Table 3

Facilitators of high-quality cancer care

TopicExpert interviewsFocus groupsSite visitsCross-cutting themes
Timeliness of careOnline appointment making for patients‘One-stop shopping’ or patient navigatorsCancer centers provide multi-disciplinary visits; care managers facilitate appointment makingCancer patients need one accountable care team and a patient navigator who helps prevent unnecessary delays in care
Coordination of careElectronic records (EHRs) or care managers to facilitate communication among providersIncrease one-stop ‘shopping’; EHRs facilitate communication across providersMulti-disciplinary care planning (tumour boards) and shared electronic informationCare team and/or navigator plus EHRs help coordinate care
AccountabilityPublic reporting of performance measuresEnhance primary care's role in cancer careIntegrated cancer care systems that are accountableCancer patients need one accountable care team or integrated system that is accountable for meeting their needs
Information needsPatient navigators and/or web-based programs help patients access useful informationHelp patients and families find reputable websites; navigators to help patients participate in decision makingSome excellent patient education but often after major decisions have been madePatients want and need help in accessing useful and timely information
Psychosocial supportPatient navigators to provide emotional supportPeer and professional psychosocial support for patients and familiesSocial workers and others with mental health training often available in community practicePsychosocial assessment and access to supportive individuals and services should be routine
EquitabilityIncreased use of telemedicine to enhance rural cancer careIncrease access to cancer centers for low-income patients and their providersIncrease linkages between safety net providers and cancer centersIncrease access to cancer centers for low-income patients and their providers
ReimbursementChanges to reimbursement that reward patient-centred servicesNot discussedFinancial incentives should encourage use of patient-centred servicesPayment policies should incentivise patient-centred care and EHRs that support patient care and performance measurement
Information technologyEHRs and patient web programs could improve care and help inform and connect patientsHelp patients find trustworthy web-based resources; utilise portable flash drives to transfer medical informationShared electronic records facilitate communication between community oncologists and cancer centersEHRs and patient web programs could reduce variation and lack of coordination in care and help inform and connect patients