THE NEW STANDARD FOR CANCER CARE

PAT I E N T R E L AT I O N S H I P M A N A G E M E N T

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A CHANGING NEW HEALTHCARE LANDSCAPE

As the healthcare landscape continues to shift toward a value-based model, new challenges arise for providers on how best to improve the patient experience. Providing high quality, coordinated cancer care that gives patients an active and engaged role is more important than ever. Practices must look at operational and technological changes necessary to succeed in today’s healthcare landscape. In this paper we focus on how patient relationship management (PRM) can transform cancer care.

1. Value-based reimbursement models are becoming more widespread with the shift away from the fee-for-service model. This shift brings new complexities and requirements. Before value-based care, care coordination was managed between the patient, their physician, and practice nurses. Today a patient’s care team may include multiple roles to help drive the best care and outcomes: navigators, triage nurses, care coordinators, social workers, financial consultants and others. All of these team members need to work together to deliver coordinated care without increasing costs.

2. Symptom management and medication adherence are essential to improving patient outcomes. The number of patients self-administering oral treatments at home is growing, which means care teams have less oversight. Regardless of what the treatment protocol is for a patient (oral chemotherapy, IV therapy, immunotherapies), adherence to treatment plans, side effect management, and remote patient monitoring are essential for improving outcomes for cancer patients today.

FOUR PILLARS OF THE CHANGING HEALTHCARE LANDSCAPE

The New Standard for Cancer Care: Patient Relationship Management

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3. Patient satisfaction has taken on increasing importance for healthcare systems. Consumerism is on the rise, information can be easily accessed online, and patients are becoming more digitally connected. The Pew Research Center reported in June of 2019 that 96% of Americans own a cellphone. Additionally, the share of Americans with smartphones is now 81% compared to 35% in 2011.1 Patients have come to expect the same level of connectivity and convenience from healthcare providers as they do from other sectors like retail or personal finance. Patient Relationship Management (PRM) is the solution that can make this happen for patients.

4. New cancer therapies and regimens are getting approved by the FDA at a lightening-fast rate. According to the Cancer Letter, in 2018 the FDA approved 19 applications for new cancer drugs and biologics, 38 supplemental indications, and four biosimilars.2 Chemotherapy is still a powerful treatment for cancer, but new targeted therapies and immunotherapies are becoming more prevalent leading to complex and novel treatment regimens that require added support throughout treatment.

All of these factors combined necessitate a new model to deliver care.

Source: Navigating Cancer Patient Survey. 6,500 patients surveyed by Navigating Cancer, June 2018 to May 2019.

72% of patients said they were ‘likely’ or ‘very likely’ to use a mobile app to report how they are feeling on a regular basis.

The New Standard for Cancer Care: Patient Relationship Management

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Chilmark Research defines PRM as “the use of multiple modes of outreach (such as email, messaging, and mobile applications) to assist patients in monitoring their symptoms, managing their health, learning about their conditions, coordinating the care that they receive, and dealing with the various challenges of a disjointed care delivery system – all while living their daily lives in between appointments, office visits, or other episodes of care.”3

PRM is about proactive care that is centered around the patients on their terms. Specifically in cancer care, it’s important that patients have access to multiple modes of care, while their care team needs a single platform that can streamline interactions and deliver real time information. Care teams need a way to triage and provide the appropriate coordinated care.

A PRM digital platform:• Prioritizes patient needs in order of severity

and urgency• Automatically prompts for patient-reported

outcomes• Serves as a communication platform with

embedded clinical workflows • Ensures that no patient need falls through

the cracks• Reduces administrative burden and costs• Can help improve the patient experience

and care coordination

When care team members have the ability to filter information by their individual role or focus, it allows the team to deliver better coordinated care. The technology behind PRM enables providers to change the way cancer care is delivered operationally by enabling high quality, patient-centered care at scale.

AN INTRODUCTION TO PATIENT RELATIONSHIP MANAGEMENT

“True patient relationship management (PRM) is more than just CRM for healthcare. It focuses on patients’ needs outside of the healthcare facility setting, in between care episodes, as they live their everyday lives.”

—Chilmark Research

The New Standard for Cancer Care: Patient Relationship Management

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* This study quantified the savings of two mid-sized community cancer providers that utilize Navigating Cancer’s Patient Relationship Management (PRM) solution for standardized telephone triage with integrated symptom management pathways. The authors of the study analyzed over 10,000 triage incidents documented at The Center for Cancer and Blood Disorders (CCBD) in Fort Worth, Texas and Northwest Medical Specialties (NWMS) in Tacoma, Washington.

Proactive patient care. PRM gives the care team the tools to care for patients based on patient need and preference. This can include the phone, mobile devices, email as well as in person interactions. With PRM technology each member of the care team has access to the information they need for their patients each day. Patients receive coordinated and comprehensive care according to their needs and preferences.

