Electronic shared care plan for long term care of cancer patients

Project Number

Project Status

Chief Investigator
Mark Harris

Project Coordinator
Jane Taggart, Melvin Chin (POW), Winston Liauw (St George)

Project Rationale

The prevalence of cancer is increasing due to the increasing survival of patients with cancer.  Current models of cancer follow-up care involve either specialist services continuing to provide routine care for long periods or transfer of care to general practice with little or no specialist involvement.  Our previous research has demonstrated that this places increasing demands on specialist cancer services and are not acceptable to patients or providers. There is currently no model of shared care between the cancer service and primary health care. Communication between the Cancer Service and GPs is limited and usually one way. 

Resources for Colorectal Cancer Shared Care

Below are links to the resources for Colorectal Cancer Shared Care which include:

For GPs:

Inca GP training video

Inca GP Guide – GP led

For Cancer Specialists:

Inca Specialist traiing video 

Inca Specialist Guide – GP Led

Project Aim/s

To establish and evaluate a web-based cancer shared care plan that supports long term integrated care of cancer patients treated in Cancer Services 

Project Design and Method

A 12 month pilot evaluation study of the e-care plan will be conducted with Cancer Service specialists, GPs and up to 20 patients with colorectal cancer

The intervention will follow the care pathway in the figurebelow. Cancer Service clinicians and the Care Coordinator, GPs and patients will have access to the web-based care plan. Results, referrals, health summaries etc can be uploaded and shared. The completion of tasks will be monitored and followed up by the Care Coordinator.

Interviews with participants will occur at baseline, 4-6 and 12 months.