Drug-specific videos provide consistent chemotherapy education for patients

NASHVILLE, Tenn. — A large health system’s use of drug-specific videos helped ensure consistent chemotherapy education for patients, according to a presenter at the Association of Community Cancer Centers National Oncology Conference.

Aurora Cancer Care — which serves approximately 60% of Wisconsin’s population — has about 34,000 care team members, including 1,700 member physicians and 154 oncology physicians. The system has about 25,500 active patients.

Health system leadership recognized all patients need basic information about chemotherapy and want to be able to share this information with their families. However, patient education from members of the care team can be variable.

“Our nurses are excellent, but when you have 200-plus people having these conversations — even if they are relatively well scripted — I wasn’t convinced every person would be given the same information in the same way,” James L. Weese, MD, FACS, vice president of Aurora Cancer Care and adjunct clinical professor of surgery and public health at University of Wisconsin, said during his presentation. “I also was concerned — particularly at our smaller centers — that a nurse could be called away from one of these conversations, or that the discussion could be interrupted by an emergency.”

An internally produced library includes more than 125 videos in which staff members — including oncologists, nurses and pharmacists — provide factual information about specific chemotherapy agents. The videos provide overviews of how the agents are administered and the side effects they may cause. They also address other common questions patients ask, such as whether they should adjust their diet or physical activity levels, and what symptoms should prompt them to seek emergency medical attention.

The video library allows patients to access this information on-demand through patient portals and share it with family members.

The program began in July 2016. Since then, patients have started more than 1,900 videos and approximately 85% of those have been played to completion, Weese said.

The videos are complemented by written documentation about chemotherapy agents, and patients still meet with nursing staff after watching the video to ensure they sufficiently understand the content provided in the video.

“We have found patients really do enjoy the one-on-one interaction with nurses, and we didn’t want to eliminate that from the equation,” Weese said.

A nursing educator wrote the video scripts, which were reviewed by medical oncologists, the lead administrator and Weese to ensure the content was factual and easily understandable. Each video required 3 to 4 hours of filming.

“From a staff perspective, I thought I’d get a fair amount of resistance when we asked them to participate in the videos,” Weese said. “It actually turned out to be quite popular, and we had a number of caregivers who fought over who was going to do which video.”

Because the videos have been produced internally, Weese said he was unable to provide an exact cost of the video library initiative. However, Aurora Cancer Care — which has 5,000 patients start chemotherapy each year — has determined video education of every 80 patients helps the system recapture $1,820 and allows oncology nurses to perform 40 hours of additional tasks.

Use of the video library reflects the transition to value-based care because it has ensured consistency of education, and also improved patient and caregiver engagement and satisfaction, Weese said. The effort has helped with QOPI documentation, and it also may help reduce unnecessary emergency room visits, Weese said.

“Patients want general information about their therapy, but they also want to know when to worry and what to do about it,” Weese said. “The emergency room is the most expensive place to seek care, and an emergency room visit often results in admission. We try to avoid hospital admission if at all possible.

“Our nurses told us they felt patients had much less anxiety once they knew what to expect,” Weese added. “A well-informed patient is less likely to go to the emergency room and more likely to follow directions.” – by Mark Leiser

For more information:

Weese JL. Now Playing! Drug-specific videos improve chemotherapy patient education. Presented at: Association of Community Cancer Centers National Oncology Conference; Oct. 18-20, 2017; Nashville, Tenn.

Disclosure: Weese reports a membership role on the Board of Managers at VIA Oncology.