Journal of Cancer Survivorship

, Volume 7, Issue 1, pp 124–130 | Cite as

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

  • Barbara DiCicco-Bloom
  • Regina S. CunninghamEmail author


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.


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


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.


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.


Information sharing Primary care clinicians Oncologists Care coordination Cancer care Survivor care 



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


  1. 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.PubMedCrossRefGoogle Scholar
  2. 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.PubMedCrossRefGoogle Scholar
  3. 3.
    Earle C. Long term care planning for cancer survivors: a health services research agenda. J Cancer Survivorship. 2007;1(1):64–74.CrossRefGoogle Scholar
  4. 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.PubMedCrossRefGoogle Scholar
  5. 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.CrossRefGoogle Scholar
  6. 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. 7.
    Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350–83.CrossRefGoogle Scholar
  8. 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.CrossRefGoogle Scholar
  9. 9.
    Baggs JG, Schmitt MH. Collaboration between nurses and physicians. J Nurs Scholarsh. 1988;20(3):145–9.CrossRefGoogle Scholar
  10. 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.PubMedCrossRefGoogle Scholar
  11. 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.PubMedCrossRefGoogle Scholar
  12. 12.
    Institute of Medicine. To err is human: building a safer health system. Washington DC: National Academy Press; 1999.Google Scholar
  13. 13.
    Institute of Medicine. Keeping patients safe. Washington DC: National Academy Press; 2001.Google Scholar
  14. 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.PubMedCrossRefGoogle Scholar
  15. 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.PubMedGoogle Scholar
  16. 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.PubMedCrossRefGoogle Scholar
  17. 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.PubMedCrossRefGoogle Scholar
  18. 18.
    Legant P. Commentary: who should follow our patients? J Oncol Pract. 2010;6(1):24–5.PubMedCrossRefGoogle Scholar
  19. 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.CrossRefGoogle Scholar
  20. 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.PubMedGoogle Scholar
  21. 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.PubMedCrossRefGoogle Scholar
  22. 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.PubMedCrossRefGoogle Scholar
  23. 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.PubMedCrossRefGoogle Scholar
  24. 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.PubMedCrossRefGoogle Scholar
  25. 25.
    Grunfeld E, Earle CC. The interface between primary and oncology specialty care: treatment through survivorship. JNCI Monographs. 2010;2010(40):25–30.CrossRefGoogle Scholar
  26. 26.
    Crabtree BF, Miller WL. Doing qualitative research. 2nd ed. Thousand Oaks, CA: Sage; 1999.Google Scholar
  27. 27.
    DiCicco-Bloom B. Qualitative research interviews. Medical Education. 2006;40(9):314–21.PubMedCrossRefGoogle Scholar
  28. 28.
    Patton M. Qualitative research and evaluation methods. Thousand Oaks, CA: Sage; 2002.Google Scholar
  29. 29.
    Oeffinger K, McCabe M. Models for delivering survivorship care. J Clin Oncol. 2006;24(32):5117–24.PubMedCrossRefGoogle Scholar
  30. 30.
    Rowland J, Aziz N, Tesauro G, et al. The changing face of cancer survivorship. Semin Oncol Nurs. 2001;17(4):236–40.PubMedCrossRefGoogle Scholar
  31. 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.PubMedGoogle Scholar
  32. 32.
    Coleman V. Why patients should keep their own records. J Med Ethics. 1984;10(1):27–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Hetzel MR, Williams IP, Shakespeare RM. Can patients keep their own peak-flow records reliably? Lancet. 1979;1(8116):597–9.PubMedCrossRefGoogle Scholar
  34. 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. 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.PubMedGoogle Scholar
  36. 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.PubMedCrossRefGoogle Scholar
  37. 37.
    Hahn EE, Ganz PA. Survivorship programs and care plans in practice: variations on a theme. J Oncol Pract. 2011;7(2):70–5.PubMedCrossRefGoogle Scholar
  38. 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.PubMedCrossRefGoogle Scholar
  39. 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.CrossRefGoogle Scholar
  40. 40.
    IOM. From cancer patient to cancer survivor. Washington, DC: The National Academies Press; 2006.Google Scholar
  41. 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.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Department of NursingLehman CollegeBronxUSA
  2. 2.University of PennsylvaniaPhiladelphiaUSA

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