| Abstrakt: |
Background: As more patients with cancer receive biomarker- driven therapies, there is a need to improve multidisciplinary communication and care coordination associated with biomarker testing processes. An emerging approach is to designate a navigator as a precision medicine "steward," one who ensures timely and equitable biomarker testing for patients with cancer. Objective: The Association of Community Cancer Centers (ACCC) explored how cancer programs could optimize biomarker testing processes through precision medicine stewards, an innovative role on the multidisciplinary cancer care team dedicated to coordinating and navigating biomarker testing care processes. Methods: The ACCC identified member cancer programs and clinicians that had implemented various models of biomarker navigation and conducted a series of calls and focus groups. Questions explored how cancer programs had justified and funded these new positions, the scope and responsibilities of the steward roles, and key metrics for measuring the impact of stewards on precision medicine testing processes and care coordination. Examples of job titles included biomarker navigator, genomics navigator, precision medicine test coordinator, and others. The ACCC explored how navigators and other staff may enter this new and emerging role. Results: The ACCC found that precision medicine stewards improved biomarker testing processes by managing a combination of clinical, administrative, and logistical tasks. Some of these tasks included: educating patients about testing, creating electronic ordering templates, streamlining prior authorizations, tracking tissue specimens, notifying oncologists about results, and preparing case presentations for molecular tumor boards. Stewards also checked the status of financial assistance applications and identified potential clinical trials based on test results. Their previous roles included nurse navigators, genetic counselors, oncology nurses, advanced practice nurses, or laboratory test coordinators. One cancer program found a 12-day reduction in turnaround time from test ordering to receipt of results after implementing a precision medicine stewardship program. Stewards reduced the time required to complete order forms for next-generation sequencing panels by creating templates and electronic orders that send information directly to reference laboratories. They also coordinated liquid biopsy orders when the laboratories reported that the tissue quantity was not sufficient (ie, QNS) for testing. Conclusion: The role of a precision medicine steward is emerging to improve testing processes and to facilitate better communication across medical oncology, pathology, and reference lab staff. Cancer programs that have implemented this role have seen the benefits, and several have expanded their precision medicine programs to include additional navigators and stewards. More research is needed to better determine the return on investment of precision medicine stewards in various care models. The ACCC will continue to explore how cancer programs are structuring their multidisciplinary cancer care teams to improve biomarker testing efficiency and to ensure that every eligible patient receives appropriate testing. [ABSTRACT FROM AUTHOR] |
