Skip to main content

Advertisement

SpringerLink
Log in

The experience of information sharing among primary care clinicians with cancer survivors and their oncologists

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose of study

Knowledge about information sharing among primary care clinicians, oncologists, and their cancer patients is critical given its importance in facilitating the delivery of quality care to the increasing number of cancer survivors. The purpose of our study was to provide a better understanding of the nature of interactions among primary care clinicians, patients, and oncologists throughout the cancer care continuum to better understand the transition to survivorship.

Method

Twenty-one qualitative in-depth interviews were conducted with 11 primary care physicians and 10 nurse practitioners. Themes were identified using content analysis.

Results

The following themes emerged from the data including: (1) a visit is worth a thousand written reports—primary care clinicians described the importance of patient visits during cancer treatment; (2) community vs. cancer center oncologists—primary care clinicians described differences in information sharing with community oncologists as compared with those in academic centers; (3) correcting for information deficits—primary care clinicians, unable to obtain regular progress reports directly from oncologists, developed indirect strategies to obtain information; (4) the deficiencies in post-treatment follow-up care plans; and (5) the panacea of electronic medical records and survivor care plans.

Conclusions

The themes that emerged from this work describe in detail the absence of systematic information sharing among primary care clinicians, patients, and oncologists that is needed to support quality survivorship care in the primary care setting. The descriptions by primary care clinicians contribute to a deeper understanding of the daily challenges that both interfere and/or support primary care clinicians in their care of survivors of cancer.

Implications for cancer survivors

Managing the complex care of cancer survivors often requires the expertise of a number of skilled providers. Information sharing among these individuals is one of the most fundamental aspects of ensuring effective transitions in care. Our results indicate that systematic information sharing among providers caring for cancer survivors is lacking. Identifying strategies to enhance information sharing among and between providers is essential to facilitating the delivery of high-quality survivor care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Yabroff KR, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of illness in cancer survivors: findings from a population-based national sample. J Natl Cancer Inst. 2004;96(17):1322–30.

    Article  PubMed  Google Scholar 

  2. Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009;27(17):2758–65.

    Article  PubMed  Google Scholar 

  3. Earle C. Long term care planning for cancer survivors: a health services research agenda. J Cancer Survivorship. 2007;1(1):64–74.

    Article  Google Scholar 

  4. Hewitt ME, Bamundo A, Day R, Harvey C. Perspectives on post-treatment cancer care: qualitative research with survivors, nurses, and physicians. J Clin Oncol. 2007;25(16):2270–3.

    Article  PubMed  Google Scholar 

  5. Taplin SH, Rodgers AB. Toward improving the quality of cancer care: addressing the interfaces of primary and oncology-related subspecialty care. JNCI Monographs. 2010;2010(40):3–10.

    Article  Google Scholar 

  6. Gordon S. Nursing against the odds: how health care cost cutting, media stereotypes, and medical hubris undermine nurses and patient care. Ithaca, NY: Cornell University Press; 2005. p. 95–120.

    Google Scholar 

  7. Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350–83.

    Article  Google Scholar 

  8. Edmondson AC. Speaking up in the operating room: how team leaders promote learning in interdisciplinary action teams. J Manag Stud. 2003;40(6):1419–52.

    Article  Google Scholar 

  9. Baggs JG, Schmitt MH. Collaboration between nurses and physicians. J Nurs Scholarsh. 1988;20(3):145–9.

    Article  CAS  Google Scholar 

  10. Baggs JG, Schmitt MH, Mushlin AI, Mitchell PH, Eldredge DH, Oakes D, Hutson AD. Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med. 1999;27(9):1991–8.

    Article  PubMed  CAS  Google Scholar 

  11. Ferrand E, Lemaire F, Regnier B, Kuteifan K, Badet M, Asfar P, Jaber S, Chagnon J-L, Renault A, Robert R, Pochard F, Herve C, Brun-Buisson C, Duvaldestin P. Discrepancies between perceptions by physicians and nursing staff of intensive care unit end-of-life decisions. Am J Respir Crit Care Med. 2003;167(10):1310–5.

    Article  PubMed  Google Scholar 

  12. Institute of Medicine. To err is human: building a safer health system. Washington DC: National Academy Press; 1999.

    Google Scholar 

  13. Institute of Medicine. Keeping patients safe. Washington DC: National Academy Press; 2001.

    Google Scholar 

  14. Rowland JH, Hewitt M, Ganz PA. Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol. 2006;24(32):5101–4.

    Article  PubMed  Google Scholar 

  15. Grunfeld E, Fitzpatrick R, Mant D, Yudkin P, Adewuyi-Dalton R, Stewart J, Cole D, Vessey M. Comparison of breast cancer patient satisfaction with follow-up in primary care versus specialist care: results from a randomized controlled trial. Br J Gen Pract. 1999;49(446):705–10.

    PubMed  CAS  Google Scholar 

  16. Grunfeld E, Levine MN, Julian JA, Coyle D, Szechtman B, Mirsky D, Verma S, Dent S, Sawka C, Pritchard KI, Ginsburg D, Wood M, Whelan T. Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol. 2006;24(6):848–55.

    Article  PubMed  Google Scholar 

  17. Grunfeld E, Mant D, Vessey MP, Fitzpatrick R. Specialist and general practice views on routine follow-up of breast cancer patients in general practice. Fam Pract. 1995;12(1):60–5.

