Implementing Standardized Patient Education in Radiation Oncology.

Abstract

Patient education empowers patients, improving their health status during and after cancer treatment (Howell et al., 2017). We hypothesize that standardizing healthcare provider delivery of educational materials (HPE) using an electronic medical record (EMR) will increase delivery to patients (pts). During the study period (9/2020 - 11/2022) 13,650 pts in a multi-centered single health system (HS) received HPE and were analyzed in a retrospective convenience sample frame. There were 16,769 education touchpoints from Radiation Oncology departments (RO) and 8,269 from Medical Oncology (MO) departments. Provision of HPE was standardized in RO during this era. Relationship of ethnicity, age, and sex/gender to receipt of HPE at single vs multiple time points across the HS was examined using association analysis. Within the combined sample taken from RO and MO departments in the HS the mean pt age was 64y (7 - >90); 71% of pts identified as white, 95.7% non-Hispanic, and 55% female. Across ethnicity, age, and sex/gender, increased HPE was provided in RO vs MO departments (p < 0.001). Distribution of HPE in RO was equal between male and female pts (73%), while distribution to female pts was higher than male in MO. (60% vs 57%, p < 0.001). Receipt of HPE at more than one time point was increased in RO across cancer types (Table 1). In RO, 73% of patients received education at more than one time point, compared to 58.7% in other departments (p < 0.001). Receipt of HPE at more than one time point was increased in RO for patients identifying as American Indian or Alaska Native (84% vs 0, p = 0.001, n = 28), Asian (73.4% vs 56%, p < 0.001, n = 824), and Black (75% vs 60%, p < 0.001, n = 4005). HPE was received at more than one time point in RO in 75.7% of patients age 7-39, 76.4% 40-64, 71.2% 65-79, and 67.6% in those 80 and above, compared to 62.0%, 63.2%, 56.3%, and 49.2%, respectively in MO departments (p = <0.01). Standardization of HPE within RO increased delivery to patients across gender, race/ethnicity, age, and cancer diagnosis, particularly regarding number of educational touchpoints for patients in underserved populations based on race and age. Our results suggest that widespread standardization of HPE is likely to improve distribution of education to all patient groups and should be systematically supported.