scholarly journals Patient Navigation Through the Cancer Care Continuum: An Overview

2009 ◽  
Vol 5 (4) ◽  
pp. 150-152 ◽  
Author(s):  
Janice Hopkins ◽  
Matthew P. Mumber
Keyword(s):  
Health Care ◽  
Knowledge Base ◽  
Health Care System ◽  
Scientific Knowledge ◽  
Cancer Care ◽  
Patient Navigation ◽  
Medical Specialization ◽  
Care Plans ◽  
Scientific Knowledge Base ◽  
Cancer Care Continuum

Technologic advances, medical specialization, novel payment structures, and an increased scientific knowledge base have resulted in a health care system requiring trained experts to deliver guidance as patients complete care plans: Enter the concept of patient navigation.

The Limits of Professional Self-Regulation

2020 ◽  
pp. 79-109
Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Democratic Party ◽  
Professional Autonomy ◽  
Medical Specialization ◽  
Lower Priority ◽  
Proper Role ◽  
Medical Societies ◽  
The U.S ◽  
Care System

This chapter explores the institutional roots of medical professionalism in the United States. It examines why the U.S. health care system delegates therapeutic authority to individual doctors and medical societies, with little centralized oversight in programs like Medicare. The chapter also presents findings from a national survey of physicians to gauge their views on the proper role of medical societies in medical evidence controversies. Although the tradition of professional autonomy places the physician at the center of the U.S. health care system, the survey evidence suggests that physicians do not recognize the important role their own beliefs (and potential misconceptions) about what constitutes good medical practice play in contributing to the problems of overutilization and inefficiency. The survey also reveals that doctors generally want their medical societies to forcefully defend treatments challenged by research. At the same time, the survey uncovers notable differences among the views of physicians based on both their medical specialization and partisan affiliation. Doctors who identify with the Republican Party place a somewhat higher priority on protecting clinical autonomy (and a somewhat lower priority on discouraging clinical interventions with minor or no benefits) than do doctors who identify with the Democratic Party.

Material deprivation and access to cancer care in a universal health care system

Cancer ◽  
2020 ◽  
Vol 126 (20) ◽  
pp. 4545-4552
Author(s):  
Laura E. Davis ◽  
Natalie G. Coburn ◽  
Julie Hallet ◽  
Craig C. Earle ◽  
Ying Liu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Cancer Care ◽  
Material Deprivation ◽  
Universal Health Care ◽  
Universal Health Care System ◽  
Universal Health ◽  
Care System

scholarly journals Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs

2015 ◽  
Vol 06 (02) ◽  
pp. 334-344 ◽  
Author(s):  
A. Wright ◽  
M. Krousel-Wood ◽  
E. J. Thomas ◽  
J. A. McCoy ◽  
D. F. Sittig ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Knowledge Base ◽  
Health Care System ◽  
Related Problem ◽  
Improve Patient Safety ◽  
Knowledge Bases ◽  
Health Record ◽  
Electronic Health ◽  
Care System

SummaryBackground: Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging.Objective: We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record.Methods: We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision.Results: The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%.Conclusions: We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across health-care settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes.Citation: McCoy AB, Wright A, Krousel-Wood M, Thomas EJ, McCoy JA, Sittig DF. Validation of a crowdsourcing methodology for developing a knowledge base of related problem-medication pairs. Appl Clin Inf 2015; 6: 334–344http://dx.doi.org/10.4338/ACI-2015-01-RA-0010

Implementing a User-Driven Online Quality Improvement Toolkit for Cancer Care

2015 ◽  
Vol 11 (3) ◽  
pp. e421-e427 ◽  
Author(s):  
Jeff Luck ◽  
Laura S. York ◽  
Candice Bowman ◽  
Randall C. Gale ◽  
Nina Smith ◽  
...  
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Quality Improvement ◽  
Health Information Technology ◽  
Health Information ◽  
Health Care System ◽  
Cancer Care ◽  
Integrated Health Care ◽  
Integrated Health Care System ◽  
Disease Specific

A combination of user-driven tool creation and centralized toolkit development seems to be effective for leveraging health information technology to spread disease-specific quality improvement tools within an integrated health care system.

