Results of a multistate, multi-institution implementation of a multidisciplinary cancer conference quality measurement tool.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 212-212
Author(s):  
Lijo Simpson ◽  
Anju Mathew ◽  
Robert Wojciechowski ◽  
Irina Hill
Keyword(s):  
Clinical Trials ◽  
Cancer Care ◽  
Quality Measurement ◽  
The United States ◽  
Quality Metrics ◽  
Lower Percentage ◽  
High Quality ◽  
Quality Cancer Care ◽  
Psychosocial Counselling ◽  
Virtual Platform

212 Background: The 2006 ASCO and the ESMO consensus statement on quality cancer care defined the delivery of multimodality treatment by a multidisciplinary team of appropriately skilled health professionals as an essential component of quality cancer care. Furthermore, MDCs have demonstrated improved survival in breast, head and neck, ovarian and colorectal cancers. Despite these advantages, health care systems struggle to implement and sustain MDCs due to the heavy burden imposed by the required work processes. We report on the large-scale utilization of a propriety quality measurement platform OncoLens to run MDCs across the country. Methods: Technology quality metrics were collected from the ongoing daily usage of the platform including cancer characteristics, care team utilization metrics, average attendance, quality metrics collected for accreditation and clinical trials matching on the OncoLens platform. Results: The virtual platform was accessible to around 8000 providers across the United States. In 2020, 13771 cases were discussed. Attendance of the required specialties for high quality care of Medical Oncology, Radiation Oncology, Surgery, Pathology and Radiology was attained, with the average conference attendance being 14. Race/ethnicity data on the cases revealed White (9197, 67%), Black (1817,13%), Hispanic (363,3%) and Other (2356,17%). Optional quality metrics were collected during discussions for CoC, NAPBC and NAPRC accreditation. These included NCCN guidelines discussed, Staging discussed, clinical trials discussed, Genetics discussion, palliative care discussion, rehabilitation services, reproductive counselling discussed, psychosocial counselling discussed, nutritional counselling discussed, reconstructive surgery discussion, tobacco cessation discussion across General and Site-specific conferences. Most of the case presentations were prospective. This format does enable cancer programs to collect quality metrics around Cancer program accreditation by the American College of Surgeons. 66% of patients discussed potentially matched to clinical trials during the discussion. Conclusions: A technology platform can assist cancer programs to collect quality metrics around cancer care. This gives them the ability to run data driven quality programs targeting specific quality metrics. Hispanics have a lower percentage of cases presented at MDC compared to other race/ethnicities. It is possible to have high quality discussions and attain metrics for Commission on Cancer accreditation utilizing a virtual platform.

scholarly journals Delivering High-Quality and Affordable Care Throughout the Cancer Care Continuum

2013 ◽  
Vol 31 (32) ◽  
pp. 4151-4157 ◽  
Author(s):  
Ya-Chen Tina Shih ◽  
Patricia A. Ganz ◽  
Denise Aberle ◽  
Amy Abernethy ◽  
Justin Bekelman ◽  
...  
Keyword(s):  
Cancer Care ◽  
Primary Care Physicians ◽  
New Technologies ◽  
Financial Burden ◽  
The United States ◽  
Institute Of Medicine ◽  
High Quality ◽  
Care Continuum ◽  
Quality Cancer Care ◽  
Cancer Care Continuum

The national cost of cancer care is projected to reach $173 billion by 2020, increasing from $125 billion in 2010. This steep upward cost trajectory has placed enormous an financial burden on patients, their families, and society as a whole and raised major concern about the ability of the health care system to provide and sustain high-quality cancer care. To better understand the cost drivers of cancer care and explore approaches that will mitigate the problem, the National Cancer Policy Forum of the Institute of Medicine held a workshop entitled “Delivering Affordable Cancer Care in the 21st Century” in October 2012. Workshop participants included bioethicists, health economists, primary care physicians, and medical, surgical, and radiation oncologists, from both academic and community settings. All speakers expressed a sense of urgency about the affordability of cancer care resulting from the future demographic trend as well as the high cost of emerging cancer therapies and rapid diffusion of new technologies in the absence to evidence indicating improved outcomes for patients. This article is our summary of presentations at the workshop that highlighted the overuse and underuse of screening, treatments, and technologies throughout the cancer care continuum in oncology practice in the United States.

Characteristics of the Multi Disciplinary Cancer Conference (Tumor Boards) in the COVID 19 era.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13561-e13561
Author(s):  
Lijo Simpson ◽  
Anju Mathew ◽  
Robert Wojciechowski
Keyword(s):  
Clinical Trials ◽  
Web Application ◽  
Large Scale ◽  
The United States ◽  
Quality Metrics ◽  
Care Team ◽  
Tumor Board ◽  
Case Conference ◽  
Tumor Boards ◽  
Virtual Platform

