Directly Observed Care (GO-DOC)

Patients living in extreme poverty face huge barriers in accessing cancer care.

Provider, system and personal barriers must all be overcome in order for a patient to receive timely, appropriate care and have a chance at survival.

One of the biggest challenges is navigating the complex path from diagnosis through treatment to follow-up and all the visits, financial costs, clinic locations and information overload they include.

What is GO-DOC?

The GO-DOC programs draw on successful models of patient navigation and directly observed therapy in TB/HIV and are intended to help patients more easily access cancer care.

This patient-focused intervention is based on five core principles:

  1. Accompaniment of cancer patients throughout their care journey

  2. Proactive removal of barriers to ensure that every patient receives high-quality, timely cancer care

  3. Availability of expert consultation network of specialist oncologists

  4. Patient education and empowerment

  5. Rigorous measurement and evaluation leading to continuous improvement

Goals

  • Increase the number of patients receiving initial oncologic consultation within 1 month of being referred into program

  • Increase the number of patients initiating treatment within 2 months of initial consultation

  • Increase the number of patients completing first cycle of chemotherapy on schedule

  • Ensure that all patients are referred to palliative care services when needed

  • Improve the 5-year survival rate for patients living under the poverty line

Key Partnerships

Seamless collaboration with several partners is key to the success of the DOC program.

  • DOC provider will need to get to know oncologic surgeons and ensure patients are able to schedule surgeries promptly and with necessary medical clearance.

  • Timely review of pathology will be critical in the implementation of the project. Turnaround time goals must be set collaboratively to ensure all parties are able to deliver on them.

  • If patients need to be hospitalized during their treatment (i.e. for febrile neutropenia), close communication of inpatient attending with treating oncologist and DOC provider is needed to ensure continuity of care.

  • During the first few years of the Belize oncology program, there will be no radiation capacity in the country. We will need to design and secure funding for a program to transfer patients in need of XRT to Guatemala.

GO Volunteer Kristen Cummings, RN leading an oncology training in Belize.