Promoting the shared-care model for adolescent and young adults with cancer: Optimizing referrals and care coordination with primary care providers.

Authors

null

Karen Kinahan

Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL

Karen Kinahan , Sheetal Mehta Kircher , Jessica K. Altman , Alfred Rademaker , John M Salsman , Aarati Didwania , Stacy D. Sanford

Organizations

Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, Northwestern Medicine, Chicago, IL, Northwestern University, Chicago, IL, Northwestern University Feinberg School of Medicine, Chicago, IL

Research Funding

No funding sources reported

Background: The “Shared-Care Model” involves care coordination between primary care providers (PCPs) and oncologists with aims of optimizing survivorship care. Adolescent and young adult (AYA) survivors may live decades post-diagnosis and are at risk for late effects, however, a high proportion of these patients do not have a PCP. Study objectives were to promote this model by 1) increasing the percentage of AYA with a PCP documented in the electronic medical record (EMR) via the use of a Best Practice Advisory (BPA) or “stopgap” intervention; 2) increase communication between providers by the number of clinic notes routed to providers; and 3) assess oncology providers’ attitudes/beliefs about the model and intervention. Methods: Data were collected for the 6 months prior to implementation of the BPA to determine percent of AYA with a PCP and number of notes routed to providers (T1, time point 1). The same data were collected at time point 2 (T2) after the BPA had been implemented for 6 months. Oncology providers participated in an education video module and an on-line survey at T1 and survey at T2. Results: During T1, 756 AYAs (18-39) were reviewed. 41% did not have a documented PCP in the EMR. After implementation of the BPA at T2, the percentage of patients without a PCP decreased to 31%, p < 0.0001 by Fisher’s exact test. The number of routed notes did not change significantly from T1 (38.7%) to T2 (40.6%) (p = 0.15). Of 61 eligible oncology providers, 70% completed the intervention survey at T1 and 65% at T2. Providers agreed/strongly agreed that the shared-care model is a desirable model of care (T1 = 86%; T2 = 93%); that PCPs have the skills necessary to provide cancer-related follow up care; (T1 = 51%; T2 = 46%); and that a BPA is useful for facilitating PCP referrals (T1 = 76%; T2 = 39%). Conclusions: This BPA is feasible and could potentially lead to increased PCP referral and communication for the benefit of long-term survivorship care in the AYA population.

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Abstract Details

Meeting

2016 Cancer Survivorship Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Care Coordination and Financial Implications,Communication,Late- and Long-term Effects/Comorbidities,Health Promotion,Psychosocial Issues,Recurrence and Secondary Malignancies

Sub Track

Oncology/Primary Care Communication Coordination

Citation

J Clin Oncol 34, 2016 (suppl 3S; abstr 76)

Abstract #

76

Poster Bd #

B3

Abstract Disclosures

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