Survivorship Care Plans in a Community Oncology Practice

Feasibility of Delivering Electronic Health Record (EHR)-Based Survivorship Care Plans and Planning to Cancer Survivors in a Community Oncology Practice

This is a two part observational study evaluating the feasibility of implementing an EHR-based model within a community oncology practice.

Study Overview

• Status: Completed
• Conditions: Breast Cancer; Colorectal Cancer; Prostate Cancer
• Intervention / Treatment: Behavioral: Survey

Detailed Description

Part 1: The research team will use a sociotechnical work systems model, developed by researchers at the University of Wisconsin (UW) Systems Engineering Initiative for Patience Safety (SEIPS), to guide analysis of the work system barriers and facilitators to implementing an EHR-based care planning model in community oncology practice, collected from direct observations.

Part 2: The research team will measure reach/maintenance (percentage of survivors with EHR-based survivorship care plans (SCPs) over a 9-month time period) and impact (pre/post survey of patient satisfaction and perceived care coordination).

• Study Type: Observational
• Enrollment (Actual): 30

Contacts and Locations

Study Locations

• United States
  • Wisconsin
    • Waukesha, Wisconsin, United States, 53188
      • UW Cancer Center at ProHealth Care

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Clinicians who provide care for breast, colon, or prostate patients.

Cancer patients/survivors of breast cancer (BrCa), prostate (PrCa), or colorectal (CRCa) cancer.

Description

Inclusion Criteria:

• Clinicians: Provide cancer care to BrCa, CRCa or PrCa
• Clinicians: Are a physician, advanced practice practitioner, nurse, or equivalent
• Patients: Have a diagnosis of breast, colorectal, or prostate cancer for which and EHR-based SCP will be provided
• Patients: Have been treated with curative intent (e.g. surgery, chemotherapy and/or radiation therapy) for a Stage 1-3 cancer diagnosis
• Patients: Have received some part of active cancer treatment
• Patients: Have complete active treatment (defined as surgery, chemotherapy, and/or radiation therapy). HER2-based and endocrine therapies may be ongoing and do NOT need to have been completed

Exclusion Criteria:

• Unable to complete or unwilling to answer questions in English
• Patients: Received all active cancer treatment elsewhere (e.g. "observation - only" patients)
• Patients: Have metastatic cancer

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Clinicians; Observe up to N=10 clinicians. Observations will include: Oncology history and care plan development by clinicians including use of EHR technology to develop care plans and methods used to secure necessary information for care plan creation; Provision and coordination of survivorship care occurring during care team meetings, discussions among clinicians, and survivor visits with clinicians, especially visits in which a care plan is provided to a survivor; Clinician seeking survivorship related information or resources through use of technology or discussion with other clinicians; Survivorship work or tasks performed by the clinician including adding, modifying or extracting information from the EHR and adding or modifying information in the care plan	Behavioral: Survey; Subjects (cancer patients and clinicians) will complete up to 2 surveys.
Clinicians and Patients; Surveys of N=30 breast cancer, colon cancer, and prostate cancer patients. Subjects will complete 1st survey electronically in-clinic. Subjects will either be e-mailed or mailed a survey at 4 weeks. Survey of clinicians will be sent via e-mail.	Behavioral: Survey; Subjects (cancer patients and clinicians) will complete up to 2 surveys.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
EHR-based SCPs and care planning	Asses whether barriers to EHR-based SCPs and care planning have been mitigated, based on clinician survey.	Up to 2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of providing EHR-based care planning, measured by SCP provision rates	Measured by SCP provision rates (percentage of survivors with EHR-based SCPs)	Up to 2 years
Feasibility of providing EHR-based care planning, measured by the EHR	Measured by survivor access to SCPs, per the EHR	Up to 2 years
Self-reported change in satisfaction, using survey	The impact of providing EHR-based care planning measured in change of satisfaction with perceived care coordination (assessed prior to and at 4 weeks after SCP provision)	Up to 2 years
Impact of providing EHR-based care planning	Measured by reported SCP usability, usefulness, and content (assessed prior to and at 4 weeks after SCP provision)	Up to 2 years

Collaborators and Investigators

• Sponsor: University of Wisconsin, Madison
• Collaborators: National Cancer Institute (NCI)
• Investigators: Principal Investigator: Amyé Tevaarwerk, MD, University of Wisconsin, Madison; Principal Investigator: Mary Sesto, PT, PhD, University of Wisconsin, Madison

Publications and helpful links

Helpful Links

• UW Carbone Cancer Center Home Page

Study record dates

Study Major Dates

• Study Start (Actual): September 11, 2017
• Primary Completion (Actual): February 28, 2018
• Study Completion (Actual): March 23, 2018

Study Registration Dates

• First Submitted: November 10, 2016
• First Submitted That Met QC Criteria: January 19, 2017
• First Posted (Estimate): January 23, 2017

Study Record Updates

• Last Update Posted (Actual): November 18, 2019
• Last Update Submitted That Met QC Criteria: November 14, 2019
• Last Verified: October 1, 2018

More Information

Terms related to this study

• Keywords: BrCa; PrCa; CRCa
• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms; Neoplasms by Site; Gastrointestinal Neoplasms; Digestive System Neoplasms; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Colorectal Neoplasms
• Other Study ID Numbers: UW16029; P30CA014520 (U.S. NIH Grant/Contract); A534260 (Other Identifier: UW Madison); SMPH\MEDICINE\HEM-ONC (Other Identifier: UW Madison); 2016-0760 (Other Identifier: Institutional Review Board)