Supportive Care Service Availability for Cancer Caregivers in Community Oncology Practices
- Conditions
- Supportive Care
- Registration Number
- NCT03746314
- Lead Sponsor
- Wake Forest University Health Sciences
- Brief Summary
The purpose of this study is to understand current practices for engaging with informal (unpaid) caregivers of patients with cancer, characterize the availability of supportive care services, and assess the perspectives of multi-disciplinary oncology health care providers regarding identifying and supporting caregivers.
- Detailed Description
The primary goals of this study are to: 1) estimate the prevalence of: a) caregiver identification practices, b) psychosocial and/or needs assessment practices for caregivers, and c) the availability of and funding models for supportive care services for caregivers at community oncology practices (Objective 1), and 2) assess the perspectives of multi-disciplinary oncology health care providers regarding: a) perceived responsibility for, and barriers to, assessing and supporting caregivers, b) the importance of and self-efficacy in communicating with caregivers, and c) preferences regarding systems approaches to assess and meet caregivers' needs (Objective 2). Additionally, we will explore various practice and provider -level factors that are associated with the listed outcomes in objectives 1 and 2 respectively (Objective 3a and 3b). This study is estimated to enroll 138 Supportive Care Leaders (e.g., Director of Psychosocial Oncology, Supportive Care Services, or Cancer Patient Support) and 690 multidisciplinary Oncology Providers including physicians, nurses, and physician assistants/nurse practitioners. Participants will complete a one-time web-based survey (estimated at 15-20 minutes to complete). The supportive care leader survey will capture: (1) practice characteristics including caregiver identification and psychosocial assessment practices and preferences; supportive care resources; practice structure; practice technology resources; and status of the Caregiver Advise Record and Enable (CARE) Act. The oncology provider survey will capture: (1) provider skills in caregiver communication; perceived responsibility, knowledge and skills, and awareness of resources for meeting caregiver needs; barriers to meeting caregiver needs; provider characteristics; and system intervention preferences.
For data capture regarding supportive care leaders (Objective 1 and 3a), this will be a convenience sample of responders from all WF NCORP sites, therefore no randomization or stratification is necessary.
Regarding objectives pertaining to oncology providers (Objective 2 and 3b), participating sites with corresponding supportive care leaders will identify an appropriate supportive care leader to generate 3 lists of providers: 1) physicians, 2) nurses, and 3) physician assistants/nurse practitioners who routinely provide cancer care (Oncology Care Provider Identification Form, Appendix B). Using previous Landscape data regarding oncology physicians, we estimate that 50% of practice groups have 1-9 oncology physicians, 25% have 10-20, and 25% have 20+ physicians. After practices respond with lists of physicians, nurses, and physician assistants/nurse practitioners, we will classify each site as small, medium, and large using the criteria for physicians listed above. Assuming similar distributions as seen in Landscape, we will randomly sample 4, 12, and 20 total providers at small, medium, and large sites respectively. With approximately 50% of practices participating, we plan to target a weighted average of 10 providers per practice with the goal of a weighted average of 5 completed provider surveys (50% response/practice) for a total of 690 providers included in objective 2 (sample size justification follows in section 9.3). In addition, we will stratify and proportionally allocate by provider types identified at each site using self-weighting samples supplied in their lists of providers. Therefore of those randomly sampled, we will target roughly the same proportion of physicians, nurses, and PA/nurse practitioners as identified from their site administrator. Coordinators at each NCORP practice will provide e-mail addresses only for randomly selected providers (selected numbers from a numbered list), based on the size of the center and stratified proportional to provider types.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 910
- NCI Community Oncology Research Program (NCORP) components/subcomponents providing care to adult oncology patients.
- NCORP components/subcomponents willing to: a) identify a supportive care leader knowledgeable about supportive care services that may be available to the practice and b) assist with the identification and recruitment of oncology providers for a brief provider survey.
