HER2+ Breast Cancer Neo-Adjuvant Coordination of Care Program

The HER2+ Breast Cancer Neo-Adjuvant Coordination of Care Program will evaluate the
feasibility, effectiveness, and adoption of evidence based medicine for patients with HER2+
breast cancer through a care coordination application hosted on CECity's MedConcert™
platform. The goal is to implement evidence into practice using existing patient data, and
to improve care based on knowledge that will enable care coordination between medical
oncologists and surgeons.

PHASE 1: Workflow Design The steering committee from Duke has created a workflow process
related to the HER2+ Neo-Adjuvant Therapy Treatment. The goal of the workflow is to
establish a coordinated approach to care and identifying key steps in the process. The
workflow will identify if the patient had a timely engagement of the multidisciplinary team;
if a pre-treatment assessment was performed; if neo-adjuvant therapy treatment was
prescribed; if appropriate management and adherence to treatment as prescribed occurred; if
surgery was performed and the identification of the type of surgery; and if any subsequent
therapy was prescribed. Data collection will be performed at each of the steps in the
workflow.

PHASE 2: Engagement Three sites were identified to participate in the project. Each is
affiliated with the Duke Cancer Network and are free standing hospital systems and clinics.
A coordinator will be designated at each site to guide the process, enter data and
communicate patient progress to the sites multidisciplinary project team. Routine
communication will be maintained between each site and the project team to ensure timely
resolution of any issues or to answer questions.

PHASE 3: Feedback Performance measures have been identified for which data will be collected
and aggregated. The data will be displayed in a performance monitor in the CECity
MedConcert™ application to provide feedback to providers on their performance related to the
measures. Providers will also be provided access to educational resources and improvement
opportunities through the application.

PHASE 4: Assessment of Change and Dissemination of Findings Currently, many patients with
HER2+ Breast Cancer do not have the opportunity to be evaluated by an oncologist for
neo-adjuvant treatment because of a lack of coordinated care between surgeons and
oncologists. This project will evaluate adopting evidence-based medicine for patients with
HER2+ through the use of a coordinated care application. The goal is to facilitate greater
coordination of care between oncologists and surgeons and to identify interventions for
improved care. A final report will outline the results of the coordinated care approach. The
results of this QI initiative will be developed into a manuscript for publication.

Inclusion Criteria:

- diagnosis of breast cancer

Exclusion Criteria:

- no diagnosis of breast cancer