave a voicemail or to speak directly to a member of the clinical team. In the six months since go-live, 2411 calls had been made to the system, from 794 unique telephone numbers and lasting a total of 6856 minutes. Call volumes peaked following advertisement of the system and following lockdowns due to COVID-19 outbreak. Participants were generally familiar with IVR technology, and caller feedback was largely positive. Cited benefits include convenience, toll-free access, and detailed information. Recommendations for improvement of the system include adding live agents and marketing of the system to target users. CONCLUSIONS IVR technology provides an acceptable and accessible way for provision of cancer information to patients and the general public in Uganda, live agents who are knowledgeable about cancer should be added to the IVR if possible so that individualized questions can be answered in real time.

Simulation modeling of budget-neutral expanded access to antineoplastic therapy from cost-savings derived from conversion to biosimilar pegfilgrastim-cbqv for the prophylaxis of chemotherapy-induced (febrile) neutropenia (CIN/FN) in early-stage breast cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19371-e19371
Author(s):  
Ali McBride ◽  
Karen MacDonald ◽  
Ivo Abraham
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Simulation Modeling ◽  
Early Stage ◽  
Cost Savings ◽  
Selling Price ◽  
Breast Cancer Patients ◽  
Expanded Access ◽  
Conversion Rates

e19371 Background: Biosimilars not only have the potential to reduce the cost of prophylaxis of CIN/FN but such savings could be reallocated to provide access to anti-neoplastic treatment. To demonstrate this, we simulated in a 20,000-patient panel: 1) the savings that could be realized from CIN/FN prophylaxis with biosimilar pegfilgrastim-cbqv over reference pegfilgrastim with or without on-body injector (PEG/PEG-OBI), 2) a model of expanded access to adjuvant chemotherapy with doxorubicin/cyclophosphamide for localized breast cancer from cost-savings achieved from conversion from PEG/PEG-OBI, and 3) the number-needed-to-convert (NNC) to biosimilar pegfilgrastim-cbqv from PEG/PEG-OBI to purchase one additional treatment of doxorubicin/cyclophosphamide chemotherapy. Methods: Simulation modeling from the US payer perspective utilizing:average selling price (ASP) derived from CMS Q1 2020 reimbursement limits for PEG/PEG-OBI, pegfilgrastim-cbqv, doxorubicin and cyclophosphamide;between one and six cycles of prophylaxis in a panel of 20,000 cancer patients at risk for CIN/FN; and conversion rates from PEG/PEG-OBI to biosimilar pegfilgrastim-cbqv ranging from 10% to 100%. Results: Using current ASP, cost-savings of biosimilar pegfilgrastim-cbqv over PEG/PEG-OBI in a panel of 20,000 breast cancer patients range from $445,163 (for one cycle of prophylaxis at 10% conversion) to $26,709,788 (6 cycles at 100% conversion). In a single cycle of chemotherapy, these savings translate into expanded access to doxorubicin/cyclophosphamide ranging from 1,286 cycles at 10% conversion from PEG/PEG-OBI to 12,861 cycles at 100% conversion. The savings over six cycles could provide between 7,717 additional cycles of doxorubicin/cyclophosphamide (at 10% conversion) to 77,166 cycles (at 100% conversion). The NNC from PEG/PEG-OBI to purchase one additional cycle of doxorubicin/cyclophosphamide is 2. Conclusions: These models demonstrate that CIN/FN prophylaxis with biosimilar pegfilgrastim-cbqv can generate significant cost savings for supportive cancer care. Further, these savings could be reallocated to provide access to curative anti-neoplastic treatment on a budget-neutral basis, thus enhancing the value of cancer care to both payers and patients.

scholarly journals Noninvasive Urine-Based Tests to Diagnose or Detect Recurrence of Bladder Cancer

