Department of Hematology Oncology, The Permanente Medical Group, Roseville, CA
Dinesh Kotak, Jake Marjama, Marc Flagg, Jessica Sanchez, Amber Swanson, Laura Adams, Derrick McCray, Kevin Benson, Tatjana Kolevska
Background: Advances in treatment and early diagnosis have led to an increase in the 5-year relative survival rate for patients diagnosed with cancer. As of January 2022, there were 18.1 million cancer survivors in the United States, reflecting 5.4% of the total population. This number is projected to increase by 24.4%, to 22.5 million by 2032 (Cancer Facts and Figures 2023- American Cancer Society). Survivorship program needs include surveillance, member/ patient engagement, lifestyle changes and symptom management. Survivorship appointments make up >50% of the total return visits in oncology. There is a dire need for easy-to-use technology tools to help deliver high-quality survivorship care. Methods: We developed rules to automatically create a cohort of patients with Stage II and III colon cancer. The surveillance plan was developed by experts based on national guidelines. A separate set of rules drives the automatic generation of due dates for all elements of the care plan including laboratory tests, radiology examinations and clinical evaluations. A real-time dashboard clearly shows the care gaps. Tools were added to the dashboard to help with task completion. Results: The platform was successfully rolled out to 21 medical centers in Kaiser Permanente Northern California, an integrated healthcare system providing care for 4.4 million members. We experienced an increase in the completion for each of the surveillance elements needed for patients. Laboratory tests increased by 12.5%, radiology examinations by 8%, and clinical evaluations by 16%. Results have been sustained over the first year of use. Conclusions: We have successfully developed and operationalized a digital platform to sustainably support survivorship. This platform automatically identifies our survivorship cohort, informs the care team when care gaps exist and provides tools for task completion. Our care teams have used this platform successfully to outreach patients to ensure timely surveillance. This automatic platform reduces manual, redundant tasks previously performed by the care team. Further research is needed to explore the potential for this systems-based approach to reduce disparities in care. We plan to expand this to other cancers. Planned enhancements include automatic member reminders, lifestyle recommendations and symptom management.
Month | Number of patients | CEA - % timely completion | CT Scan - % timely completion | Visit - % timely completion |
---|---|---|---|---|
3/22 | 1336 | 78 | 86 | 73 |
9/22 | 1347 | 91 | 94 | 89 |
3/23 | 1505 | 86 | 91 | 81 |
6/23 | 1546 | 88 | 91 | 83 |
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Abstract Disclosures
2019 ASCO Annual Meeting
First Author: Hira Latif
2024 ASCO Quality Care Symposium
First Author: Michelle Payan
2022 ASCO Quality Care Symposium
First Author: Elizabeth Boutin McGrath
2023 ASCO Annual Meeting
First Author: Changchuan Jiang