Published in:
01-02-2020 | General Medicine
The Johns Hopkins Primary Care for Cancer Survivor Clinic: lessons learned in our first 4 years
Authors:
Youngjee Choi, Archana Radhakrishnan, Darshan Mahabare, Shalom Patole, Sydney M. Dy, Craig E. Pollack, Zackary D. Berger, Kimberly S. Peairs
Published in:
Journal of Cancer Survivorship
|
Issue 1/2020
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Abstract
Purpose
We established the Primary Care for Cancer Survivor (PCCS) Clinic in 2015 to address transition and care delivery challenges unique to cancer survivors. We describe the clinical program, detail patients from the first 4 years of implementation, and discuss lessons learned during the process.
Methods
We abstracted relevant patient information from the electronic medical record, administered a needs assessment survey at initial visits, and collected relative value unit (RVU) data.
Results
Between August 2015 and May 2019, we saw 230 PCCS patients with an increasing number of referrals yearly; nearly half were breast cancer survivors. At the initial visit, patients reported a median of 9 needs, with emotional needs most prevalent; over a third received at least one referral. PCCS patients generated higher billing codes and average RVUs compared with general patients.
Conclusions
In its first 4 years, the PCCS program has thrived as a unique model of cancer survivorship centered in primary care. PCCS patients reported numerous needs, emphasizing the critical need for a multi-disciplinary approach in this population. With increasing referrals, we have considered different risk stratification and staffing models for capacity and expansion. By generating more RVUs per visit compared with the general clinic, PCCS has demonstrated financial sustainability. Buy-in from our oncology colleagues, divisional support from general medicine, along with our collaboration of like-minded internists have allowed us to be a robust program.
Implications for Cancer Survivors
Models of survivorship care embedded in primary care can provide meaningful, patient-centered care for cancer survivors.