Innovative Integration: Using Technology Platforms to Improve Education, Care Planning, and Chronic Disease Self-Management for Cancer Survivors

The Intersection of Two Worlds: Survivorship Care Planning and Cancer Registries

Authors:

Cathy Bledsoe (Presenter)
DB Consulting Group

A. Blythe Ryerson, Centers for Disease Control and Prevention
Joseph Rogers, Centers for Disease Control and Prevention
Smitha Kolli, DB Consulting Group
Randi Rycroft, Colorado Department of Public Health and Environment
Debbie Webster, Michigan Department of Health and Human Services
Mikal Giancola, Louisiana State University School of Public Health
Donna Williams, Louisiana State University School of Public Health
Johna Peterson, Washington State Department of Health

Public Health Statement: Cancer survivors have unique health needs which may extend for years after treatment completion. In order to educate patients and encourage appropriate follow-up, professional organizations and cancer advocates recommend that patients receive a survivorship care plan (SCP). An SCP is a personalized summary of a patient’s diagnosis, treatment, possible late effects, and follow-up care guidelines. However, creation of SCPs is often limited by time and resources.

Purpose: Examine how cancer registries can help hospital-based providers efficiently develop SCPs through the pilot of a tool which pre-populates care plans with registry data.

Methods/Approach: CDC’s Web Plus Survivorship Module partially populates SCPs with data from cancer registries, thus “jump starting” the SCP development process. It is currently deployed in seven states. Cancer Registry and Comprehensive Cancer Program staff from those states have participated in monthly meetings with CDC’s Program Manager to determine successes, challenges, and potential improvements to the program.

Results: There are three primary ways cancer registries can help clinicians deliver SCPs to patients: (1) identification of eligible patients, (2) consolidation of data from multiple hospitals, and (3) use of registry data as a starting point for SCP development. There may also be opportunities for clinicians to help cancer registries improve data quality and identify new cases.

Conclusions/Implications: Cancer registries can expand the use of routinely collected data to directly improve patient-centered care through the creation of SCPs. Together, registries and clinicians can leverage existing resources to provide cancer survivors with a tool for navigating ongoing care.

AYA STEPS: A Mobile App to Enhance Uptake of Survivorship Care Plans for Adolescent and Young Adult Survivors of Childhood Cancer

Authors:

Lisa Schwartz (Presenter)
The Children’s Hospital of Philadelphia

Dava Szalda, The Children’s Hospital of Philadelphia
Alexandra Psihogios, The Children’s Hospital of Philadelphia
Elizabeth Ver Hoeve, The Children’s Hospital of Philadelphia
Lauren Daniel, Rutgers Camden
Lindsay Anderson, The Children’s Hospital of Philadelphia
Eliana Butler, The Children’s Hospital of Philadelphia
Wendy Hobbie, The Children’s Hospital of Philadelphia
Linda Jacobs, Perelman School of Medicine of the University of Pennsylvania
Jill Ginsberg, The Children’s Hospital of Philadelphia
Linda Fleisher, The Children’s Hospital of Philadelphia
Keisha Houston, Centers for Disease Control and Prevention
Natasha Buchanan Lunsford, Centers for Disease Control and Prevention
Carolyn Vachani, Perelman School of Medicine of the University of Pennsylvania
Margaret Hampshire, Perelman School of Medicine of the University of Pennsylvania
James Metz, Perelman School of Medicine of the University of Pennsylvania
Christine Hill-Kayser, Perelman School of Medicine of the University of Pennsylvania

Public Health Statement: The current study meets a critical need to improve survivorship self-management among adolescent and young adult (AYA) survivors of childhood cancer.

Purpose: AYA survivors have suboptimal engagement in follow-up care, health-promoting behaviors, and knowledge regarding health promotion, cancer history, and late effects. AYA STEPS (AYA Self-Management via Texting, Education, & Plans for Survivorship) is a mobile app that aims to improve survivorship self-management, especially uptake of health care recommendations via survivorship care plans (SCP). We will present development and initial implementation data of AYA STEPS.

Methods/Approach: AYA STEPS represents a modification of the LifeScience Technologies self-management app and includes a personalized SCP, tailored daily text messages for 16 weeks, a medication list, calendar of medical appointments, and nutrition and exercise trackers. Text message tailoring reflects recommendations from an established SCP (OncoLink.org) for age, selected health goal, and time since treatment. Gamification features include earning incentive points by responding to text messages. The app and the text bank were tested via qualitative interviews. AYA STEPS randomized controlled trial will test the effectiveness of the SCP alone versus the SCP with the AYA STEPS app with 210 participants. We expect that those receiving the app will report better adherence to their SCPs.

Results: We will present data on data enrollment, including sample baseline characteristics and selected health goals, feasibility, and app acceptability. An app demonstration will be conducted.

Conclusions/Implications: We anticipate that AYA STEPS will demonstrate initial feasibility and acceptability and may be a promising intervention for improving self-management among AYA survivors.

Survivorship Care Planning: Implementing the Web Plus Survivorship Module among Breast Cancer Survivors in New Orleans, LA

Authors:

Mikal Giancola (Presenter)
Louisiana State University School of Public Health

Donna Williams, Louisiana State University School of Public Health
Xiao-Cheng Wu, Louisiana State University School of Public Health
Loch Michelle, Louisiana State University Health
Powel Lorrie, Louisiana State University School of Nursing

Public Health Statement: The Commission on Cancer (CoC) requires providers to give survivorship care plans (SCPs) to cancer survivors. Creating these plans is time-consuming and involves compiling information from multiple sources. SCPs aim to improve survivor outcomes and facilitate coordination of care between the patient, the oncologist, and the primary care provider.

Purpose: Discuss the pros and cons of populating SCPs using tumor registry data and CD’s Web Plus Survivorship Module at the pilot facility.

Methods/Approach: Using the Web Plus Survivorship Module to provide SCPs to cancer patients, The Louisiana Cancer Prevention and Control Programs (LCP) collaborated with the Louisiana Tumor Registry (LTR) and the University Medical Center- New Orleans Hospital (UMC-NO). LTR supported CDC’s Web Plus Survivorship Module on its server.

Results: Pros: Oncologists like it, prepopulated fields save time. Easy to read, attractive, and functional layout. Includes info for patient, oncologist, and primary care doctor. No recurring subscription cost. Follow-up care section requires provider customization Cons: Hospital difficulty with Tumor Registrar staffing; LTR estimates it takes 263 days for it to receive data from UMC-NO. During the pilot, we worked with CDC to resolve problems with printing the SCPs, importing records with incomplete dates, built-in report viewer, and field validation. Prepopulated data is only as complete as the data on hand at LTR.

Conclusions/Implications: Organizations implementing CDC’s Web Plus Survivorship Module will want dedicated champions to develop a process that works for them. After adoption, this should be a sustainable solution to SCPs for that organization.