Study notes challenges when transitioning cancer patients from hospitals

The Association of Community Cancer Centers (ACCC) has released a study of how  - and how well - the cancer patient's transition from the hospital inpatient setting to outpatient oncology group is managed. Findings suggest that some community hospital cancer programs have developed innovative solutions to manage the transition process, however there is room for improvement in developing specific processes and policies.

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. Only 3% of surveyed hospitals have one.

• Transition checklists are rare, with 15% of surveyed hospitals managing 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 report notes that substantial progress has been made in introducing electronic health records (EHR) and computerized physician order entry (CPOE) systems into hospitals and oncology practices. Those systems have 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, according to the study. 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.

The study was compiled from two online surveys, one for oncology physician practices and the other for hospital-based oncology programs. Nearly 100 participants completed the surveys.