title: Regional Multiteam Systems in Cancer Care Delivery.
abstract: Teamwork is essential for addressing many of the challenges that arise in the coordination and delivery of cancer care, especially for the problems that are presented by patients who cross geographic boundaries and enter and exit multiple health care systems at various times during their cancer care journeys. The problem of coordinating the care of patients with cancer is further complicated by the growing number of treatment options and modalities, incompatibilities among the vast variety of technology platforms that have recently been adopted by the health care industry, and competing and misaligned incentives for providers and systems. Here we examine the issue of regional care coordination in cancer through the prism of a real patient journey. This article will synthesize and elaborate on existing knowledge about coordination approaches for complex systems, in particular, in general and cancer care multidisciplinary teams; define elements of coordination derived from organizational psychology and human factors research that are applicable to team-based cancer care delivery; and suggest approaches for improving multidisciplinary team coordination in regional cancer care delivery and avenues for future research. The phenomenon of the mobile, multisystem patient represents a growing challenge in cancer care. Paradoxically, development of high-quality, high-volume centers of excellence and the ease of virtual communication and data sharing by using electronic medical records have introduced significant barriers to effective team-based cancer care. These challenges urgently require solutions.
authors.affiliation: University of Rochester Medical Center; American Cancer Society, Hope Lodge, Rochester; St James Mercy Hospital, Hornell, NY; Barts Health; and Center for Implementation Science, King's College London, London, United Kingdom.
authors.forename: Katia
authors.initials: K
authors.lastname: Noyes
authors.affiliation: University of Rochester Medical Center; American Cancer Society, Hope Lodge, Rochester; St James Mercy Hospital, Hornell, NY; Barts Health; and Center for Implementation Science, King's College London, London, United Kingdom.
authors.forename: John R T
authors.initials: JR
authors.lastname: Monson
authors.affiliation: University of Rochester Medical Center; American Cancer Society, Hope Lodge, Rochester; St James Mercy Hospital, Hornell, NY; Barts Health; and Center for Implementation Science, King's College London, London, United Kingdom.
authors.forename: Irfan
authors.initials: I
authors.lastname: Rizvi
authors.affiliation: University of Rochester Medical Center; American Cancer Society, Hope Lodge, Rochester; St James Mercy Hospital, Hornell, NY; Barts Health; and Center for Implementation Science, King's College London, London, United Kingdom.
authors.forename: Ann
authors.initials: A
authors.lastname: Savastano
authors.affiliation: University of Rochester Medical Center; American Cancer Society, Hope Lodge, Rochester; St James Mercy Hospital, Hornell, NY; Barts Health; and Center for Implementation Science, King's College London, London, United Kingdom.
authors.forename: James S A
authors.initials: JS
authors.lastname: Green
authors.affiliation: University of Rochester Medical Center; American Cancer Society, Hope Lodge, Rochester; St James Mercy Hospital, Hornell, NY; Barts Health; and Center for Implementation Science, King's College London, London, United Kingdom.
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration*; D012004:Rectal Neoplasms / Q000556:secondary / Q000628:therapy*