Creating Virtual Integration and Improved Oncology Care Quality Through a Co-Management Services Agreement.

Purpose: Implementation of a co-management services agreement (Co-MSA) creates agreed-upon cancer care delivery quality metrics, a forum for discussion of service line oversight, and virtually integrated care without institutional employment of oncologists. The goal of this project was to demonstrate that a Co-MSA improved predefined quality metrics and provided enhanced communications between a health system's oncology service line and a group of independent oncologists.

Methods: Iterative planning discussions were scheduled biweekly over an 18-month period.

Second-line treatment outcomes after first-line sunitinib therapy in metastatic renal cell carcinoma.

This study was conducted to evaluate the treatment outcomes associated with common second-line targeted therapies given after first-line sunitinib for metastatic renal cell carcinoma (mRCC). The sample comprised patients with mRCC (n = 257) who were receiving second-line everolimus, sorafenib, or temsirolimus between April 1, 2008, and February 29, 2011, after first-line sunitinib treatment. The patients were followed-up from the start of second-line treatment until treatment failure (defined as advancement to a third-line therapy or to mortality) or the last observation in the medical and pharmacy databases.

Advance care planning with your patients.

Studies have shown that patients want their doctor to talk to them about their advance care plans, and they want that discussion sooner rather than later.

A financial counselor on the practice staff: a win-win.

Patients with cancer are often burdened by financial stresses during treatment. The presence of a financial counselor can help alleviate these concerns for both patients and providers.