Donohue SarahMaria, Sesto Mary E, Hahn David L, Buhr Kevin A, Jacobs Elizabeth A, Sosman James M, Andreason Molly J, Wiegmann Douglas A, Tevaarwerk Amye J
University of Wisconsin School of Medicine and Public Health; University of Wisconsin, Madison; and University of Wisconsin Carbone Cancer Center, Madison, WI.
University of Wisconsin School of Medicine and Public Health; University of Wisconsin, Madison; and University of Wisconsin Carbone Cancer Center, Madison, WI
J Oncol Pract. 2015 May;11(3):e329-35. doi: 10.1200/JOP.2014.003335. Epub 2015 Mar 24.
Survivorship care plans for cancer survivors may facilitate provider-to-provider communication. Primary care provider (PCP) perspectives on care plan provision and use are limited, especially when care plans are generated by an electronic health record (EHR) system. We sought to examine PCPs' perspectives regarding EHR-generated care plans.
PCPs (N = 160) who were members of the Wisconsin Research and Education Network listserv received a sample 10-page plan (WREN cohort). PCPs (n = 81) who had or were currently seeing survivors enrolled onto one of our survivorship clinical trials received a copy of the survivor's personalized care plan (University of Wisconsin [UW] cohort). Both cohorts received a survey after reviewing the plan. All plans were generated within an EHR.
Forty-six and 26 PCPs participated in the WREN and UW cohorts, respectively. PCPs regarded EHR-generated plans as useful in coordinating care (88%), understanding treatments (94%), understanding treatment adverse effects (89%), and supporting clinical decisions (82%). Few felt using EHR-generated plans would disrupt clinic workflow (14%) or take too much time (11%). Most (89%) preferred receiving the plan via EHR. PCPs reported consistent provision (81%) and standard location in the medical record (89%) as key factors facilitating their use of survivorship care plans. Important facilitators of care plan use included a more abbreviated plan, ideally one to three pages (32%), and/or a plan specifically tailored to PCP use (57%).
Plans were viewed as useful for coordinating care and making clinical decisions. However, PCPs desired shorter, clinician-oriented plans, accessible within an EHR and delivered and located in a standardized manner.
癌症幸存者的生存护理计划可能有助于医护人员之间的沟通。初级保健提供者(PCP)对护理计划的提供和使用的看法有限,尤其是当护理计划由电子健康记录(EHR)系统生成时。我们试图研究PCP对EHR生成的护理计划的看法。
威斯康星研究与教育网络邮件列表的成员PCP(N = 160)收到一份10页的示例计划(WREN队列)。有或正在诊治参与我们其中一项生存临床试验幸存者的PCP(n = 81)收到了幸存者的个性化护理计划副本(威斯康星大学[UW]队列)。两个队列在查看计划后都接受了调查。所有计划均在EHR内生成。
分别有46名和26名PCP参与了WREN和UW队列。PCP认为EHR生成的计划在协调护理(88%)、理解治疗(94%)、理解治疗不良反应(89%)以及支持临床决策(82%)方面很有用。很少有人认为使用EHR生成的计划会扰乱诊所工作流程(14%)或花费太多时间(11%)。大多数人(89%)更喜欢通过EHR接收计划。PCP报告说持续提供(81%)和在病历中有标准位置(89%)是促进他们使用生存护理计划的关键因素。护理计划使用的重要促进因素包括更简短的计划,理想情况下为一到三页(32%),和/或专门为PCP使用量身定制的计划(57%)。
这些计划被认为对协调护理和做出临床决策很有用。然而,PCP希望有更简短、以临床医生为导向的计划,可在EHR中获取,并以标准化方式提供和定位。