*This blog post was written by the Kimmel Cancer Center's development specialist, Allison Rich.
Anyone who has ever heard the words “you have cancer” knows that no part of their life remains unaffected by the reality of this diagnosis. Yet even though we know this to be true, the traditional approach to cancer medicine has not always incorporated these multifaceted and all-encompassing impacts into the plan of care. Here at Johns Hopkins, Claire Snyder, Ph.D., is seeking to transform this traditional paradigm, ensuring that every aspect of functioning and well-being is taken into account throughout the course of a patient’s cancer treatment and beyond.
Dr. Snyder’s background in healthcare outcomes and quality of life began when she was an undergraduate. Upon returning to Duke University from a health policy internship on Capitol Hill, she took a course on value in healthcare. This course showed her that medicine as a whole was largely lacking an evidence-based approach to understanding how what we do and how we do it impacts the day-to-day lives of patients and families. The awareness she gained in this course deeply resonated with her, and she knew that this was something that she wanted to spend the rest of her life doing.
This revelation has in fact shaped the course of her entire career, and is what drove Dr. Snyder to go on to receive her Master of Health Science in Health Policy, and then her Ph.D. in Health Policy & Management, from the Johns Hopkins Bloomberg School of Public Health. Johns Hopkins is still her professional home today, where she holds appointments in Medicine, Oncology, and Health Policy & Management. Her work centers on two principle areas: improving communication between cancer care providers and primary care providers across the treatment continuum and into survivorship, and developing tools to help cancer care providers better monitor patient well-being during active treatment. Broadly speaking, Dr. Snyder describes her work as assessing “how we can we use the patient’s own voice to improve the quality of life they experience and the quality of care they receive.”
Currently, Dr. Snyder’s work in improving communication between cancer providers and primary care providers focuses on how to help cancer patients transition to survivorship when their initial treatment is complete. Her research and that of her colleagues has shown that many cancer survivors don’t receive the care that they should be getting – or, in some cases, even receive care that they don’t actually need. To remedy this issue, the National Academy of Medicine recommends that patients receive a “survivorship care plan,” or SCP, when they complete treatment. This document summarizes the therapies received and outlines the follow-up care needed, and is intended to be a tool for both survivors and primary care providers. Dr. Snyder is co-Principal Investigator of a randomized, controlled trial to investigate the best approaches for delivering SCPs in the most effective and efficient manner possible, with the goal of ensuring that survivors and their primary care providers are both on precisely the same page, without placing a burden on either the survivor or their oncology care team. As these plans are now required for accreditation by the American College of Surgeons Commission on Cancer, Dr. Snyder’s work is exceptionally relevant to creating a model which will ensure that patients and providers have access to this important document both here at Hopkins and at other cancer centers across the region.
For patients who have not yet concluded their treatment process, Dr. Snyder has also spearheaded efforts to, as she describes, “make quality of life assessment as routine a part of cancer care as laboratory values and imaging studies, so that when a patient is being seen by their cancer clinician, the clinician has in front of him or her the lab values, the imaging studies, and the patient’s own report of their feelings, functioning, and well-being.” Dr. Snyder and her colleagues hope that this effort will not only help clinicians identify issues that may have otherwise gone unnoticed, but will also give patients an open line of communication to discuss topics that are sometimes difficult to raise, such as sexual function. Since Dr. Snyder implemented this approach through an online portal called PatientViewpoint, patients and providers alike have expressed how beneficial it is to have the opportunity to readily discuss these issues. While clinicians reported that the portal allowed them to gain insight into elements of their patients’ health that may not have come up during a standard office visit, such as increased feelings of depression or life events conflicting with treatment schedules, patients revealed that the process made them feel that their oncology team truly cared about them not only as patients but as people, allowing them to voice concerns about topics such as body image that may otherwise have been forgotten between visits or pushed to the wayside in light of other medical concerns. For Dr. Snyder, comments such as these underscore the value of what she calls “putting the ‘care’ in cancer care.”
In addition to focusing on making sure the patient’s voice is heard across the entire cancer care spectrum, and providing a mechanism for this data to be included in the medical record in a systematic and routine way, Dr. Snyder also established a platform for Johns Hopkins faculty who are passionate about these same issues to come together and establish a research community, called the BLOCS program. BLOCS, which stands for Building Lifestyle, Outcomes, and Care Services Research in Cancer, created a home for researchers and clinicians who, like Dr. Snyder, believe strongly in finding ways to improve quality of life and care delivery for patients and their families. Currently, BLOCS has 30 members, including clinicians and researchers from multiple disciplines, and facilitates additional research advances through communication, collaboration, and connections that would be far more difficult to make were it not for BLOCS.
Since she first discovered its incredible importance as an undergraduate, Dr. Snyder has dedicated her career to learning how to best serve patients and families, whether they have just received a cancer diagnosis or are well on the road of survivorship. Whether the prognosis is fantastic or difficult, she and her colleagues, including the members of the BLOCS program, believe that honing the tools necessary to improve the quality of how we provide cancer care at Johns Hopkins is of paramount importance, allowing patients to feel that their personhood is never taken out of the equation, and that their entire care team is united in the effort to provide them with the best possible quality of life for as long as is feasible.
If you are interested in learning more about Dr. Snyder’s work and opportunities for support, please contact Ashlyn Sowell at asowell2@jhmi.edu.
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s Hopkins in the Division of Medical Psychology, says her assessments usually require a three- to four-hour appointment. “I will review a patient’s medical records, and spend an hour taking a medical history while focusing on issues such as stress, sleep, mood, and in what kinds of situations the patient notices cognitive difficulties.” One of her technicians provides formal, one-on-one cognitive testing designed to look at different thinking skills, such as the ability to pay attention, to think quickly, to remember, to plan and to reason and problem-solve. Then patients fill out questionnaires that address mood, stress, sleep and fatigue.
