104 Background: Care coordination among oncology and primary care physicians (PCPs) is an essential element of survivorship care. Providers at an NCI-designated comprehensive cancer center noted gaps in coordinating care with PCPs. We sought to develop a program that enhances communication and education between provider groups to ensure a seamless continuum of care thereby improving overall survivorship care. Methods: The Fox Chase Cancer Center (FCCC) Care Connect program was created to comprehensively connect PCPs in the regional service area with cancer center providers. Program participation requirements for PCP’s include attendance at 2 of 4 targeted professional education programs and participation in quality measures for breast, cervical, and colon cancer screening. Formalized processes to efficiently move patients between oncologists and PCP’s were established. Communication gaps were addressed by providing electronic access via a secure physician portal, access to FCCC disease navigation services, and establishment of designated referral navigators to coordinate clinical needs between provider groups. Results: FCCC initiated the Care Connect program with 5 PCP practices. During a 3 month pilot phase, FCCC directed 19 patients to Care Connect PCP’s to manage ongoing clinical needs and implement survivorship plans. Eight-six percent of referrals were classified as non-urgent. Median time from referral to PCP appointment was 16 days, 24% below regional average. One CME education program was conducted during the pilot phase. Of the attendees, 91% reported an intent to change current practice by implementing a new procedure, discussing new information or seek additional information. Attendees identified potential care barriers which will be included in future program development. Post-education, one practice referred 3 patients to the lung cancer screening program. Conclusions: A formal program that aligns PCPs and oncologists is an effective initiative to improve communication and awareness of cancer patient survivorship needs in oncology and primary care settings.
12029 Background: Geriatric Assessment (GA) is recommended for evaluating an older cancer patient’s (pt) fitness for treatment. We conducted a prospective study evaluating the current gaps that exist in the assessment of older pts with metastatic breast cancer (MBC) in community practices (CP). Methods: Self-administered validated GA was compared to provider assessment (PA) of MBC pts ≥ 65-years-old treated at CP in the US. Providers were blinded to the GA results until their evaluation was completed. Differences in PA vs GA detected abnormalities were assessed using McNemar’s test. The effect of patient/provider factors on the rate of abnormalities not identified was assessed using regression models, clustering by provider and adjusting for the number of prior pts seen. Results: 100 pts were enrolled across 9 CP (median age 73.9, (65-90)). GA detected a total of 356 abnormalities in 96/100 (96%) pts, of which 223 required immediate interventions. African American and widowed/single pts were more likely to have abnormalities identified by GA. On average PA did not identify abnormalities detected by validated GA in 2 of 8 domains. 73% of functional status, 86% of social support, 44% of nutritional, and 96% of cognitive abnormalities detected by GA were not identified by PA (all P < 0.0001). Providers with more years of clinical experience were more likely to identify abnormalities (compared to < 5 years (y) in practice: 5-10 y in practice, p = 0.149; 11-15 y in practice, p = 0.028; > 15 y in practice, p = 0.017). GA had the most significant impact on pts with decreased ECOG PS (p = 0.045). Pts found to have an abnormal Timed Up and Go (TUG) test were more likely to have additional abnormalities in other domains (mean 4.3 vs 2.1, Wilcoxon p < 0.001), and more abnormalities not identified by the PA (p < 0.001). Providers were “surprised” by GA results in 33% of cases, mainly with cognitive or social support findings, and reported plans for management change for 40% of pts based on GA findings. Conclusions: Including a GA in the care of older pts with MBC in CP is beneficial as validated GA has a high detection rate of abnormalities not detected by PA.
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