Abstract 987: Enhancing oncology navigation services: a mixed methods approach to developing an EHR power form to improve metrics and reporting
Authors: Kelsie Campbell, Joi Torrence-Hill, Karey A. Whitten, Melissa Abbud, Jynette Querubin, Charis Stewart, Mariana Dobre, Trista A. Beard, Fatimata Sanogo, Chanita Hughes Halbert
Journal: Cancer Research (2025)

Importance: Pioneered in the 1990s by Dr. Harold P. Freeman, patient navigation interventions are a key strategy for addressing cancer disparities among underserved populations. Despite widespread adoption, the efficacy and cost-effectiveness of oncology navigation interventions require further evaluation. Organizations such as the Academy of Oncology Nurse and Patient Navigators (AONN+) have established evidence-based metrics to demonstrate the value of oncology navigation programs. However, inconsistencies in data collection and the limitations of Electronic Health Record (EHR) systems hinder effective reporting. Objectives: To identify critical gaps in navigation tracking practices and develop a standardized power form for integration into the Cerner EHR system to improve tracking and reporting of navigation metrics in an established cancer navigation program. Design, Setting, and Participants: A cohort of 517 patients seen between July 1, 2022, and June 30, 2024, at University of Southern California Norris Comprehensive Cancer Center (USC NCCC). The cohort consisted of 137 breast, 312 lung, and 68 sarcoma cancer patients. We introduced an Excel-based navigation tracking tool in January 2023, adapted from a tool provided for the American Cancer Society's Navigational Capacity Building Initiative; shadowed navigators and interviewed with leadership to gather qualitative data on patient flow, tracking protocols, and program priorities. Main Outcomes/Measures: Primary outcomes included navigation caseload, diagnosis-to-treatment times, and treatment adherence for the cohort at USC NCCC. Qualitative data assessment included the consistency of the documentation of primary outcomes, clinical trial referrals, care transitions, and program goals. Results: Most patients (82.0%) were over age 50, with 42.4% identifying as White, 15.4% as Asian, and 5.4% as Black/African American. Caseloads increased from 158 in July 2022 to 268 in June 2024, and average diagnosis-to-treatment times decreased from 33 to 22 days. Qualitative data identified critical gaps in tracking practices, such as inconsistent documentation of treatment initiation dates, clinical trial referrals, and care transitions (e.g., transfers to other facilities, transitions to survivorship, or ongoing treatment) Conclusion: These findings informed the development of a power form to track diagnosis-to-treatment times, treatment adherence, no show rates, clinical trials referrals, and care transitions, to address data collection gaps and align with navigator and leadership priorities. Scheduled for implementation on January 1, 2025, the power form will streamline workflows, enhance data-driven decision making in cancer care, and support reimbursement for navigation services under the new Principal Illness Navigation designation by the Centers for Medicare &amp; Medicaid Services. Citation Format: Kelsie Campbell, Joi Torrence-Hill, Karey A. Whitten, Melissa Abbud, Jynette Querubin, Charis Stewart, Mariana Dobre, Trista A. Beard, Fatimata Sanogo, Chanita Hughes Halbert. Enhancing oncology navigation services: a mixed methods approach to developing an EHR power form to improve metrics and reporting [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 987.