A 27-question survey of Association of American Cancer Institutes (AACI) members, including many NCI-designated centers, found several ways to improve coordination of care between the main centers and their satellite sites
PLYMOUTH MEETING, PA [July 6, 2021] – New research in the June 2021 issue ofJNCCN – Journal of the National Comprehensive Cancer Network assesses the quality of cancer care provided by expanded sites coordinated by some of the largest cancer centers in the country. The study was designed to develop strategies for disseminating discoveries and expanding access through the AACI’s Network Care Initiative launched by former AACI President Stanton L. Gerson, MD, director of the Case Comprehensive Cancer Center to implement the highest quality cancer treatment. The results were calculated based on the responses to a mixed methods survey that was answered by 69 cancer centers between September 2017 and December 2018, with 56 reporting at least one network practice location at that time.
Just over half said that the network locations had full access to the main centers’ electronic medical records (EMRs), and even fewer main centers had full access to the records at all of their network locations.
“Our results show that the alignment of the network locations needs to be improved, particularly with patient navigators, treatment pathways and access to clinical trials,” said Dr. Gerson, lead researcher on the study and interim dean of the Case Western Reserve University School of Medicine. “Most federal cancer center reviews do not assess the total population of cancer patients cared for by large cancer centers and their affiliated sites. These data suggest that a very significant proportion of the new cancer cases are being cared for by these centers and their networks. Better coordination of cancer centers and networks could ultimately lead to improved access to clinical trials for the underrepresented communities that many of these network locations serve. “
According to the survey results, some important ways to improve coordination of care are:
- Implementing Integrated EMRs Across Networks;
- Review of best clinical nursing practices with stricter use of nursing pathways and coordination of diagnostic and treatment planning across sites;
- Greater awareness and support for clinical cancer studies at all network locations; and
- Improved medical oversight of clinical and research expectations, recruitment, review, and other links with the cancer center’s major campus locations.
“Many studies show that consistency through care plans and guidelines improves patient outcomes, clinical response, and survival. More proactive approaches, including nursing pathways, cross-network tumor boards, and recognizing the value of placing disease professionals in network locations, will improve the standardization of cross-location care, ”added Dr. Gerson added.
“Differences in outcomes in cancer care, particularly patient survival, have been shown between the NCI-designated cancer centers and public hospitals that care for two-thirds of cancer patients in the United States,” commented Lawrence N. Shulman, MD, associate Director of Clinical Services at the University of Pennsylvania’s Abramson Cancer Center who was not involved in this research. “Rural cancer programs often have a limited number of cancer doctors covering all relevant specialties, and city safety net hospitals often have limited financial resources to support high quality cancer programs. Partnerships between academic cancer centers and community and safety net hospitals have the potential to improve outcomes for a wider range of cancer patients in the United States. Supporting these cancer programs could be seen as an obligation on academic cancer centers. This study outlines some potential support mechanisms. “
The COVID-19 pandemic that began long after this survey was completed and the growing call for more diversity in clinical trials are also fueling the need to better integrate network locations to provide quality care to underserved populations. On June 7th, NCCN presented a webinar on “Using Network Satellite Sites” as part of a series on COVID-19 and the operation of cancer centers. Dr. Shulman was one of the panelists, along with other members of the NCCN Best Practices Committee. This video is available at: NCCN.org/covid-19.
To read the full study, visit JNCCN.org. Free access to Status of Cancer Care at Network Sites of the Nation’s Academic Cancer Centers is available until September 10, 2021.
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Via the National Comprehensive Cancer Network
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