Digitizing the cancer care continuum: Electronic, shareable survivorship care plans.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 10101-10101
Author(s):  
Jeremy Warner ◽  
Suzanne E Maddux ◽  
Jeff Brown ◽  
John Turner Hamm ◽  
John C. Krauss ◽  
...  
Keyword(s):  
Cancer Care ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Continuum ◽  
Care Plans ◽  
Cancer Care Continuum

Patient Navigation and Cancer Care Delivery

2018 ◽  
Author(s):  
Harold P. Freeman ◽  
Melissa A. Simon
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Patient Navigation ◽  
Care Delivery ◽  
Clinical Care ◽  
Quality Care ◽  
Successful Implementation ◽  
Care Continuum ◽  
Patient Navigators ◽  
Health Care Delivery Systems

Although the US health care system offers the very best care to many, the poor and uninsured typically face challenges in accessing timely health care, even when faced with a life-threatening disease such as cancer. Spurred by unmet patient needs and the growing complexity of health care delivery systems, patient navigation seeks to diminish social, economic, cultural, and medical system barriers to timely quality care. This case study discusses the emergence of patient navigation as a strategy for improving cancer outcomes, especially among vulnerable populations. It explores challenges and opportunities related to advancing successful implementation of patient navigation across the cancer care continuum. It seeks to harness and apply the power and energy of patient navigators with the goal of guiding individuals across the health care continuum—from the communities where they live all the way through screening, diagnosis, and treatment at clinical care sites.

A Comprehensive Program Enabling Effective Delivery of Regional Genetic Counseling

2018 ◽  
Vol 28 (5) ◽  
pp. 996-1002 ◽  
Author(s):  
Jubilee Brown ◽  
Aly Athens ◽  
David L. Tait ◽  
Erin K. Crane ◽  
Robert V. Higgins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Health Care ◽  
Genetic Counseling ◽  
Cancer Patients ◽  
Health Care System ◽  
Patient Navigation ◽  
Counseling Services ◽  
Comprehensive Program ◽  
Genetic Counseling Services

ObjectivesThe aim of this study was to demonstrate the utility of a comprehensive program involving management-based evidence, telemedicine, and patient navigation to provide genetic counseling services for patients with ovarian and breast cancer across a geographically large health care system.MethodsWe identified all patients with newly diagnosed ovarian and breast cancer in our health care system from January 2013 to December 2015 through the cancer registry. Referral characteristics and testing outcomes were recorded for each year and compared using the χ2 or Fisher exact test.ResultsBecause the implementation of this program, the number of new ovarian cancer cases remained constant (109–112 cases/year) but patients referred for genetic counseling increased annually from 37% to 43% to 96% (P < 0.05). The percentage of ovarian cancer patients who underwent genetic testing increased annually from 24% to 27% to 53% (P < 0.05). The number of new breast cancer patients was constant (1543–1638 cases/year). The percentage of patients with triple negative breast cancer referred for genetic counseling rose from 69% in 2013 to 91% in 2015; the percentage of patients who underwent testing increased annually from 59% to 86% (P < 0.05). Of women with breast cancer diagnosed at less than 45 years of age, 78% to 85% were referred for genetic counseling across this period; the percentage of patients who underwent testing increased annually from 66% to 82% (P < 0.05). Patient navigation was initiated and was available to all patients in the system during this period. Telemedicine consults were performed in 118 breast/ovarian patients (6%) during this period.ConclusionsA comprehensive program may improve access to effective genetic counseling services in patients with ovarian and breast cancer despite geographic barriers.

Understanding and Surviving the Transition to Value-Based Oncology

2013 ◽  
pp. e361-e368 ◽  
Author(s):  
John V. Cox ◽  
John D. Sprandio ◽  
Ronald Barkley
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Cancer Care ◽  
Business Models ◽  
Cancer Center ◽  
Value Proposition ◽  
Business Innovation ◽  
New Business ◽  
Sustainable Health ◽  
New Business Models

This paper and the three presentations it supports are drawn from the theme of the 2012 Cancer Center Business Summit (CCBS): “Transitioning to Value-Based Oncology: Strategies to Survive and Thrive.” The CCBS is a forum on oncology business innovation, and the principal question the organizers address each year is “What are the creative, innovative, and best business models and practices that are being conceived or piloted today that may provide a responsible and sustainable platform for the delivery of cancer care tomorrow?” At this moment in health care—when so much is in flux and new business models and solutions abound—the oncology sector has a solemn responsibility: to forge the business models and relationships that will help to define a new cancer care value proposition and a sustainable health care system of tomorrow for the benefit of the patients it serves to get it “right.”

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