About 4R Oncology®
4R – Right Information and Right Care for the Right Patient at the Right Time
Personalized patient-facing care planning:
Supports both patient self-management and coordinated care delivery
- Roadmap for systematic coordination of care delivery at the “right” time and sequence (4,5)
- Provides tools, information for patient self-management, including timing & sequence of care (4,6)
Patient self-management: capacity to play active role in planning and managing their care and life during and after cancer treatment (7,8)
Imperative for optimal delivery of comprehensive care and outcomes:
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Cancer care
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Supportive care and health maintenance
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Social care to address practical, employment, financial, family, and other needs
Necessary to manage clinician workload, shortage as care complexity increases
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Navigation, and coordination support could be directed to patients not willing or able to self-manage
Cancer care is highly interdependent. Inadequate timing & sequencing leads to care breakdowns, worse outcomes, wider disparities
Cancer Care timing and sequencing
- Genetic assessment prior to surgery, other treatment decisions
- Biomarker testing prior to treatment decision
- Proactive toxicity management, etc.
Supportive care & health maintenance
- Fertility preservation before systemic therapy
- Smoking/vaping cession before treatment
- Flu vaccine before treatment
- Comorbidity care before and during treatment, etc.
Social care
- Addressing transportation prior to start of treatment
- Timely identification and support for financial, food and housing hardship
- Child/elder care needs, etc.
References
1.Levit L, Balogh E, Nass S, et al (eds): Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Washington (DC), National Academies, Press (US), 2013
2.McCorkle R, Ercolano E, Lazenby M, et al: Self-management: Enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin 61:50-62, 2011
3.Balogh EP, Ganz PA, Murphy SB, et al: Patient-centered cancer treatment planning: Improving the quality of oncology care. Summary of an Institute of Medicine workshop. Oncologist 16:1800-1805, 2011
4.Trosman et at. Evaluation of the Novel 4R Oncology Care Planning Model in Breast Cancer: Impact on Patient Self-Management and Care Delivery in Safety-Net and Non-Safety-Net Centers. JCO Oncol Pract. 2021 Aug;17(8):e1202-e1214.
5.Liu et al. Fostering a High-Functioning Team in Cancer Care Using the 4R Oncology Model: Assessment in a Large Health System and a Blueprint for Other Institutions. JCO Oncol Pract. 2022 Sep 30
6.Trosman et al. Care for a Patient With Cancer As a Project: Management of Complex Task Interdependence in Cancer Care Delivery. J Oncol Pract. 2016 Nov;12(11):1101-1113.
7. McCorkle R, et al: Self-management: Enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin 61:50-62, 2011
8. Howell D et al. Management of cancer and health after the clinic visit: A call to action for self-management in cancer care. J Natl Cancer Inst 113:523-531, 2021