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Published in: Journal of Cancer Survivorship 1/2013

01-03-2013

The experience of information sharing among primary care clinicians with cancer survivors and their oncologists

Authors: Barbara DiCicco-Bloom, Regina S. Cunningham

Published in: Journal of Cancer Survivorship | Issue 1/2013

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Abstract

Purpose of study

Knowledge about information sharing among primary care clinicians, oncologists, and their cancer patients is critical given its importance in facilitating the delivery of quality care to the increasing number of cancer survivors. The purpose of our study was to provide a better understanding of the nature of interactions among primary care clinicians, patients, and oncologists throughout the cancer care continuum to better understand the transition to survivorship.

Method

Twenty-one qualitative in-depth interviews were conducted with 11 primary care physicians and 10 nurse practitioners. Themes were identified using content analysis.

Results

The following themes emerged from the data including: (1) a visit is worth a thousand written reports—primary care clinicians described the importance of patient visits during cancer treatment; (2) community vs. cancer center oncologists—primary care clinicians described differences in information sharing with community oncologists as compared with those in academic centers; (3) correcting for information deficits—primary care clinicians, unable to obtain regular progress reports directly from oncologists, developed indirect strategies to obtain information; (4) the deficiencies in post-treatment follow-up care plans; and (5) the panacea of electronic medical records and survivor care plans.

Conclusions

The themes that emerged from this work describe in detail the absence of systematic information sharing among primary care clinicians, patients, and oncologists that is needed to support quality survivorship care in the primary care setting. The descriptions by primary care clinicians contribute to a deeper understanding of the daily challenges that both interfere and/or support primary care clinicians in their care of survivors of cancer.

