Innovating Cancer Care Delivery: the Example of the 4R Oncology Model for Colorectal Cancer Patients
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Care delivery innovation is necessary to address the growing complexity of cancer care across specialties and integrate new diagnostics, treatments, and services into care delivery. Informed by Cancer Care Delivery Research (CCDR), multilevel intervention research, and other disciplines, this article describes the 4-step cancer care delivery innovation cycle. The cycle guides collaborative efforts of cancer clinicians, researchers, patients, and other stakeholders to systematically define care delivery problems and formulate, test, and implement care innovations to effectively address problems. We illustrate the 4 steps of the innovation cycle with the example of developing the 4R Oncology Model for colorectal cancer (4R is Right Information and Right Care for the Right Patient at the Right Time). The 4R is a multilevel intervention informed by CCDR, the team science, and lessons learned from other models, such as survivorship care planning. We offer additional considerations for balancing the need to innovate with concerns about constrained resources and overextended workforce. We suggest to focus on care delivery models which are synergistic with other efforts and do not require extensive information systems support in earlier cycles of development.
KeywordsCare delivery models Cancer care delivery 4R Oncology Model Care delivery innovation Care delivery redesign Systems engineering in cancer care delivery Project management in care delivery
Compliance with Ethical Standards
Conflict of Interest
Julia Trosman has received consulting fees (paid to Center for Business Models in Healthcare, Glencoe, IL) from Genentech.
Christine Weldon has received consulting fees (paid to Center for Business Models in Healthcare, Glencoe, IL) from Genentech.
Sheetal Kircher declares that she has no conflict of interest.
William Gradishar declares that he has no conflict of interest.
Al Benson III has received research funding from Novartis, Acerta Pharma, Celgene, Advanced Accelerator Applications, Merck Sharpe & Dohme, Taiho Pharmaceuticals, Bristol-Myers Squibb, and MedImmune/AstraZeneca; has received consulting/advisory fees from Bristol-Myers Squibb, Guardant Health, Eli Lilly & Company, Exelixis, Purdue Pharma, Xcenda, inVentiv Health, Inc., Axio, Genentech, Bayer, Merck, Rafael Pharmaceuticals, and Terumo; has served as a Data Monitoring Committee member for Astellas, Infinity Pharmaceuticals, and Merck Sharpe & Dohme; has given CME presentations for Harborside, meeting presentations for the National Comprehensive Cancer Network; and has served on an Editorial Board for Emron.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently,4 have been highlighted as: • Of importance •• Of major importance
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