Strategies for Meeting Patient Expectations and Improving Patient Experience During Cancer Treatment

Scientific advances have led to a significant reduction in cancer mortality and increased survival rates,  yet the number of annual cancer diagnoses continues to grow, with over two million new diagnoses expected in 2024. This dynamic presents both challenges and opportunities for hospital cancer programs as health care providers face an imperative to increase access to services to meet new patient demands while also ensuring capacity to manage ongoing, multi-year care for survivors, who often develop deep and personal relationships with their cancer care teams and trust for the hospital brand based on their care.

Hospitals and hospital-managed cancer programs play a central and vital role in cancer treatment.  However, as more cancer treatment moves to outpatient settings and technology advances, more nontraditional “disruptors” seek to enter the cancer care market and to compete on patient experience. Access to cutting-edge treatments and clinical trials have long been critical differentiators for hospital cancer programs but patient-centered care and patient experience of care play an increasing role in quality, patient outcomes, and patient choice of provider.

Care navigation, logistical coordination, and improved communication have become “table stakes” for providers hoping to establish longitudinal relationships with complex patients.

Our recent white paper outlines strategies and considerations for hospitals seeking to optimize experience for cancer patients, excerpts of which are included below.

Patients expect their cancer care be individualized and for their episodes of care to be organized around their needs and preferences, not dictated by convenience to the providers. In particular, hospitals will need to focus on:

• Comprehensive care—Patients with a cancer diagnosis or those at risk for cancer are looking to their provider not only for the latest treatments and access to clinical trials, but also for programs that identify cancer risk, offer prevention strategies, and support their quality of life during and after treatment or through long-term episodes of care. As many patients will live with cancer or the side effects of treatment for many years, they want ongoing support to meet their needs.
• Convenient care—Patients want less disruption in their lives and value easy and timely access to necessary services, less waiting time, and more real-time or rapid bi-directional communication with providers. This is particularly valuable to patients needing to maintain their and/or their families’ ability to work as they often face financial pressures, no small part of which includes maintaining their health insurance or managing health care co-payments.
• Care close to home—For patients who must travel a distance for expert treatment, providers should be sensitive to the disruptive nature of travel and schedule services accordingly. Given the increasingly longitudinal nature of cancer treatment episodes, patients prefer as much support as close to home as possible or virtually and the continued advance of technology facilitates such a migration of care toward home-based care. An evolving workforce and training programs focused on different skill sets will be needed to support new distributed care models.
• More convenient access to clinical trials - While many cancer patients express willingness to participate in clinical research, providing access to clinical trials, with all the infrastructure and clinical practice culture requirements, enrollment and distributed access continues to prove challenging for hospitals.

Perhaps the most critical area for a cancer program to address is extraordinarily timely access for patients and referring physicians when cancer is suspected or diagnosed. Patients and referring physicians alike are looking for user-friendly triage with:

• A live person answering the phone
• Expanded hours for the access center
• An e-mail option to request an appointment
• Timely access to a clinician for access-related triage questions (e.g., nurse or advanced practice provider)
• Timely first appointments, optimally in less than five days, sooner preferred
• Ease of registration and aid in getting the necessary records
• A communication loop back to the referring primary care provider or specialist
• Access resources that speak other languages common in the patient population

To support patient-centered care, hospitals should evaluate the feasibility of coordinating scheduling for all cancer specialists by disease site all on the same day whenever possible; investing in patient navigators to address barriers and/or communicate with the patient especially at the start of treatment, including navigators who speak the patient’s primary language; offering a financial navigator; and advancing strategies for decentralized clinical trials in the circumstances where trial requirements can be managed (often with technology solutions) closer to home.

Leading programs are also investing more in psycho-social supports, expanded symptom management programs, home-based care models, nutrition programs, and partnering with emerging companies to enhance patient experience through technology supports.

Over the past two decades, considerable emphasis has been placed on the coordination of cancer care across specialties and disciplines and across the continuum in an effort to address fragmentation, which undermines both quality and patient satisfaction. Traditional payment models do not support many of the investments that providers must make to improve patient experience; in fact, the payment system has contributed directly to the problem of fragmented episodes of care. The emergence of new entrants into the market with a focus on patient experience is both evidence of the delivery system’s shortcomings and a source of risk for even more fragmentation unless implemented in close association with hospitals and health systems. For hospitals to be the providers of comprehensive, longitudinal cancer care for their patients, it will be essential that expanding patient expectations— for better access, improved navigation/coordination, less disruption to their employment and social productivity, and a measurably higher quality of life (not just survival)—be met, either directly by the providers or through partnerships.