Online Tools to Create Survivorship Care Plans
Suzanne Mahon, RN, DNSc, AOCN®, AGN-BC, is a professor in the Division of Hematology/Oncology, Department of Internal Medicine at Saint Louis University in Missouri.

Journey Forward, a free online survivorship tool, allows oncology professionals to create personalized treatment plans, treatment summaries, and care plans that can be printed out and shared with patients and their primary care providers. It has templates for several common cancer types, including breast, colon, and lung cancers, as well as a generic care plan that can be adapted for other malignancies. The Care Plan Builder is secure and can be downloaded from

ONS, along with partners from Anthem Inc., the Cancer Support Community, Genentech, the National Coalition for Cancer Survivorship, and the UCLA Cancer Survivorship Center, developed this system after the National Academy of Medicine, formerly the Institute of Medicine, released the report From Cancer Patient to Cancer Survivor: Lost in Transition. The report recommended that all survivors have a survivorship care plan that summarizes their cancer treatment and recommendations for long-term care.

As an oncology professional who works in the area of cancer prevention, detection, and genetics, I find that one of the most valuable aspects of a survivorship care plan is that it helps patients see the importance of a long-term plan for cancer prevention and detection. It shifts the focus to wellness. Often, patients are focused on their fears of recurrence—which is reasonable—but in many cases the risk is actually higher for a second primary cancer. A well-constructed care plan will include a recipe for cancer screening with the goal of detecting a second cancer early when it is treatable.

Building any survivorship care plan is going to take time. Multiple providers can add information to complete the care plan, but ultimately someone needs to be responsible to ensure that the care plan gets completed, is discussed with the patient, and is forwarded to appropriate providers. One advantage of Journey Forward is the ability to import information from other parts of the electronic medical record, which can decrease the time spent inputting data.

Oncology nurses can also use it as a teaching tool to educate patients about prevention and early detection of cancer during the survivorship phase. As patients enter survivorship, they may need encouragement and education about how their care is changing and how they can advocate for themselves. The survivorship care plan gives them a tool to help them gain confidence and ensure they are getting the care and screening they need.

Survivorship care plans should be more than a form necessary to meet a requirement for accreditation. It can be a potential means to promote wellness and improve quality of life in cancer survivors. Free survivorship tools like Journey Forward can be used to decrease the time required to create tailored care plans, while also offering your patients teachable moments about prevention, early detection, follow-up care, and how to act as their own advocates.