Cost savings with symptom management pathways. Standardized phone triage is a key tactic to help patients avoid ER visits, according to Advisory Board’s Oncology Roundtable.

Triage coupled with standardized symptom management pathways ensure consistent care that meets each patient’s needs. A recent study published in the Journal of Oncology Practice

identified a 6 to 7% reduction in ER events over a 6 month period due to symptom management using standardized pathways. They estimated that the annual number of avoided ER events due to triage was 426 for two mid-sized practices analyzed for the study. That amounts to a savings of $3.85 million for the two practices.4*

KEY BENEFITS OF PRM FOR CANCER CARE

Annual Savings of $3.85 million

HELPFUL TIPS

Strategy 1: Identify drivers of avoidable utilization

Strategy 2: Encourage patients to report symptoms

Strategy 3: Dedicate resources to urgent symptom management

• Standardized phone triage• Remote symptom monitoring• Proactive support of high risk

patients

Advisory Board recommended strategies to reduce ER visits5

The New Standard for Cancer Care: Patient Relationship Management

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Improved patient outcomes with remote monitoring and patient-reported outcomes. PRM can reduce barriers to patients reporting symptoms and communicating with their care team more by giving them a simple tool to use on a regular basis. Advisory Board states the common barriers patients face for reporting symptoms and side effects are:

1. Worried about bothering their care team

2. Don’t know who to contact

3. Fears that treatment will be stopped

Remote monitoring tools that are integrated with PRM will prompt patients via text message or email to report any symptoms they may be experiencing. That information is populated in the care team’s workboard in order of severity. The care team can decide on the appropriate follow up and all the patient had to do was record their symptoms. Research led by Ethan Basch, MD, MSc found that collecting patient-reported

outcomes resulted in fewer hospitalizations, better medication adherence, and improved quality of life.6,7*

Increased patient engagement. Patients need one central, convenient place to access their information, including personalized education and follow up care instructions. It’s also essential to be able to easily share information with caregivers, friends, and family. A PRM brings value to the patient by offering all the benefits of a simple portal in addition to additional services. PRMs deliver personalized education and information during diagnosis and treatment, empowering the patient to take part in shared decision making, manage their self-care, and follow their treatment plan.

* Basch Study: In this follow-up from a randomized controlled trial, patients were asked to complete an online report at least once a week and to rate their symptoms on a scale of one to four. They were able to actively participate in their care, which improved communication with their care team. Automatic email alerts were sent to nurses for severe or worsening symptoms, and symptom printouts were shared with the physician at appointments. This approach has been shown to allow for better treatment of symptoms, fewer ER visits, and longer time on therapy.

Results: Health-related quality of life improved more for participants in the study group than typical care (34% vs 18%). Patients who self-reported symptoms had fewer ER admissions (34% vs 41%) or hospitalizations (45% vs 49%), and they stayed on chemotherapy longer (mean 8.2 vs 6.3 months). After an average follow-up of seven years, the median overall survival of the intervention group was five months longer (31.2 vs 26 months, respectively).

Median survival for patients who self-reported symptoms was 5 months longer than the control group.

KEY BENEFITS OF PRM (Continued)

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manage their treatment are more likely to maintain medication adherence. Studies have shown that patient-centered care is the way of the future, with increased patient satisfaction, better quality of life, and longer lifespan.

The care team. The centralized nature of PRM is also a huge asset for the care team. From the phone operator to the social worker to the triage team - everyone has a unique and important role to play. Unify the care team by pulling together those distinct interactions in a single, comprehensive view for true care coordination. PRM also allows providers to have better visibility into the care provided by their team, giving them a comprehensive look ath the patient-centered care at their clinic. More effective and efficient tools like filters and streamlined workflows enable staff to work at top-of-license. The ability to view and prioritize issues across all patients allows for effective and efficient patient care.

Administrators. Whether a hospital, multi-location community practice, or a small practice, PRM offers significant advantages for administrators, service line directors, and executive directors. Because the PRM can track activities and incoming data in real time, staff can quickly identify issues and opportunities for improvement. A PRM enables cancer care providers to automate tasks to meet regulatory requirements and comply with value-based program requirements. This type of patient-centered care results in a more efficient use of resources, better patient outcomes, and reduced costs.

Patients and caregivers. Cancer patients can often feel overwhelmed by the amount of information they receive during an office visit, as well as everything they need to remember for their treatment. The average adult immediately forgets 40% to 80% of medical information after an appointment.8 A PRM benefits the patient by providing a streamlined experience. Patients and their caregivers will have a central location to access to their medical information, read personalized education materials, and securely message with their care team. Patients are able to have more informed conversations with clinic staff and their provider, and they will spend less time waiting for answers as their care team can more quickly address issues through the PRM system. Cancer patients who feel they have more agency in developing their treatment plan and have the tools to proactively

HOW PRM HELPS

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The New Standard for Cancer Care: Patient Relationship Management

THE REAL WORLD IMPACT of PRM with Navigating Cancer

Triage nurses reported preventing 100+ ED visits in 2018.

