Delayed cancer diagnosis due to breakdowns in the cancer screening process. Incomplete information on benefits and harms provided to patients making treatment decisions. Poor communication and coordination between specialists involved in cancer care. Diminished adherence to oral medication due to patient cost. Inadequate monitoring of cancer survivors for cancer recurrence. Lack of attention to caregiver needs. Disparities in cancer care due to age, gender, race, ethnicity, sexual orientation, rural residence, education, and income. Purchase and promotion of new and costly, but unproven, technologies by medical facilities. Shifting reimbursement strategies. Minimal integration of patient-reported outcomes into clinical care. Failure to communicate and act on advance directives. Continued increases in the societal costs of cancer care.
Understanding the many challenges of cancer care is the focus of the new Healthcare Delivery Research Program in the Division of Cancer Control and Population Sciences at the National Cancer Institute (NCI). Our current vision is patient-centered, evidence-based care that minimizes the burden of cancer on individuals and society.
I use the word “current” because we are early in the evolution of this new program. We anticipate an extended process in which we will engage our colleagues in other federal agencies, external experts, our grantees, and other stakeholders in identifying and prioritizing scientific questions for the next decade. Our staff will then translate these scientific questions into the creation of research resources, funding opportunity announcements, and other activities in which we can spur the creation of evidence of use to individuals, providers, delivery system administrators, government policy-makers, and other participants in high value cancer care.
We will simultaneously pursue this planning process and an expansion of NCI activities in healthcare delivery research. The latter includes increased pursuit and promotion of funding opportunity announcements that were under development prior to the creation of our new program. We will accelerate efforts to identify and facilitate the creation of the next generation of data. Our activities in the electronic assessment of patient-reported outcomes will remain a priority. We consider our role in the expansion of existing and creating of new networks of health care providers and systems essential to the creation and rigorous evaluation of interventions. We will take every opportunity to promote investigator-initiated research.
These activities will be driven by our current mission, which is to support innovative methodological, observational, and interventional research to understand and improve care delivery processes and outcomes at the individual, provider, and system level.
Future blogs will address the rationale for our name, vision, and mission, as well as highlight the challenges we see in cancer care and our efforts to support research to address those challenges.
We are excited about our new Healthcare Delivery Research Program and hope you are too!