University of New Mexico Comprehensive Cancer Center, MSC 07-4025, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
Department of Internal Medicine, Division of Hematology and Oncology, University of New Mexico, MSC 07-4025, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
Support Care Cancer. 2021 Sep;29(9):5021-5028. doi: 10.1007/s00520-021-06043-w. Epub 2021 Feb 15.
Survivorship care plans (SCPs) summarize patients' treatment and act as an education and communication tool between oncologists and primary care providers (PCPs). But creation and delivery of SCPs are challenging, labor intensive, and costly. The University of New Mexico Comprehensive Cancer Center (UNM CCC) treats a poor, rural, and minority patient population, and our purpose was to implement and evaluate a process to create and deliver SCPs to patients and PCPs.
Providers placed an electronic SCP order, basic information was imported, and staff compiled treatment details. Flagged SCPs were then ready for delivery, providers approved of and delivered the SCP at the next encounter, and the SCP was sent to the PCP.
By April 2020, 283 SCPs were ordered, 241 (85.2%) were created by the designated staff, and 97 (34.2%) were given to patients after definitive therapy for breast cancer (59.1%), gynecological cancers (10.8%), prostate cancer (7.4%), colorectal cancer (5.1%), and lymphomas (4.8%). Of 97 SCPs eligible to be sent to PCPs, 75 (77.3%) were mailed or sent via EMR. Of the 41 (48.9%) SCPs sent via mail or fax, only 8 (8.3%) were received and 5 (5.2%) integrated.
This study shows that SCPs can be delivered to patients in a poor, rural, and minority patient population but that PCP receipt and integration of SCPs are poor. Future efforts need to ensure that an oncologist to PCP education and communication tool is able reach and be integrated by PCPs.
生存护理计划(SCP)总结了患者的治疗情况,是肿瘤学家和初级保健提供者(PCP)之间进行教育和沟通的工具。但是,SCP 的制定和交付具有挑战性,需要大量的人力和财力。新墨西哥大学综合癌症中心(UNM CCC)治疗的是贫穷、农村和少数民族患者群体,我们的目的是实施和评估一种向患者和 PCP 制定和提供 SCP 的流程。
提供者下达电子 SCP 医嘱,基本信息被导入,工作人员则汇总治疗细节。标记的 SCP 准备好交付,提供者在下一次就诊时批准并交付 SCP,然后将 SCP 发送给 PCP。
截至 2020 年 4 月,共下达了 283 份 SCP 医嘱,其中 241 份(85.2%)由指定工作人员制定,97 份(34.2%)在乳腺癌(59.1%)、妇科癌症(10.8%)、前列腺癌(7.4%)、结直肠癌(5.1%)和淋巴瘤(4.8%)的明确治疗后给予了患者。在 97 份有资格发送给 PCP 的 SCP 中,有 75 份(77.3%)通过邮寄或 EMR 发送。在通过邮件或传真发送的 41 份 SCP 中,只有 8 份(8.3%)被接收,5 份(5.2%)被整合。
本研究表明,SCP 可以提供给贫穷、农村和少数民族患者群体的患者,但 PCP 接收和整合 SCP 的情况不佳。未来的工作需要确保肿瘤学家和 PCP 之间的教育和沟通工具能够被 PCP 接收并整合。