Implications for cancer survivors

Managing the complex care of cancer survivors often requires the expertise of a number of skilled providers. Information sharing among these individuals is one of the most fundamental aspects of ensuring effective transitions in care. Our results indicate that systematic information sharing among providers caring for cancer survivors is lacking. Identifying strategies to enhance information sharing among and between providers is essential to facilitating the delivery of high-quality survivor care.
Literature
1.
go back to reference Yabroff KR, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of illness in cancer survivors: findings from a population-based national sample. J Natl Cancer Inst. 2004;96(17):1322–30.PubMedCrossRef Yabroff KR, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of illness in cancer survivors: findings from a population-based national sample. J Natl Cancer Inst. 2004;96(17):1322–30.PubMedCrossRef
2.
go back to reference Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009;27(17):2758–65.PubMedCrossRef Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009;27(17):2758–65.PubMedCrossRef
3.
go back to reference Earle C. Long term care planning for cancer survivors: a health services research agenda. J Cancer Survivorship. 2007;1(1):64–74.CrossRef Earle C. Long term care planning for cancer survivors: a health services research agenda. J Cancer Survivorship. 2007;1(1):64–74.CrossRef
4.
go back to reference Hewitt ME, Bamundo A, Day R, Harvey C. Perspectives on post-treatment cancer care: qualitative research with survivors, nurses, and physicians. J Clin Oncol. 2007;25(16):2270–3.PubMedCrossRef Hewitt ME, Bamundo A, Day R, Harvey C. Perspectives on post-treatment cancer care: qualitative research with survivors, nurses, and physicians. J Clin Oncol. 2007;25(16):2270–3.PubMedCrossRef
5.
go back to reference Taplin SH, Rodgers AB. Toward improving the quality of cancer care: addressing the interfaces of primary and oncology-related subspecialty care. JNCI Monographs. 2010;2010(40):3–10.CrossRef Taplin SH, Rodgers AB. Toward improving the quality of cancer care: addressing the interfaces of primary and oncology-related subspecialty care. JNCI Monographs. 2010;2010(40):3–10.CrossRef
6.
go back to reference Gordon S. Nursing against the odds: how health care cost cutting, media stereotypes, and medical hubris undermine nurses and patient care. Ithaca, NY: Cornell University Press; 2005. p. 95–120. Gordon S. Nursing against the odds: how health care cost cutting, media stereotypes, and medical hubris undermine nurses and patient care. Ithaca, NY: Cornell University Press; 2005. p. 95–120.
7.
go back to reference Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350–83.CrossRef Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350–83.CrossRef
8.
go back to reference Edmondson AC. Speaking up in the operating room: how team leaders promote learning in interdisciplinary action teams. J Manag Stud. 2003;40(6):1419–52.CrossRef Edmondson AC. Speaking up in the operating room: how team leaders promote learning in interdisciplinary action teams. J Manag Stud. 2003;40(6):1419–52.CrossRef
9.
go back to reference Baggs JG, Schmitt MH. Collaboration between nurses and physicians. J Nurs Scholarsh. 1988;20(3):145–9.CrossRef Baggs JG, Schmitt MH. Collaboration between nurses and physicians. J Nurs Scholarsh. 1988;20(3):145–9.CrossRef
10.
go back to reference Baggs JG, Schmitt MH, Mushlin AI, Mitchell PH, Eldredge DH, Oakes D, Hutson AD. Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med. 1999;27(9):1991–8.PubMedCrossRef Baggs JG, Schmitt MH, Mushlin AI, Mitchell PH, Eldredge DH, Oakes D, Hutson AD. Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med. 1999;27(9):1991–8.PubMedCrossRef
11.
go back to reference Ferrand E, Lemaire F, Regnier B, Kuteifan K, Badet M, Asfar P, Jaber S, Chagnon J-L, Renault A, Robert R, Pochard F, Herve C, Brun-Buisson C, Duvaldestin P. Discrepancies between perceptions by physicians and nursing staff of intensive care unit end-of-life decisions. Am J Respir Crit Care Med. 2003;167(10):1310–5.PubMedCrossRef Ferrand E, Lemaire F, Regnier B, Kuteifan K, Badet M, Asfar P, Jaber S, Chagnon J-L, Renault A, Robert R, Pochard F, Herve C, Brun-Buisson C, Duvaldestin P. Discrepancies between perceptions by physicians and nursing staff of intensive care unit end-of-life decisions. Am J Respir Crit Care Med. 2003;167(10):1310–5.PubMedCrossRef
12.
