Cargando…

Understanding primary care-oncology relationships within a changing healthcare environment

BACKGROUND: Management of care transitions from primary care into and out of oncology is critical for optimal care of cancer patients and cancer survivors. There is limited understanding of existing primary care-oncology relationships within the context of the changing health care environment. METHO...

Descripción completa

Detalles Bibliográficos
Autores principales: Tsui, Jennifer, Howard, Jenna, O’Malley, Denalee, Miller, William L., Hudson, Shawna V., Rubinstein, Ellen B., Ferrante, Jeanne M., Bator, Alicja, Crabtree, Benjamin F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882058/
https://www.ncbi.nlm.nih.gov/pubmed/31775653
http://dx.doi.org/10.1186/s12875-019-1056-y
_version_ 1783474072929173504
author Tsui, Jennifer
Howard, Jenna
O’Malley, Denalee
Miller, William L.
Hudson, Shawna V.
Rubinstein, Ellen B.
Ferrante, Jeanne M.
Bator, Alicja
Crabtree, Benjamin F.
author_facet Tsui, Jennifer
Howard, Jenna
O’Malley, Denalee
Miller, William L.
Hudson, Shawna V.
Rubinstein, Ellen B.
Ferrante, Jeanne M.
Bator, Alicja
Crabtree, Benjamin F.
author_sort Tsui, Jennifer
collection PubMed
description BACKGROUND: Management of care transitions from primary care into and out of oncology is critical for optimal care of cancer patients and cancer survivors. There is limited understanding of existing primary care-oncology relationships within the context of the changing health care environment. METHODS: Through a comparative case study of 14 innovative primary care practices throughout the United States (U.S.), we examined relationships between primary care and oncology settings to identify attributes contributing to strengthened relationships in diverse settings. Field researchers observed practices for 10–12 days, recording fieldnotes and conducting interviews. We created a reduced dataset of all text related to primary care-oncology relationships, and collaboratively identified patterns to characterize these relationships through an inductive “immersion/crystallization” analysis process. RESULTS: Nine of the 14 practices discussed having either formal or informal primary care-oncology relationships. Nearly all formal primary care-oncology relationships were embedded within healthcare systems. The majority of private, independent practices had more informal relationships between individual primary care physicians and specific oncologists. Practices with formal relationships noted health system infrastructure that facilitates transfer of patient information and timely referrals. Practices with informal relationships described shared commitment, trust, and rapport with specific oncologists. Regardless of relationship type, challenges reported by primary care settings included lack of clarity about roles and responsibilities during cancer treatment and beyond. CONCLUSIONS: With the rapid transformation of U.S. healthcare towards system ownership of primary care practices, efforts are needed to integrate strengths of informal primary care-oncology relationships in addition to formal system driven relationships.
format Online
Article
Text
id pubmed-6882058
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-68820582019-12-03 Understanding primary care-oncology relationships within a changing healthcare environment Tsui, Jennifer Howard, Jenna O’Malley, Denalee Miller, William L. Hudson, Shawna V. Rubinstein, Ellen B. Ferrante, Jeanne M. Bator, Alicja Crabtree, Benjamin F. BMC Fam Pract Research Article BACKGROUND: Management of care transitions from primary care into and out of oncology is critical for optimal care of cancer patients and cancer survivors. There is limited understanding of existing primary care-oncology relationships within the context of the changing health care environment. METHODS: Through a comparative case study of 14 innovative primary care practices throughout the United States (U.S.), we examined relationships between primary care and oncology settings to identify attributes contributing to strengthened relationships in diverse settings. Field researchers observed practices for 10–12 days, recording fieldnotes and conducting interviews. We created a reduced dataset of all text related to primary care-oncology relationships, and collaboratively identified patterns to characterize these relationships through an inductive “immersion/crystallization” analysis process. RESULTS: Nine of the 14 practices discussed having either formal or informal primary care-oncology relationships. Nearly all formal primary care-oncology relationships were embedded within healthcare systems. The majority of private, independent practices had more informal relationships between individual primary care physicians and specific oncologists. Practices with formal relationships noted health system infrastructure that facilitates transfer of patient information and timely referrals. Practices with informal relationships described shared commitment, trust, and rapport with specific oncologists. Regardless of relationship type, challenges reported by primary care settings included lack of clarity about roles and responsibilities during cancer treatment and beyond. CONCLUSIONS: With the rapid transformation of U.S. healthcare towards system ownership of primary care practices, efforts are needed to integrate strengths of informal primary care-oncology relationships in addition to formal system driven relationships. BioMed Central 2019-11-28 /pmc/articles/PMC6882058/ /pubmed/31775653 http://dx.doi.org/10.1186/s12875-019-1056-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Tsui, Jennifer
Howard, Jenna
O’Malley, Denalee
Miller, William L.
Hudson, Shawna V.
Rubinstein, Ellen B.
Ferrante, Jeanne M.
Bator, Alicja
Crabtree, Benjamin F.
Understanding primary care-oncology relationships within a changing healthcare environment
title Understanding primary care-oncology relationships within a changing healthcare environment
title_full Understanding primary care-oncology relationships within a changing healthcare environment
title_fullStr Understanding primary care-oncology relationships within a changing healthcare environment
title_full_unstemmed Understanding primary care-oncology relationships within a changing healthcare environment
title_short Understanding primary care-oncology relationships within a changing healthcare environment
title_sort understanding primary care-oncology relationships within a changing healthcare environment
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882058/
https://www.ncbi.nlm.nih.gov/pubmed/31775653
http://dx.doi.org/10.1186/s12875-019-1056-y
work_keys_str_mv AT tsuijennifer understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment
AT howardjenna understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment
AT omalleydenalee understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment
AT millerwilliaml understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment
AT hudsonshawnav understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment
AT rubinsteinellenb understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment
AT ferrantejeannem understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment
AT batoralicja understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment
AT crabtreebenjaminf understandingprimarycareoncologyrelationshipswithinachanginghealthcareenvironment