Using technology to improve patient-provider communication and delivery of quality care.

Abstract

76 Background: Shared decision making (SDM) is a cornerstone of patient-centered care with 85-90% of breast cancer (BC) patients preferring an active or shared role in decision-making for breast surgery. SDM has been shown to, improve patients’ understanding of treatment options, result in more conservative care choices, and lead to lower healthcare costs. However, implementation is complex as numerous misconceptions exist. Methods: We are conducting a multi-site, quality improvement (QI) project to improve SDM behaviors and adherence to quality measures through a combination of provider education and use of a novel technology platform, the Carevive Care Planning System. This platform elicits patient preferences, concerns, history, and symptoms, and presents these data with algorithm-driven recommendations as part of a treatment plan. We report results from baseline provider surveys assessing perception and knowledge of SDM. Results: Baseline surveys from 28 participants were analyzed; 43% from a university based cancer center and 57% from community based cancer centers. Survey respondents were MDs (43%), NPs (7%) and RNs (46%), all specializing in Hematology and/or Oncology. When asked, “What percentage of breast cancer patients prefers an active or shared role in decision making?”, only 29% believed 85-90% of BC patients desired an active or shared role as suggested by surgical literature; 43% believed between 55-70% of patients wanted to be engaged in decision-making. Commonly reported barriers to SDM are shown in the table below. Conclusions: Physicians may underestimate patient’s desire to participate in shared decision-making. The barriers to implementing SDM in oncology practice will likely require multi-faceted interventions to overcome. We aim to address these gaps through an intervention aimed at enhancing knowledge and patient-provider engagement through treatment summaries. [Table: see text]