- NCORP components/subcomponents who share staff and supportive care services may participate as a single practice group
- A staff member at each site who is most knowledgeable about supportive care services for adult oncology patients (e.g., Director of Manger of Psychosocial Oncology, Supportive Care Services, or Cancer Patient Support). If an administrator or leader cannot be identified, the nurse manager or clinic director will be asked to identify a staff member most knowledgeable about psychosocial or supportive care services for adult oncology patients or complete the survey himself or herself.
- Must be a physician, nurse, or physician assistant/nurse practitioner, who routinely provides cancer care to adult oncology patients, including medical, radiation and surgical oncologists or physician assistants (PAs), nurse practitioners (NPs), and nurses who work in oncology settings.
- Must have been in practice at component/subcomponent for at least 6 months.
- Component/subcomponent exclusively care for pediatric oncology patients. Given the distinct caregiver experience and needs of caregivers of pediatric oncology patients, we are not including components/sub-components that exclusively provide care for pediatric oncology patients.
- Providers in practice less than 6 months.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Percent of Practices that have Mechanisms in Place to Identify Primary Caregivers Included in One-Time Web-Based Survey; Up to 20 minutes Total Practices that have a mechanism in place to identify and document a primary, informal caregiver for cancer patients will be identified by using the following Landscape 2017 Survey item: "Does your practice have a mechanism in place to identify and document a primary, informal (unpaid) caregiver for cancer patients?"
Percent of Practices that have Mechanisms in Place to Provide Psychosocial and/or Needs Assessments for Caregivers Included in One-Time Web-Based Survey; Up to 20 minutes Total Methods, documentation, settings and timing will be collected and assessed from practices that have mechanisms in place to identify primary caregivers.
Percent of Practices that have Availability of and Funding Models for Supportive Care Services Included in One-Time Web-Based Survey; Up to 20 minutes Total Percent of practices that have availability of and funding models for supportive care services provided to patients only, caregivers only, or both patients and caregivers will be assessed using items and content adapted from the Service Availability Measure and the Supportive Care Resources surveys.
Providers' Perceived Responsibility per SPARCCS Included in One-Time Web-Based Survey; Up to 20 minutes Total Questions used to collect perceived responsibility are adapted from the Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) on a scale of 0-4, "strongly disagree" to "strongly agree". These questions assess modifiable constructs that can be targeted for systems level interventions including: 1) questions assessing perceived responsibility for assessing caregivers; 2) questions assessing skills and time to support caregivers; and 3) questions assessing awareness of resources for caregivers in practice and community.
Providers' Perceived Responsibility for Barriers to Meeting Caregiver Needs Included in One-Time Web-Based Survey; Up to 20 minutes Total Barriers to meeting needs of caregivers will be assessed using a 20-item tool designed by our team in prior research which was adapted for this study. Providers will report the extent to which they believe each barrier (e.g., time, lack of specialized staff, reimbursement) impacts service delivery for caregivers on a scale of 0-3, "not a barrier at all" to "Major barrier".
Providers' Ratings of Perceived Importance of Skills in Caregiver Communication Included in One-Time Web-Based Survey; Up to 20 minutes Total Providers' perceived skills in caregiver communication assesses providers' perceived importance, self-efficacy, and need for more training in 4 caregiver communication skills: 1) educating caregivers about ways to support a care recipient during treatment and recovery, 2) detecting when caregivers are anxious, depressed, or overwhelmed, 3) providing information about resources available to support caregivers, 4) assessing problems between caregivers and patients that impact patient treatment or recovery (15 items). These 15 items are adapted from a provider patient communication instrument on a scale of 0-4, "not at all" to "extremely/very much".
Providers' System Intervention Preferences Included in One-Time Web-Based Survey; Up to 20 minutes Total Providers' system intervention preferences will be assessed with 13 items assessing providers' preferences for offering different types of system interventions on a scale of 0-4, "not alt all interested" to "extremely interested"; 12 items assessing willingness and preferences for receiving training in each type of systems intervention on a scale of 0-2, "definitely" to "no".
