title: Oncologists' perspectives on post-cancer treatment communication and care coordination with primary care physicians.
abstract: Post-treatment cancer care is often fragmented and of suboptimal quality. We explored factors that may affect cancer survivors' post-treatment care coordination, including oncologists' use of electronic technologies such as e-mail and integrated electronic health records (EHRs) to communicate with primary care physicians (PCPs). We used data from a survey (357 respondents; participation rate 52.9%) conducted in 2012-2013 among medical oncologists caring for patients in a large US study of cancer care delivery and outcomes. Oncologists reported their frequency and mode of communication with PCPs, and role in providing post-treatment care. Seventy-five per cent said that they directly communicated with PCPs about post-treatment status and care recommendations for all/most patients. Among those directly communicating with PCPs, 70% always/usually used written correspondence, while 36% always/usually used integrated EHRs; telephone and e-mail were less used. Eighty per cent reported co-managing with PCPs at least one post-treatment general medical care need. In multivariate-adjusted analyses, neither communication mode nor intensity were associated with co-managing survivors' care. Oncologists' reliance on written correspondence to communicate with PCPs may be a barrier to care coordination. We discuss new research directions for enhancing communication and care coordination between oncologists and PCPs, and to better meet the needs of cancer survivors post-treatment.
authors.affiliation: Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD, USA.
authors.forename: C N
authors.initials: CN
authors.lastname: Klabunde
authors.affiliation: Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.|Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: D
authors.initials: D
authors.lastname: Haggstrom
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.|RAND Corporation, Santa Monica, CA, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Kahn
authors.affiliation: Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: S W
authors.initials: SW
authors.lastname: Gray
authors.affiliation: School of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Kim
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
authors.forename: B
authors.initials: B
authors.lastname: Liu
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
authors.forename: J
authors.initials: J
authors.lastname: Eisenstein
authors.affiliation: Department of Health Care Policy, Harvard Medical School and Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: N L
authors.initials: NL
authors.lastname: Keating
mesh_terms: D000359:Aftercare / Q000379:methods* / Q000523:psychology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D000073116:Cancer Survivors; D003142:Communication; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D020380:Needs Assessment; D009369:Neoplasms / Q000628:therapy*; D000072103:Oncologists / Q000523:psychology*; D058007:Physicians, Primary Care / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D014481:United States
keywords: cancer care delivery; cancer survivorship; care coordination; health care provider communication; primary care physician