Survivorship Care: What does it take? The experience at Sylvester Comprehensive Cancer Center (SCCC), University of Miami Health Systerm (UHEALTH).

Abstract

82 Background: SCCC faces obstacles similar to programs challenged with the development of a cancer survivorship program. Informatics is one of the major limiting resources in continuing to improve and move the survivorship program forward at a large academic institution. An electronic order referral system is pivotal for success. Sylvester at UHEALTH has 7 campuses spread out over 60 miles in a heavily populated area of South Florida. UHEALTH developed a workflow that allowed providers to enter order referrals for identified patients. Methods: At UHEALTH, within EPIC, patients (PTS) have order referrals placed for their needs. The scheduling department contacts PTS to arrange their appointments. With the assistance of our EPIC team and oncology scheduling service, we developed a survivorship order referral. Its purpose was to streamline the process from identification of appropriate PTS, entering order referral and then scheduling PTS into open templates throughout the institution. This order referral is a useful tool within the electronic health record that assists in tracking and scheduling PTS for the survivorship clinic visit type created. The centralized survivorship clinic established itself at the same time the order referral pilot started. Results: UHEALTH piloted the order referral at main campus and 1 of our 6 satellite locations. The pilot showed that from the period of January 2017 - June 2017, providers referred 142 PTS to a survivorship clinic. PTS had the right to refuse the Survivorship visit, but it was important to offer the clinic and explain its purpose. After a successful 6-month period, we expanded the order referral to include three other satellite locations. Conclusions: It is our recommendation to other institutions who use EPIC to create an ambulatory order referral process for referring and scheduling identified PTS to a survivorship clinic. An EPIC order referral increases PTS referrals to survivorship. Institution specific analytics are tracked through order referrals placed and survivorship visit type appointments made. Further research is necessary to understand reasons for PTS refusing or cancelling survivorship appointments.