BACKGROUND
Prostate cancer is one of the most common oncologic diagnoses in VA. Follow-up after radiation treatment involves PSA lab work and a provider visit every 6 months to evaluate for recurrence and longterm side effects. This requires a large amount of VA resources in terms of staff time and can lead to reduced provider access and increased outsourcing costs. If the veteran has in person appointments, this also increases time and travel costs for the veteran.
METHODS
The Cleveland VA Radiation Oncology department has designed a novel Prostate Cancer Tracker to monitor veterans for prostate cancer follow-up. The novel workflow uses a combination of data analysis and sorting techniques along with a dedicated clinical team to triage patients to (1) direct counseling for biochemical recurrence or (2) continued follow-up through the tracker. This process improves resource utilization, efficiently tracks patients, and reduces the risk of a patient lost to follow-up. The program started in August 2022 and has been running in a pilot phase until January 2023. Patient statistics using VA analytics were collected for January 2023 to March 2023.
RESULTS
At the end of March 2023, the tracker contained 250 patients. 56 veterans had their lab work coordinated with PCP labs to avoid unnecessary needle sticks. 50 letters for overdue labs were sent out of which 31 resulted in returning to standard of care follow up. 6 patients were converted from the tracker to in person for counseling regarding biochemical recurrence. The number of in person appointments saved was 80 per month, resulting in better access for providers and savings for veterans for miles driven and veteran’s time. In addition, we have reduced outsourcing costs by re-capturing outsourced veterans back to VA for prostate cancer follow-up.
CONCLUSIONS
The prostate cancer tracker workflow is a novel workflow that has had a successful pilot as a VA iNET seed investee. We plan to expand its use within our department and further quantify improvements for the VA. We are actively looking to expand to other VA sites.