University of Kansas Cancer Center, Westwood, KS
Jennifer R. Klemp , Becky N. Lowry , Judy A Johnston , Kyla Alsman , Danielle Peereboom , Trish Long , Susan Krigel , Hope Krebill , Allen Greiner
Background: While evidence-based guidelines for survivorship care exist, implementation in oncology and primary care practices has fallen short. There is little evidence of the barriers preventing successful implementation in rural primary care and oncology practices. We sought to assess knowledge gaps and barriers to successful implementation of evidence-based survivorship care guidelines in rural Kansas practices. Methods: Midwest Cancer Alliance, outreach arm of the University of Kansas Cancer Center, and Kansas Patients and Providers Engaged in Prevention Research, completed interviews in rural primary care and oncology practices. Results: Primary Care (n=7) and Oncology Practices (n=4): Interviews with primary care physicians, medical oncologists, advanced practice providers, nurses, tumor registrar, outreach coordinator, and office management & staff. Conclusions: Rural primary care and oncology practices experienced barriers to delivering survivorship care including: educational gaps, communication of history, treatment, and recommendations, EHR integration, and lack of resources. Next steps focus on a unified approach to state-wide survivorship education of patients, primary care and oncology practices.
Cross-Cutting Themes | Specific Barriers | |
---|---|---|
Oncology | Primary Care | |
Provider & Patient engagement, communication | · collaboration with community and providers | · lack of documented history, results, treatment summary, & guidelines |
· role delineation among primary care and oncology | · role delineation & responsibilities among patients and providers | |
Knowledge Gaps | · education across all disciplines | · knowledge around guidelines |
· community & survivor understanding of survivorship | · awareness of available resources | |
Access to Survivorship Care & Resources | · accreditation standards | · transportation & financial |
· support from administration | · SCP as chronic disease plan | |
· inconsistent SCP delivery | · inconsistent oncology recommendations | |
· poor access to specialists | ||
Organizational structure | · workflow issues impacting care delivery | · lack of EHR integration |
· inadequate care coordination | · inconsistent reimbursement | |
· lack of EHR generated SCP | · inadequate social services care coordination |
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