Breast Cancer Clinical Trial
Official title:
HER2+ Breast Cancer Neo-Adjuvant Coordination of Care Program
Currently many patients with HER2+ Breast Cancer do not have the opportunity to be evaluated
by a medical oncologist for neo-adjuvant treatment due to the current lack of care
coordination between the surgeon/surgical oncologist and the medical oncologists.
This project will evaluate the feasibility to enhance knowledge that drives adoption of
evidence based care, and evaluate the improvement in care coordination between oncologists
and surgeons for patients with HER2+ Breast Cancer in the Neo-Adjuvant setting.
The HER2+ Breast Cancer Neo-Adjuvant Coordination of Care Program will evaluate the
feasibility, effectiveness, and adoption of evidence based medicine for patients with HER2+
breast cancer through a care coordination application hosted on CECity's MedConcert™
platform. The goal is to implement evidence into practice using existing patient data, and to
improve care based on knowledge that will enable care coordination between medical
oncologists and surgeons.
PHASE 1: Workflow Design The steering committee from Duke has created a workflow process
related to the HER2+ Neo-Adjuvant Therapy Treatment. The goal of the workflow is to establish
a coordinated approach to care and identifying key steps in the process. The workflow will
identify if the patient had a timely engagement of the multidisciplinary team; if a
pre-treatment assessment was performed; if neo-adjuvant therapy treatment was prescribed; if
appropriate management and adherence to treatment as prescribed occurred; if surgery was
performed and the identification of the type of surgery; and if any subsequent therapy was
prescribed. Data collection will be performed at each of the steps in the workflow.
PHASE 2: Engagement Three sites were identified to participate in the project. Each is
affiliated with the Duke Cancer Network and are free standing hospital systems and clinics. A
coordinator will be designated at each site to guide the process, enter data and communicate
patient progress to the sites multidisciplinary project team. Routine communication will be
maintained between each site and the project team to ensure timely resolution of any issues
or to answer questions.
PHASE 3: Feedback Performance measures have been identified for which data will be collected
and aggregated. The data will be displayed in a performance monitor in the CECity MedConcert™
application to provide feedback to providers on their performance related to the measures.
Providers will also be provided access to educational resources and improvement opportunities
through the application.
PHASE 4: Assessment of Change and Dissemination of Findings Currently, many patients with
HER2+ Breast Cancer do not have the opportunity to be evaluated by an oncologist for
neo-adjuvant treatment because of a lack of coordinated care between surgeons and
oncologists. This project will evaluate adopting evidence-based medicine for patients with
HER2+ through the use of a coordinated care application. The goal is to facilitate greater
coordination of care between oncologists and surgeons and to identify interventions for
improved care. A final report will outline the results of the coordinated care approach. The
results of this QI initiative will be developed into a manuscript for publication.
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