scholarly journals Policy Challenges and Opportunities to Address Changing Paradigms in Cancer Care Delivery

2019 ◽  
Vol 17 (5) ◽  
pp. 424-431
Author(s):  
Katy Winckworth-Prejsnar ◽  
James McCanney ◽  
Alyssa A. Schatz ◽  
Warren Smedley ◽  
Leonidas C. Platanias ◽  
...  
Keyword(s):  
Cancer Care ◽  
Working Group ◽  
Care Delivery ◽  
Quality Care ◽  
Healthcare Delivery ◽  
Policy Recommendations ◽  
Healthcare Delivery System ◽  
Challenges And Opportunities ◽  
Innovative Therapies ◽  
Payment Models

Multiple factors are forcing the healthcare delivery system to change. A movement toward value-based payment models is shifting these systems to team-based integration and coordination of care for better efficiencies and outcomes. Workforce shortages are stressing access and quality of care for patients with cancer and survivors, and their families and caregivers. Innovative therapies are expensive, forcing payers and employers to prioritize resources. Patients are advocating for care models centered on their needs rather than those of providers. In response, payment policies have recently focused on the promotion of alternative payment models that incentivize coordinated, high-quality care with consideration for value and controlling the increasing overall costs associated with cancer and its treatment. Given the multitude of factors confounding cancer care, NCCN convened a multistakeholder working group to examine the challenges and opportunities presented by changing paradigms in cancer care delivery. The group identified key challenges and developed policy recommendations to address 4 high-visibility topics in cancer care delivery. The findings and recommendations were then presented at the NCCN Policy Summit: Policy Challenges and Opportunities to Address Changing Paradigms in Cancer Care Delivery in September 2018, and multistakeholder roundtable panel discussions explored these findings and recommendations along with additional items. This article encapsulates the discussion from the NCCN Working Group meetings and the NCCN Policy Summit, including multistakeholder policy recommendations on delivery issues in cancer care designed to help inform national policies moving forward.

The HOLA COVID-19 study: Evaluating the impact of caring for patients with COVID-19 on cancer care delivery in Latin America.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1537-1537
Author(s):  
Carolina Bernabe Ramirez ◽  
Ana I. Velazquez Manana ◽  
Coral Olazagasti ◽  
Cristiane Decat Bergerot ◽  
Enrique Soto Perez De Celis ◽  
...  
Keyword(s):  
Latin America ◽  
Latin American ◽  
Cancer Care ◽  
Online Survey ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Significant Proportion ◽  
Multiple Choice Questions ◽  
Patients With Cancer ◽  
The Impact

1537 Background: The severe acute respiratory syndrome 2 (SARS-cov-2) virus causing COVID-19 has brought great challenges to global health services affecting cancer care delivery, outcomes, and increasing the burden in oncology providers (OP). Our study aimed to describe the challenges that OP faced while delivering cancer care in Latin America. Methods: We conducted an international cross-sectional study using an anonymous online survey in Spanish, Portuguese, and English. The questionnaire included 43 multiple choice questions. The sample was stratified by OP who have treated patients with COVID-19 versus those who have not treated patients with COVID-19. Data was analyzed with descriptive statistics and Chi-square tests. Results: A total of 704 OP from 20 Latin American countries completed the survey (77% of 913 who started the survey). Oncologists represented 46% of respondents, followed by 25% surgical-oncologists. Of the respondents, 56% treated patients with COVID-19. A significant proportion of OP reported newly adopting telemedicine during COVID-19 (14% vs 72%, p=0.001). More than half (58%) of OP reported making changes to the treatments they offered to patients with cancer. As shown in the table, caring for patients with COVID-19 significantly influenced practice patterns of OP. Access to specialty services and procedures was significantly reduced: 40% noted significantly decreased or no access to imaging, 20% significantly decreased or no access to biopsies, 65% reported delays in surgical oncology referrals, and 49% in radiation oncology referrals. A vast majority (82%) reported oncologic surgeries were delayed or cancelled, which was heightened among those treating patients with COVID-19 (87% vs 77%, p=0.001). Conclusions: The COVID-19 pandemic has significantly affected the way cancer care is delivered in globally. Although changes to healthcare delivery are necessary as a response to this global crisis, our study highlights the significant disruption and possible undertreatment of patients with cancer in Latin America that results from COVID-19.[Table: see text]

