Transcript ProviderPPTFINALJune2012x

Health Provider Teams:
How you can support
cancer survivors
after treatment
Washington CARES about Cancer Partnership:
Survivorship Taskforce
June 2012
Presentation Outline
•
•
•
•
•
•
•
•
Survivors in the U.S.
Lost in transition
Descriptions
Certification/accreditation
Reimbursement
When to transition care
Models of survivorship care
Examples
Survivors in the U.S.
• More than 12 million cancer survivors in the U.S.
• This is a 400% increase in the past 40 years
• There are an estimated 250,000 cancer survivors
in Washington State
• More than 2 out of 3 people diagnosed with
cancer are alive more than 5 years later
Lost in Transition
• 2005 report released by The Institute of Medicine
• Titled “From Cancer Patient to Cancer Survivor: Lost in
Transition”
• Recommends every cancer survivor receives a
survivorship care plan
• Found: www.iom.edu.reports/2005/title
Survivorship Care Plan
Set of documents the oncology team puts together for
each patient to describe his/her cancer, all of the
treatments received, and future needs to stay healthy.
Includes:
• Ongoing care the patient will need (i.e. tests for recurrence,
identifying and managing late and long-term effects of the cancer
and treatments, etc).
• A personalized set of recommendations on how to stay healthy
and take care of themselves after having cancer (i.e. healthy
eating, active living, and emotional support).
• Full contact information for all of their doctors, nurses, and
anyone else that took care of them.
Treatment Summary
Includes the patient’s diagnostic evaluation and the
treatment(s) received. These should include:
• Disease characteristics (site, stage, grade, marker information)
• Dates of treatment initiation and completion
• Types of treatments (surgery, radiation, chemotherapy, etc.)
including drugs used, dosages, treatment response and major
toxicities experienced
• Psychosocial, nutritional, and other supportive services provided
When to transition care
• After treatment
• Should include:
• Management of treatment side effects , including
potential late effects of therapy
• Cancer surveillance
• Preventive care recommendations to maintain and
improve patient’s health
Challenges in transition
• Survivors may not have services in their community
• Survivors may have barriers (i.e. insurance, disabilities, cultural
and health disparities, etc)
• Survivors may not know what they need, or even know what
to ask for. They may be afraid, feeling like they’re on their
own.
• Providers may be making assumptions about coordination
with one another
• Who orders follow-up tests?
• Are they talking to one another regularly?
Certification
• Providers do not need special certification to complete
these
• In 2015, programs who have COC accreditation will need
to provide survivors with a treatment summary/care plan
in order to maintain their certification status.
• Now is a good time to setup processes in preparation.
• More details:
American College of Surgeon’s Commission on Cancer (COC)
http://www.facs.org/cancer/
Reimbursement
• Charge a (CPT) Level 5 Established Patient Office
Visit under the Primary Cancer Diagnosis Code
(ICD 9), including “more than 50% of time spent
on counseling and coordination of care”
Models of Survivorship Care
Models of Survivorship Care
Communication
• Whoever is completing the survivorship care
plan and treatment summary should
communicate back to:
• Primary oncologist
• Primary care provider
Templates: Survivorship CPs
www.journeyforward.org
Templates
• Journey Forward
www.journeyforward.org
• Lance Armstrong Survivorship
www.livestrongcareplan.org
• American Society of Clinical Oncology
www.cancer.net/patient/survivorship
• National Cancer Institute
www.cancer.gov/cancertopics/coping/survivorship
Support Services & Resources
• Prevention & risk factors
• Healthy eating
• Active living
• Preventive visits
• Psychosocial supportive care after treatment for
survivors and family: healing emotionally, physically, and
spiritually after treatment
• Support groups
• Individual Counseling
• Educational materials
Upcoming materials
• New website: www.wacancer.org
• DONE: Patient factsheet on cancer survivorship and
treatment summaries
• Palliative Care: Provider fact sheet – Coming soon
• Palliative Care: Patient fact sheet – Coming soon
More information
References
• Calculated by applying national estimates to Washington’s 2011 population. See MMWR:
www.cdc.gov/mmwr/preview/mmwrhtml/mm6009a1.htm
• Cancer survivor = Defined as a person who has been diagnosed and overcome any type of cancer.
Time begins at diagnosis and lasts to the end of life.
• CDC and the Lance Armstrong Foundation (LAF) are leading a public health effort to address the
issues faced by the growing number of cancer survivors living with, through, and beyond cancer.
Through their collaboration, A National Action Plan for Cancer Survivorship: Advancing Public
Health Strategies was developed. The National Action Plan represents the combined effort of
almost 100 experts in cancer survivorship and public health. Many cancer associations/societies,
institutions, hospitals, cancer centers and individual physicians are moving forward with the
development of Survivorship Programs across the nation.
• American College of Surgeons: Cancer Programs:
www.facs.org/cancer/coc/programstandards2012.html. Website accessed on 2/1/12.
• www.asco.org/ascov2/Practice+&+Guidelines/Quality+Care/Quality+Measurement+&+Improvem
ent/Chemotherapy+Treatment+Plan+and+Summary/Cancer+Treatment+Plan+and+Summary+Res
ources
• www.cancer.net/patient/Publications+and+Resources/Support+and+Resource+Links/General+Can
cer+Organizations+and+Resources/Support+Groups
Thank you!
Special thanks to Dr. Scott Baker
for contributing materials and slides