1. ASCO Presentation Summary: Chemotherapy Treatment Plan and Summary Templates as a Component of Comprehensive Cancer Care Kansas Cancer Partnership University of Kansas Medical Center Nursing School Building Kansas City, KS July 29, 2009

2. www.asco.org/treatmentsummary Modifiable Templates Include: Cancer Treatment Plan and Summary Breast Cancer Treatment Plan and Summary Colon Cancer Treatment Plan and Summary Non Small Cell Lung Cancer Treatment Plan and Summary Small Cell Lung Cancer Treatment Plan and Summary

3. Purpose and Use of Templates improve documentation and coordination of cancer treatment and survivorship care facilitate provider-to-provider and provider-to- patient communication may be distributed to patients or providers as records of care planned and received NOT intended to replace detailed chart documentation, including complete patient histories or chemotherapy flow sheets

4. Treatment Plan and Summary Concise documentation to improve communication and coordination  Provider to provider  Provider to patient Treatment plan: prepared at the initiation of a course of cancer chemotherapy Treatment summary: prepared at the end of a chemotherapy treatment course

5. Treatment Plan Definition Diagnosis, including the cancer site, histology and stage Goals of therapy Patient health status and comorbid conditions Surgical history and notable pathology findings Chemotherapy regimen and starting dosages Duration of treatment and number of planned cycles Major side effects of chemotherapy

6. Treatment Summary Definition Chemotherapy treatment delivered, including number of cycles administered, duration, and extent of dose reduction Reason treatment was stopped Major toxicities and/or hospitalizations Treatment response Follow up care plan and determination of responsibility among relevant providers

7. ASCO “Lost in Transition” Report Increase in survivors (10 million) PCPs, other providers not always familiar with late effects of cancer  Don’t get explicit guidance from oncologists Lack of evidence for best practices in caring for cancer survivors

8. ASCO “Lost in Transition” Main Recommendation Each cancer patient receive a survivorship care plan  information critical to long-term care  cancer diagnosis, treatment, and potential consequences  timing and content of follow-up visits  wellness/prevention recommendations  legal rights affecting employment and insurance  psychological and support services

9. Additional Recommendations and Considerations Institutions consider adoption/develop systems to promote communication and comprehensive cancer care coordination Integrating into Electronic Health Records Provide tools to patients and clinicians Barriers:  time and payment system that doesn’t recognize these crucial services  change in physician/staff office routine