Oncologists’ perspectives on post‐cancer treatment communication and care coordination with primary care physicians |
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| Authors: | C.N. Klabunde PhD D. Haggstrom MD MAS K.L. Kahn MD S.W. Gray MD B. Kim MD MPhil B. Liu PhD J. Eisenstein MS N.L. Keating MD MPH |
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| Affiliation: | 1. Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD, USA;2. Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA;3. Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA;4. David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA;5. RAND Corporation, Santa Monica, CA, USA;6. Division of Medical Oncology, Dana‐Farber Cancer Institute, Boston, MA, USA;7. Harvard Medical School, Boston, MA, USA;8. School of Medicine, University of California San Francisco, San Francisco, CA, USA;9. Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA;10. Department of Health Care Policy, Harvard Medical School and Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA |
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| Abstract: | Post‐treatment cancer care is often fragmented and of suboptimal quality. We explored factors that may affect cancer survivors’ post‐treatment care coordination, including oncologists’ use of electronic technologies such as e‐mail and integrated electronic health records (EHRs) to communicate with primary care physicians (PCPs). We used data from a survey (357 respondents; participation rate 52.9%) conducted in 2012–2013 among medical oncologists caring for patients in a large US study of cancer care delivery and outcomes. Oncologists reported their frequency and mode of communication with PCPs, and role in providing post‐treatment care. Seventy‐five per cent said that they directly communicated with PCPs about post‐treatment status and care recommendations for all/most patients. Among those directly communicating with PCPs, 70% always/usually used written correspondence, while 36% always/usually used integrated EHRs; telephone and e‐mail were less used. Eighty per cent reported co‐managing with PCPs at least one post‐treatment general medical care need. In multivariate‐adjusted analyses, neither communication mode nor intensity were associated with co‐managing survivors’ care. Oncologists’ reliance on written correspondence to communicate with PCPs may be a barrier to care coordination. We discuss new research directions for enhancing communication and care coordination between oncologists and PCPs, and to better meet the needs of cancer survivors post‐treatment. |
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| Keywords: | cancer care delivery cancer survivorship care coordination health care provider communication primary care physician |
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