Table 4.

Barriers to Survivorship Treatment Summary and Care Plan Implementation: Community-Based Perspective

Barrier	Strategies to Overcome Barrier
Time constraints
Time intensive to gather data and complete form	Use tumor registry data to populate form
Time span (lag) between patient completing therapy and tumor registry abstracting data	Purchase commercially available software product to electronically populate fields Implement RQRS in tumor registry to provide more timely data abstraction
Information technology
Manually populated forms versus documents automatically populated from EHRs	Nurse navigators/nurse practitioners manually populate forms (many standard templates available online)
Lack of shared EHRs between cancer centers and private practice physician offices	Purchase software for shared EHRs between cancer centers and private practice physician offices
Poor access to private practice medical records	Use (expand upon) existing processes for communicating and requesting information from private practice staff
	Establish agreements for access to private practice medical records
Processes and responsibilities
For which patients are treatment summaries appropriate?	Obtain feedback from multidisciplinary teams to identify survivor populations on which to focus for initial implementation
When additional treatment is received, how are updates made to the summary?	Establish survivorship clinics
Care plan recommendations
Lack of standards for adult cancer survivorship surveillance	Collaborate with multidisciplinary team members to establish follow-up surveillance (and care) recommendations based on ASCO, NCCN, and other professional guidelines

NOTE. Data adapted.³⁹

Abbreviations: ASCO, American Society of Clinical Oncology; EHR, electronic health record; NCCN, National Comprehensive Cancer Network; RQRS, rapid quality reporting system.