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1650
Author(s):  
Marine Charpentier ◽  
Charly Gutierrez ◽  
Thierry Guillaudeux ◽  
Grégory Verhoest ◽  
Rémy Pedeux
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Body Fluid ◽  
Early Stage ◽  
Ease Of Use ◽  
High Rate ◽  
Low Grade ◽  
High Grade ◽  
Liquid Biopsies

Liquid biopsies are increasingly used for the diagnosis and follow-up of cancer patients. Urine is a body fluid that can be used to detect cancers and others diseases. It is noninvasive and easy to collect. To detect Bladder Cancer (BC), cytology is the first assay used. It is an effective way to detect high grade BC but has a high rate of equivocal results, especially for low grade BC. Furthermore, cystoscopy is used to confirm cytology results and to determine cancer status. Cystoscopy is also effective but highly invasive, and not well accepted by patients, especially for BC follow-up. In this review we survey the numerous assays recently developed in order to diagnose BC at an early stage, and to facilitate the follow-up of patients. We discuss their effectiveness, ease of use, and applications. Finally, we discuss assays that, in the future, could improve the diagnosis and management of BC patients.

PATIENT INFORMATION CULTURE AS A FACTOR IN THE TIMELINESS OF CANCER CARE

2021 ◽  
pp. 135-141
Author(s):  
Funticova E.L. ◽  
Kozlov V.A. ◽  
Mushnikov D.L. ◽  
Ananyina L.G. ◽  
Khmel A.A.
Keyword(s):  
Cancer Patients ◽  
Patient Information ◽  
Cancer Care ◽  
Medical Information ◽  
Health Sector ◽  
Survey Method ◽  
Sample Population ◽  
Information Culture ◽  
Study Program ◽  
The Right

Information and its quality have always been important conditions for making the right decisions. The issues of methodical assessment of patient awareness, quality of organization and medical information in the public and private health sector remain unresolved. At the same time, there are very few scientific papers devoted to the research of the information culture of cancer patients. The aim of the study is to develop proposals to improve it on the basis of an assessment of the current state of the information culture of cancer patients. Research base: GBUS IWOOD. Time of the study 2020. Methods: sociological, analytical, documentary. The study program included the use of a survey method on a specially developed questionnaire "A map of social and hygienic research of patient information culture", which included 15 questions of a closed type. The unit of observation is a patient of cancer profile. The sample population, formed by random selection, was 400 patients. Based on the analysis of the medical records, patients were divided into groups, depending on the timeliness of seeking medical care for cancer. The t-Student criterion was used to determine the validity of the difference in the comparison groups. Differences between the groups were considered reliable at p<0.05. According to the results of the study, 5 components of the patient information culture have been identified, its important role in ensuring the timeliness of cancer care has been established, the levels and nature of the reduction in assessments of its current condition have been determined, and measures to improve the information culture of cancer patients have been proposed, which can be demanded by practical doctors, management of medical institutions, health authorities in shaping the areas of hygiene education and education of the population. As a result of the implementation of the proposals, positive dynamics of assessments on all components of patient information culture have been achieved.

scholarly journals Interventions for Maximizing Quality Communication in Cancer Care: A Systematic Review of Systematic Reviews

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 99s-99s ◽  
Author(s):  
S. Licqurish ◽  
L. Pattuwage ◽  
S. Chima ◽  
A. Qama ◽  
J. Emery
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
Cancer Patients ◽  
Systematic Reviews ◽  
Cancer Care ◽  
Effective Communication ◽  
Cochrane Library ◽  
Cancer Information ◽  
Evidence Based ◽  
Communication Interventions

