Using technology to improve patient-provider communication and delivery of quality care.

Authors

Gabrielle Rocque

Gabrielle Betty Rocque

University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL

Gabrielle Betty Rocque, Amanda Hathaway, Karina I. Halilova, Michele Gaguski, Kathryn A Thomas, Carrie Tompkins Stricker, Karen Hammelef, SarahLena Panzer, Paul B. Jacobsen, Joanne S. Buzaglo, Douglas W. Blayney

Organizations

University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL, University of Alabama at Birmingham, Comprehensive Cancer Center, Division of Hematology and Oncology, Birmingham, AL, Atlanticare Cancer Care Institute, Egg Harbor Township, NJ, Carevive Systems, Inc., Miami, FL, Moffitt Cancer Center, Tampa, FL, Cancer Support Community, Research and Training Institute, Philadelphia, PA, Stanford University, Stanford, CA

Research Funding

Pharmaceutical/Biotech Company

Background: Shared decision making (SDM) is a cornerstone of patient-centered care with 85-90% of breast cancer (BC) patients preferring an active or shared role in decision-making for breast surgery. SDM has been shown to, improve patients’ understanding of treatment options, result in more conservative care choices, and lead to lower healthcare costs. However, implementation is complex as numerous misconceptions exist. Methods: We are conducting a multi-site, quality improvement (QI) project to improve SDM behaviors and adherence to quality measures through a combination of provider education and use of a novel technology platform, the Carevive Care Planning System. This platform elicits patient preferences, concerns, history, and symptoms, and presents these data with algorithm-driven recommendations as part of a treatment plan. We report results from baseline provider surveys assessing perception and knowledge of SDM. Results: Baseline surveys from 28 participants were analyzed; 43% from a university based cancer center and 57% from community based cancer centers. Survey respondents were MDs (43%), NPs (7%) and RNs (46%), all specializing in Hematology and/or Oncology. When asked, “What percentage of breast cancer patients prefers an active or shared role in decision making?”, only 29% believed 85-90% of BC patients desired an active or shared role as suggested by surgical literature; 43% believed between 55-70% of patients wanted to be engaged in decision-making. Commonly reported barriers to SDM are shown in the table below. Conclusions: Physicians may underestimate patient’s desire to participate in shared decision-making. The barriers to implementing SDM in oncology practice will likely require multi-faceted interventions to overcome. We aim to address these gaps through an intervention aimed at enhancing knowledge and patient-provider engagement through treatment summaries.

Provider-reported barriers to SDM.

BarriersN (%)
Patients say they want to take a more active role, really
they want the physician to tell them what treatment
to choose
16 (57.1%)
Shared decision making will take too much time and
effort
12 (42.9%)
Patients are not fully able to understand the risks/
benefits of the treatment options
12 (42.9%)

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Abstract Details

Meeting

2016 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Practice of Quality and Cost, Value, and Policy in Quality

Track

Cost, Value, and Policy in Quality,Practice of Quality,Science of Quality

Sub Track

Involving Patients in Quality Care

Citation

J Clin Oncol 34, 2016 (suppl 7S; abstr 76)

DOI

10.1200/jco.2016.34.7_suppl.76

Abstract #

76

Poster Bd #

G3

Abstract Disclosures

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