go back to reference Institute of Medicine. To err is human: building a safer health system. Washington DC: National Academy Press; 1999. Institute of Medicine. To err is human: building a safer health system. Washington DC: National Academy Press; 1999.
13.
go back to reference Institute of Medicine. Keeping patients safe. Washington DC: National Academy Press; 2001. Institute of Medicine. Keeping patients safe. Washington DC: National Academy Press; 2001.
14.
go back to reference Rowland JH, Hewitt M, Ganz PA. Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol. 2006;24(32):5101–4.PubMedCrossRef Rowland JH, Hewitt M, Ganz PA. Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol. 2006;24(32):5101–4.PubMedCrossRef
15.
go back to reference Grunfeld E, Fitzpatrick R, Mant D, Yudkin P, Adewuyi-Dalton R, Stewart J, Cole D, Vessey M. Comparison of breast cancer patient satisfaction with follow-up in primary care versus specialist care: results from a randomized controlled trial. Br J Gen Pract. 1999;49(446):705–10.PubMed Grunfeld E, Fitzpatrick R, Mant D, Yudkin P, Adewuyi-Dalton R, Stewart J, Cole D, Vessey M. Comparison of breast cancer patient satisfaction with follow-up in primary care versus specialist care: results from a randomized controlled trial. Br J Gen Pract. 1999;49(446):705–10.PubMed
16.
go back to reference Grunfeld E, Levine MN, Julian JA, Coyle D, Szechtman B, Mirsky D, Verma S, Dent S, Sawka C, Pritchard KI, Ginsburg D, Wood M, Whelan T. Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol. 2006;24(6):848–55.PubMedCrossRef Grunfeld E, Levine MN, Julian JA, Coyle D, Szechtman B, Mirsky D, Verma S, Dent S, Sawka C, Pritchard KI, Ginsburg D, Wood M, Whelan T. Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol. 2006;24(6):848–55.PubMedCrossRef
17.
go back to reference Grunfeld E, Mant D, Vessey MP, Fitzpatrick R. Specialist and general practice views on routine follow-up of breast cancer patients in general practice. Fam Pract. 1995;12(1):60–5.PubMedCrossRef Grunfeld E, Mant D, Vessey MP, Fitzpatrick R. Specialist and general practice views on routine follow-up of breast cancer patients in general practice. Fam Pract. 1995;12(1):60–5.PubMedCrossRef
19.
go back to reference Blaauwbroek R, Zwart N, Bouma M, Meyboom-de Jong B, Kamps WA, Postma A. The willingness of general practitioners to be involved in the follow-up of adult survivors of childhood cancer. J Cancer Survivorship: Res Pract. 2007;1(4):292–7.CrossRef Blaauwbroek R, Zwart N, Bouma M, Meyboom-de Jong B, Kamps WA, Postma A. The willingness of general practitioners to be involved in the follow-up of adult survivors of childhood cancer. J Cancer Survivorship: Res Pract. 2007;1(4):292–7.CrossRef
20.
go back to reference Nissen J, Beran M, Lee M, Mehta S, Pine D, Pine Swenson K. Views of primary care providers on follow-up care of cancer patients. Family Medicine. 2007;39(7):477–82.PubMed Nissen J, Beran M, Lee M, Mehta S, Pine D, Pine Swenson K. Views of primary care providers on follow-up care of cancer patients. Family Medicine. 2007;39(7):477–82.PubMed
21.
go back to reference Brazil K, Sussman J, Bainbridge D, Whelan T. Who is responsible? The role of family physicians in the provision of supportive cancer care. J Oncol Pract. 2010;6(1):19–24.PubMedCrossRef Brazil K, Sussman J, Bainbridge D, Whelan T. Who is responsible? The role of family physicians in the provision of supportive cancer care. J Oncol Pract. 2010;6(1):19–24.PubMedCrossRef
22.
go back to reference Mao JJ, Bowman MA, Stricker CT, DeMichele A, Jacobs L, Chan D, Armstrong K. Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients. J Clin Oncol. 2009;27(6):933–8.PubMedCrossRef Mao JJ, Bowman MA, Stricker CT, DeMichele A, Jacobs L, Chan D, Armstrong K. Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients. J Clin Oncol. 2009;27(6):933–8.PubMedCrossRef
23.
go back to reference Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ. 2002;324(7341):819–23.PubMedCrossRef Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ. 2002;324(7341):819–23.PubMedCrossRef
24.
go back to reference Lenz ER, Mundinger MON, Kane RL, Hopkins SC, Lin SX. Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Med Care Res Rev. 2004;61(3):332–51.PubMedCrossRef Lenz ER, Mundinger MON, Kane RL, Hopkins SC, Lin SX. Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Med Care Res Rev. 2004;61(3):332–51.PubMedCrossRef
25.
go back to reference Grunfeld E, Earle CC. The interface between primary and oncology specialty care: treatment through survivorship. JNCI Monographs. 2010;2010(40):25–30.CrossRef Grunfeld E, Earle CC. The interface between primary and oncology specialty care: treatment through survivorship. JNCI Monographs. 2010;2010(40):25–30.CrossRef
