The experience of information sharing among primary care clinicians with cancer survivors and their oncologists
- 630 Downloads
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.
KeywordsInformation 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.
- 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
- 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.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
- 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
- 26.Crabtree BF, Miller WL. Doing qualitative research. 2nd ed. Thousand Oaks, CA: Sage; 1999.Google Scholar
- 28.Patton M. Qualitative research and evaluation methods. Thousand Oaks, CA: Sage; 2002.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
- 40.IOM. From cancer patient to cancer survivor. Washington, DC: The National Academies Press; 2006.Google Scholar