Treatment Prices at the Point of Care in a Clinical Oncology Service: Pilot Project
Treatment Prices at the Point of Care in a Clinical Oncology Service: Pilot Project
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DOI：
10.1200/jop.2016.012997
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发表时间：
2016-10-01
影响因子：
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通讯作者：
Chen, Eric
中科院分区：
文献类型：
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作者：
Henrikson, Nora B.;Lau, Rebecca W.;Chen, Eric
癌症患者越来越希望与临床医生讨论癌症护理费用。我们的目的是提高临床医生获得治疗price.MethodsWe开发了一个试点工具和配套的工作流程，在一个综合护理系统的四个肿瘤诊所。该在线工具包括50份可打印的癌症治疗方案说明书，可直接从电子健康记录中查阅。每张表格都以患者友好的语言列出了一个治疗周期的所有药物和服务的代码和价格。联合国没有提供病人一级的费用分摊。我们评估了资源的推出，初步使用，并通过初步users.ResultsThe项目的便利性调查的可接受性成功推出。价格表的初始网络流量超过了发布期间订购的治疗数量。三分之一的调查答卷人报告说，至少每周使用一次成本表。最有用的功能是改善了对成本信息的访问，基于治疗方案的布局以及满足患者需求的能力。该资源被评定为对患者、工作人员和组织普遍具有高价值。建议的改进包括提供患者水平的成本分摊（63%），然后扩展项目，包括更多的协议（33%）。这些改进正在进行中。结论试点是可行的，建立了查找价格数据的能力，并且没有对工作人员的工作量产生不利影响。它解决了一个明确的需求，并显示出很高的潜在整体价值，特别是其基于协议的格式。该资源缺乏对自付费用的个性化估计是报告的最大差距。
PurposePatients with cancer increasingly wish to discuss cancer care costs with clinicians. We aimed to improve clinician access to treatment prices.MethodsWe developed a pilot tool and accompanying workflow for four oncology clinics in an integrated care system. The online tool included 50 printable worksheets for cancer treatment protocols and was accessible directly from the electronic health record. Each sheet included codes and prices for all drugs and services for one treatment cycle in patient-friendly language. The worksheets did not provide patient-level cost-shares. We evaluated the resource's launch, initial use, and acceptability through a convenience survey of initial users.ResultsThe project was successfully launched. Initial Web traffic to price sheets exceeded the number of treatments ordered during the launch period. One third of survey respondents reported use of the cost sheets at least once a week. The most useful features were improved access to cost information, treatment protocol-based layout, and ability to meet patient needs. The resource was rated as generally high value to patients, staff, and the organization. Suggested improvements included provision of patient-level cost sharing (63%) followed by expansion of the project to include more protocols (33%). These improvements are in progress.ConclusionThe pilot was feasible, built capacity to locate price data, and did not adversely affect staff workload. It addressed a clear need and demonstrated high potential overall value, especially with its protocol-based format. The resource's lack of personalized estimates of out-of-pocket charges was the biggest gap reported.