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (271)
Mercy Hospital
🇺🇸Coon Rapids, Minnesota, United States
Southwest Oncology PC
🇺🇸Durango, Colorado, United States
Longmont United Hospital
🇺🇸Longmont, Colorado, United States
Saint Alphonsus Cancer Care Center-Boise
🇺🇸Boise, Idaho, United States
LSU Health Sciences Center at Shreveport
🇺🇸Shreveport, Louisiana, United States
Delbert Day Cancer Institute at PCRMC
🇺🇸Rolla, Missouri, United States
Mercy Clinic-Rolla-Cancer and Hematology
🇺🇸Rolla, Missouri, United States
Heartland Regional Medical Center
🇺🇸Saint Joseph, Missouri, United States
CoxHealth South Hospital
🇺🇸Springfield, Missouri, United States
Great Falls Clinic
🇺🇸Great Falls, Montana, United States
Saint Patrick Hospital - Community Hospital
🇺🇸Missoula, Montana, United States
Southeastern Medical Oncology Center-Jacksonville
🇺🇸Jacksonville, North Carolina, United States
Dayton Physicians LLC-Wayne
🇺🇸Greenville, Ohio, United States
Clackamas Radiation Oncology Center
🇺🇸Clackamas, Oregon, United States
Geisinger Wyoming Valley/Henry Cancer Center
🇺🇸Wilkes-Barre, Pennsylvania, United States
AnMed Health Cancer Center
🇺🇸Anderson, South Carolina, United States
Pacific Gynecology Specialists
🇺🇸Seattle, Washington, United States
Swedish Medical Center-First Hill
🇺🇸Seattle, Washington, United States
Kaiser Permanente Washington
🇺🇸Seattle, Washington, United States
Swedish Medical Center-Cherry Hill
🇺🇸Seattle, Washington, United States
Good Samaritan Hospital - Cincinnati
🇺🇸Cincinnati, Ohio, United States
TriHealth Cancer Institute-Westside
🇺🇸Cincinnati, Ohio, United States
Cancer Center of Kansas-Wichita Medical Arts Tower
🇺🇸Wichita, Kansas, United States
Minimally Invasive Surgery Hospital
🇺🇸Lenexa, Kansas, United States
Community Medical Hospital
🇺🇸Missoula, Montana, United States
Health Partners Inc
🇺🇸Minneapolis, Minnesota, United States
Mercy Hospital Oklahoma City
🇺🇸Oklahoma City, Oklahoma, United States
University of Texas Health Science Center at San Antonio
🇺🇸San Antonio, Texas, United States
Providence Saint Joseph Medical Center/Disney Family Cancer Center
🇺🇸Burbank, California, United States
Rocky Mountain Cancer Centers-Lakewood
🇺🇸Lakewood, Colorado, United States
Anchorage Oncology Centre
🇺🇸Anchorage, Alaska, United States
Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
🇺🇸Jonesboro, Arkansas, United States
Providence Alaska Medical Center
🇺🇸Anchorage, Alaska, United States
Christiana Care Health System-Christiana Hospital
🇺🇸Newark, Delaware, United States
Christiana Care Health System-Wilmington Hospital
🇺🇸Wilmington, Delaware, United States
Alegent Health Mercy Hospital
🇺🇸Council Bluffs, Iowa, United States
Menorah Medical Center
🇺🇸Overland Park, Kansas, United States
Mercy Medical Center - Des Moines
🇺🇸Des Moines, Iowa, United States
TidalHealth Nanticoke / Allen Cancer Center
🇺🇸Seaford, Delaware, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
🇺🇸Savannah, Georgia, United States
Rocky Mountain Cancer Centers-Longmont
🇺🇸Longmont, Colorado, United States
MedStar Georgetown University Hospital
🇺🇸Washington, District of Columbia, United States
Medical Oncology and Hematology Associates-Laurel
🇺🇸Des Moines, Iowa, United States
Mountain Blue Cancer Care Center
