Outcomes in breast cancer from the patient perspective: Development of an innovative, user-centered platform for collection and reporting of patient-reported data.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 188-188
Author(s):  
Elena Tsangaris ◽  
Rakasa Pattanaik ◽  
Joanna O'Gorman ◽  
Jessica Means ◽  
Noah Sarucia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Web Application ◽  
Clinical Care ◽  
Quality Improvement Initiative ◽  
Breast Cancer Care ◽  
Clinical Implementation ◽  
Patient Reported ◽  
Reported Data ◽  
User Centered

188 Background: Transition towards a patient-centered healthcare model has been recognized as an important step towards improving the quality and coordination of breast cancer care. Although evidence suggests that patient self-reporting of quality of life improves clinical care, there are significant barriers to successful collection and use of patient-reported data (PRD) including a lack of a technology designed to fully engage patients and providers, limited electronic health record (EHR) integration, and suboptimal clinical implementation strategies. To address this, our team developed imPROVE, an innovative and customizable patient-reported data (PRD) collection platform consisting of a patient web-application and a clinician portal. Methods: This study was performed as a quality improvement initiative at Dana-Farber Cancer Institute (DFCI) and Brigham and Women’s Hospital (BWH). Multiple perspectives were sought from key stakeholders to ensure that the content and design of the platform target the needs of the end-users and garners the latest in technological advances. Development and testing were performed using best practices in user-centered design and agile development, and iterative programming sprints followed by stakeholder feedback and testing. Content was evaluated using probing questions about relevance, comprehensiveness, and clarity. Design was assessed through feedback about the look and feel of the platform and its usability. Results: A multidisciplinary team of 28 stakeholders in the field of breast cancer care, patient-reported outcomes research and value-based healthcare was assembled. Recurring group meetings (n = 8), individual patient interviews (n = 23), and two focus groups with the DF/HCC Breast Cancer Advocacy Group, were conducted. The resultant application is a hybrid mHealth application that is supported by iOS and Android and is comprised of five screens (myCare, myStory, myResources, myCommunity, myNotes). Patients are provided written and graphical displays of their PRD as well as tailored resources that are customized depending on their type and stage of treatment. The clinician portal is comprised of an overview table listing all patients enrolled for each individual clinician, as well as individual patient profiles demonstrating demographic, clinical, and outcomes data. Conclusions: imPROVE has the potential to create a paradigm shift in the delivery of care for breast cancer patients. Next steps will include implementation of imPROVE within the breast oncology and plastic surgery services at DFCI and BWH.

Does the innovative 4R Care Delivery Model improve timing and sequencing of guideline recommended breast cancer care in safety net and non-safety net centers?

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 562-562
Author(s):  
Christine B. Weldon ◽  
Julia Rachel Trosman ◽  
Della F. Makower ◽  
Bruce D. Rapkin ◽  
Moreen Bozier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Safety Net ◽  
Similar Rate ◽  
Care Patient ◽  
Control Cohort ◽  
Breast Cancer Care ◽  
Recommended Care ◽  
Reported Data

562 Background: Under the NCI ASCO Teams Project, we proposed a 4R Model which enables patient (pt) and care team to manage timing and sequencing of interdependent care with a novel multimodality 4R Care Project Plan (Trosman JOP ’16). 4R (Right Info/Care/Patient/Time) was previously piloted at 3 Chicago centers (Weldon ASCO ‘18). Methods: A new study tested impact of 4R on timing and sequencing of guideline recommended care at 4 safety net and 3 non safety net US centers. 4R Plans were provided to stage 0-III breast cancer pts Jan-Nov’18, 4R cohort. Clinical and pt reported data analyses compared 4R cohort (N=105) to a historical control cohort of pts who received care pre-4R, Jan - Dec ’17 (N=190). Results: We significantly improved 3 referral metrics and 4 referral completion metrics - receipt of care by pts who were referred (Table). After referrals, safety net pts had a significant increase in 4R vs control cohort in receiving genetic consult (72%, 21/29 vs. 42%, 18/43, p=.02) and dental visit (100%, 6/6 vs. 20%, 1/5, p=.02). They had lower increases in flu shot referrals (41%, 24/58, vs 36%, 37/104, NS) and dental referrals (10%, 6/58, vs 5%, 5/104, NS) than non safety net pts who had significant increases. Other metrics improved at a similar rate for safety net and non safety net pts. Conclusions: 4R markedly improved referral and receipt of interdependent guideline recommended breast cancer care. For most metrics safety net pts benefited from 4R at a similar or higher rate than non safety net pts, indicating that 4R may reduce care disparities. Low increases in referrals for safety net pts and in trial referral/enrollment for all pts must be addressed. An expansion of 4R across the US continues this work. [Table: see text]