Background: Clinician communication has shown to influence cancer patients' perception of care and satisfaction. Effective communication is therefore a critical aspect of patient-centered care. Health services should be implementing evidence-based communication interventions to improve the provision of cancer care to patients. Aim: We conducted a systematic review of the literature with the aim to identify effective communication strategies and/or interventions to improve clinician-patient communication. Methods: Five electronic databases (MEDLINE, Embase, PsycINFO, the Cochrane Library and CINAHL Plus) were searched for relevant citations from 2005 until October 2015 using search terms related to “cancer”, “information” and “communication”. Titles and abstracts were evaluated by two independent reviewers. Selected full text publications were assessed against the eligibility criteria. Quality was assessed using the AMSTAR guidelines and GRADE. Due to the enormity of the literature, only systematic reviews were included. Results: The database search yielded 2934 unique citations, of which 198 full texts were retrieved. After applying the inclusion and exclusion criteria, 41 systematic reviews were included. The included studies were broadly categorized under six major themes: e-health, technological and telephone-based interventions (n=9); patient education and tools (n=5); communication training (n=9); education interventions to improve cancer pain (n=6); tools to facilitate patients' participation in care/decision making (n=8); nurse delivered interventions (n=6). Conclusion: There are an enormous number of studies of communication interventions for cancer patients. The quality of the evidence to support some of these interventions is low; whereas other interventions have stronger evidence of effectiveness. Therefore, health services and clinicians should carefully consider which interventions they choose to implement. The recommendations from this review will assist clinicians and health services to choose evidence-based interventions which can improve care provision and/or patient outcomes.

Understanding differences in total cancer care cost by service site.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18345-e18345
Author(s):  
Karen K. Fields ◽  
Jason M Burkett ◽  
Cindy Terrano ◽  
Floyd Dukes ◽  
Bharat Gorantla ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Cancer Care ◽  
Early Stage ◽  
Peer Group ◽  
Peer Groups ◽  
Total Cost ◽  
Lung Cancer Patients ◽  
One Year

e18345 Background: Oncology providers are under mounting pressure to deliver high quality and increasingly complex cancer treatment while simultaneously managing the cost pressures coming from payers and patients alike. Developing an effective strategy to compare costs can be an important tool for assessing and improving performance and cost effectiveness from both a clinical and market competitive standpoint. This comparison can be difficult to achieve in practice, especially between different sites of care and across heterogeneous patient populations. Methods: A large commercial claims dataset with reimbursement data for claims incurred between 2014 and 2017 was used to identify lung cancer patients by site of care. We calculated average annual total cost of care (TCC) for a one year period for patients with a new cancer diagnosis following a one year period of no claims for lung cancer. For study purposes, Moffitt Cancer Center (MCC) was compared to two other peer groups: Large Hospital Systems (LHS) and small hospitals and community-based oncology practices (CBOP). Patients were assigned to each peer group when a majority of claims ( > 70%) were attributed to one of the peer groups. We analyzed overall average annual TCC for all patients and then created a sub-cohort of patients who received surgery within the study period to define early stage patients based on known standard patterns of care for newly diagnosed lung cancer. Results: There were 1249 new lung cancer patients in the study across all three peer groups with an average annual TCC of $134K per patient (range: $110K to $149K). When considering the sub-cohort of early stage patients (n = 396), MCC’s average annual TCC was $124K per patient which was significantly lower than LHS ($152K; p < 0.0499) and CBOP ($167K; p < 0.01). Conclusions: Although claims data generally contain only limited clinical information such as procedures, supplies and diagnosis, this limitation can be address by incorporating known standard of care patterns for cancer treatment to create comparable groups. Using this approach, national claims sets can be leveraged as the basis of a powerful analysis tool for understanding the Total Cost of Cancer care across institutional boundaries while still achieving meaningful comparability of the analyzed patient population.

