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Journal of Oncology Practice

Ronald D Ennis, Anish B Parikh, Mark Sanderson, Mark Liu, Luis Isola
PURPOSE: The Oncology Care Model (OCM) must be clinically relevant, accurate, and comprehensible to drive value-based care. METHODS: We studied OCM data detailing observed and expected expenses for 6-month-long episodes of care for patients with prostate cancer. We constructed seven disease state-treatment dyads into which we grouped each episode on the bases of diagnoses, procedures, and medications in OCM claims data. We used this clinical-administrative stratification model to facilitate a comparative cost analysis, and we evaluated emergency department and hospital utilization and drug therapy as potential drivers of cost...
February 11, 2019: Journal of Oncology Practice
Anish B Parikh, William Smith, Mark Sanderson, Kavita Dharmarajan, Mark Liu, Luis Isola, Ronald D Ennis
PURPOSE: If identifiable, potentially avoidable hospitalizations (PAHs) can serve as an important target for cost containment efforts in oncology. METHODS: PAHs among a cohort of Medicare patients with prostate cancer were identified using a two-stage consensus-driven review process. In stage 1, two clinicians independently evaluated admissions records using a case review form, which we modified from a previous study to assess for PAHs. In stage 2, any admissions that the reviewers disagreed on or were unsure of were re-examined in a larger group of clinicians to yield a consensus determination regarding avoidability...
February 11, 2019: Journal of Oncology Practice
Gabrielle B Rocque, Courtney P Williams, Amanda R Hathaway, Karina I Halilova, Carrie T Stricker, Nicholas C Coombs, William N Dudley, Kathryn A Thomas, Michele Gaguski, Stéphanie Crist, Mary May Kozlik, Patti Larkin, Austin Cadden, Meredith I Jones
PURPOSE: The Center for Medicare & Medicaid Innovation Oncology Care Model (OCM) requires documentation of a 13-point Institute of Medicine care management plan for Medicare patients. In addition, OCM includes evaluation of quality using key performance measures that align with the ASCO Quality Oncology Practice Initiative (QOPI). Both efforts are designed to improve patient-centered care and foster patients' engagement in their care plan. METHODS: A multicenter quality improvement project was conducted to develop a strategy to meet the OCM treatment planning (TP) requirement (Plan), pilot clinician education coupled with use of electronic TP in early-stage breast cancer (Do), evaluate the impact of TP on QOPI measures (Study), and develop recommendations for future implementation (Act)...
January 31, 2019: Journal of Oncology Practice
Emily B Walling, Mark Fiala, Andrea Connolly, Alyssa Drevenak, Sarah Gehlert
PURPOSE: Pediatric patients with cancer who live in rural communities face disparate access to medical services compared with those in urban areas. Our objectives were to use qualitative methods to describe how living in a rural setting during receipt of treatment at an urban cancer center affects a patient's clinical course and to identify feasible areas of intervention to enhance service to these families. MATERIALS AND METHODS: We conducted semistructured interviews of caregivers of pediatric patients with cancer who received treatment at an urban pediatric hospital in the Midwest...
January 31, 2019: Journal of Oncology Practice
Jada G Hamilton, Margaux Genoff Garzon, Joy S Westerman, Elyse Shuk, Jennifer L Hay, Chasity Walters, Elena Elkin, Corinna Bertelsen, Jessica Cho, Bobby Daly, Ayca Gucalp, Andrew D Seidman, Marjorie G Zauderer, Andrew S Epstein, Mark G Kris
PURPOSE: IBM Watson for Oncology trained by Memorial Sloan Kettering (WFO) is a clinical decision support tool designed to assist physicians in choosing therapies for patients with cancer. Although substantial technical and clinical expertise has guided the development of WFO, patients' perspectives of this technology have not been examined. To facilitate the optimal delivery and implementation of this tool, we solicited patients' perceptions and preferences about WFO. METHODS: We conducted nine focus groups with 46 patients with breast, lung, or colorectal cancer with various treatment experiences: neoadjuvant/adjuvant chemotherapy, chemotherapy for metastatic disease, or systemic therapy through a clinical trial...
