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The Johns Hopkins Primary Care for Cancer Survivor Clinic: lessons learned in our first 4 years

  • Youngjee ChoiEmail author
  • Archana Radhakrishnan
  • Darshan Mahabare
  • Shalom Patole
  • Sydney M. Dy
  • Craig E. Pollack
  • Zackary D. Berger
  • Kimberly S. Peairs
Article

Abstract

Purpose

We established the Primary Care for Cancer Survivor (PCCS) Clinic in 2015 to address transition and care delivery challenges unique to cancer survivors. We describe the clinical program, detail patients from the first 4 years of implementation, and discuss lessons learned during the process.

Methods

We abstracted relevant patient information from the electronic medical record, administered a needs assessment survey at initial visits, and collected relative value unit (RVU) data.

Results

Between August 2015 and May 2019, we saw 230 PCCS patients with an increasing number of referrals yearly; nearly half were breast cancer survivors. At the initial visit, patients reported a median of 9 needs, with emotional needs most prevalent; over a third received at least one referral. PCCS patients generated higher billing codes and average RVUs compared with general patients.

Conclusions

In its first 4 years, the PCCS program has thrived as a unique model of cancer survivorship centered in primary care. PCCS patients reported numerous needs, emphasizing the critical need for a multi-disciplinary approach in this population. With increasing referrals, we have considered different risk stratification and staffing models for capacity and expansion. By generating more RVUs per visit compared with the general clinic, PCCS has demonstrated financial sustainability. Buy-in from our oncology colleagues, divisional support from general medicine, along with our collaboration of like-minded internists have allowed us to be a robust program.

Implications for Cancer Survivors

Models of survivorship care embedded in primary care can provide meaningful, patient-centered care for cancer survivors.

Keywords

Cancer survivors Primary care Continuity of patient care 

Notes

Acknowledgments

We thank Candace Nigrin and Amanda Bertram for their respective clinical and research support. We are grateful to Jamison Kies for her assistance with additional data support. We would like to acknowledge the Merck Foundation and our philanthropic benefactors for their financial support of our research efforts.

Funding information

This work was financially supported by the Merck Foundation (grant number N022890).

Compliance with ethical standards

Conflict of interest

Dr. Kimberly Peairs has received salary support from the Merck Foundation grant. Dr. Craig Pollack owns stock in Gilead Pharmaceuticals. The other authors declare that they have no conflict of interest.

Supplementary material

11764_2019_816_MOESM1_ESM.pdf (310 kb)
ESM 1 (PDF 310 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Johns Hopkins School of MedicineLuthervilleUSA
  2. 2.University of Michigan School of MedicineAnn ArborUSA
  3. 3.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  4. 4.Johns Hopkins Berman Institute of BioethicsBaltimoreUSA
  5. 5.Johns Hopkins Sidney Kimmel Comprehensive Cancer CenterBaltimoreUSA

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