Lani Alison Discusses How the OCM Allowed for Better Integration of Palliative Care

Lani M. Alison, BSN, MS, HCQ, PCMH, CCE, vice president of Clinical Affairs, Regional Cancer Care Associates, explains how the implementation of the Oncology Care Model (OCM) allowed practices to better integrate palliative care.

Transcript

How has the implementation of the OCM allowed practices to better integrate palliative care, and what impact does that have?

The practice transformation plan, which is really the heart of the Oncology Care Model, requires that we provide a patient a 13-point institute of medicine care plan, and one of those is either survivorship care planning for patients whose trajectory is survivorship and end of life, and part of that is really when the patient actually understands that the cancer has progressed and then the conversation starts. RCCA’s approach to this is it doesn’t matter, as long as you have spoken to the patient about cancer therapy. It may not be the metastatic type.

But I think in any chronic disease, not just cancer, we should really have a conversation with the patient about advanced care planning. Who is their healthcare proxy? Because that is pretty much a non-threatening or not very uncomfortable to talk about. In my family, we have already spoken about that. So, the conversation is a little bit lighter rather than a patient who is already in palliative care or you’re going to tell the patient we’re going to start you on palliative care and they don’t even have a healthcare proxy. It’s a big challenge.

OCM has really paved the way. We use it as the standard of care for cancer because it requires that. In the OCM model, it is very difficult to succeed if you don’t have end of life, palliative care that includes palliative care and hospice and actually bereavement as part of its services. We have to really think about the patient’s outcomes, which include financial outcomes for the patients, as well as the total patient experience. It has to be part of that. If you start asking about their healthcare proxy, when the time comes, you just move along the conversation and say, “Ok, Suzy is you’re proxy, now we’re going to think about your cancer has progressed, what is next?” So, then if the patient is in pain, we’re going to talk about palliation, so you really are informing the caregivers of the patient what could be next. So, it’s not going to be such an uncomfortable conversation anymore.