Does the innovative 4R Care Delivery Model improve timing and sequencing of guideline recommended breast cancer care in safety net and non-safety net centers?

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 36-36
Author(s):  
Christine B. Weldon ◽  
Julia Rachel Trosman ◽  
Della F. Makower ◽  
Bruce D. Rapkin ◽  
Moreen Bozier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Safety Net ◽  
Similar Rate ◽  
Care Patient ◽  
Control Cohort ◽  
Breast Cancer Care ◽  
Recommended Care ◽  
Reported Data

36 Background: Under the NCI ASCO Teams Project, we proposed a 4R Model which enables patient (pt) and care team to manage timing and sequencing of interdependent care with a novel multimodality 4R Care Project Plan (Trosman JOP ’16). 4R (Right Info/Care/Patient/Time) was previously piloted at 3 Chicago centers (Weldon ASCO ‘18). Methods: A new study tested impact of 4R on timing and sequencing of guideline recommended care at 4 safety net and 3 non safety net US centers. 4R Plans were provided to stage 0-III breast cancer pts Jan - Nov’18, 4R cohort. Clinical and pt reported data analyses compared 4R cohort (N = 105) to a historical control cohort of pts who received care pre-4R, Jan - Dec ’17 (N = 190). Results: We significantly improved 3 referral metrics and 4 referral completion metrics - receipt of care by pts who were referred (Table). After referrals, safety net pts had a significant increase in 4R vs control cohort in receiving genetic consult (72%, 21/29 vs. 42%, 18/43, p = .02) and dental visit (100%, 6/6 vs. 20%, 1/5, p = .02). They had lower increases in flu shot referrals (41%, 24/58, vs 36%, 37/104, NS) and dental referrals (10%, 6/58, vs 5%, 5/104, NS) than non safety net pts who had significant increases. Other metrics improved at a similar rate for safety net and non safety net pts. Conclusions: 4R markedly improved referral and receipt of interdependent guideline recommended breast cancer care. For most metrics safety net pts benefited from 4R at a similar or higher rate than non safety net pts, indicating that 4R may reduce care disparities. Low increases in referrals for safety net pts and in trial referral/enrollment for all pts must be addressed. An expansion of 4R across the US continues this work. [Table: see text]

scholarly journals Implementing Patient-Reported Outcome Measures in Clinical Breast Cancer Care: A Systematic Review

2019 ◽  
Vol 22 (10) ◽  
pp. 1197-1226 ◽  
Author(s):  
Laurentine S.E. van Egdom ◽  
Arvind Oemrawsingh ◽  
Lisanne M. Verweij ◽  
Hester F. Lingsma ◽  
Linetta B. Koppert ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Outcome Measures ◽  
Cancer Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Breast Cancer Care ◽  
Patient Reported ◽  
Clinical Breast

scholarly journals Involvement of Primary Care Physicians in the Decision Making and Care of Patients With Breast Cancer

2016 ◽  
Vol 34 (33) ◽  
pp. 3969-3975 ◽  
Author(s):  
Lauren P. Wallner ◽  
Paul Abrahamse ◽  
Jaspreet K. Uppal ◽  
Christopher R. Friese ◽  
Ann S. Hamilton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Decision Making ◽  
Cancer Care ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Treatment Decisions ◽  
Care Providers ◽  
Breast Cancer Care ◽  
Patient Reported

