Two-Year Survival Comparing Web-Based Symptom Monitoring vs Routine Surveillance Following Treatment for Lung Cancer

Denis, Fabrice; Basch, Ethan; Septans, Anne Lise; Bennouna, Jaafar; Urban, T.; Dueck, Amylou C.; Letellier, Christophe

doi:10.1001/jama.2018.18085

Cited by 399 publications

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“…Research is needed to test how technology can be used to improve cancer care delivery throughout the cancer care continuum from initial patient assessment to self‐care management and triage to support services. Recently, Basch et al and Denis et al found that a reporting system for patient‐reported symptoms also improved survival . Such a system could be leveraged to also provide triage to cancer rehabilitation services; including this in a rapid learning environment in which the model of care could be monitored and improved upon by stakeholders would be ideal.…”

Section: Introductionmentioning

confidence: 99%

A health services research agenda to fully integrate cancer rehabilitation into oncology care

Pergolotti

Alfano

Cernich

et al. 2019

Cancer

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Adults with cancer are at risk of restricted functioning in work, usual activities, life roles, and quality of life both during and after cancer treatment. Herein, the authors discuss unique opportunities to examine how cancer rehabilitation, delivered as part of cancer and survivorship care, might help to achieve the quadruple aim of better patient health, better patient experience, and lower cost for patients who receive services, as well as improving the work life of clinicians and staff.

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Section: Introductionmentioning

confidence: 99%

A health services research agenda to fully integrate cancer rehabilitation into oncology care

Pergolotti

Alfano

Cernich

et al. 2019

Cancer

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“…It has even been suggested that patients lacking computer experience may have less developed health communication skills and may thereby benefit more from a structured program for reporting symptoms . Two promising randomized trials have demonstrated lengthened patient survival when symptoms are monitored via home‐based ePROs . The first trial randomized 766 advanced cancer patients at one academic medical center during chemotherapy, while the other included 121 advanced non‐progressive lung cancer patients right after treatment, and followed them for 2 years .…”

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confidence: 99%

“…In both studies, ePRO group participants completed weekly, web‐based self‐reports of a limited number of common symptoms, while the control group received standard care. When the ePRO group participants reported a severe or worsening symptom, an email alert was triggered to the clinical staff responsible for the care of that patient, and action was taken at the clinicians’ discretion and 7.6 months longer for lung cancer patients in the ePRO group compared to the control group after 2 years .…”

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confidence: 99%

“…When the ePRO group participants reported a severe or worsening symptom, an email alert was triggered to the clinical staff responsible for the care of that patient, and action was taken at the clinicians’ discretion and 7.6 months longer for lung cancer patients in the ePRO group compared to the control group after 2 years . Improved health‐related quality of life, less frequent admission to the emergency room or hospital, and longer tolerability of treatment (including chemotherapy) were also reported …”

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confidence: 99%

“…In addition, a Norwegian multicenter study on follow‐up after gynecological cancer (Lifestyle and Empowerment Techniques in Survivorship of Gynecologic Oncology – The LETSGO‐study) is planned, which will integrate ePROs in the follow‐up at intervention hospitals (N = 5) while the control hospitals (N = 5) will continue traditional follow‐up (LETSGO pilot study, NCT03453788). The LETSGO ePRO study is developed by clinicians and based on the same principles as in the published studies described above . The patients will receive a monthly reminder to answer 10 questions pertaining to common symptoms of cancer recurrence, originating from the The European Organization for the Research and Treatment of Cancer (EORTC) and adapted for patient use.…”

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confidence: 99%

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the Centers for Medicare & Medicaid Services (CMS) Innovation Center released details of a proposed alternative payment model for medical oncology care, called Oncology Care First (OCF), for public comment. 1 The OCF model will succeed the Oncology Care Model (OCM), which will expire at the end of 2020. When it started in 2016, the OCM, which was voluntary, was important in oncology due to its emphasis on value-based care transformation.The OCM requires practices to implement the following care transformation activities for patients receiving systemic cancer treatment: (1) 24/7 patient access to a clinician who can view the medical record; (2) patient navigation services; (3) documentation of a care plan that contains all components of the National Academy of Medicine's Care Management Plan; (4) delivery of guideline-recommended care; (5) use of a federally certified electronic health record system; and (6) use of data for continuous quality improvement. There are currently 140 participating practices, which represents about 10% of US oncology practices. Because some of the largest multisite community and academic networks in the country are included, this represents about 25% of patients receiving systemic cancer treatment in the United States.Recognizing that care enhancements can be expensive and cumbersome to implement, the CMS provides OCM practices with upfront monthly payments of $160, in addition to standard fee-for-service, for each patient receiving systemic cancer treatment (chemotherapy, immunotherapy, targeted therapy, or hormonal treatment). Practices can use these funds to support care transformation by hiring patient navigators, social workers, and care coordinators; building acute care alternatives to the emergency department; implementing treatment pathway programs; and creating or licensing software for population management. 2 Practices are incentivized to reduce costs of care via shared savings based on benchmark prices and quality measurement. Although it is still early, there is some evidence that the OCM features have led to reduced emergency department visits, intensive care unit admissions, and hospitalizations at the end of life, 3 which provide value and improve the patient experience. The early experience with the OCM also reveals how difficult it is to actualize care transformation because it requires changes in technology, patient engagement, communications, personnel, workflow, data reporting, and perhaps at the most fundamental level, a change in culture and mindset.Building on the success of the OCM, the CMS structured the OCF model as a capitated model with upfront

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Two-Year Survival Comparing Web-Based Symptom Monitoring vs Routine Surveillance Following Treatment for Lung Cancer

Cited by 399 publications

References 4 publications

A health services research agenda to fully integrate cancer rehabilitation into oncology care

A health services research agenda to fully integrate cancer rehabilitation into oncology care

Electronic patient‐reported outcomes to monitor symptoms after gynecological cancer treatment

Adding Patient-Reported Outcomes to Medicare’s Oncology Value-Based Payment Model

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