January 28, 2019: Journal of Oncology Practice
Isabel Arrillaga-Romany, William T Curry, Justin T Jordan, Daniel P Cahill, Brian V Nahed, Robert L Martuza, Jay S Loeffler, Susann J Järhult, Alona Muzikansky, Adam B Cohen, Aneesh B Singhal, Joshua N Goldstein, Tracy T Batchelor
PURPOSE: To reduce care variation and improve the management of patients with newly identified single brain masses and no history of cancer, we implemented a dedicated admission protocol. METHODS: We reviewed records of 206 patients who presented to our emergency department between January 2010 and May 2016 with a new single brain mass but no history of cancer. Patients admitted before the protocol implementation were designated the pre-implementation group (PRE), and those admitted after implementation were designated the post-implementation group (POST)...
January 25, 2019: Journal of Oncology Practice
Komal K Patel, Timothy J Brown, Arjun Gupta, Taylor Roberts, Eileen Marley, Hsiao C Li, Navid Sadeghi
BACKGROUND: Rasburicase is a recommended treatment of tumor lysis syndrome and patients at high-risk for developing tumor lysis syndrome. Unfortunately, it is expensive, and unnecessary use raises costs of care. METHODS: Plan, Do, Study, Act methodology was used to decrease the inappropriate use of rasburicase. In the Plan phase, a multidisciplinary quality improvement team reviewed the rasburicase ordering process and its prescription patterns at Parkland Health and Hospital System between October 2015 and September 2017 to determine appropriate interventions for improvement...
January 23, 2019: Journal of Oncology Practice
Paul Celano, Erin B Kennedy, Thomas K Oliver, Robin T Zon
No abstract text is available yet for this article.
January 22, 2019: Journal of Oncology Practice
Laura Tenner, Trisha V Melhado, Raudel Bobadilla, Barbara J Turner, Robert Morgan
No abstract text is available yet for this article.
January 22, 2019: Journal of Oncology Practice
Sheetal M Kircher, Jessica Yarber, Josh Rutsohn, Yanina Guevara, Madison Lyleroehr, Hannah Alphs Jackson, Jessica Walradt, Bijal Desai, Mary Mulcahy, Aparna Kalyan, Al B Benson, Mark Agulnik, Nisha Mohindra, Jonas DeSouza, Sofia F Garcia
PURPOSE: National organizations encourage communication about costs of cancer care; however, few data are available on health system models for identifying and assisting patients with financial distress (FD). We report the feasibility and acceptability of a financial counseling (FC) intervention for patients who receive chemotherapy at a comprehensive cancer center. MATERIALS AND METHODS: Patients were randomly assigned 1:1 to FC or standard care. The FC arm received education, financial assistance screening, and an estimation tool with total billed charges and out-of-pocket (OOP) cost of one cycle of chemotherapy from a financial counselor through phone call and in-person visit...
January 9, 2019: Journal of Oncology Practice
Paul Celano, Erin B Kennedy, Robin T Zon
No abstract text is available yet for this article.
January 9, 2019: Journal of Oncology Practice
Rohit G Ganju, Mindi TenNapel, Allen M Chen, Melissa Mitchell
PURPOSE: Data have demonstrated that hypofractionated radiation therapy (HFRT) and conventionally fractionated radiation therapy regimens are equivalent with respect to outcomes. Efforts to increase HFRT use have had mixed success. We implemented a prospective peer review chart rounds integrating all practice sites and reviewed the use of HFRT in an attempt to identify potential predictors of use. MATERIALS AND METHODS: Patients treated with whole-breast radiation therapy within our cancer care network from January 2016 to June 2017 were evaluated...
January 9, 2019: Journal of Oncology Practice
Katherine Sborov, Stephanie Giaretta, Amanda Koong, Sonya Aggarwal, Rebecca Aslakson, Michael F Gensheimer, Daniel T Chang, Erqi L Pollom
PURPOSE: For patients treated with palliative radiation, we examined the association between life expectancy predictions by radiation oncologists and aggressive end-of-life care. MATERIALS AND METHODS: We included decedents from a study that assessed the ability of oncologists to predict survival of patients with metastatic cancer who received radiation. We identified patients who died within 12 months of study enrollment to assess accuracy of predictions. Aggressive end-of-life care was defined by the National Quality Forum, ASCO Quality Oncology Practice Initiative metrics, and advanced radiation modalities in the last month of life...
