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EVOLUTION IN ONCOLOGY PRACTICE MANAGEMENT™ Continued from from page page 22 24 Continued
How does the medication ordering and fulfillment process work with OncoMed? Having an efficient and focused process in place is very important. We have been able to institute a process where we have someone devoted to being our liaison with OncoMed. When a patient comes in and his or her benefits are precertified, we send the person’s case information to OncoMed, and the drugs are sent to us directly, along with all the administration supplies. We get them on a next-day basis, or sooner if needed, and everything is clearly labeled with patient-specific information. That makes a huge difference to us when dealing with OncoMed versus some specialty pharmacies that some insurers have imposed upon us to use, which get the drugs wrong, ship them late, and have no idea of the correct administration supplies. How does the relationship with OncoMed allow you and your team to
focus on what is important? I will give you a “before-and-after” example. Before we worked with OncoMed, 50% or more of our time was spent on managing drug costs and reimbursement. We had 5 people managing pharmacy at the 3 locations; we have been able to reduce that number of employees to 1. Before, we had to continually make sure that we were not underwater on drugs, as reimbursement rates and times fluctuated. OncoMed has made it possible to not devote time and effort on that. Based on your experience, what would you say about OncoMed to hematologists and oncologists considering such a move? It is definitely a relationship that every infusion center or oncologist has to explore. When dealing with narrowing reimbursement margins and delayed reimbursement, ultimately it will be beneficial to switch to OncoMed.
Pharmacists filling orders at the OncoMed facility.
THE LEADERSHIP OF ONCOMED – THE ONCOLOGY PHARMACY
Burt Zweigenhaft CEO, OncoMed
Kevin Askari, RPh President and Chief Clinical Pharmacist OncoMed
Ellen Scharaga, RPh Senior Vice President OncoMed
To learn more about OncoMed or to request a presentation, contact OncoMed at 1-877-662-6633, extension 1298 or marketing@oncomed.net, or go to www.oncomed.net.
Survivorship Program Bridging the Gaps in Cancer Care... Continued from page 23 and after treatment. Relationship changes and concerns, including intimacy, are discussed. Re-entry into practical and instrumental roles (eg, parent, spouse, employee) and anxiety regarding return to work, insurance coverage, and finances are explored. The social worker provides feedback on strengths and concerns of the survivor. If needed, a patient is referred for counseling or psychological intervention. The relationship between diet and cancer recurrence is still evolving, but studies have shown that reducing fat by choosing leans meats and avoiding highfat and caloric foods, increasing intake of fruits and vegetables, and maintaining healthy body weight play a role in cancer prevention.4 The nutritionist re views the patient’s current diet and outlines methods to incorporate healthy eating. The survivor is counseled on dietary changes that can reduce the risk of chronic diseases, such as heart disease
and diabetes. A plan for weight management is another critical area, and advice is given on increasing, maintaining, or losing weight safely. Patients often have numerous dietand supplement-related questions. The volume of information available to patients from many sources can make it difficult to discern scientifically based information from testimonials and fads. The nutritionist assists with evaluating claims and products that promote cancer prevention or recurrence. The patient is given reputable sources and association contacts that provide accurate information on a variety of dietary claims. The oncology pharmacist is a key member of the survivorship team. The pharmacist reviews past courses of therapy and provides a comprehensive list and cumulative doses of all chemotherapy the patient has received. Because antineoplastic agents administered during treatment can result in a wide range
GREEN HILL HEALTHCARE COMMUNICATIONS NO. 2
of toxicities, contributing to long-term side effects for the survivor, it is imperative to review this information.5 The pharmacist assesses all current medications, both prescription and over-the-counter products, that the patient is taking. It is important that herbal supplements and any home remedies be part of this comprehensive review. This assists in determining any potential drug–drug interactions that can occur with these seemingly harmless interventions and ensure maximum benefit from the medication regimen. The physical therapist takes an active role in evaluating current physical state and outlining a program for optimal functioning. The therapist focuses on the overall level of physical activity and fatigue, bone health, and, when indicated, neuropathy and lymphedema management. The ability to perform daily activities and endurance are assessed. Special instructions that range from spe-
cific exercises to a structured walking program may be delivered. Maintaining bone health, especially in breast cancer and lymphoma survivors, requires use of bone density scans, ordered by the physician, to identify the presence of osteoporosis and osteopenia.6 If either of these conditions are present, weight-bearing exercises will be recommended by the physical therapist. All survivors are given information on ways to maintain healthy bones. The physical therapist also assesses lymphedema and neuropathy. Individuals at risk for lymphedema are educated by the physical therapist on precautions and self-care techniques to reduce the risk. Those with symptoms are taught appropriate interventions, such as proper skin care, self-massage, and correct compression. Neuropathy assessments are performed based on specific regimens or patient symptoms. Continued on page 32
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