🇺🇸Golden, Colorado, United States
Reid Health
🇺🇸Richmond, Indiana, United States
Saint Luke's Cancer Institute - Twin Falls
🇺🇸Twin Falls, Idaho, United States
Beebe Medical Center
🇺🇸Lewes, Delaware, United States
Saint Alphonsus Cancer Care Center-Caldwell
🇺🇸Caldwell, Idaho, United States
Saint Luke's Cancer Institute - Boise
🇺🇸Boise, Idaho, United States
Good Samaritan Regional Health Center
🇺🇸Mount Vernon, Illinois, United States
Physicians' Clinic of Iowa PC
🇺🇸Cedar Rapids, Iowa, United States
Delaware Clinical and Laboratory Physicians PA
🇺🇸Newark, Delaware, United States
Kansas Institute of Medicine Cancer and Blood Center
🇺🇸Lenexa, Kansas, United States
Kootenai Medical Center
🇺🇸Coeur d'Alene, Idaho, United States
Beebe Health Campus
🇺🇸Rehoboth Beach, Delaware, United States
Central Care Cancer Center - Great Bend
🇺🇸Great Bend, Kansas, United States
Medical Oncology Hematology Consultants PA
🇺🇸Newark, Delaware, United States
Kootenai Cancer Center
🇺🇸Post Falls, Idaho, United States
Mercy Hospital Fort Smith
🇺🇸Fort Smith, Arkansas, United States
Rocky Mountain Cancer Centers-Penrose
🇺🇸Colorado Springs, Colorado, United States
Alaska Oncology and Hematology LLC
🇺🇸Anchorage, Alaska, United States
Helen F Graham Cancer Center
🇺🇸Newark, Delaware, United States
Alaska Women's Cancer Care
🇺🇸Anchorage, Alaska, United States
Katmai Oncology Group
🇺🇸Anchorage, Alaska, United States
Flaget Memorial Hospital
🇺🇸Bardstown, Kentucky, United States
Cancer Center of Kansas - Wichita
🇺🇸Wichita, Kansas, United States
Jewish Hospital Medical Center South
🇺🇸Shepherdsville, Kentucky, United States
Essentia Health Saint Joseph's Medical Center
🇺🇸Brainerd, Minnesota, United States
Saint Joseph London
🇺🇸London, Kentucky, United States
Anchorage Associates in Radiation Medicine
🇺🇸Anchorage, Alaska, United States
Mercy Cancer Center-West Lakes
🇺🇸Clive, Iowa, United States
Commonwealth Cancer Center-Corbin
🇺🇸Corbin, Kentucky, United States
Essentia Health Cancer Center
🇺🇸Duluth, Minnesota, United States
Unity Hospital
🇺🇸Fridley, Minnesota, United States
Bon Secours DePaul Medical Center
🇺🇸Norfolk, Virginia, United States
Essentia Health Hibbing Clinic
🇺🇸Hibbing, Minnesota, United States
Abbott-Northwestern Hospital
🇺🇸Minneapolis, Minnesota, United States
Baptist Memorial Hospital and Cancer Center-Union County
🇺🇸New Albany, Mississippi, United States
Kalispell Regional Medical Center
🇺🇸Kalispell, Montana, United States
CHI Health Saint Francis
🇺🇸Grand Island, Nebraska, United States
Billings Clinic Cancer Center
🇺🇸Billings, Montana, United States
Saint Louis Cancer and Breast Institute-Ballwin
🇺🇸Ballwin, Missouri, United States
AtlantiCare Health Park-Cape May Court House
🇺🇸Cape May Court House, New Jersey, United States
Wayne Memorial Hospital
🇺🇸Goldsboro, North Carolina, United States
Community Hospital of Anaconda
🇺🇸Anaconda, Montana, United States
Saint Elizabeth Regional Medical Center
🇺🇸Lincoln, Nebraska, United States
Onslow Memorial Hospital
🇺🇸Jacksonville, North Carolina, United States
Bozeman Deaconess Hospital
🇺🇸Bozeman, Montana, United States
Saint Peter's Community Hospital
🇺🇸Helena, Montana, United States
AtlantiCare Surgery Center
🇺🇸Egg Harbor Township, New Jersey, United States