Preparing for an Epidemic: Cancer Care in an Aging Population

2014 ◽  
pp. 133-137 ◽  
Author(s):  
Ya-Chen Tina Shih ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Care Delivery ◽  
Quality Care ◽  
Aging Population ◽  
Population Based ◽  
Cancer Drug ◽  
Evidence Based ◽  
Evidence Based Care

The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer.

scholarly journals Breaking the bottle neck to enhance pediatrics renal transplantation at Soba university hospital: Role of a non-governmental organization

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Ihab B. Abdalrahman ◽  
Shaima N. Elgenaid ◽  
Rashid Ellidir ◽  
Asma Nizar Mohammed Osman Abdallah ◽  
Safa Ahmed Hassan Hamid ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Quality Care ◽  
Healthcare Delivery ◽  
University Hospital ◽  
Healthcare Delivery System ◽  
Governmental Organization ◽  
Low Resource ◽  
Number Of Patients ◽  
Stage Renal Disease ◽  
The Impact

High cost and limited resources of pediatrics renal transplant in low-resource countries limits the number of transplants. However, the collaboration between government and community sector provided high quality care for these patients. Here we highlight the impact of a non-governmental organization in facilitating pediatrics renal transplant. Data was collected from files of all pediatric patients withend stage renal disease who received renal transplant between January 2010 and December 2017 at Soba University Hospital (77 patients). The 8-year period was divided into 16 intervals of 6 months each. The number of patients who received renal transplant ranged from 1 to 12 patients in each interval. There was a rise in 2017 when 21 (28.7%) patients received kidney transplant. In the last 6 months in 2017 there was a significant reduction in duration of hospital stay compared to the rest of the period; it dropped from 16.36 to 9.92 days (P=0.003). Partnership between governmental and non-governmental sectors is a good strategy in low resource area to bridge some of the gaps of healthcare delivery system.

scholarly journals The Heart Failure Readmission Intervention by Variable Early Follow-up (THRIVE) Study

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Keane K. Lee ◽  
Rachel C. Thomas ◽  
Thida C. Tan ◽  
Thomas K. Leong ◽  
Anthony Steimle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care Physicians ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Clinic Visit ◽  
Heart Failure Hospitalization ◽  
Healthcare Delivery System ◽  
Unique Identifier ◽  
Clinic Visits

Background: In-person clinic follow-up within 7 days after discharge from a heart failure hospitalization is associated with lower 30-day readmission. However, health systems and patients may find it difficult to complete an early postdischarge clinic visit, especially during the current pandemic. We evaluated the effect on 30-day readmission and death of follow-up within 7 days postdischarge guided by an initial structured nonphysician telephone visit compared with follow-up guided by an initial clinic visit with a physician. Methods and Results: We conducted a pragmatic randomized trial in a large integrated healthcare delivery system. Adults being discharged home after hospitalization for heart failure were randomly assigned to either an initial telephone visit with a nurse or pharmacist to guide follow-up or an initial in-person clinic appointment with primary care physicians providing usual care within the first 7 days postdischarge. Telephone appointments included a structured protocol enabling medication titration, laboratory ordering, and booking urgent clinic visits as needed under physician supervision. Outcomes included 30-day readmissions and death and frequency and type of completed follow-up within 7 days of discharge. Among 2091 participants (mean age 78 years, 44% women), there were no significant differences in 30-day heart failure readmission (8.6% telephone, 10.6% clinic, P =0.11), all-cause readmission (18.8% telephone, 20.6% clinic, P =0.30), and all-cause death (4.0% telephone, 4.6% clinic, P =0.49). Completed 7-day follow-up was higher in 1027 patients randomized to telephone follow-up (92%) compared with 1064 patients assigned to physician clinic follow-up (79%, P <0.001). Overall frequency of clinic visits during the first 7 days postdischarge was lower in participants assigned to nonphysician telephone guided follow-up (48%) compared with physician clinic-guided follow-up (77%, P <0.001). Conclusions: Early, structured telephone follow-up after hospitalization for heart failure can increase 7-day follow-up and reduce in-person visits with comparable 30-day clinical outcomes within an integrated care delivery framework. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03524534.

scholarly journals Psychological Support and Telehealth Options for Patients with Cancer during the Covid-19 Pandemic in Saudi Arabia

