Austin Elizabeth J, Kilgore Mark R, Ko Cynthia W, Parker Elizabeth U, Alvarez Rebeca, Koch Lisa K, Donlan Amelia W, Lee Janie M, Flanagan Meghan R, DeStefano Lauren M, Javid Sara H, Gore John L
Department of Health Systems and Population Health, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98105, USA.
Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.
Cancer Causes Control. 2023 Apr;34(4):399-406. doi: 10.1007/s10552-023-01669-z. Epub 2023 Jan 25.
New federal legislation in the United States grants patients expanded access to their medical records, making it critical that medical records information is understandable to patients. Provision of informational summaries significantly increase patient perceptions of patient-centered care and reduce feelings of uncertainty, yet their use for cancer pathology is limited.
Our team developed and piloted patient-centered versions of pathology reports (PCPRs) for four cancer organ sites: prostate, bladder, breast, and colorectal polyp. The objective of this analysis was to identify common barriers and facilitators to support dissemination of PCPRs in care delivery settings. We analyzed quantitative and qualitative data from pilot PCPR implementations, guided by the RE-AIM framework to explore constructs of reach, effectiveness, adoption, implementation, and maintenance.
We present two case studies of PCPR implementation - breast cancer and colorectal polyps-that showcase diverse workflows for pathology reporting. Cross-pilot learnings emphasize the potential for PCPRs to improve patient satisfaction, knowledge, quality of shared decision-making activities, yet several barriers to dissemination exist.
While there is promise in expanding patient-centered cancer communication tools, more work is needed to expand the technological capacity for PCPRs and connect PCPRs to opportunities to reduce costs, improve quality, and reduce waste in care delivery systems.
美国新的联邦立法赋予患者更多获取其医疗记录的权利，这使得医疗记录信息能被患者理解变得至关重要。提供信息摘要显著提高了患者对以患者为中心的护理的认知，并减少了不确定性的感觉，但其在癌症病理学中的应用有限。
我们的团队为四个癌症器官部位（前列腺、膀胱、乳腺和结肠息肉）开发并试点了以患者为中心的病理报告版本（PCPRs）。本分析的目的是确定在护理提供环境中支持PCPRs传播的常见障碍和促进因素。我们分析了试点PCPR实施中的定量和定性数据，以RE-AIM框架为指导，探索覆盖范围、有效性、采用、实施和维持等方面的构建。
我们展示了两个PCPR实施的案例研究——乳腺癌和结肠息肉——展示了病理报告的不同工作流程。跨试点学习强调了PCPRs提高患者满意度、知识水平以及共享决策活动质量的潜力，但仍存在一些传播障碍。
虽然扩展以患者为中心的癌症沟通工具具有前景，但仍需要更多工作来扩展PCPRs的技术能力，并将PCPRs与降低成本、提高质量和减少护理提供系统中的浪费的机会联系起来。