Providence Newberg Medical Center
🇺🇸Newberg, Oregon, United States
Bethesda North Hospital
🇺🇸Cincinnati, Ohio, United States
Southeastern Medical Oncology Center-Goldsboro
🇺🇸Goldsboro, North Carolina, United States
Blanchard Valley Hospital
🇺🇸Findlay, Ohio, United States
Southeastern Medical Oncology Center-Clinton
🇺🇸Clinton, North Carolina, United States
Indu and Raj Soin Medical Center
🇺🇸Beavercreek, Ohio, United States
Geisinger Medical Oncology-Lewisburg
🇺🇸Lewisburg, Pennsylvania, United States
Novant Health Cancer Institute - Statesville
🇺🇸Statesville, North Carolina, United States
Geisinger Medical Center
🇺🇸Danville, Pennsylvania, United States
TriHealth Cancer Institute-Anderson
🇺🇸Cincinnati, Ohio, United States
Bon Secours Saint Mary's Hospital
🇺🇸Richmond, Virginia, United States
Saint Alphonsus Medical Center-Ontario
🇺🇸Ontario, Oregon, United States
Wayne Hospital
🇺🇸Greenville, Ohio, United States
Upper Valley Medical Center
🇺🇸Troy, Ohio, United States
Saint Elizabeth Youngstown Hospital
🇺🇸Youngstown, Ohio, United States
Saint Charles Health System-Redmond
🇺🇸Redmond, Oregon, United States
Oncology Hematology Care Inc-Kenwood
🇺🇸Cincinnati, Ohio, United States
Good Samaritan Hospital - Dayton
🇺🇸Dayton, Ohio, United States
Springfield Regional Cancer Center
🇺🇸Springfield, Ohio, United States
Springfield Regional Medical Center
🇺🇸Springfield, Ohio, United States
Greater Dayton Cancer Center
🇺🇸Kettering, Ohio, United States
Dayton Physicians LLC-Upper Valley
🇺🇸Troy, Ohio, United States
Providence Cancer Institute Clackamas Clinic
🇺🇸Clackamas, Oregon, United States
Geisinger Cancer Services-Pottsville
🇺🇸Pottsville, Pennsylvania, United States
Geisinger Medical Group
🇺🇸State College, Pennsylvania, United States
Swedish Cancer Institute-Edmonds
🇺🇸Edmonds, Washington, United States
Providence Regional Cancer System-Centralia
🇺🇸Centralia, Washington, United States
Swedish Medical Center-Ballard Campus
🇺🇸Seattle, Washington, United States
Cancer Center of Western Wisconsin
🇺🇸New Richmond, Wisconsin, United States
Billings Clinic-Cody
🇺🇸Cody, Wyoming, United States
Welch Cancer Center
🇺🇸Sheridan, Wyoming, United States
Centerpoint Medical Center LLC
🇺🇸Independence, Missouri, United States
Freeman Health System
🇺🇸Joplin, Missouri, United States
Mercy Hospital Springfield
🇺🇸Springfield, Missouri, United States
Mercy Hospital Saint Louis
🇺🇸Saint Louis, Missouri, United States
Mercy Hospital Washington
🇺🇸Washington, Missouri, United States
Riverwood Healthcare Center
🇺🇸Aitkin, Minnesota, United States
Cambridge Medical Center
🇺🇸Cambridge, Minnesota, United States
Essentia Health Saint Mary's Medical Center
🇺🇸Duluth, Minnesota, United States
Fairview Southdale Hospital
🇺🇸Edina, Minnesota, United States
Lake Region Healthcare Corporation-Cancer Care
🇺🇸Fergus Falls, Minnesota, United States
Hennepin County Medical Center
🇺🇸Minneapolis, Minnesota, United States
Monticello Cancer Center
🇺🇸Monticello, Minnesota, United States
North Memorial Medical Health Center
🇺🇸Robbinsdale, Minnesota, United States
Essentia Health - Park Rapids
🇺🇸Park Rapids, Minnesota, United States
Regions Hospital
🇺🇸Saint Paul, Minnesota, United States
Minnesota Oncology Hematology PA-Woodbury
