Opening the Black Box: The Impact of an Oncology Management Program Consisting of Level I Pathways and an Outbound Nurse Call System

Hoverman, J. Russell; Klein, Ira; Harrison, Debra W.; Hayes, Jad; Garey, Jody S.; Harrell, Robyn K.; Sipala, Maria; Houldin, Scott; Jameson, Melissa; Abdullahpour, Mitra; McQueen, Jessica; Nelson, Greg; Verrilli, Diana K.; Neubauer, Marcus A.

doi:10.1200/jop.2013.001210

Cited by 45 publications

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References 8 publications

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“…Recent studies investigating patients during cancer treatment showed a decrease in emergency room visits and lower cancer-related medical costs [16, 17]. However, no studies are available on the effects of CM on quality of life after completion of cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

Case management to increase quality of life after cancer treatment: a randomized controlled trial

et al. 2017

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BackgroundCase management has been shown to be beneficial in phases of cancer screening and treatment. After treatment is completed, patients experience a loss of support due to reduced contact with medical professionals. Case management has the potential to offer continuity of care and ease re-entry to normal life. We therefore aim to investigate the effect of case management on quality of life in early cancer survivors.MethodsBetween 06/2010 and 07/2012, we randomized 95 patients who had just completed cancer treatment in 11 cancer centres in the canton of Zurich, Switzerland. Patients in the case management group met with a case manager at least three times over 12 months. Patient-reported outcomes were assessed after 3, 6 and 12 months using the Functional Assessment of Cancer Therapy (FACT-G) scale, the Patient Assessment of Chronic Illness Care (PACIC) and the Self-Efficacy scale.ResultsThe change in FACT-G over 12 months was significantly greater in the case management group than in the control group (16.2 (SE 2.0) vs. 9.2 (SE 1.5) points, P = 0.006). The PACIC score increased by 0.20 (SE 0.14) in the case management group and decreased by 0.29 (SE 0.12) points in the control group (P = 0.009). Self-Efficacy increased by 3.1 points (SE 0.9) in the case management group and by 0.7 (SE 0.8) points in the control group (P = 0.049).ConclusionsCase management has the potential to improve quality of life, to ease re-entry to normal life and to address needs for continuity of care in early cancer survivors.Trial registrationThe study has been submitted to the ISRCTN register under the name “Case Management in Oncology Rehabilitation” on the 12th of October 2010 and retrospectively registered under the number ISRCTN41474586 on the 24th of November 2010.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3213-9) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Case management to increase quality of life after cancer treatment: a randomized controlled trial

et al. 2017

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“…Alternatively, reaching patients before they present to the ED may be a preferable approach to reducing hospital admissions and enhancing outpatient management. Exponents of the oncology patient-centered medical home have described their experience in reducing acute care utilization [15,16] which is largely based on availability of high-functioning telephone triage services and timely outpatient clinical evaluation for acute complaints [17]. Though promising, the generalizability of these types of interventions remains unproven.…”

Section: Accepted Manuscriptmentioning

confidence: 98%

An ED pilot intervention to facilitate outpatient acute care for cancer patients

Brooks

Chen

Murakami

et al. 2016

The American Journal of Emergency Medicine

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“…5,6 Cost savings have been reported in several pilot studies testing the use of clinical decision support and bundled payment models to incentivize the use of cost-effective treatments when equally efficacious regimens exist. 7,8 Other research has demonstrated variation in the use of inpatient services for patients with advanced cancer at the regional level but not doi: 10 at the practice level. 9 Some pilot projects have reported reductions in inpatient utilization through enhanced care management.…”

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confidence: 98%

“…9 Some pilot projects have reported reductions in inpatient utilization through enhanced care management. 10,11 Stakeholders have emphasized opportunities to produce savings by supporting poorly reimbursed aspects of care, such as care planning, care coordination, and enhanced outpatient services to prevent costly inpatient admissions. 12,13 To our knowledge, no study has yet examined the magnitude of variation at the practice level for key oncology services.…”

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confidence: 99%

Wide Variation In Payments For Medicare Beneficiary Oncology Services Suggests Room For Practice-Level Improvement

et al. 2015

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In recent years many policy makers have recommended alternative payment models in medical oncology in order to reduce costs and improve patient outcomes. Yet information on how oncology practices differ in their use of key service categories is limited. We measured annual payments for key service categories delivered to fee-for-service Medicare beneficiaries receiving care from 1,534 medical oncology practices in 2011-12. In 2012, differences in payments per beneficiary at the seventy-fifth-percentile practice compared to the twenty-fifth-percentile practice were $3,866 for chemotherapy (including administration and supportive care drugs), $1,872 for acute medical hospitalizations, and $439 for advanced imaging. Supportive care drugs, bevacizumab, and positron-emission tomography accounted for the greatest percentage of variation. Average practice payments for service categories were highly correlated across years but not correlated with each other, which suggests that service categories may be affected by different physician practice characteristics. These differences, even when clinical guidelines exist, demonstrate the potential for quality improvement that could be accelerated through alternative payment models.

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Opening the Black Box: The Impact of an Oncology Management Program Consisting of Level I Pathways and an Outbound Nurse Call System

Abstract: Implementation of Innovent positively affected patient care in several ways: Fewer ER visits and IPAs occurred, in-patient days decreased, cancer-related use costs were reduced, and on-pathway adherence increased.

Cited by 45 publications

References 8 publications

Case management to increase quality of life after cancer treatment: a randomized controlled trial

Case management to increase quality of life after cancer treatment: a randomized controlled trial

An ED pilot intervention to facilitate outpatient acute care for cancer patients

Wide Variation In Payments For Medicare Beneficiary Oncology Services Suggests Room For Practice-Level Improvement

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