Much of oncology nursing education focuses on IV administration of systemic therapies because for years, that was the only route. Until 2004, only two cancer therapies were approved for subcutaneous (SC) administration, and just nine others were added through 2012. However, as more familiar IV therapies get SC counterparts, including the more recent approvals of four high-volume monoclonal antibodies (mAbs), infusion nurses are using them more regularly in practice.

Under a newly refreshed strategy, the Centers for Medicare and Medicaid Services’ (CMS) Innovation Center is expanding models in the healthcare industry that reduce program costs and improving quality and outcomes for Medicare and Medicaid beneficiaries, the agency announced in an October 2021 white paper.

Delaying initiation of cancer treatment by just four weeks is associated with increased mortality rates for patients with seven types of cancers, regardless of treatment type, researchers reported in BMJ.

Patients with cancer who experience unexpected and long-lasting treatment outcomes are considered exceptional responders, but researchers and clinicians had no insight as to why the patients did so well with treatment. Results of a new study now show that genomic characterizations of cancer can uncover genetic alterations that may contribute to the phenomenon, researchers reported in Cancer Cell.

How often have you gone to the mailbox, pulled out your latest issue of the Oncology Nursing Forum or Clinical Journal of Oncology Nursing, and excitedly read about some innovative study with game-changing outcomes that’ll revolutionize the delivery of health care—only to find that it never moves off the pages of the journal? What does it take to move research from the proverbial bench to the community? That was the focus of the Fourth Annual Meeting of the Patient Centered Outcomes Research Institute (PCORI), “From Evidence to Impact: Putting What Works into Action,” held from October 31–November 2, 2018, in Washington DC. 

With the ubiquity of smartphones and, more recently, smart watches and fitness trackers, the potential to use these devices to monitor and assist patients with cancer has never been greater. Being able to monitor and respond to patient data through fitness trackers could help healthcare professionals provide swift, accurate interventions in the future. Our proof-of-concept study, “Wireless Monitoring Program of Patient-Centered Outcomes and Recovery Before and After Major Abdominal Cancer Surgery,” explored the feasibility and acceptability of using technology, including fitness monitors, to efficiently monitor patient-generated health data by answering the following questions: 

Most emergencies can manifest in the blink of an eye. Whether it’s a medical emergency, a car accident, an act of nature, or something else, emergencies are sudden crises that require swift, immediate action. For many patients with cancer, among the most distressing challenges along the treatment journey is the possibility of experiencing an oncologic emergency.

Because of immunosuppression from cancer or its treatment, patients are at a higher risk for viral, bacterial, and fungal infections. Patients who develop infections may experience dose delays or reductions that compromise optimal treatment outcomes, resulting in higher mortality rates, longer hospitalizations, and higher cost of care.

The cost of cancer care and the quality of patient services has always been a top priority in health care. However, the Centers for Medicare & Medicaid Services (CMS) Innovation Center has been working to strengthen both elements of care. CMS, through its Oncology Care Model (OCM) division, works with cancer care providers to develop payment strategies and performance categories in treatment plans for patients with cancer.

That “science, informatics, incentives, and culture are aligned for continuous improvement and innovation” in care delivery through evidence-based practice (EBP) that uses research outcomes, clinical expert perspectives, and patient and family engagement, the National Academy of Medicine Roundtable on Value and Science-Driven Health Care project charter visualizes. By 2020, the goal is to ensure that 90% of clinical decisions are individualized yet supported by the most current, relevant, and best-available evidence and effective tools are in place to measure outcomes. 

A large study published in the Journal of the National Cancer Institute found that patients with nonmetastatic breast, lung, or colorectal cancer who chose to use only alternative medicine had substantially worse survival than patients who received conventional cancer treatment.

It’s beneficial to think about financial toxicity in terms of issues adhering to treatment. Mounting evidence suggests that patients with financial toxicity aren’t adhering to their cancer care. It’s becoming a common side effect of cancer treatment, and patients might be less likely to take treatments their medical team prescribes because of it, leading to substandard care.

The cost of health care in the United States has been the source of debate for years. Questions range from the extent of Medicare and a Medicaid coverage, how—or if—the government should regulate drug prices, who deserves coverage, and how Institutions collect payments from insurance companies. But often, one important aspect is missing from the numerous conversations on health care, treatments, and financial reimbursements: the patients.

More than a decade ago, the National Academy of Medicine first proposed that “all patients should be given a comprehensive summary and a clear explanation of the details of their cancer therapy as well as recommendations for necessary follow-up.” This seemingly simple task has proved difficult to deliver in many cancer care settings.

Appropriate nurse staffing is only one of the critical factors that contribute to optimal patient outcomes and is as important as the systems, technology, and quality standards in any care setting. The relationship between poor staffing, daily variation in quality, and increased workload to increased care errors, missed care, and patient and nurse dissatisfaction is well described.

Patients know their own experiences best. Evidence has shown that providers are unaware of about half of patients’ symptoms during cancer care. When patients directly report their symptoms using online questionnaires, it can help close this gap in communication. Bringing the patient voice into practice using patient-reported outcomes (PROs) can not only make us aware of their symptoms—enabling earlier interventions—but can also make care delivery more patient-centered.

Technology can—at times—seem miraculous, especially as it evolves in healthcare settings. Simple technologic tools have been able to lower costs, increase efficiency, minimize delays in treatment times, and even provide new, lifesaving procedures for cancer treatment.

The ONS Oncology Nurse Generalist competencies define the fundamental knowledge, skills, and abilities that nurses new to oncology practice should develop or acquire within the first one to two years of oncology practice. The target audience includes both beginning nurses new to practice as well as seasoned nurses who enter the oncology specialty after working in another area.

When the National Academy of Medicine, formerly the Institute of Medicine, released its 2010 report, The Future of Nursing: Leading Change, Advancing Health, it cited a need for improvement in nursing education and practice through the implementation of nursing competencies.

Oncology institutions across the United States are implementing big change in the way nurses and physicians deliver care to patients with cancer. By highlighting quality care and smart spending, facilities are reimagining the way cancer is treated in America. New procedures, research, and technology have redefined the way cancer is treated, so a new system for delivery and reimbursement is vital to ensure that quality care can be delivered at a reasonable cost.

Oncology care is a complex, expensive, and often-fragmented area of medicine. To understand the potential need for a new payment model in oncology care, a thorough evaluation of all the data was important. By reviewing the oncology literature associated with costs and quality, we discovered that there were wide variations in the costs associated with the treatment of advanced cancers, but little variation in the outcomes of patients. We also identified gaps in patient care that we thought could be improved.

This is the teaser.