The Institute of Medicine (IOM) strongly recommends that all breast cancer patients who are ending active treatment have a "survivorship plan." Such a plan should assist patients in moving back to their primary care physician (PCP), provide advice for reducing risk for cancer recurrence or new cancer development, and address the remaining psychosocial challenges and aftereffects of cancer and cancer treatment. However, because oncology providers are usually very busy, a comprehensive plan is often neglected. This has taken on heightened urgency because new standards published by American College of Surgeons (ACS) require evidence of survivorship planning for accreditation beginning in 2015. Polaris Health Directions (Small Business) and the University of Massachusetts Medical School (UMass, Research Institute) have partnered to solve the problem of poor survivorship planning with the Polaris Oncology Survivor Transition (POST) system. The POST will blend input from the oncology team and a patient self-assessment to create versions of a Survivorship Plan for the oncology provider, PCP, and patient. Each version will contain the following components, but the length and specific content will be dictated by the needs of the end-user: (1) a medical history and oncology treatment summary;(2) a medical plan that lists testing and medical appointments for the next 12 months;(3) personally tailored educational information and referrals related to psychosocial and physical functioning, including the option of a faxed referral to mental health provider for those reporting significant distress;(4) recommendations and resource links pertaining to health behaviors that may improve quality of life and reduce the chance of recurrence;and (5) recommendations and referrals for supportive care, including resources to assist with spirituality and financial concerns. Finally, patients will complete updat assessments at follow up oncology appointments, and the Plan will be adjusted based on new information.
The specific aims of Phase 1 are to (1) design and build a prototype of the software, and (2) conduct a field test, refining the prototype iteratively with breast cancer patients and their clinicians until the software meets the target evaluation criteria (n~30). The POST is highly innovative as it will be the first system to produce tailored survivorship plans fuly reflecting IOM and ACS requirements. Furthermore, it will be the first survivorship system to communicate bi-directionally with the EHR, to be driven by both provider and patient input, to allow updates to reflect changes in the patient's condition over time, and to encompass both a medical and a psychosocial summary. Since PCPs currently receive little or no information from the oncology team, the POST's transmission of a Survivorship Plan tailored to meet the PCP's needs is pioneering. The POST's commercialization potential is strong as it can lead to improvements in patient health, help providers perform essential functions more easily and assist organizations in complying with the regulatory standards. Polaris has already established a strong presence in the target market with its distress management product.
The POST's public health impact is likely to be substantial because it will improve cancer survivorship planning, which is currently an important deficiency in cancer care recognized by the Institute of Medicine and the American College of Surgeons. The POST will have many potential benefits for patients such as: (1) improved long-term health outcomes, including reduced morbidity and mortality;(2) improved psychosocial outcomes and quality of life;(3) smoother transitions back into old and new life roles;and (4) improved continuity and coordination of care between providers. The POST's influence will reach beyond the patients it directly serves;it will help move forward the emerging science that seeks to understand how to optimally design and implement survivorship planning within complicated systems and communities.