COOPE: A digital health system to facilitate financial navigation of out-of-pocket cancer costs

项目总结 随着患者支付更多的医疗费用，癌症治疗的自付费用(OOP)正在增加 一般，包括更高的保险费和更高的免赔额、共同保险和共同支付。癌 分娩被描述为“处于危机中的系统”，因为治疗费用的财政负担影响到近一半。 新诊断的癌症患者。在这个第一阶段的SBIR项目中，我们将构建和测试开箱即用的癌症 Estiator(Coope)，一个移动/网络系统，帮助启动新的癌症患者的财务咨询 癌症治疗。遵循三个具体目标，我们将使用以人为中心的设计(HCD)方法来 开发一个系统，供直接与患者打交道的财务顾问使用。在目标1中，我们将进行 对20个潜在系统终端用户(财务顾问、癌症患者及其 护理人员、肿瘤学家、授权代表)，以探讨当前对癌症成本讨论的看法 以及在患者治疗开始之前估计的OOP成本数据的可用性。在目标2中，我们将构建一个 基于AIM中确定和概述的建议和规范的用户告知Coope原型 1.原型将由财务顾问审查并迭代，以生成将在 随后进行了现场测试。在目标3中，我们将使用混合方法进行一项初步研究，以研究Coope的使用 在参加肿瘤学护理模式(OCM)的城市三级安全网医院进行财务咨询。 我们将检查可用性和有用性、使用模式、对成本信息的感知知识、患者 满意度、估计的准确性和财务困境。可用性和有用性的度量(即，SEQ， UMUX-Lite)将用于评估系统的可接受性和确定第二阶段项目的潜力。结果 这一第一阶段SBIR项目将进一步开发和验证一个试点系统，以评估 这一制度对财务规划和财务毒性的影响。

PROJECT SUMMARY Out-of-pocket (OOP) costs of cancer treatment are increasing as patients pay more of their health care costs in general, including higher insurance premiums and higher deductibles, co-insurance, and copayments. Cancer delivery has been described as a “system in crisis” as the financial burden of treatment costs affects nearly half of newly-diagnosed cancer patients. In this Phase I SBIR project, we will build and test Cancer Out-Of-Pocket Estimator (COOPE), a mobile/web system to assist with financial counseling for cancer patients initiating new cancer treatments. Following three specific aims, we will use a human-centered design (HCD) approach to develop a system for primary use by financial counselors working directly with patients. In Aim 1, we will conduct a requirements analysis with 20 potential system end users (financial counselors, cancer patients and their caregivers, oncologists, authorization representatives) to probe current perceptions of cancer cost discussions and the availability of estimated OOP cost data before initiation of patient treatment. In Aim 2, we will build a user-informed prototype of COOPE based on recommendations and specifications identified and outlined in Aim 1. The prototype will be reviewed by financial counselors and iterated to generate a version that will be used in subsequent field testing. In Aim 3, we will conduct a pilot study using mixed methods to study the use of COOPE in financial counseling at an urban, tertiary safety net hospital participating in the Oncology Care Model (OCM). We will examine usability and usefulness, usage patterns, perceived knowledge of cost information, patient satisfaction, accuracy of estimates, and financial distress. Measures of usability and usefulness (i.e., SEQ, UMUX-Lite) will be used to assess system acceptability and determine the potential of a Phase II project. Results of this Phase I SBIR project will go towards further development and validation of a pilot system to assess the effects of this system on financial planning and financial toxicity.