{'fraction_non_alphanumeric': 0.027442371020856202, 'fraction_numerical': 0.0, 'mean_word_length': 6.125, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Organization- and System-Level Factors Influencing Implementation Overview of Case Studies

Organization- and health system-level determinants of cancer outcomes are critical to understand. Studies focusing only on individual- or provider-level factors contributing to differential outcomes may mask the important, and often far-reaching, influence of organizational and system-wide structures, policies, norms, and behaviors that drive outcomes. This chapter explores case studies including implementation of patient reported outcomes symptom monitoring within a large academic medical center; cancer patient navigation programs to reduce social, economic, cultural, and system barriers to timely cancer care; how psychosocial support has been integrated into community-based and Veterans Administration (VA) oncology programs; and implementing Lynch syndrome testing within a VA integrated health care system.