Purpose Collaborative care between cancer specialists and primary care providers (PCPs) may improve the delivery of high-quality cancer care. Yet, patient perspectives about how involved the PCPs were in their breast cancer care and treatment decisions remain unknown. Patients and Methods A weighted random sample of women newly diagnosed with breast cancer in 2013 to 2014, as reported to the SEER registries in Los Angeles, California, and Georgia, were sent a survey approximately 6 months after diagnosis (N = 2,279, 71% response rate). The distributions of patient-perceived PCP quality (six questions about PCP access and awareness of values) and the following three measures of patient-reported PCP involvement were assessed: how informed the respondent felt her PCP was about her breast cancer (engagement); how often the respondent talked with her PCP (communication); and how often the respondent felt the PCP participated in treatment decisions (participation). Adjusted mean scores of patient-reported satisfaction with and deliberation about the surgical treatment decision were then compared across levels of PCP engagement, communication, and participation using multivariable linear regression. Results The majority of women in this sample perceived high PCP quality (63.6%), high PCP breast cancer engagement (66.2%), and high PCP communication (69.1%). More than a third of women (35.4%) reported that their PCP participated in their treatment decisions. Higher PCP engagement was associated with higher decision satisfaction when compared with low PCP engagement (adjusted P = .003). Conclusion Patient perceptions of PCP quality and PCP involvement in breast cancer care during treatment are high for most women, and PCPs often participate in breast cancer treatment decisions. However, PCP involvement did not lead to meaningful improvements in patients’ appraisals of their decision making.

scholarly journals Breast cancer care in Alberta: a Patients perspective

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Alysha Crocker ◽  
Susan Anderes ◽  
Linda Verbeek ◽  
Janice Chobanuk ◽  
David W Olson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Breast Surgery ◽  
Breast Cancer Patients ◽  
Breast Cancer Care ◽  
Quality Healthcare ◽  
Imaging Result ◽  
Email Address ◽  
Patient Reported

IntroductionEach year in Alberta, over 2,300 women are affected by breast cancer. In Alberta, a multi-year Breast Health Initiative is underway to improve breast cancer care; reduce wait times, coordinate care, and enhance patient experience. Patient reported experience measurements are important to inform and advance patient and family-centred care. Objectives and ApproachThe aim is to assess breast cancer patients’ experiences at two survey points; after surgeon consult and after breast surgery. Patients meeting inclusion criteria; highly suspicious of cancer on imaging result (i.e. BI-RADS 5), referral to Calgary or Edmonton breast program, English speaking, and having an email address are recruited by RN coordinators or nurse navigators. Automated survey invitations from REDCap are used. Seven days after the surgeon consult the first survey is sent and seven days after breast surgery the second survey is sent. ResultsPatient recruitment began November 27, 2017 and January 2, 2018 for Edmonton and Calgary, respectively. As of February, 2018, 45 patients had been recruited. Of these, the first survey was sent to 34 (i.e. seven days post surgeon consult) and 19 (56%) had completed the survey. All those eligible (18) agreed to participate in the upcoming second survey. Of those, six had provided their surgery date and the second survey which both were completed. Recruitment is ongoing until the conference, at that time there will be sufficient numbers to report findings. Conclusion/ImplicationsPatient and family-centred care is an element of high-quality healthcare which AHS has identified as a priority. These results will report on the breast cancer patients’ perspectives and generate important information for clinicians and administrators to use for decision making and quality improvement of health services.

scholarly journals Recommendations for streamlining precision medicine in breast cancer care in Latin America

2021 ◽  
Author(s):  
Isabel Alvarado‐Cabrero ◽  
Franco Doimi ◽  
Virginia Ortega ◽  
Jurema Telles Oliveira Lima ◽  
Rubén Torres ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Latin America ◽  
Precision Medicine ◽  
Cancer Care ◽  
Breast Cancer Care
Sign in / Sign up

Export Citation Format

Share Document