26.
go back to reference Crabtree BF, Miller WL. Doing qualitative research. 2nd ed. Thousand Oaks, CA: Sage; 1999. Crabtree BF, Miller WL. Doing qualitative research. 2nd ed. Thousand Oaks, CA: Sage; 1999.
27.
28.
go back to reference Patton M. Qualitative research and evaluation methods. Thousand Oaks, CA: Sage; 2002. Patton M. Qualitative research and evaluation methods. Thousand Oaks, CA: Sage; 2002.
29.
go back to reference Oeffinger K, McCabe M. Models for delivering survivorship care. J Clin Oncol. 2006;24(32):5117–24.PubMedCrossRef Oeffinger K, McCabe M. Models for delivering survivorship care. J Clin Oncol. 2006;24(32):5117–24.PubMedCrossRef
30.
go back to reference Rowland J, Aziz N, Tesauro G, et al. The changing face of cancer survivorship. Semin Oncol Nurs. 2001;17(4):236–40.PubMedCrossRef Rowland J, Aziz N, Tesauro G, et al. The changing face of cancer survivorship. Semin Oncol Nurs. 2001;17(4):236–40.PubMedCrossRef
31.
go back to reference Hillner BE, Smith TJ, Desch CE. Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. J Clin Oncol. 2000;18(11):2327–40.PubMed Hillner BE, Smith TJ, Desch CE. Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. J Clin Oncol. 2000;18(11):2327–40.PubMed
32.
33.
go back to reference Hetzel MR, Williams IP, Shakespeare RM. Can patients keep their own peak-flow records reliably? Lancet. 1979;1(8116):597–9.PubMedCrossRef Hetzel MR, Williams IP, Shakespeare RM. Can patients keep their own peak-flow records reliably? Lancet. 1979;1(8116):597–9.PubMedCrossRef
34.
go back to reference Koppel R, Davidson S, Wears R, Sinsky C. In: Koppel R, Gordon S, editors. First do less harm: confronting the inconvenient problems of patient safety. Ithaca: Cornell University Press; 2012. Koppel R, Davidson S, Wears R, Sinsky C. In: Koppel R, Gordon S, editors. First do less harm: confronting the inconvenient problems of patient safety. Ithaca: Cornell University Press; 2012.
35.
go back to reference Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, Morton S, Shekelle P. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144:742–52.PubMed Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, Morton S, Shekelle P. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144:742–52.PubMed
36.
go back to reference Earle CC. Failing to plan is planning to fail: improving the quality of care with survivorship care plans. J Clin Oncol. 2006;24(32):5112–6.PubMedCrossRef Earle CC. Failing to plan is planning to fail: improving the quality of care with survivorship care plans. J Clin Oncol. 2006;24(32):5112–6.PubMedCrossRef
37.
go back to reference Hahn EE, Ganz PA. Survivorship programs and care plans in practice: variations on a theme. J Oncol Pract. 2011;7(2):70–5.PubMedCrossRef Hahn EE, Ganz PA. Survivorship programs and care plans in practice: variations on a theme. J Oncol Pract. 2011;7(2):70–5.PubMedCrossRef
38.
go back to reference Ganz PA, Casillas J, Hahn EE. ensuring quality care for cancer survivors: implementing the survivorship care plan. Semin Oncol Nurs. 2008;24(3):208–17.PubMedCrossRef Ganz PA, Casillas J, Hahn EE. ensuring quality care for cancer survivors: implementing the survivorship care plan. Semin Oncol Nurs. 2008;24(3):208–17.PubMedCrossRef
39.
go back to reference Ganz PA, Hahn EE. Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2008;26(5):759–67.CrossRef Ganz PA, Hahn EE. Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2008;26(5):759–67.CrossRef
40.
go back to reference IOM. From cancer patient to cancer survivor. Washington, DC: The National Academies Press; 2006. IOM. From cancer patient to cancer survivor. Washington, DC: The National Academies Press; 2006.
41.
go back to reference Salz T, Oeffinger K, Lewis P, Williams R, Rhyne R, Yeazel M. Primary care providers’ needs and preferences for information about colorectoal cancer survivorship care. J Am Board Fam Med. 2012;25(5):635–51.PubMedCrossRef Salz T, Oeffinger K, Lewis P, Williams R, Rhyne R, Yeazel M. Primary care providers’ needs and preferences for information about colorectoal cancer survivorship care. J Am Board Fam Med. 2012;25(5):635–51.PubMedCrossRef
Metadata
Title
The experience of information sharing among primary care clinicians with cancer survivors and their oncologists
Authors
Barbara DiCicco-Bloom
Regina S. Cunningham
Publication date
01-03-2013
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 1/2013
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-012-0253-7

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