title: Leveraging electronic health record systems to create and provide electronic cancer survivorship care plans: a pilot study.
abstract: OBJECTIVE
  The Institute of Medicine (IOM) recommends cancer survivors receive survivorship care plans after completing active cancer treatment. However, care plan creation requires significant time and effort, contributing to diminished adoption of this recommendation. Electronic health record (EHR) systems have been proposed as a solution. We assessed the feasibility of creating and delivering care plans within an EHR system.
  
  
  METHODS
  Thirty-eight breast cancer survivors without existing care plans were recruited during a follow-up visit to their primary oncologist. Using an EHR template, an oncologist created an individualized care plan for each participant. Time spent creating each plan was recorded. Participant use and feedback were collected.
  
  
  RESULTS
  Participants enrolled a median of 19.7 months after diagnosis (range, 4.3 to 57 months). A minority of IOM-recommended plan elements could be automatically imported without any manual entry. The majority of elements required interpretation and manual import by the clinician. However, with an established infrastructure for importing elements, the time needed to create a care plan electronically was short (median, 3 minutes; range 2 to 12 minutes). Most survivors (n = 36; 95%) successfully accessed their care plans online and spent a median of 12 minutes (range, 0.5 to 61.9 minutes) reviewing them. Survivors perceived the plans as useful and did not generally report difficulty in accessing them online or understanding content.
  
  
  CONCLUSIONS
  Rapid care plan creation and delivery within an EHR is possible. Plans were available to all (survivors, oncologists, primary care physicians) via the EHR. Further research is required to explore the barriers to automating data importation into plans as well as the impact of EHR-integrated plans.
authors: University of Wisconsin, Madison, WI at4@medicine.wisc.edu.
authors: Amye J
authors: AJ
authors: Tevaarwerk
authors: University of Wisconsin, Madison, WI.
authors: Kari B
authors: KB
authors: Wisinski
authors: University of Wisconsin, Madison, WI.
authors: Kevin A
authors: KA
authors: Buhr
authors: University of Wisconsin, Madison, WI.
authors: Ucheanna O
authors: UO
authors: Njiaju
authors: University of Wisconsin, Madison, WI.
authors: May
authors: M
authors: Tun
authors: University of Wisconsin, Madison, WI.
authors: Sarah
authors: S
authors: Donohue
authors: University of Wisconsin, Madison, WI.
authors: Navnit
authors: N
authors: Sekhon
authors: University of Wisconsin, Madison, WI.
authors: Thomas
authors: T
authors: Yen
authors: University of Wisconsin, Madison, WI.
authors: Douglas A
authors: DA
authors: Wiegmann
authors: University of Wisconsin, Madison, WI.
authors: Mary E
authors: ME
authors: Sesto
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008875:Middle Aged; D010347:Patient Care Planning; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D017741:Survivors