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Patient support call center: Interaction with the oncology clinic.

84 Background: Cancer patients receiving chemotherapy can become ill, often leading to hospitalization, adding huge costs to care. This is especially true with older cancer patients. Innovent Oncology (IO), an oncology disease management program, and Texas Oncology (TO) are conducting a novel program, funded by Aetna. Patients who begin IV chemotherapy are called by an IO nurse, working remotely, but with access to TO's Electronic Medical Record. If the call center nurse detects a concern she notifies the practice. IO then tracks the action taken by the practice. We report on the incidence of practice notification, intervention that occurred, and incidence of hospitalization within 7 days of practice contact.

METHODS: This pilot program enrolls patients of Medicare age (Aetna Medicare Advantage members). Intervention calls (IC) to the practice are made at the discretion of the IO nurse. We identified all IC's made from June 2013 to June 2015. We then categorized the actions taken by the practice and report on the four most common actions. IO receives a daily file from Aetna with hospital data. We looked at hospitalizations within 7 and 14 days from the IC.

RESULTS: 430 patients were enrolled over the above time period. 164 had at least one IC (215 total); 38% of patients had at least one IC. The four most common actions taken by the practice were: new medication prescription (N = 128); education over the phone (76); office visit within 24 hours (45); lab work ordered (22). 14 patients were admitted within 7 days of IC and 18 (inclusive of the 14) admitted within 14 days of IC.

CONCLUSIONS: The IC's are made when the IO nurse detects a problem during telephonic outreach. Therefore, this group of patients is at some risk for deterioration. Out of 215 IC's made, 14 patients were admitted within 7 days of the call. We believe this number is low in this Medicare-age population and the results are promising. We believe the coordination between the patient support nurse and the clinic is partly responsible. This is a novel program so we can't compare the IC/hospitalization rate to other data bases but, at the least, we can use this as a baseline going forward.

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