National Cancer Institute, Bethesda, MD; Emory University, Atlanta, GA; and University of California San Francisco, San Francisco, CA DOI: 10.1200/JOP.2016.020156; published online ahead of print at jop.ascopubs.org on January 24, 2017. Health Information Systems Approach to Managing Task Interdependence in Cancer Care Teams Veronica Chollette, Derrick D. Beasley, Ekland Abdiwahab, and Stephen Taplin The National Academy of Medicine (NAM) identified the need to improve care co- ordination more than a decade ago. Care coordination is the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care. 1 When care is not well coordinated, errors, omissions, and harms occur. 2 In their 2001 report, Crossing the Quality Chasm, 3 the NAM emphasized that to achieve expected care quality, attention to care process and co- ordination was needed. 4 There were also high expectations that Health IT would contribute to better coordinated care, and there has been a huge investment in in- formation technology. 3 Despite these in- vestments and hopes, when the NAM looked specifically at cancer care 12 years later in 2013, they characterized it as a system in crisis because coordination was largely the exception rather than the rule. 5 The slow progress in care coordination inspires a rethinking of how Health IT can be designed to help patient care teams better manage challenges related to co- ordination of care among and across the multiple teams of clinicians, practices, and health systems involved in cancer care. It is not surprising that care coor- dination is a challenge in cancer care be- cause it often requires the cooperation of two or more people to complete a task; diagnosing a cancer, taking care of comorbid disease, safely infusing chemotherapy, and recognizing the long- term consequences of therapy all require the interaction of physicians, nurses, clerks, and technical staff. In fact, there are few tasks in cancer care that do not require some degree of reliance on two or more people, and that challenge was recognized in many of the articles in the recent Special Series in Journal of Oncology Practice on teams in cancer care. 6 Team researchers call this work interdependent and recog- nize that there is some variation in the degree to which the interaction and co- ordination of team members is required to complete the task. 7 We suggest that con- sideration of how Health IT can assist in the management of interdependent tasks may be a path toward achieving coordinated care. Our suggestion is that thinking about task coordination as the management of interdependent work may clarify what we need from information technology. An article by Trosman et al 6 in the recent series on teams in cancer care highlights the challenge of managing this interdependent work. We suggest that rising to this challenge is exactly what information technology must do to con- tribute to improving care. 6,8, 9, 10-12 Trosman et al suggest that people in health care do not always recognize and manage the in- terdependent tasks of medical care and therefore may not be operating as an ef- fective team. 154 Volume 13 / Issue 3 / March 2017 n Journal of Oncology Practice Copyright © 2017 by American Society of Clinical Oncology Editorial Downloaded from ascopubs.org by 35.171.159.93 on October 2, 2022 from 035.171.159.093 Copyright © 2022 American Society of Clinical Oncology. All rights reserved.