Appendix D.1
The Cancer Treatment Plan and Summary: Re-Engineering the Culture of Documentation to Facilitate High Quality Cancer Care

Deborah Schrag, MD, MPH*

Molla Donaldson, DrPH**


Cancer chemotherapy is typically administered over many days, sometimes in the hospital and sometimes in office settings. It is notoriously difficult, and often impossible, to recreate cancer treatment histories from medical records. This impedes communication between and among health care systems, physicians, and patients as they traverse the spectrum of cancer care. Medical record keeping does not include preparation of synoptic overviews when patients transition from one therapy to another. For these reasons, it can be difficult for patients and physicians to assemble an accurate understanding of individual chemotherapy treatments as well as the overall trajectory of a patient’s cancer care. The availability of new and better drugs for treating cancer means that patients are living longer, receiving more treatment, and managing the consequences of these therapies. In turn, living longer means that cancer patients’ medical records become thicker and it becomes even more challenging and time-consuming to create a history from those written records. In addition, like society as a whole, cancer patients are increasingly mobile, seeking care at multiple settings and interacting with a variety of health care and allied professionals. In conjunction with the


Health Outcomes Research Group, Memorial Sloan-Kettering Cancer Center


American Society of Clinical Oncology

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