Care Coordination for Breast Cancer Survivors in Urban Underserved Communities: Will Treatment Summaries and Survivorship Care Plans Be Enough?

BACKGROUND

Few studies have examined cancer care coordination at federally qualified health centers (FHQCs). The Commission on Cancer's (CoC) standard 3.3, i.e., treatment summaries and survivorship care plans (TS-SCPs), is aimed at improving communication between cancer specialists and primary care providers (PCPs) across all healthcare systems. Whether this will improve care at FQHCs is unclear. We sought to understand breast cancer care coordination at FQHCs before the stepwise implementation of standard 3.3.

METHODS

In 2014, we conducted a retrospective chart review at five Chicago FQHCs. We used ICD-9 codes to identify 109 breast cancer cases diagnosed within 5 years of the chart review. We examined charts for (1) external cancer records, (2) PCP documentation of breast cancer histories, and (3) documentation of PCP engagement in cancer-relevant follow-up care.

RESULTS

Less than 50% of the charts had PCP documentation of more than one area of cancer-relevant follow-up care. Availability of external records did not increase PCP engagement in cancer-relevant follow-up care. Instead, PCPs who documented information about their patient's breast cancer treatments also documented more cancer-relevant follow-up care.

CONCLUSION

Before the stepwise implementation of TS-SCPs, less than 50% of the charts had PCP documentation of more than one area of cancer-related follow-up care. The TS-SCP is designed to facilitate care coordination between specialists and PCPs through increased communication. Our results suggest the availability of external cancer information did not necessarily translate into care delivery. This suggests communication of information alone is insufficient.