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Re-engineering Survivorship Care Plans to Support Primary Care Needs and Workflow: Results From an Engineering, Primary Care and Oncology Collaborative for Survivorship Health (EPOCH)

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Abstract

Maintaining the health of survivors requires communication, collaboration and care coordination between oncology and primary care. Primary care clinicians have been acknowledged as important recipients of survivorship care plans (SCPs); however, current SCP templates have not been evaluated for usefulness in the primary care context. We surveyed and interviewed primary care clinicians from a rural research network regarding SCP content, format and layout (phase 1), and potential use and clinical workflows around SCPs (phase 2). Based on these data, an existing SCP template was iteratively redesigned to better support survivorship care in the primary care setting. A total of 13 clinicians (9 MDs, 4 APPs) participated. Interviewees advocated for maintaining a single SCP document shared by survivors and clinicians. Changes to the SCP template included prioritizing follow-up over summary of treatment and removing or down-playing screening recommendations not impacted by cancer or cancer treatment. The re-engineered SCP was regarded as highly relevant for survivors, but clinicians noted the significant effort to “disassemble” SCPs in order to enter the information into on the receiving health record. Primary care clinicians value the information in SCPs but had important recommendations regarding content, layout, and format. Additionally, a significant effort appears to be required by recipients in order to extract SCP information for future use.

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Acknowledgements

The authors would like to thank the following: participating providers and members of the Wisconsin Survivorship research Program (WiSP), UWCCC Survivorship Program, and Wisconsin Research and Education Network (WREN).

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Funding

This work was supported by the NCI Cancer Center Support Grant P30 CA014520, by the NIH CTSA at UW-Madison grant UL1TR000427, as well as the University of Wisconsin-Madison School of Medicine and Public Health’s Wisconsin Partnership Program, WPP-ICTR grant # 3086.

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Authors and Affiliations

  1. Division of Hematology/Oncology, University of Wisconsin, Madison, 6037 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA

    Amye J. Tevaarwerk, James Haine, Mary F. Henningfield, David Hahn & Mary E. Sesto

  2. Carbone Cancer Center, Madison, WI, USA

    Amye J. Tevaarwerk, Xiao Zhang & Mary E. Sesto

  3. Gilda’s Club Madison, Middleton, WI, USA

    Kirsten Norslien

  4. UW Hospitals and Clinics, Madison, WI, USA

    Chelsea Stietz

Authors
  1. Amye J. Tevaarwerk
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  2. Xiao Zhang
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  3. James Haine
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  5. Mary F. Henningfield
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  6. Chelsea Stietz
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  7. David Hahn
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  8. Mary E. Sesto
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Corresponding author

Correspondence to Amye J. Tevaarwerk.

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Conflict of Interest

1. Hahn, David — none

2. Haine, James — none

3. Henningfield, Mary F. — none

4. Norslien, Kirsten — none

5. Sesto, Mary E. — none

6. Stietz, Chelsea — none

7. Tevaarwerk, Amye J. — Epic Systems (family member)

8. Zhang, Xiao — none

Additional information

Implications for Cancer Survivors

SCPs can be designed to better support primary care information needs, as can the delivery of information. These likely represent significant barriers to use of SCPs within the primary care setting.

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Tevaarwerk, A.J., Zhang, X., Haine, J. et al. Re-engineering Survivorship Care Plans to Support Primary Care Needs and Workflow: Results From an Engineering, Primary Care and Oncology Collaborative for Survivorship Health (EPOCH). J Canc Educ 37, 1654–1661 (2022). https://doi.org/10.1007/s13187-021-02008-z

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