Decision Tree to Improve Access for People with Gynecologic Cancer

Gynecologic cancers—a category including cervical, uterine, and all other forms of cancer that originate in the female reproductive system—affect roughly 100,000 women each year. Unfortunately, for many of these patients it can be difficult to access needed care in a timely fashion. This is more than inconvenient. Delays in cancer treatment increase mortality rates and impose unnecessary social and financial burdens on patients. In December 2021, mean referral times for this patient population ranged as high as 25 days across the Penn Medicine system. Lag times from requesting a new appointment to being seen could extend up to one month or longer for more than a third of new patients.

A new approach aims to shorten wait times and improve access to care for this population by tackling the many barriers which exist, including a lack of effective decision support for care teams, a triage system for expediting and prioritizing new patients, and streamlining work-flow across sites. The project’s cornerstone is a decision tree, an algorithm specifically designed to streamline the scheduling process for patients diagnosed with gynecologic cancer. The decision tree enables practices to more easily prioritize patients based on the treatment required and the urgency of the need. The plan also automates the collection of baseline information via Penn Medicine’s electronic medical record platform. Further this project will collect patient-reported outcomes, and provider preferences.

The gynecologic oncology innovations team including clinical administrative leaders, patient coordinators, advanced practice providers, physicians and Penn- innovations center staff will review piloting and implementation outcomes of the decision tree actions, integration of processing through EPIC- electronic medical records platform and incorporation of patient and provider reported outcomes.

An initial pilot will take place at two primary clinical sites, then further expanded. Researchers hope to eventually create a process map that integrates provider locations, consultation needs, and practice capacity, among other factors, to more efficiently allocate appointment slots and ensure all patients receive access to optimal gynecologic oncology care.

Penn Medicine OptumLabs