CENTER FOR CANCER AND BLOOD DISORDERS

VIRGINIA ONCOLOGY ASSOCIATES

OKLAHOMA CANCER SPECIALISTS AND RESEARCH INSTITUTE

The average time for symptom-related incidents resolved in 2019 so far is 2 hours 14 minutes (looking at more than 7,000 symptom incidents).

From April to June of 2018, 50% reduction on return call wait times leading to expanded patient communication.

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“This technology helps keep the whole care team on the same page. Our triage nurses feel more empowered to act on a patient’s standing orders rather than having to consult a physician. Patients receive faster care, and physicians have fewer follow-up calls to make at the end of the day.”

—Barry Russo, CEO, Center for Cancer and Blood Disorders

“We are more efficient and effective as a team since patient needs are clearly displayed in order of priority. This has been especially useful for us to pick up where someone else left off - nothing gets missed.”

—Staff insight, Virginia Oncology Associates

“We have been able to significantly improve our triage process – expediting incoming phone calls and providing quicker intervention for symptom management in real time for our patients.”

—Chief Nursing Director, Oklahoma CancerSpecialists and Research Institute

THE REAL WORLD IMPACT (Continued)

KEY TAKEAWAY

Patients extended their time on treatment by 21% and one-year survival increased by 13%.

Contact us today at (800) 925-4456 or email us at inquiries@navigatingcancer.com.

NAVIGATING CANCER ASCO 2017 STUDY

The impact of a pemetrexed educational program for lung cancer patients from 58 oncology practices delivered from 2014-2016 via the Navigating Cancer patient education platform was assessed for this study. Results showed with statistical significance that lung cancer patients on IV treatment who received and opened educational materials sent to them by Navigating Cancer extended their time on treatment by 21%, or 50 days longer, and one-year survival increased by 13%.9

Patient-centered care is essential to succeed in today’s healthcare landscape. Patients need multiple methods to access information and communicate with their care team outside the typical 15 minute office visit. Using PRM combines your people, process, and technology to create a better coordinated care experience.

Navigating Cancer created one of the first patient-centered platforms for oncology in 2008. As the leading authority in oncology patient relationship management, our mission is to improve the patient experience through our technology solutions. Learn more about what Patient Relationship Management can do for your organization.

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The New Standard for Cancer Care: Patient Relationship Management

ABOUT NAVIGATING CANCERNavigating Cancer is the leading Patient Relationship Management technology and solutions company focused on improving the patient experience, delivering more effective care management and enabling oncology care innovation. With over 1,700 providers adopting our platform, Navigating Care is the most broadly deployed patient management platform in oncology. Our solutions improve clinical workflows, oncology content, and data capabilities together to empower more personalized care, increase performance, and deliver insights that help improve care for cancer patients. For more information, please visit www.navigatingcancer.com or follow us on Twitter @navcancer. www.navigatingcancer.com

References: 1. Pew Research Center: internet and technology. Mobile fact sheet. https://www.pewinternet.org/fact-sheet/mobile. Published June 12, 2019. Accessed July 22, 2019. 2. Dietz C, Bin Han Ong M. FDA approves 19 new cancer drugs and biologics in 2018—and don’t forget two new endpoints and “real-time” review. https://cancerletter.com/articles/20190125_2/. Published January 25, 2019. Accessed July 22, 2019. 3. Eastwood B. Patient relationship management market scan report. https://www.chilmarkresearch.com/chilmark_report/patient-relationship-management-market-scan-report. Accessed July 22, 2019. 4. Barkley R, Soobader M-J, Wang J, Blau S, Page RD. Reducing Cancer Costs Through Symptom Management and Triage Pathways. J Oncol Pract. 2019;15(2):e91-e97. 5. Advisory Board Oncology Roundtable. 6. Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D. Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA. 2017 Jul 11;318(2):197-198. 7. Memorial Sloan Kettering Cancer Center. Real-time, patient-reported symptom monitoring demonstrates an overall survival benefit. https://www.mskcc.org/press-releases/real-time-patient-reported-symptom-monitoring-demonstrates-overall-survival-benefit. Accessed July 30, 2019. 8. Kessels RPC. Patients’ memory for medical information. J R Soc Med. 2003;96(5):219-222. 9. Howard SC, Yeatman TJ, Watson ML, Lam C. Increasing the duration and efficacy of intravenous chemotherapy using a patient-centered digital education program: Navigating Cancer’s program for patients receiving pemetrexed for lung cancer. J Clin Oncol. 2017;35 (suppl; abstr e18025).

©2019 Navigating Cancer, Inc.