2021 ◽  
Vol 8 ◽  
Author(s):  
Manal Banaser ◽  
Sami Alshammary
Keyword(s):  
Cancer Patients ◽  
Support Groups ◽  
Cancer Care ◽  
Healthcare Delivery ◽  
Psychosocial Care ◽  
Multidisciplinary Care ◽  
Psychological Support ◽  
Registry Data ◽  
Cancer Center ◽  
Healthcare Delivery System

Background: COVID-19 concerns are associated with an increase in symptoms of depression and anxiety among cancer patients. Telehealth services hold incredible potential for providing psychological support to cancer patients. In a technology-assisted intervention for telehealth, hotline services are a valuable tool to provide psychosocial care. This paper examines the use of hotline services to offer psychological support to cancer patients. Methods: A retrospective analysis of hotline calls patient registry data was conducted. Data were collected from a single cancer center in Riyadh, from May 2020 to March 2021, with a random sample of 877 callers to cancer hotline services. Responses of a satisfaction questionnaire were linked to call-related concerns of registry data.  Results: A total of 877 calls were received, the majority of which came from Riyadh locals. Patient disease complaints accounted for 210 calls (24%), while retake medicine requests accounted for 251 calls (28.62%). 143 (16.31%) calls were about scheduled new appointments, 261 calls (29.76%) were about psychological issues induced by Covid-19, such as worry, fear, and anxiety symptoms, and 12 calls (1.37%) having to do with Covid-19. Seven hundred seventy-two callers (88 %) indicated satisfaction with the services call attended. Discussion: Hotline services in cancer care have been identified as a key resource telehealth service that positively influences patient satisfaction and meets cancer patient needs in the face of the pandemic. This study also highlighted the need for other telehealth services, such as mental health mobile applications, virtual multidisciplinary care, and online support groups, which can provide an excellent option for providing psychological support to cancer patients. Conclusion: This study found that providing Cancer Care Hotline services during a pandemic improves patient-centered care and a more efficient healthcare delivery system. 

Patient Navigation and Cancer Care Delivery

2018 ◽  
Author(s):  
Harold P. Freeman ◽  
Melissa A. Simon
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Patient Navigation ◽  
Care Delivery ◽  
Clinical Care ◽  
Quality Care ◽  
Successful Implementation ◽  
Care Continuum ◽  
Patient Navigators ◽  
Health Care Delivery Systems

Although the US health care system offers the very best care to many, the poor and uninsured typically face challenges in accessing timely health care, even when faced with a life-threatening disease such as cancer. Spurred by unmet patient needs and the growing complexity of health care delivery systems, patient navigation seeks to diminish social, economic, cultural, and medical system barriers to timely quality care. This case study discusses the emergence of patient navigation as a strategy for improving cancer outcomes, especially among vulnerable populations. It explores challenges and opportunities related to advancing successful implementation of patient navigation across the cancer care continuum. It seeks to harness and apply the power and energy of patient navigators with the goal of guiding individuals across the health care continuum—from the communities where they live all the way through screening, diagnosis, and treatment at clinical care sites.

A Multidisciplinary Remote Healthcare Delivery System to Increase Health Care Access, Pathology Screening, and Treatment in Developing Countries

2019 ◽  
pp. 1376-1409
Author(s):  
Thierry Oscar Edoh ◽  
Pravin Amrut Pawar ◽  
Bernd Brügge ◽  
Gunnar Teege
Keyword(s):  
Health Care ◽  
Delivery System ◽  
Health Care Access ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Access To Healthcare ◽  
Healthcare Delivery System ◽  
Care Access ◽  
Traditional Practitioners ◽  
Remote Care

In this paper, the authors describe a case study of the poor access to healthcare in developing world, case of Benin, a West African developing country. The authors identify problems and the existing obstacles for applying standard Telemedicine and eHealth solutions. The authors particularly describe an adapted multidisciplinary remote care delivery system approach for improving and increasing the use of existing health services as well as the access to healthcare by overcoming some cultural, social, financial, and at least linguistic barriers. The multidisciplinary remote care delivery system integrates traditional practitioners, because most people are more confident with the traditional medicine. The authors further present a practical test which has shown that their approach has the potential to improve the quality and effectiveness of health care in rural and other concerned regions and also increase the accessibility to health care system.