🇺🇸Woodbury, Minnesota, United States
Lakeview Hospital
🇺🇸Stillwater, Minnesota, United States
Rice Memorial Hospital
🇺🇸Willmar, Minnesota, United States
Essentia Health Virginia Clinic
🇺🇸Virginia, Minnesota, United States
Mercy Medical Center
🇺🇸Durango, Colorado, United States
Penrose-Saint Francis Healthcare
🇺🇸Colorado Springs, Colorado, United States
Rocky Mountain Cancer Centers - Pueblo
🇺🇸Pueblo, Colorado, United States
Littleton Adventist Hospital
🇺🇸Littleton, Colorado, United States
Saint Luke's Cancer Institute - Fruitland
🇺🇸Fruitland, Idaho, United States
Saint Alphonsus Medical Center-Nampa
🇺🇸Nampa, Idaho, United States
Idaho Urologic Institute-Meridian
🇺🇸Meridian, Idaho, United States
Kootenai Cancer Clinic
🇺🇸Sandpoint, Idaho, United States
Novant Health Cancer Institute - Thomasville
🇺🇸Thomasville, North Carolina, United States
Park Nicollet Clinic - Saint Louis Park
🇺🇸Saint Louis Park, Minnesota, United States
Saint Francis Regional Medical Center
🇺🇸Shakopee, Minnesota, United States
Porter Adventist Hospital
🇺🇸Denver, Colorado, United States
Alegent Health Immanuel Medical Center
🇺🇸Omaha, Nebraska, United States
Hematology and Oncology Consultants PC
🇺🇸Omaha, Nebraska, United States
Novant Health Forsyth Medical Center
🇺🇸Winston-Salem, North Carolina, United States
Alegent Health Bergan Mercy Medical Center
🇺🇸Omaha, Nebraska, United States
Novant Health Oncology Specialists
🇺🇸Winston-Salem, North Carolina, United States
Alegent Health Lakeside Hospital
🇺🇸Omaha, Nebraska, United States
Creighton University Medical Center
🇺🇸Omaha, Nebraska, United States
Providence Portland Medical Center
🇺🇸Portland, Oregon, United States
Wake Forest University Health Sciences
🇺🇸Winston-Salem, North Carolina, United States
Providence Saint Vincent Medical Center
🇺🇸Portland, Oregon, United States
Rocky Mountain Cancer Centers-Thornton
🇺🇸Thornton, Colorado, United States
Walter Knox Memorial Hospital
🇺🇸Emmett, Idaho, United States
Miami Valley Hospital North
🇺🇸Dayton, Ohio, United States
Novant Health Cancer Institute - Wilkesboro
🇺🇸Wilkesboro, North Carolina, United States
Saint Mary Corwin Medical Center
🇺🇸Pueblo, Colorado, United States
Fairview Lakes Medical Center
🇺🇸Wyoming, Minnesota, United States
Central Care Cancer Center - Bolivar
🇺🇸Bolivar, Missouri, United States
Miami Valley Hospital
🇺🇸Dayton, Ohio, United States
Dayton Physicians LLC-Atrium
🇺🇸Franklin, Ohio, United States
Saint Charles Health System
🇺🇸Bend, Oregon, United States
Atrium Medical Center-Middletown Regional Hospital
🇺🇸Franklin, Ohio, United States
Kettering Medical Center
🇺🇸Kettering, Ohio, United States
First Dayton Cancer Care
🇺🇸Kettering, Ohio, United States
Community Medical Center
🇺🇸Scranton, Pennsylvania, United States
Geisinger Medical Center-Cancer Center Hazleton
🇺🇸Hazleton, Pennsylvania, United States
Saint Joseph Warren Hospital
🇺🇸Warren, Ohio, United States
Bay Area Hospital
🇺🇸Coos Bay, Oregon, United States
Lewistown Hospital
🇺🇸Lewistown, Pennsylvania, United States
Memorial Hospital
🇺🇸Chattanooga, Tennessee, United States
Jewish Hospital
🇺🇸Louisville, Kentucky, United States
Saints Mary and Elizabeth Hospital
🇺🇸Louisville, Kentucky, United States
Jewish Hospital Medical Center Northeast
🇺🇸Louisville, Kentucky, United States