The role of digital clinical measures in improving cancer care and research.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13584-e13584
Author(s):  
Jennifer Goldsack ◽  
Ariel Aguilo ◽  
Andrea Coravos ◽  
Chris Economos ◽  
Kate Lyden
Keyword(s):  
Best Practices ◽  
Cancer Care ◽  
Digital Health ◽  
Performance Status ◽  
Vital Signs ◽  
High Quality ◽  
Non Profit ◽  
Digital Medicine ◽  
Oncology Trial ◽  
Clinical Measures

e13584 Background: From objectively assessing performance status to recording simple vital signs, the adoption of high quality digital clinical measures offers enormous possibilities for transforming cancer care & research. However, the development & deployment of high quality digital measures in oncology lags behind adoption in other therapeutic areas. At the time of submission, the DiMe library of digital endpoints reports 166 unique digital endpoints being used in industry sponsored trials of new medical products, but none are being used in an oncology trial. There are seven digital clinical measures working their way through the FDA qualification program, but none in oncology. During the pandemic, care for patients with cardiac and other chronic conditions transitioned out of the clinic & into the home powered not only by virtual visits, but high quality information from remote monitoring. A study of oncology care facilities worldwide reported 89% finding difficulty in delivering usual care due to the challenges of safely bringing patients into the clinic during COVID. Methods: From March to Sep 2020, cross-industry stakeholders at the Digital Medicine Society (DiMe), Elektra Labs, Genentech, Koneksa, Myokardia, Sage Bionetworks, Scripps Research, and the US Food & Drug Administration came together to synthesize best practices from the digital health field, breaking down silos to create ‘ The Playbook’, the comprehensive and accessible “how-to” guide to support all stakeholders working to advance the safe, effective, ethical, and equitable use of digital clinical measures to improve lives. In October 2020, DiMe -- a 501c3 non-profit dedicated to advancing digital medicine to improve lives -- convenened a pre-competitive collaboration of 44 participants from 29 organizations to drive the adoption of the best practices articulated in The Playbook. Results: The Playbook describes trans-industry consensus for best practices for developing and deploying digital clinical measures across patient care, clinical research, and public health, including for oncology. Conclusions: The clinical, technical, and operational best practices necessary to develop and deploy high quality digital clinical measures into cancer care & research have been established. There is no reason for their successful adoption in oncology to lag behind other therapeutic areas. The Playbook and additional resources to support implementation due for launch on April 30 are critical tools for the field of oncology.

Are Older Cancer Patients Being Referred to Oncologists? A Mail Questionnaire of Ontario Primary Care Practitioners to Evaluate Their Referral Patterns

2003 ◽  
Vol 21 (24) ◽  
pp. 4627-4635 ◽  
Author(s):  
Carol A. Townsley ◽  
Kendra Naidoo ◽  
Gregory R. Pond ◽  
Wendy Melnick ◽  
Sharon E. Straus ◽  
...  
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Cancer Care ◽  
Older Patients ◽  
Early Stage ◽  
Care Physician ◽  
Cancer Symptoms ◽  
Referral Decisions ◽  
Older Cancer Patients

Purpose: Understanding why older patients are frequently underrepresented in cancer services use and clinical research may help to increase their participation in clinical trials and eventually result in better cancer care for this vulnerable population. Methods: To identify potential barriers that may prevent older cancer patients from being referred from a primary care physician (PCP) to an oncology specialist, a self-administered questionnaire was mailed to 9,312 PCPs throughout Ontario. Results: With a one-time mailing, 2,240 questionnaires were returned (response rate, 24%) of which 2,089 (93%) were assessable. Although 86% of respondents would refer most older patients with early-stage, potentially curable cancers to oncologists, only 65% would refer those with advanced-stage, potentially incurable cancers. The factors that most influence referral decisions of PCPs are patient’s desire to be referred (69%), type (54%) and stage (49%) of cancer, and severity of cancer symptoms (49%). Other factors including age do not seem to influence the referral decision. Approximately 9% of respondents found it difficult to refer older cancer patients to oncology specialists, with the most commonly cited barriers being the length of waiting lists, mandatory tissue diagnosis before referral, and the belief that oncologists seldom relate to PCPs. Conclusion: Most PCPs stated that they would refer all elderly patients with cancer to oncologists and that referral decisions were based mainly on patients’ wishes. Continued efforts are needed to overcome barriers in the referral process and to understand the perspectives of elderly patients to enhance their cancer care.

Sign in / Sign up

Export Citation Format

Share Document