An analysis of cancer care coordination over the last 30 years shows that the process offers many benefits to oncology patients, including fewer hospitalizations and visits to emergency departments and increased patient satisfaction with care. Coordination also was found to confer benefits for clinicians themselves, in such areas as information sharing of best practices and better patient symptom management. The study was presented at the American Society of Clinical Oncology’s 2013 Quality Care Symposium held November 1-2, 2013, in San Diego, California (Abstract 103).
For the study, researchers analyzed PubMed, EMBASE, Medline, CINAHL, and the Cochrane Library; they identified 50 of 1241 abstracts published between 1980 and 2013; about half of these 50 studies were published after 2009, and eight met the added criteria for meta-analysis.
Based on their literature review, researchers identified the following most common care coordination interventions: patient navigators; home “telehealth” (eg, automated telephone surveys of patient symptoms during chemotherapy with responses reviewed by nurses); nurse case managers or care coordinators; and palliative care programs.
In 44 of the studies analyzed (83%), coordination resulted in improved cancer care (Box). The researchers concluded that although they found effective interventions taking place across the care spectrum, more consistent definitions of cancer care coordination are needed, along with higher quality and more comprehensive measures, to inform future effectiveness research.
“There needs to be more attention and resources paid to educating and engaging providers in coordinating cancer care and to empowering patients for self-management, including discussing survivorship planning with both their oncologists and their primary care providers,” said lead study author Sherri Sheinfeld Gorin, PhD, senior scientific consultant at the National Cancer Institute.
“Our study is the first to assess and quantify how much of a difference cancer care coordination can make.”
Here is an article that we should all have and submit to our administrators. It helps prove the utility of cancer care coordinators. Often these positions can be overlooked because of the lack of billable visits. This analysis that was presented at ASCO’s 2013 Quality Care Symposium, clearly gives evidence to support all oncology centers providing these specialists. With today’s focus in healthcare on costs, the most compelling evidence should be the fewer hospitalizations and emergency visits. From a clinical standpoint, the sharing of best practices among colleagues would be highly motivating for me. Lastly, anyone who wants to continue to provide quality oncology care needs to focus on patient satisfaction and management.
Depending on the institution and the needs, there are varying options for providing care coordination. The article mentions the most common interventions being navigators, telehealth, and nurse care managers and palliative care programs. For example, at a hospital in the radiology department, the patient navigators are more commonly utilized because they help decrease the time from diagnosis to delivery of cancer treatment or care. The nurse case managers are usually provided by the cancer centers or hospitals and their purpose is to coordinate between specialists, and help with referrals. Lastly, palliative care is now a specialty offered in almost every hospital and oncology clinic.
There is an abundance of data to support the use of these providers to help with symptom management. They have proven very effective for patient satisfaction and emotional well-being.
We are unfortunately in a time period where the cost of providing healthcare services is under great scrutiny. We must not forget that the goal is to provide quality oncologic care, and to do this we must involve cancer care coordinators.