January 8, 2019: Journal of Oncology Practice
Bridgette Thom, Annelies H Boekhout, Stacie Corcoran, Roberto Adsuar, Kevin C Oeffinger, Mary S McCabe
INTRODUCTION: As the number of cancer survivors grows, new models of survivorship care are being implemented, but there is limited evaluation to date. This retrospective review assesses the concordance of care provided to adult-onset cancer survivors by advanced practice providers (nurse practitioners and physician assistants) with Institute of Medicine guidelines for survivorship care. METHODS: Records from three survivorship clinics at a single institution were reviewed for frequency of recurrence surveillance, screening for second cancers, symptom management (physical, psychological), health promotion education (alcohol, tobacco, cholesterol, and bone density screenings; diet/exercise discussion), care coordination, and provision of care plan...
January 7, 2019: Journal of Oncology Practice
Christopher J L Stone, Andrew Robinson, Erin Brown, Mihaela Mates, Conrad B Falkson, Timothy Owen, Allison Ashworth, Christopher M Parker, Aamer Mahmud, Anna Tomiak, Sou Kishore Thain, Richard Gregg, Kenneth R Reid, Wiley Chung, Geneviève C Digby
PURPOSE: Timely lung cancer care has been associated with improved clinical outcomes and patient satisfaction. We identified improvement opportunities in lung cancer management pathways at Kingston Health Sciences Centre. Quality improvement strategies led to the implementation of a multidisciplinary lung cancer clinic (MDC). METHODS: We set an outcome measure of decreasing the time from diagnosis to first cancer treatment by 10 days within 6 months of clinic implementation...
January 7, 2019: Journal of Oncology Practice
Katy E French, Iris Recinos, Alexis B Guzman, Thomas A Aloia, Mike Hernandez, Spencer S Kee, Alicia M Kowalski, Farzin Goravanchi, Jeffrey Cerny, Karen V Cleckler-Hughes, Elizabeth Rebello
PURPOSE: As health care costs rise, continuous quality improvement and increased efficiency are crucial to reduce costs while providing high-quality care. Time-driven activity-based costing (TDABC) can help identify inefficiencies in processes of cancer care delivery. This study measured the process performance of Port-a-Cath placement in an outpatient cancer surgery center by using TDABC to evaluate patient care process. METHODS: Data were collected from the Anesthesia Information Management System database and OneConnect electronic health record (EHR) for Port-a-Cath cases performed throughout four phases: preintervention (phase I), postintervention, stabilization, and pre-new EHR (phases II and III), and post-new EHR (phase IV)...
January 7, 2019: Journal of Oncology Practice
Elena M Stoffel, Shannon E McKernin, Alok A Khorana
No abstract text is available yet for this article.
December 27, 2018: Journal of Oncology Practice
Wendy S Rubinstein
No abstract text is available yet for this article.
December 19, 2018: Journal of Oncology Practice
Anthony M Villano, Alexander Zeymo, James McDermott, Dany Barrak, Keith R Unger, Nawar M Shara, Kitty S Chan, Waddah B Al-Refaie
PURPOSE: Surgery continues to be the dominant therapy for the management of retroperitoneal soft-tissue sarcoma (RPS). Many groups advocate performing these resections at high-volume hospitals (HVHs), given their complexity. We therefore sought to explore whether RPS surgery has indeed begun to regionalize to HVHs in the same manner as pancreatic cancer (PC) surgery during the last decade. METHODS: We identified 70,763 patients who underwent surgical resection for RPS or PC using the National Cancer Database (2004 to 2015)...
December 14, 2018: Journal of Oncology Practice
Sunny C Lin, Scott E Regenbogen, John M Hollingsworth, Russell Funk, Julia Adler-Milstein
PURPOSE: To improve care coordination for complex cancers, it is critical to establish a more nuanced understanding of the types of providers involved. As the number of provider types increases, strategies to support cancer care coordination must adapt to a greater variety of information needs, communication styles, and treatment strategies. METHODS: We categorized providers into 11 types, using National Provider Identifier specialties. Using Medicare claims, we counted the number of unique combinations of provider types billed during preoperative, operative, and postdischarge care for colon cancer surgery and assessed how this count varies across hospitals...
December 14, 2018: Journal of Oncology Practice
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