Facilitators and Barriers to Implementing a Patient-Centered Oncology Care Model

Area of Science:

• Oncology
• Healthcare Management
• Patient-Centered Care

Background:

• Oncology practices often function as the "medical home" for patients.
• Existing systems may not fully support comprehensive patient-centered care.
• Need for enhanced standards in oncology medical homes is recognized.

Purpose of the Study:

• To pilot new oncology medical home standards focusing on accessible, continuous, coordinated, and team-based care.
• To examine variations in standard adoption across diverse practices.
• To compare self-reported implementation with external evaluations.

Main Methods:

• Pilot study involving five southeastern Pennsylvania medical oncology practices (2014-2016).
• Implementation support included training webinars and technical assistance.
• External reviewers assessed implementation, supplemented by site visits and interviews with providers and patients.

Main Results:

• Practices demonstrated increased implementation of patient-centered oncology standards, notably in continuous quality improvement (QI).
• Areas like care coordination, access, and evidence-based decision support showed less successful implementation or decline.
• Qualitative findings identified facilitators (leadership support, physician buy-in) and barriers (resources, staffing), with health IT having mixed effects.

Conclusions:

• Oncology practices made progress in patient-centered care processes during the pilot.
• Key elements for successful transformation include robust systems for tracking improvement, staff training, leadership commitment, and aligned financial incentives.