mind that the summaries are only a starting point for sets of discussions. Dr. Peter Raich of Denver Health Medical Center added that an interdisciplinary approach is needed to develop the treatment plan and summary, and these tools need to be aimed at the patient. Perhaps two instruments are needed, one for physician communication and the other for patient communication. These documents would provide a proactive way to educate and guide patients into the survivorship phase of their treatment. This phase of care provides a teachable moment, and it should be used to help patients with lifestyle changes that will be very important as they continue in their survivorship.
Dr. Greenfield concluded that however the treatment plan and summary evolve, with perhaps two tracks, a physician track and a patient track, it would put oncology at the forefront of many other medical specialties. There have been many quality-related activities in other disciplines, but the focus is usually entirely on the medical and not on the psychosocial aspects of care. If there were a way to put the two together, it would represent a huge national step forward, and, as has been pointed out, payers may be able to use the documentation and facilitate adoption.
Dr. Donaldson congratulated Dr. Schrag for the enormous amount of work she has undertaken on the treatment plan and summary, and pointed out that, although the effort has been led within ASCO, there is an understanding that additional members of the survivorship community will have to be involved in further development. Development will move ahead to accommodate practices with and without an electronic health record, but, regardless of the platform, some agreement is needed on content. A question was raised regarding dissemination and the role of specialty societies. A group called the Cancer Quality Alliance has recently been formed, co-chaired by Ellen Stovall and Patricia Ganz, which includes representatives from insurance companies, the federal government, social work, nursing, and so on, across the board. The Cancer Quality Alliance is therefore a logical place for both development and dissemination activities relating to treatment plans and summaries.
Ms. Carol Curtiss raised the concern that the draft templates under discussion would appear to be very useful to health care providers in understanding what is happening to patients, but they may not be very useful to patients in learning to live well through diet and exercise and getting back to wellness. Not enough is known in these areas to provide very specific advice; however, she thought that it could be frightening for patients to simply receive a list of potential late effects without some guidance on what they themselves can do to maintain or improve their health.
Ms. Wendy Landier described how the Children’s Oncology Group (COG) has developed evidence-based, long-term follow-up guidelines and treatment summary forms (see Appendix F). A lesson learned over years of