New Streamlined Template for Cancer Survivors Saves Time

Jenni Laidman

October 15, 2014

A new template for the creation of a cancer survivorship care plan (SCP) will remove some of the barriers faced by clinicians designing transition plans for patients who have completed cancer therapies, according to a statement from the American Society of Clinical Oncology (ASCO).

The SCP template was discussed during a press conference, held in advance of the Quality Care Symposium 2014, to coincide with the release of the statement on SCPs, which was published online October 14 in the Journal of Oncology Practice.

The template is part of the Cancer Survivorship Compendium.

SCPs are designed to inform patients and their primary care physicians about prevention, surveillance, intervention, and coordination of care for new or recurrent cancers and for any late effects of cancer treatment.

Although care plans were recommended in a 2005 Institute of Medicine report, less than 30% of patients receive them, according to a recent study (J Cancer Educ. Published online April 6, 2014).

"There have been a number of national studies done that show that SCPs are being used for some of the patients, some of the time, in some of the practices," said Deborah K. Mayer, PhD, RN, advanced practice oncology nurse and professor of the adult geriatric health division at the University of North Carolina School of Nursing in Chapel Hill, and chair of the ASCO Survivorship Care Plan Work Group.

Pressure to use SCPs is increasing, she noted, especially because the Commission on Cancer adopted a phase-in of SCPs in September, with the goal of 100% use by 2019.

The Commission on Cancer has endorsed the template, Dr Mayer reported. "We're hoping that, in partnership with them, this new template will increase adoption; we'll be able to measure that over time."

The time it takes an oncologist to complete an SCP using the previous ASCO template, developed nearly a decade ago, is one of the principal barriers to the widespread adoption of SCPs, Dr Mayer and colleagues note in their statement.

Other barriers include the lack of reimbursement for creating SCPs, the challenge of coordinating which caregiver is responsible for which service, and the lack of a universal electronic health record (EHR) system that can help in the completion of an SCP.

The new template requires much less time to complete and clarifies physician roles.

In a pilot study, clinicians from 11 oncology practices took an average of 30 minutes to complete the new template (range, 10 - 60 min), Dr Mayer reported during the press conference. "The longer time had to do with learning the new template, but also had to do with complex patients who had more complicated therapies," she said.

As EHRs are adapted to the task, the template should require less time. The times reported were for "a paper and pencil completion," Dr Mayer explained. "When the template is semi-auto-completed, it should decrease the amount of time. When that happens, I think we'll see increased adoption."

As the time to complete SCPs shortens and as they become incorporated with EHRs, the issue of reimbursement for the activity should be less acute, Dr Mayer said. "We're hoping that will become less of an issue as this becomes more integrated and it takes a lot less time."

Coauthor Claire Snyder, PhD, from Johns Hopkins School of Medicine in Baltimore, reports stock or other ownership of Immunomedics, Merck, Oncolytics Biotech, and Express Scripts; serving as a consultant for Walgreens; and receiving research funding from WellPoint and Genentech.

J Oncol Pract. Published online October 14, 2014. Abstract


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