Live Virtual Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Informed Financial Consent: The Challenges to Implementation  (#125)

Sanchia Aranda 1 , Kate Whittaker 1 , Megan Varlow 1
  1. Cancer Council Australia, Sydney, NSW, Australia

One aspect of financial toxicity relates to out of pocket expenses for medical and allied health services, with an increasing body of evidence pointing to the negative experience and impact of these expenses. Out of pocket costs are often unexpected by the patient (bill shock) with little to no consultation about alternatives that may involve lower or no cost. At COSA 2018 our collaboration (Cancer Council Australia, Breast Cancer Network Australia, Canteen and Prostate Cancer Foundation Australia) launched a standard for Informed Financial Consent (IFC) for public consultation. The IFC standard has now been endorsed by 14 organisations and over the next six months our goal is to encourage implementation of the standard within health services and medical practices. This presentation will focus on implementation strategies and the challenges we envisage during this process.

Our implementation strategy focuses on three key phases. Phase 1 centres on engaging with a coalition of the willing; those who are potential champions for the standard or early adopters within their health setting. Phase 2 consists of then widening this engagement in ways that encourage take up more widely across the health system and phase 3 centres on embedding IFC as business as usual so that it acts as an informal regulation – the way a ‘reasonable’ clinician would be seen to perform in the general course of obtaining consent.  

The challenges to the adoption of IFC are anticipated or are already occurring in three main areas:

  1. Erroneous perceptions that the IFC standard is critical of doctors and of fees being charged
  2. Resistance based on concerns regarding competition and other regulatory requirements
  3. Difficulties in monitoring uptake and compliance