New Payment Models and Big Data Analytics

2014 ◽  
pp. 1622-1636
Author(s):  
Avnish Rastogi
Keyword(s):  
Care Delivery ◽  
Healthcare Delivery ◽  
Big Data Analytics ◽  
National Research Council ◽  
International Perspective ◽  
Institute Of Medicine ◽  
Healthcare Delivery System ◽  
Quality Outcomes ◽  
Younger Age ◽  
Government Mandates

It has been fascinating to watch how American healthcare delivery system is going through a paradigm shift to meet new government mandates and bend the care delivery cost curve. For years, US health care system has been fragmented and falling short on quality, outcomes, costs, and lacking framework to support care continuum. According to the study conducted by National Research Council and the Institute of Medicine, for many years, US population has been dying at the younger age than population with similar characteristics in other countries such as Canada, Australia and Japan. When compared with the peer countries, US Population did worse in health areas such as drug related deaths, obesity, chronic diseases, disability, etc. (Institute of Medicine of the National Academics. 2013 in, U.S Health in International Perspective Shorter Lives, Poorer Health.)

Real-time locating systems to improve healthcare delivery: A systematic review

2021 ◽  
Author(s):  
Kevin M Overmann ◽  
Danny T Y Wu ◽  
Catherine T Xu ◽  
Shwetha S Bindhu ◽  
Lindsey Barrick
Keyword(s):  
Systematic Review ◽  
Real Time ◽  
Care Delivery ◽  
Quality Care ◽  
Healthcare Delivery ◽  
Healthcare Setting ◽  
Lessons Learned ◽  
Clinical Environment ◽  
Qualitative Synthesis ◽  
Meta Analyses

Abstract Objective Modern health care requires patients, staff, and equipment to navigate complex environments to deliver quality care efficiently. Real-time locating systems (RTLS) are local tracking systems that identify the physical locations of personnel and equipment in real time. Applications and analytic strategies to utilize RTLS-produced data are still under development. The objectives of this systematic review were to describe and analyze the key features of RTLS applications and demonstrate their potential to improve care delivery. Materials and Methods We searched MEDLINE, SCOPUS, and IEEE following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were articles that utilize RTLS to evaluate or influence workflow in a healthcare setting. We summarized aspects of relevant articles, identified key themes in the challenges of applying RTLS to workflow improvement, and thematically reviewed the state of quantitative analytic methodologies. Results We included 42 articles in the final qualitative synthesis. The most frequent study design was observational (n = 24), followed by descriptive (n = 12) and experimental (n = 6). The most common clinical environment for study was the emergency department (n = 12), followed by entire hospital (n = 7) and surgical ward (n = 6). Discussion The focus of studies changed over time from early experience to optimization to evaluation of an established system. Common narrative themes highlighted lessons learned regarding evaluation, implementation, and information visibility. Few studies have developed quantitative techniques to effectively analyze RTLS data. Conclusions RTLS is a useful and effective adjunct methodology in process and quality improvement, workflow analysis, and patient safety. Future directions should focus on developing enhanced analysis to meaningfully interpret RTLS data.

Collaborating With Advanced Practice Providers: Impact and Opportunity

2017 ◽  
pp. e1-e7
Author(s):  
Heather M. Hylton ◽  
G. Lita Smith
Keyword(s):  
Nurse Practitioners ◽  
Cancer Care ◽  
Care Delivery ◽  
Quality Care ◽  
Cost Effective ◽  
Physician Assistants ◽  
Direct Patient Care ◽  
Advanced Practice ◽  
Care Access ◽  
Centered Care

Although significant progress has been made in cancer care, access to coordinated, high-quality care across the cancer care continuum remains a challenge for many patients. With significant workforce shortages in oncology anticipated, physician assistants (PAs) and nurse practitioners (NPs)—known collectively as advanced practice providers (APPs)—are considered to be a part of the solution to bridging the gap between the supply of and demand for oncology services. APPs are integral to the provision of team-based care in oncology, and optimizing the roles of all members of the patient’s care team is vital to ensuring the teams are cost-effective and that each team member is performing at the functional level intended. Studies have shown significant patient, physician, and APP satisfaction with collaborative care models, and APPs are well positioned to enhance value for patients in the oncology setting. Understanding the full scope of APP impact can be challenging as it extends well beyond direct patient care. As rapid progress in cancer care continues, innovative approaches to care delivery will be necessary to ensure patients’ access. Effective oncologist–APP partnerships will be key to providing optimal, value-centered care to patients.

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