    Article  PubMed  CAS  Google Scholar 

  18. Legant P. Commentary: who should follow our patients? J Oncol Pract. 2010;6(1):24–5.

    Article  PubMed  Google Scholar 

  19. Blaauwbroek R, Zwart N, Bouma M, Meyboom-de Jong B, Kamps WA, Postma A. The willingness of general practitioners to be involved in the follow-up of adult survivors of childhood cancer. J Cancer Survivorship: Res Pract. 2007;1(4):292–7.

    Article  Google Scholar 

  20. Nissen J, Beran M, Lee M, Mehta S, Pine D, Pine Swenson K. Views of primary care providers on follow-up care of cancer patients. Family Medicine. 2007;39(7):477–82.

    PubMed  Google Scholar 

  21. Brazil K, Sussman J, Bainbridge D, Whelan T. Who is responsible? The role of family physicians in the provision of supportive cancer care. J Oncol Pract. 2010;6(1):19–24.

    Article  PubMed  Google Scholar 

  22. Mao JJ, Bowman MA, Stricker CT, DeMichele A, Jacobs L, Chan D, Armstrong K. Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients. J Clin Oncol. 2009;27(6):933–8.

    Article  PubMed  Google Scholar 

  23. Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ. 2002;324(7341):819–23.

    Article  PubMed  Google Scholar 

  24. Lenz ER, Mundinger MON, Kane RL, Hopkins SC, Lin SX. Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Med Care Res Rev. 2004;61(3):332–51.

    Article  PubMed  Google Scholar 

  25. Grunfeld E, Earle CC. The interface between primary and oncology specialty care: treatment through survivorship. JNCI Monographs. 2010;2010(40):25–30.

    Article  Google Scholar 

  26. Crabtree BF, Miller WL. Doing qualitative research. 2nd ed. Thousand Oaks, CA: Sage; 1999.

    Google Scholar 

  27. DiCicco-Bloom B. Qualitative research interviews. Medical Education. 2006;40(9):314–21.

    Article  PubMed  Google Scholar 

  28. Patton M. Qualitative research and evaluation methods. Thousand Oaks, CA: Sage; 2002.

    Google Scholar 

  29. Oeffinger K, McCabe M. Models for delivering survivorship care. J Clin Oncol. 2006;24(32):5117–24.

    Article  PubMed  Google Scholar 

  30. Rowland J, Aziz N, Tesauro G, et al. The changing face of cancer survivorship. Semin Oncol Nurs. 2001;17(4):236–40.

    Article  PubMed  CAS  Google Scholar 

  31. Hillner BE, Smith TJ, Desch CE. Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. J Clin Oncol. 2000;18(11):2327–40.

    PubMed  CAS  Google Scholar 

  32. Coleman V. Why patients should keep their own records. J Med Ethics. 1984;10(1):27–8.

    Article  PubMed  CAS  Google Scholar 

  33. Hetzel MR, Williams IP, Shakespeare RM. Can patients keep their own peak-flow records reliably? Lancet. 1979;1(8116):597–9.

    Article  PubMed  CAS  Google Scholar 

  34. Koppel R, Davidson S, Wears R, Sinsky C. In: Koppel R, Gordon S, editors. First do less harm: confronting the inconvenient problems of patient safety. Ithaca: Cornell University Press; 2012.

    Google Scholar 

  35. Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, Morton S, Shekelle P. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144:742–52.

    PubMed  Google Scholar 

  36. Earle CC. Failing to plan is planning to fail: improving the quality of care with survivorship care plans. J Clin Oncol. 2006;24(32):5112–6.

    Article  PubMed  Google Scholar 

  37. Hahn EE, Ganz PA. Survivorship programs and care plans in practice: variations on a theme. J Oncol Pract. 2011;7(2):70–5.

    Article  PubMed  Google Scholar 

  38. Ganz PA, Casillas J, Hahn EE. ensuring quality care for cancer survivors: implementing the survivorship care plan. Semin Oncol Nurs. 2008;24(3):208–17.

    Article  PubMed  Google Scholar 

  39. Ganz PA, Hahn EE. Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2008;26(5):759–67.

    Article  Google Scholar 

  40. IOM. From cancer patient to cancer survivor. Washington, DC: The National Academies Press; 2006.

    Google Scholar 

  41. Salz T, Oeffinger K, Lewis P, Williams R, Rhyne R, Yeazel M. Primary care providers’ needs and preferences for information about colorectoal cancer survivorship care. J Am Board Fam Med. 2012;25(5):635–51.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Terry Falco for her assistance with this investigation.

Author information

Authors and Affiliations

  1. Department of Nursing, Lehman College, 250 Bedford Park West, Bronx, NY, 10468, USA

    Barbara DiCicco-Bloom

  2. University of Pennsylvania, Philadelphia, PA, USA

    Regina S. Cunningham

Authors
  1. Barbara DiCicco-Bloom
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Regina S. Cunningham
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Regina S. Cunningham.

Rights and permissions

Reprints and permissions

About this article

Cite this article

DiCicco-Bloom, B., Cunningham, R.S. The experience of information sharing among primary care clinicians with cancer survivors and their oncologists. J Cancer Surviv 7, 124–130 (2013). https://doi.org/10.1007/s11764-012-0253-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-012-0253-7

Keywords

Search

Navigation