What is team-based cancer care, and how has it evolved over the past decade? A special series in ASCO’s JCO Oncology Practice highlights transformations in team-based delivery models within the cancer care system and their potential direction. A carefully curated series of 15 peer-reviewed articles examines various aspects of team-based care, including the dynamic and flexible ways that teams and team members work together (described as “teams of teams”), equity in teams, nonphysician perspectives, and technology’s role in team-based care. The special series is a direct outgrowth of an ongoing dialogue between the National Cancer Institute (NCI) and ASCO to recognize the interest in and growing evidence base on team-based care.
A 2015 article in JCO Oncology Practice1 defines teams as “two or more individuals who interact dynamically, independently, and adaptively to achieve a common goal that is shared within the context of a larger group or organization.” Researchers in the series cited that teams in the cancer care delivery system often span across different disciplines in both inpatient and outpatient settings, that care teams constantly evolve based on patient needs, and that the cancer care team interacts with other teams to contribute to comprehensive patient care. They noted that several factors influence cancer care, which include competing goals, leadership, organizational context, and others. The understanding of how teams work is a core foundation of team-based care.
Closer Look at the Special Series
The series looks at the role of various providers in teams, including a significant increase in the use of advanced practice providers (APPs) and their role expansion in many cancer care delivery settings. Because of patient demand and a shortage in the number of oncologists, APPs and other practitioners across disciplines—pharmacists, nutritionists, social workers, nurse navigators, and advocates—were tasked with filling the gap in patient needs and services. This expansion of roles within cancer care delivery teams point to the trend of increasing specialization, increases in the number of patients facing cancer and managing chronic conditions, and calls to address social risk factors in clinical settings.2
The special series also reviews how advances in technology have enabled teams to engage in rapid communication, improved error checking, and more thorough documentation.3 However, these studies also point out other goals that have not been fully realized by these advances, including lack of communication between electronic medical record systems and their role in alleviating administrative burden. Other disadvantages point to accessibility of health data; lack of shared patient decision-making; and factors such as age, socioeconomic status, and geographic location are barriers to accessing reliable technology.
This is ASCO’s second series on the topic, with the first published in 2016. Overall, the JCO Oncology Practice special series underscores the importance of different types of team-based cancer care and their role in addressing disparities in access to care and health outcomes. It acknowledges the progress that has been made in care coordination and team effectiveness and stresses the continued need for team- and equity-based principles across all care delivery settings.
REFERENCES
1. Taplin SH, Weaver S, Salas E, et al: Reviewing cancer care team effectiveness. J Oncol Pract 11:239-246, 2015.
2. Pickard TA, Hylton H, Mitchell SA: The science of teams and provision of team-based care in oncology: An advanced practice provider perspective. JCO Oncol Pract 19:16-18, 2023.
3. Caparso C, Friese CR: Technology supports to cancer care teams: Promises and pitfalls. JCO Oncol Pract 19:13-15, 2023.
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