It’s easy to overlook important information when a patient is first diagnosed — many factors could easily lead to hospital readmission after initial treatment. And for cancer patients, there is an especially high risk for distress-related comorbidities. While chronic pain is a common problem for survivors, addressing psychological factors also plays a large role in recovery. In fact, a recent study in the Journal of the National Comprehensive Cancer Network shows that in a two-month period following screening for distress, adherence to screening protocols led to fewer emergency department visits and hospitalizations.
As of 2015, CoC Standard 3.2 requires that cancer centers screen patients for distress and, if detected, respond with treatment. The Standard is also a requirement for cancer center accreditation. It asks cancer committees to define one or more medical procedures that are part of a pivotal visit for distress screening or review of results if gathered electronically or via mail.
Some examples of a “pivotal medical visit” include time of diagnosis, pre-surgical and post-surgical visits, and first visit with the medical oncologist to discuss chemotherapy, routine visit with a radiation oncologist, or post-chemotherapy follow-up visit. Preference is given to pivotal medical visits at times of greatest risk for distress, such as at time of diagnosis, transitions during treatment (such as from chemotherapy to radiation therapy) and transitions off treatment.
So why the focus on yet another metric? The NCCN Distress Thermometer and other tools like PHQ-9 can uncover crippling conditions that negatively impact a patient’s outcomes. These can be devastating to the patient as well as the treatment facility. And as we know, many patients are reluctant to self-report their symptoms.
The JNCCN study consisted of a review of a specified, CoC-accredited EHR to determine if distress screening protocols were adhered to and, if so, the effect on ED usage and hospitalization. Data for the period from January through April 2015 were analyzed from a total of 8,409 EHRs at 55 cancer centers. Researchers found that the overall protocol adherence rate for distress screening was 62.7%. That means a full 28.5% of patients had not been properly screened.
However, there is good news: when overall protocol adherence was observed, roughly 19% fewer patients utilized the emergency department or were readmitted to the hospital. The fewer people going to the ED for preventable health issues, the greater cost savings will be. Those funds can then go to truly improving care quality and not just addressing chronic, preventable issues.
Proper distress screening has positive benefits for providers and patients alike. But a concern in the findings was that often there is no way in the EHR to ensure that the screen occurs, one of many issues that the industry needs to overcome. Considering how one in three patients did not receive the appropriate screening for distress, there needs to be deeper investigation into quality control measures to ensure that screening protocols are followed.
To find out how Cordata offers automated adherence to the protocols for screening and ease of distress instrument administration through our engagement features, contact cam.teems@cordatahealth.com.