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Stanford University School of Medicine

High-value oncology practices include “support for the patient journey”

Earlier this week I wrote about a landmark paper in the Annals of Family Medicine in which Stanford researchers, led by health care policy expert Arnold Milstein, MD, identified tangible changes physicians and health care organization could implement to better deliver high-quality, low-cost care to primary care patients. The intersection of these two goals is known as "high-value" care, and it's an important goal for physicians, legislators and insurers nationwide who are working together to lower skyrocketing health care costs in this country.

Now Milstein and Stanford oncologist Douglas Blayney, MD, have published a similar paper in JAMA Oncology detailing a parallel study in oncology care.

As Blayney, who is the former director of the Stanford Cancer Institute, explained in our release:

Cancer care is expensive, and physicians and insurers sometimes question the value of the non-medical or non-clinical services that we provide for patients. Here, we identify for the first time specific aspects of high-quality, low-cost care that provide value for patients and payers and that can be adopted by doctors and organizations across the country.

The researchers found that, in addition to an early discussion with each patient of the limitations, expectations and goals of cancer care, aspects of high-value care often centered around what they termed "support for the patient journey." These included the early involvement and normalization of palliative care -- not just for end-of-life issues, but also to help alleviate or manage treatment side effects; the availability of a dedicated outpatient facility for cancer patients to address their urgent care needs in an ambulatory care setting; and the designation of a point person to help patients with common problems including navigating an often confusing health care system, concerns about financing or transportation issues and where to turn for social and emotional support.

"Our findings suggest that many of the places that provide high-value care are also particularly good at providing these often unreimbursed, non-medical services," Blayney said.

Milstein is the the director of Stanford's Clinical Excellence Research Center, the first university-based research center exclusively dedicated to discovering, testing and evaluating cost-saving innovations in clinically excellent care. As in the primary care paper, he and the authors of the current study hope that their findings help many more oncology care practices achieve the high-value care designation.

Previously: Identifying 'high-value' practices in primary care; a Stanford study pinpoints key attributesA glimpse inside Stanford Coordinated Care, an innovative model of health care and Spotting stellar primary care practices, Stanford study identifies 10 practices that lead to excellence

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