Provide and attest to 24 hours a day, 7 days a week patient access to an appropriate clinician who has real-time access to practice’s medical records (SPAC systems capture and provides care coordination via its mobile application and patient support staff for 24 hours a day.)
Attestation and use of ONC-certified electronic health records (EHRs).
Utilize data for continuous quality improvement (SPAC captures real time patient symptoms).
Provide core functions of patient navigation (SPAC makes patient navigation and management simple and helps automate the process).
Document a care plan that contains the 13 components in the Institute of Medicine Care Management Plan (SPAC makes the care plan access for 24/7 from any EMR) Practice has to develop the care plan for each patient see below:
Patient information (e.g., name, date of birth, medication list, and allergies)
Diagnosis, including specific tissue information, relevant biomarkers, and stage
Treatment goals (curative, life-prolonging, symptom control, palliative care)
Initial plan for treatment and proposed duration, including specific chemotherapy drug names, doses, and schedule as well as surgery and radiation therapy (if applicable)
Expected response to treatment
Treatment benefits and harms, including common and rare toxicities and how to manage these toxicities, as well as short-term and late effects of treatment
Information on quality of life and a patient’s likely experience with treatment
Who will take responsibility for specific aspects of a patient’s care (e.g., the cancer care team, the primary care/geriatrics care team, or other care teams)
Advance care plans, including advanced directives and other legal documents
Estimated total and out-of-pocket costs of cancer treatment
A plan for addressing a patient’s psychosocial health needs, including psychological, vocational, disability, legal, or financial concerns and their management
Survivorship plan, including a summary of treatment and information on recommended follow-up activities and surveillance, as well as risk reduction and health promotion activities
Treat patients with therapies consistent with nationally recognized clinical guidelines see below:
Coordinating appointments with providers to ensure timely delivery of diagnostic and treatment services
Maintaining communication with patients, survivors, families, and the health care providers to monitor patient satisfaction with the cancer care experience
Ensuring that appropriate medical records are available at scheduled appointments
Arranging language translation or interpretation services
Facilitating financial support and helping with paperwork
Arranging transportation and/or child/elder care
Facilitating linkages to follow-up services
Providing access to clinical trials, and
Building partnerships with local agencies and groups (e.g., referrals to other services and/or cancer survivor support groups).