Optimizing survivorship transitions utilizing an EHR visual alert.

Abstract

e13508 Background: There is a large and growing population of cancer survivors at risk for chronic health conditions and secondary malignancies. Despite advances in electronic health record (EHR) technology, many systems lack automated tools to identify patients eligible for transition to survivorship care. In the absence of a streamlined process, primary oncology clinics often become overwhelmed, resulting in care delays for established patients and reduced access for new patients. This project aimed to develop an integrated, non-disruptive EHR-based tool to accurately flag patients eligible for transition to survivorship care. Methods: A multidisciplinary team—comprising survivorship providers, EHR analysts, and key stakeholders from primary oncology departments—collaborated to define criteria for survivorship transition, based on MD Anderson Cancer Survivorship Algorithms. Inclusion criteria considered cancer type, time since treatment completion, and treatment department. Exclusion criteria were designed to omit patients with metastatic disease, those undergoing active treatment, or those enrolled in clinical trials. A series of virtual meetings followed multiple variations of the eligibility registry and team-based chart reviews to validate the tool by assessing the registry’s positive predictive value (PPV) and a false negative rate (FNR). After each round of chart reviews, debrief meetings informed iterative refinements to the EHR report. A non-intrusive visual alert was also developed to appear on provider clinic templates, minimizing workflow disruption. Results: To date, 15 of 24 survivorship eligibility registries are completed and in production. The PPVs ranged between 50% to 100%, while the FNRs were relatively low, ranging from 0-15%. The EHR alert appears as a visual indicator on the clinic template, requiring no additional clicks and avoiding disruptive workflow interruptions. In Fiscal Year 2025, survivorship clinic referrals increased by 33%. Conclusions: This project demonstrates the feasibility and scalability of EHR-based identification of survivorship-eligible patients. The integration of a visual alert system has increased survivorship referrals and reduced pressure on primary oncology clinics. Expansion of this system is ongoing across the institution. Completed eligibility registries. Thyroid Cancer​PPV – 80%​ FNR – 6%​ Sarcoma​PPV – 85%​ FNR – 8%​ Thoracic Surgery​PPV – 83%​ FNR – 0%​ Head and Neck Surgery​PPV – 67%​ FNR – 15%​ GI-Gastric​PPV – 85%​ FNR – 0%​ Melanoma MedOnc​PPV – 99%​ FNR – 4%​ Lymphoma-Hodgkin​PPV – 67%​ FNR – 6%​ GI-Pancreas​PPV – 64%​ FNR – 0%​ BMO ​PPV – 87%​ FNR – 4%​ Neurosurgery​PPV – 72%​ FNR – 0%​ GYN​PPV – 76%​ FNR – 3%​ GU/Urology-Prostate​PPV – 96%​ FNR – 5% ​ Melanoma SurgOnc​PPV – 100%​ FNR – 0%​ GI-Colon​PPV – 83%​ FNR – 9%​ GU/Urology-Kidney​PPV – 54% ​ FNR – 8%​