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Revealing Treatment Costs at the Point of Care Beneficial to Patients and Providers

A tool integrating costs associated with common cancer treatments with electronic medical records was beneficial to both physicians and patients, according to results of a study presented at the conference.

Patients have long expressed a desire to more easily discuss costs associated with cancer treatment, especially as treatment costs continue to rise; however, many institutions refer patients to central customer service centers that are unable to fully address oncology-specific questions. 

In response to this concern, Nora B Henrikson, PhD, MPH, Group Health Research Institute (Seattle, WA), presented a study she and her colleagues conducted to analyze the effectiveness of integrating cost information with electronic health records. 

The system was developed, launched, and evaluated by the team of researchers at 4 oncology clinics that were part of Group Health, an integrated care delivery system in Washington state. The online tool included 50 printable worksheets with cost data relating to the most commonly ordered cancer treatments, accessible through the electronic health record. The sheets included prices for all drugs, supportive medications, tests, and professional services for one treatment cycle. All pricing data was audited for accuracy by comparing available information with patient bills. Patient-level cost-sharing information was not included, however. In addition, all information on the sheets was presented in such a way that patients could easily understand it. 

To evaluate the launch, initial use, and acceptability of the tool, researchers issued and analyzed a convenience survey to initial users. At launch, the number of people viewing the information sheets exceeded the number of total treatments actually being delivered. Overall, one-third of survey respondents reported that they used the information sheets at least once per week, and 70% of providers said that using them had no impact on their workloads. 

On a scale of 1 (lowest) to 10 (highest), the mean value assigned to the tool was reported as 7.9 to patients, 7.8 to the oncology service line, 7.7 to Group Health as a whole, and 6.5 to general work or practice. Additionally, staff reported that responses among patients using the resource were generally positive. Respondents reported that some of the most valuable benefits associated with use of the tool included improved access to cost information, treatment layouts, and better ability to meet patients’ needs. 

Although use of the resource elicited an overall positive response, participants suggested that adding patient-level cost burdens and more treatment protocols could improve it even further. 

In conclusion, Dr Henrikson said that the resource addressed a clear need, demonstrating high potential value without a negative impact on staff workload. 

The team is already considering ways to enhance the project, most notably by adding patient cost-sharing data and expanding it to cover pricing data for all 300 oncology treatment protocols used at Group Health.  The goal, said Dr Henrikson, closing out her presentation, would be to offer treatment cost information proactively to all patients. 

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