Oncology APCM Care Plan Documentation Checklist

List the active cancer diagnosis plus at least one other chronic condition, such as hypertension or treatment-induced diabetes.

Record verbal or written consent for APCM services, including an explanation of cost-sharing and 24/7 access to care protocols.

Document how the patient accesses the care team after hours, specifically for urgent symptoms like neutropenic fever or severe pain.

Perform and document a comprehensive assessment of physical, functional, and psychosocial needs relevant to the cancer stage.

Document a full review of chemotherapy, immunotherapy, and supportive care drugs like anti-emetics or anticoagulants.

Log systematic checks for neuropathy, mucositis, and cytopenias between infusion cycles to ensure early intervention.

Document screening for colitis, pneumonitis, or endocrine changes for patients currently on checkpoint inhibitors.

Record pain levels, analgesic efficacy, and side effects like opioid-induced constipation, adhering to palliative standards.

Track weight changes and caloric intake, documenting interventions for cancer cachexia or treatment-related malabsorption.

Integrate automated phone check-in data into the EHR to demonstrate continuous monitoring of patient-reported outcomes.

Align APCM documentation with NCCN survivorship guidelines, including recurrence monitoring and late-effect screening.

Document the plan for secondary cancer screenings and routine health maintenance tailored to the primary cancer history.

Record communications with cardiology, endocrinology, or primary care regarding treatment-induced comorbidities.

For patients in trials, document compliance with study-specific monitoring and reporting requirements within the care plan.

Assess and record the patient's mental health status, focusing on fear of recurrence or financial toxicity issues.