EHRs in Primary Care Practices Not Suited for Cancer History

The EHRs have limited capability to record information on patients’ cancer history, and clinicians are not provided with actionable recommendations for follow-up care.

Primary care medicine is currently not able to meet the healthcare needs of cancer survivors, despite a long effort by the medical establishment to move long-term survivorship care out of the specialist’s realm, according to a new Rutgers study.

The study, published in JAMA Internal Medicine, examined 12 advanced primary care practices selected from a national registry of workforce innovators; not one had a comprehensive survivorship care program in place.

According to the National Cancer Institute, there are 15.5 million cancer survivors in the United States, a number expected to reach 20.3 million by 2026. The vast majority of these patients are seen in primary care practices.

The researchers, who over nearly two years spent 10–12 days observing each of the practices (based in Colorado, Illinois, Maine, New York, Pennsylvania, and Washington) and interviewing clinicians and administrators, identified several barriers to integrating survivorship care into primary medicine.

It found that no distinct clinical category for clinicians to identify cancer survivors exists. EHRs used in primary care practices have limited capability to record information on patients’ cancer history, and clinicians are not provided with actionable recommendations for follow-up care.

Medical records sometimes are lost as patients change clinicians over the years, leaving patients to report their cancer histories to their primary care doctors.

In addition to these issues, primary care physicians are concerned about their knowledge gaps in cancer care and the need to monitor changing information in oncology.