From: Cancer care coordination in rural Hawaii: a focus group study
CC-related challenges | |
Access to care | “… having your doctor change all the time and you don’t know them and they don’t know you and every doctor has their different process… “ |
“…but for us here specifically on [island], the revolving door of oncologists that we have all been seeing has been a little problematic.” | |
Insurance-related challenges | “…[insurance] initially rejected giving me the [medication], so I had to stay an additional 24 hours in Honolulu to get the shot until [insurance] finally approved giving me the [medication] so I could fly home earlier, but it’s costing me thousands of dollars… “ |
Travel | “…[Insurance] won’t reimburse for the travel, or the hotel, and my husband comes with me every time…” |
Medical literacy | “…we were informed by his PCP that he has cancer. And then after that the PCP gave us the referral to see the oncology at [Medical Center] then that’s it. So after that, she’s out of the picture…” |
Facilitators of CC | |
Electronic Patient portal | “[the electronic patient portal] has been awesome, it’s allowed everyone that’s been a part of my care for me to like access things, to see everything… “ |
Team-based approach | “… I am a [HMO] patient, so all my experiences are positive because they flew me over to Oahu to meet with the MDT, which is the Multidisciplinary Team. I was put in a room and all the doctors went there to talk to me.” |
Family caregiver support | “…my dad doesn’t speak English at all–so each time, I need to go with him…if there was any problem we can always call in…” |
Local clinic staff | “…What’s also been helpful has been the consistency, and I would say my infusion team has been amazing on the [island]. They are everyday heroes, I would never do that job, but every single one of them in the entire department I love! “ |
Self-advocacy | |
Self-advocacy | “…I pretty much stay on top of doctors and remind them when they come in exactly where I’m at, exactly what issues I’m having with my labs, those kinds of things…” |
Others | |
COVID-related challenges | “…in the middle of COVID, missing that companionship during infusion and just having to be by yourself for 3, 4 hours of treatment, I think that was the part that sucked the most. “ |