Oncology clinical trials and insurance coverage: An update in a tenuous insurance landscape

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151873/1/cncr32360_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151873/2/cncr32360.pd

Physicians' perspectives on medication adherence and health promotion among cancer survivors

Survey responses from primary care physicians ( n= 30), oncologists ( n= 30), and other specialists who treat cancer patients ( n= 31), along with interviews of 12 oncologists, indicate that physicians do not often engage in healthy lifestyle promotion with cancer survivors and fear that providing health promotion advice would distress or overwhelm patients, compromising their medical regimen adherence. Additional health promotion barriers were perceived patient disinterest, cancer as oncologists’ focal concern, time pressure, insufficient behavior change training, and care coordination challenges

Establishing survivorship care planning in a comprehensive cancer center to meet clinic needs and accreditation standards

59 Background: Standard 3.3 of the American College of Surgeons Commission on Cancer (CoC) patient-centered care guidelines requires that accredited institutions deliver SCPs to all patients completing cancer treatment with curative intent (10% of eligible patients in 2015 and increasing incrementally to 100% in 2019). Implementation of SCP delivery has been challenging and limited to date. We describe our implementation process at the Robert H. Lurie Comprehensive Cancer Center. Methods: We established a multidisciplinary working group that developed and administered a survey of providers’ attitudes towards SCPs and preferences for delivery, assessed clinical workflows, then developed and vetted customized SCP templates within the electronic health record (EHR) and two complimentary SCP delivery models. Results: Twelve providers completed the survey (6 physicians, 5 advanced practice providers [APPs], 1 nurse). 67% viewed SCPs as feasible within workflows, 75% felt designated survivorship clinicians were best equipped to deliver SCPs; All reported SCPs were beneficial to patients; and 92% felt SCPs were beneficial to inter-provider communication. Cited barriers were: time and staff required and non-optimal billing. To harmonize with existing workflows, we established two delivery models: (1) clinical groups with a low volume of survivors relative to available nursing staff complete and deliver SCPs themselves; (2) clinical groups with high volumes of survivors relative to available nursing staff refer patients to a centralized survivorship clinic where SCPs are delivered by designated survivorship APPs. All elements of the ASCO templates were incorporated into our EHR templates. We reduced free-text data entry by designing templates where 20% of the fields are auto-populated from existing EHR data and another 65% use drop-down menus. Mean completion time is 12 minutes (range 10-30 minutes; n= 30). Conclusions: CoC-accredited institutions across the nation are working to meet Standard 3.3. We present our experiences developing and implementing SCP delivery models, including lessons learned to inform models of survivorship care under development at other institutions