Alaska Breast Care and Surgery LLC
🇺🇸Anchorage, Alaska, United States
Anchorage Radiation Therapy Center
🇺🇸Anchorage, Alaska, United States
CHI Saint Vincent Cancer Center Hot Springs
🇺🇸Hot Springs, Arkansas, United States
Saint Anthony Hospital
🇺🇸Lakewood, Colorado, United States
Parker Adventist Hospital
🇺🇸Parker, Colorado, United States
Rocky Mountain Cancer Centers-Parker
🇺🇸Parker, Colorado, United States
Medical Oncology and Hematology Associates-West Des Moines
🇺🇸Clive, Iowa, United States
Saint Luke's Cancer Institute - Nampa
🇺🇸Nampa, Idaho, United States
Central Care Cancer Center - Garden City
🇺🇸Garden City, Kansas, United States
Mercy Medical Center-West Lakes
🇺🇸West Des Moines, Iowa, United States
Greater Regional Medical Center
🇺🇸Creston, Iowa, United States
Saint Joseph Hospital East
🇺🇸Lexington, Kentucky, United States
Saint Joseph Radiation Oncology Resource Center
🇺🇸Lexington, Kentucky, United States
Fairview Ridges Hospital
🇺🇸Burnsville, Minnesota, United States
Essentia Health - Deer River Clinic
🇺🇸Deer River, Minnesota, United States
Essentia Health Saint Mary's - Detroit Lakes Clinic
🇺🇸Detroit Lakes, Minnesota, United States
Miller-Dwan Hospital
🇺🇸Duluth, Minnesota, United States
Essentia Health - Fosston
🇺🇸Fosston, Minnesota, United States
Minnesota Oncology Hematology PA-Maplewood
🇺🇸Maplewood, Minnesota, United States
Saint John's Hospital - Healtheast
🇺🇸Maplewood, Minnesota, United States
Fairview Northland Medical Center
🇺🇸Princeton, Minnesota, United States
Ridgeview Medical Center
🇺🇸Waconia, Minnesota, United States
Essentia Health Sandstone
🇺🇸Sandstone, Minnesota, United States
United Hospital
🇺🇸Saint Paul, Minnesota, United States
Baptist Cancer Center-Grenada
🇺🇸Grenada, Mississippi, United States
Mercy Hospital Joplin
🇺🇸Joplin, Missouri, United States
Research Medical Center
🇺🇸Kansas City, Missouri, United States
Saint Louis Cancer and Breast Institute-South City
🇺🇸Saint Louis, Missouri, United States
Mercy Hospital South
🇺🇸Saint Louis, Missouri, United States
Benefis Healthcare- Sletten Cancer Institute
🇺🇸Great Falls, Montana, United States
CHI Health Good Samaritan
🇺🇸Kearney, Nebraska, United States
Novant Health Cancer Institute - Kernersville
🇺🇸Kernersville, North Carolina, United States
Novant Health Cancer Institute - Mount Airy
🇺🇸Mount Airy, North Carolina, United States
Essentia Health - Jamestown Clinic
🇺🇸Jamestown, North Dakota, United States
Essentia Health Cancer Center-South University Clinic
🇺🇸Fargo, North Dakota, United States
Dayton Physicians LLC-Miami Valley South
🇺🇸Centerville, Ohio, United States
Saint Elizabeth Boardman Hospital
🇺🇸Boardman, Ohio, United States
Miami Valley Hospital South
🇺🇸Centerville, Ohio, United States
Dayton Physician LLC-Miami Valley Hospital North
🇺🇸Dayton, Ohio, United States
Armes Family Cancer Center
🇺🇸Findlay, Ohio, United States
Orion Cancer Care
🇺🇸Findlay, Ohio, United States
Saint Alphonsus Medical Center-Baker City
🇺🇸Baker City, Oregon, United States
Christiana Care Health System-Concord Health Center
🇺🇸Chadds Ford, Pennsylvania, United States
Geisinger Medical Oncology-Selinsgrove
🇺🇸Selinsgrove, Pennsylvania, United States
Saint Francis Hospital
🇺🇸Federal Way, Washington, United States
