Health2 Resources provides strategic research, analysis for ACCC project

Health2 Resources provided strategic research and analysis for Association of Community Cancer Centers project

The Association of Community Cancer Centers announced that results of a landmark study of how—and how well—the cancer patient's transition from the hospital inpatient setting to outpatient oncology group is managed. The study, designed to help hospitals and oncology groups improve their transition processes. The study was conducted by the Association of Community Cancer Centers, was conducted by ACCC, with strategic research and analysis provided by Health2 Resources.

Findings from the study (available on ACCC's website at www.accc-cancer.org) suggest that some community cancer programs have developed innovative solutions to manage various aspects of the transition process. Still, there is room for further improvement in developing specific processes and policies designed to manage the cancer patient's transition between care settings. Health2 Resources fielded two surveys for the project—one of hospitals with oncology programs and the other of community oncology physician practices—to gather data for statistical analysis.

Among the findings:

• Few hospitals in the study monitor readmissions or follow up with their discharged patients.
• Oncology-specific transition policies are largely non-existent (3 percent of surveyed hospitals have one).
• Transition checklists are rare (15 percent of surveyed hospitals manage the transition with a checklist).
• While some organizations had transition programs in place, few of them are using survey and measurement tools to analyze those processes for quality improvement.
• The transition challenge is to identify and manage the patient and family needs at a time and in a location in which neither system (hospital nor oncology group) has control, accountability, or responsibility.

The study found that there has been substantial progress in recent years in introducing electronic health records (EHR) and computerized physician order entry (CPOE) systems into hospitals and oncology practices. Those systems have greatly improved medication reconciliation and the ability of community oncologists to access appropriate medical records pertaining to their recently hospitalized patients.

Overall, a number of challenges remain: Patients move between two modes of care that are generally operated by two separate organizations, often without common information systems and sometimes with only limited shared information. Hospitals compete with each other for patients, as do physicians, and sometimes the competition can get in the way of good communication during the patient transition. The cost of managing the transition is not built into the reimbursement structure. And multiple challenges can occur in the electronic transfer of usable data between the hospital and the oncology group EHR systems, especially for medical groups admitting patients to several hospitals.

Nine community cancer programs were identified from among survey respondents as providing exemplary activities related to transitioning cancer patients between care settings. Health2 Resources conducted interviews and developed case examples from each of the sites. ACCC will profile these "exemplary" programs as well as offer descriptions of processes that these programs use in patient transition and include practical tools, such as discharge instructions, patient hand-off sheet, and patient navigator checklist, among others, within a special issue of Oncology Issues, March/April 2011.

In addition to the ACCC Care Transitions project, Health2 Resources has experience with research and strategic communications in employer benefit design, use of electronic medical records and new models of care such as the patient-centered medical home and accountable care organizations.