Jessica MacIntyre on Improving LLS Referrals For Patients With Hematologic Malignancies

By developing an app which can be integrated into the electronic health record (EHR), nurse leaders helped improve the process of referring patients with hematologic malignancies to the leukemia and lymphoma society (LLS). Findings were presented in a poster during the 48th Annual Oncology Nursing Society Congress.

Jessica MacIntyre, DNP, MBA, APRN, NP-C, AOCNP, executive director of clinical operations and advanced registered nurse practitioner at Sylvester Comprehensive Cancer Center, presented on the findings. In a postpresentation interview, she discussed the key takeaways with Oncology Nursing News®.

Unfortunately, the costs of treatments for hematologic malignancies are expensive and can lead to financial difficulties, quality of life issues, and adherence challenges for many patients. These challenges are especially pronounced among those patients who belong to underserved groups.

The LLS offers information, supports services, and financial assistance to patients with these malignancies, yet, although these services are free, they are often underutilized. Nurse investigators helped to develop and implement a novel Fast Healthcare Interoperability Resource (FHIR) based app, which would be integrated into the EHR. This app was designed to facilitate the referral of patients with newly diagnosed blood disorders to critical support resources at LLS by using a Best Practice Advisory (BPA) alert to a hematologic cancer nurse navigator.

The nurse navigator would perform intake and discuss LLS services with the patient. He or she would then complete the information to transmit the referral to LLS. Patients were prompted to sign consent forms prior to their fist appointment. If a patient declined, an in-basket message would be sent to the social worker to reassess at a later date.

After receiving the signed consent form, an LLS information specialist would contact the patient to discuss different available resources and services.

Prior the FHIR app, referrals to LLS were not systematically captured at Sylvester. They were also in paper format. Over the past 2 years, fewer than 10 referrals were documented at the Cancer Center. Postimplementation, however, not only were the number of referrals improved, but metric tracking was also made possible.

Over the course of 15 months following implementation, 245 patients were electronically referred to LLS. During this time, LLS had approximately 700 interactions with these patients.

“It is a much easier process,” MacIntyre noted. “In the past, we used to do paper forms; we used to fax paper forms to our advocacy groups to refer patients for their services. Now it's a touch of a button, so it is much easier.”

Reference

MacIntyre J, Sae-Hau M, Disare K, Torrents S, Buckta B, Berkowitz S. Development of an electronic referral to the leukemia & lymphoma society (LLS): enhancing access to patient resources and information. Poster presented at: 48th Annual Oncology Nursing Society Congress; April 26-30, 2023; San Antonio, TX. Accessed April 28, 2023. https://ons.confex.com/ons/2023/meetingapp.cgi/Paper/12560