Saint Francis Cancer Center
🇺🇸Greenville, South Carolina, United States
Bon Secours Memorial Regional Medical Center
🇺🇸Mechanicsville, Virginia, United States
Memorial GYN Plus
🇺🇸Ooltewah, Tennessee, United States
Baptist Memorial Hospital and Cancer Center-Memphis
🇺🇸Memphis, Tennessee, United States
Pulmonary Medicine Center of Chattanooga-Hixson
🇺🇸Hixson, Tennessee, United States
Baptist Memorial Hospital and Cancer Center-Collierville
🇺🇸Collierville, Tennessee, United States
Saint Joseph Regional Cancer Center
🇺🇸Bryan, Texas, United States
Bon Secours Saint Francis Medical Center
🇺🇸Midlothian, Virginia, United States
Virginia Commonwealth University/Massey Cancer Center
🇺🇸Richmond, Virginia, United States
Bon Secours Health Center at Harbour View
🇺🇸Suffolk, Virginia, United States
Providence Regional Cancer System-Aberdeen
🇺🇸Aberdeen, Washington, United States
Harrison HealthPartners Hematology and Oncology-Bremerton
🇺🇸Bremerton, Washington, United States
PeaceHealth Saint Joseph Medical Center
🇺🇸Bellingham, Washington, United States
Highline Medical Center-Main Campus
🇺🇸Burien, Washington, United States
Harrison Medical Center
🇺🇸Bremerton, Washington, United States
Saint Elizabeth Hospital
🇺🇸Enumclaw, Washington, United States
Providence Regional Cancer Partnership
🇺🇸Everett, Washington, United States
Saint Clare Hospital
🇺🇸Lakewood, Washington, United States
Swedish Cancer Institute-Issaquah
🇺🇸Issaquah, Washington, United States
PeaceHealth Saint John Medical Center
🇺🇸Longview, Washington, United States
Kadlec Clinic Hematology and Oncology
🇺🇸Kennewick, Washington, United States
Providence Regional Cancer System-Lacey
🇺🇸Lacey, Washington, United States
Harrison HealthPartners Hematology and Oncology-Poulsbo
🇺🇸Poulsbo, Washington, United States
Providence Regional Cancer System-Shelton
🇺🇸Shelton, Washington, United States
PeaceHealth United General Medical Center
🇺🇸Sedro-Woolley, Washington, United States
Franciscan Research Center-Northwest Medical Plaza
🇺🇸Tacoma, Washington, United States
Northwest Medical Specialties PLLC
🇺🇸Tacoma, Washington, United States
Duluth Clinic Ashland
🇺🇸Ashland, Wisconsin, United States
PeaceHealth Southwest Medical Center
🇺🇸Vancouver, Washington, United States
Providence Saint Mary Regional Cancer Center
🇺🇸Walla Walla, Washington, United States
Gundersen Lutheran Medical Center
🇺🇸La Crosse, Wisconsin, United States
Northwest Wisconsin Cancer Center
🇺🇸Ashland, Wisconsin, United States
Providence Regional Cancer System-Yelm
🇺🇸Yelm, Washington, United States
Saint Luke's Cancer Institute - Meridian
🇺🇸Meridian, Idaho, United States
Heartland Hematology and Oncology
🇺🇸Kearney, Nebraska, United States
New Ulm Medical Center
🇺🇸New Ulm, Minnesota, United States
Midlands Community Hospital
🇺🇸Papillion, Nebraska, United States
Fairview Clinics and Surgery Center Maple Grove
🇺🇸Maple Grove, Minnesota, United States
Baptist Memorial Hospital and Cancer Center-Desoto
🇺🇸Southhaven, Mississippi, United States
Cox Cancer Center Branson
🇺🇸Branson, Missouri, United States
Baptist Memorial Hospital and Cancer Center-Golden Triangle
🇺🇸Columbus, Mississippi, United States
Baptist Memorial Hospital and Cancer Center-Oxford
🇺🇸Oxford, Mississippi, United States