Innovating Cancer Care Delivery: the Example of the 4R Oncology Model for Colorectal Cancer Patients

Julia Trosman*, Christine Weldon, Sheetal Kircher, William Gradishar, Al Benson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Care delivery innovation is necessary to address the growing complexity of cancer care across specialties and integrate new diagnostics, treatments, and services into care delivery. Informed by Cancer Care Delivery Research (CCDR), multilevel intervention research, and other disciplines, this article describes the 4-step cancer care delivery innovation cycle. The cycle guides collaborative efforts of cancer clinicians, researchers, patients, and other stakeholders to systematically define care delivery problems and formulate, test, and implement care innovations to effectively address problems. We illustrate the 4 steps of the innovation cycle with the example of developing the 4R Oncology Model for colorectal cancer (4R is Right Information and Right Care for the Right Patient at the Right Time). The 4R is a multilevel intervention informed by CCDR, the team science, and lessons learned from other models, such as survivorship care planning. We offer additional considerations for balancing the need to innovate with concerns about constrained resources and overextended workforce. We suggest to focus on care delivery models which are synergistic with other efforts and do not require extensive information systems support in earlier cycles of development.

Original languageEnglish (US)
Article number11
JournalCurrent treatment options in oncology
Issue number2
StatePublished - Feb 1 2019


  • 4R Oncology Model
  • Cancer care delivery
  • Care delivery innovation
  • Care delivery models
  • Care delivery redesign
  • Project management in care delivery
  • Systems engineering in cancer care delivery

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)


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