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Disclaimer: CME certification for these activities has expired. All information is pertinent to the timeframe in which it was released.


Emerging Trends In Cancer Therapy And Supportive Care: Practical Insights For Clinicians


GOAL
To provide oncology nurses and oncology physician assistants with up-to-date information on their role in the treatment and management of patients with cancer-related anemia and neutropenia.

TARGET AUDIENCE
This activity is designed for oncology nurses and oncology physician assistants. No prerequisites required.

LEARNING OBJECTIVES
The Institute for Johns Hopkins Nursing and Johns Hopkins University School of Medicine take responsibility for the content, quality, and scientific integrity of this CE activity. At the conclusion of this activity, the participant should be able to:

  • Examine the economic implications of poorly documented supportive care treatment decisions.
  • Discuss reimbursement policies and how they may impede the implementation of evidence-based practice guidelines.
  • Describe the process of integrating evidence-based practice guidelines as a standardized approach to supportive care issues.

ACCREDITATION STATEMENT
The Institute for Johns Hopkins Nursing is accredited as a provider of continuing education in nursing by the American Nurses Credentialing Center's Commission on Accreditation.The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education
for physicians.

CREDIT DESIGNATION STATEMENT
The Institute for Johns Hopkins Nursing designates this activity for a maximum of 0.6 contact hours. Claim only those contact hours actually spent in the activity. (50 minutes of contact = 1 contact hour.)

The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 0.5 category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

The estimated time to complete this educational activity: 30 minutes.

Release date: January 15, 2006.
Expiration date: January 15, 2008.

DISCLAIMER STATEMENT
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Institute for Johns Hopkins Nursing and the Johns Hopkins University School of Medicine names implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

This program is supported by an educational grant from Amgen Inc.

Full Disclosure Policy Affecting CE Activities:
As a provider accredited by the American Nurses Credentialing Center (ANCC), it is the policy of The Institute for Johns Hopkins Nursing to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The Program Directors and Participating Faculty reported the following:

PROGRAM DIRECTORS

MiKaela Olsen, RN, MS, OCN
Oncology and BMT Clinical Nurse Specialist
Sidney Kimmel Comprehensive Cancer Center
The Johns Hopkins Hospital
Baltimore, Maryland
Ms Olsen reports serving on the speakers' bureaus for Amgen Inc. and GlaxoSmithKline.

Scott W. Possley, PA-C
Physician Assistant
New York Presbyterian Hospital
New York, New York
Mr Possley reports holding stock in CuraGen Corporation; and receiving honoraria from Amgen Inc.

Jerry L. Spivak, MD
Professor of Medicine and Oncology
Johns Hopkins University School of  Medicine
Director, Center for Chronic  Myeloproliferative Disorders
The Johns Hopkins Hospital
Baltimore, Maryland
Dr Spivak reports serving as a consultant for Novartis and Roche Pharmaceuticals.

PARTICIPATING FACULTY

Tina Maluso-Bolton, RN, MSN, NP
Nurse Practitioner
Kaiser Permanente Southern California 
Regional Bone Marrow Transplant Program
City of Hope National Medical Center
Durante, California
Ms Bolton reports serving as a consultant for Amgen Inc.

Joyce Kane, RN, MS(c), RHIT
Manager
Performance Improvement
Sidney Kimmel Comprehensive Cancer Center
Johns Hopkins Hospital
Baltimore, Maryland
Ms Kane reports having no financial or advisory relationships with corporate organizations related to this activity.

Notice: No faculty member has indicated that his/her article will reference unlabeled/unapproved uses of drugs or devices.

Advanced Studies in Nursing provides disclosure information from contributing authors, lead presenters, and participating faculty. Advanced Studies in Nursing does not provide disclosure information from authors of abstracts and poster presentations. The reader shall be advised that these contributors may or may not maintain financial relationships with pharmaceutical companies.

Navigating The System: Tackling Reimbursement
MiKaela Olsen, RN, MS, OCN,* Jerry L. Spivak, MD,  and Scott W. Possley, PA-Cà

Supportive care for chemotherapy-induced complications has advanced considerably in the past several years. Effective treatments are now available for neutropenia, anemia, mucositis, and nausea and vomiting, and it is now possible to proactively prevent neutropenia and anemia. Evidence-based clinical practice guidelines are now available for most of these complications, providing advanced practice oncology nurses and oncology physician assistants with practical tools for decision making in supportive care. However, reimbursement requirements in the United StatesÑespecially Medicare reimbursement, which is commonly the coverage available for oncology treatmentsÑmay be a deterrent to implementing some evidence-based practices, especially in the treatment of neutropenia and anemia. This is despite the fact that studies have demonstrated that the presence of any of these complications may lead to delays in chemotherapy treatment, which may negatively affect treatment outcomes. Nonetheless, it is possible to integrate evidence-based practice guidelines into a clinical oncology practice as a standardized approach to supportive care issues in such a way as to provide high-quality supportive care and still enable maximal reimbursement. This issue of Advanced Studies in Nursing features a review article by MiKaela Olsen, RN, MS, OCN, in which Ms Olsen explores the current status of Medicare reimbursement in the supportive care setting. She also examines the impact on the ability of a healthcare practice to follow evidence-based practice guidelines and includes up-to-date coding and documentation tips for maximizing reimbursement.

In her clinician interview, Tina Maluso-Bolton, RN, MSN, NP, discusses the unique reimbursement challenges experienced in the academic medical center setting and the impact of the current Medicare reimbursement scheme on supportive care.

Ms Olsen and Joyce Kane, RN, MS(c), RHIT, and Ms Maluso-Bolton contribute 2 case studies illustrating different reimbursement issues faced in the treatment of patients with chemotherapy-induced anemia and neutropenia.

We hope this issue of Advanced Studies in Nursing provides useful information on emerging treatment guidelines and changing reimbursement rules, helping you to provide patients with the highest quality of supportive care

*Oncology and BMT Clinical Nurse Specialist, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, Maryland.

 Professor of Medicine and Oncology, Johns Hopkins University School of Medicine, Director, Center for Chronic Myeloproliferative Disorders, The Johns Hopkins Hospital, Baltimore, Maryland.

Physician Assistant, New York Presbyterian Hospital, New York, New York.
Address correspondence to: MiKaela Olsen, RN, MS, OCN, Oncology and BMT Clinical Nurse Specialist, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, The Harry & Jeannette Weinberg Building, Suite 1100, 401 North Broadway, Baltimore, MD 21231. E-mail:
olsenmi@jhmi.edu.





Johns Hopkins Advanced Studies in Medicine (ISSN-1558-0334), is published by Galen Publishing, LLC, d/b/a ASiM, PO Box 340, Somerville, NJ 08876. (908) 253-9001. Copyright ©2012 by Galen Publishing. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. ASiM is a registered trademark of The Healthcare Media Group, LLC.