e13561 Background: Cancer centers in the US are required to discuss a minimum of 15% analytic cases and prospective presentation (minimum 80%) in the multidisciplinary case conference (tumor board, MDCC), per the Commission on Cancer accrediting standards. Tumor board discussion have been shown to improve treatment decision making and patient outcomes. These meetings were in person meetings in the Pre-COVID era. The COVID 19 pandemic and the subsequent requirements for social distancing forced hospitals to move most MDCCs to a virtual format. We report on the large scale utilization of a propriety Care-Coordination platform OncoLens to run MDCCs across the country. Methods: Technology quality metrics were collected from the ongoing daily usage of the platform including time characteristics, care team utilization metrics, average attendance, quality metrics collected for accreditation and clinical trials matching on the OncoLens platform. Results: The virtual platform was accessible to around 8000 providers across the United States. On average per month there were 250 virtual meetings with over 290,000 meeting minutes. Conferences ranged from 30 minutes to 4 hours. 75% of users used the web application 25% of users utilized their smart phones .System uptime was 99.99%. Hospitals were able to conduct General and Site specific conferences. Virtual attendance of the required specialties of Medical Oncology, Radiation Oncology, Surgery, Pathology and Radiology was attained, with the average conference attendance being 14. On average hospitals required 2 administrative training sessions. Most of the case presentations were prospective. This format does enable cancer programs to collect quality metrics around Cancer program accreditation by the American College of Surgeons. A wide variety of common and rare cancer types were discussed in the virtual format. 66% of patients discussed potentially matched to clinical trials during the discussion. Conclusions: The shift of MDCCs to a mostly virtual environment occurred quickly in response to the COVID 19 pandemic. It took an average of 2 training classes to get the cancer care team on board with the use of new technology. It is possible to have high quality discussions and attain metrics for Commission On Cancer accreditation utilizing a virtual platform.

Successful Strategies to Address Disparities: Insurer and Employer Perspectives

2020 ◽  
pp. 292-300
Author(s):  
Manali I. Patel ◽  
Richard Snyder ◽  
Otis Brawley
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Cancer Disparities ◽  
Care Providers ◽  
High Quality ◽  
Quality Cancer Care

Disparities in cancer have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Disparate cancer outcomes continue to affect many populations in the United States and globally, including racial and ethnic minorities, populations with low income and education, and residents of rural areas or low socioeconomic neighborhoods, among others. Addressing cancer disparities requires approaches that are multilevel. Addressing social determinants of health, such as removing obstacles to health (e.g., poverty, discrimination, access to housing and education, jobs with fair pay, and health care) can reduce cancer disparities. However, to achieve cancer health equity, multilevel approaches are required to ensure that access to high-quality cancer care and equitable receipt of evidence-based services can reduce cancer disparities. Policy, health system interventions, and innovative delivery and health care coverage approaches by private and public payers, employer-based payers, and labor union organizations can assist in ensuring access to and receipt of high-quality cancer care while addressing the high costs of care delivery. Partnerships among patients, caregivers, employers, health care providers, and health care payers can make impactful changes in the way in which cancer care is delivered and, in turn, can assist in reducing cancer disparities.

Challenges and Opportunities in Delivering High-Quality Cancer Care: A 2016 Update

2016 ◽  
pp. e294-e300
Author(s):  
Patricia A. Ganz ◽  
Michael J. Hassett ◽  
David C. Miller
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
Quality Measurement ◽  
Quality Measures ◽  
The United States ◽  
Institute Of Medicine ◽  
Patients With Cancer ◽  
Quality Cancer Care ◽  
Challenges And Opportunities ◽  
Quality Improvement Collaboratives

Herein, both the rationale and scope of current initiatives aimed at improving the quality of cancer care delivery in the United States are described. First, we discuss a recent report from the Institute of Medicine that issued a strong call for both the development of quality measures in oncology and implementation of a learning health care system in which data and experience from clinical practice can inform continuous improvements in cancer care. Second, we review the multiple, diverse initiatives that are underway to identify, test, and validate quality measures for the entire spectrum of cancer care. Finally, we discuss regional quality improvement collaboratives as one successful approach to creating a cycle of quality measurement, identification of best practices, and implementation of changes in practice patterns that ultimately yield improved care and outcomes for patients with cancer.

scholarly journals Delivering high-quality cancer care: The critical role of quality measurement

Healthcare ◽  
2014 ◽  
Vol 2 (1) ◽  
pp. 53-62 ◽  
Author(s):  
Tracy E. Spinks ◽  
Patricia A. Ganz ◽  
George W. Sledge ◽  
Laura Levit ◽  
James A. Hayman ◽  
...  
Keyword(s):  
Cancer Care ◽  
Critical Role ◽  
Quality Measurement ◽  
High Quality ◽  
Quality Cancer Care

Rural comprehensive cancer care: A qualitative analysis of current challenges and limitations.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18538-e18538
Author(s):  
Jacklyn M Engelbart ◽  
Sydney Evans ◽  
Xiang Gao ◽  
Mary Chen Schroeder ◽  
Jennifer Hrabe ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cancer Care ◽  
System Level ◽  
Limited Resources ◽  
Care Providers ◽  
High Quality ◽  
Cancer Centers ◽  
Quality Cancer Care ◽  
National Organizations ◽  
Rural Patients

e18538 Background: Providing comprehensive and coordinated cancer care in rural settings can be difficult due to limited resources. Meeting cancer care standards established by the American Society of Clinical Oncology Quality Oncology Practice Initiative or the American College of Surgeons Commission on Cancer is also challenging due to limited resources; the vast majority of certified or accredited practices/hospitals are in metropolitan areas. It is critical to describe barriers faced by rural providers so models can be developed to facilitate high quality cancer care. Qualitative interviews were conducted to elicit current challenges and barriers among rural Iowa cancer care providers, with the goal of identifying strategies that could facilitate high quality cancer care in rural areas. Methods: Eleven cancer providers associated with 10 (out of 12) Iowa hospitals that diagnose or treat > 100 cancer patients annually and are in non-metropolitan/rural counties (Rural-Urban Continuum Code: 4-9) were interviewed via telephone or video conference. Questions focused on services offered, perceived patient- and system-level barriers to cancer care, perceived strengths and challenges in providing and assessing quality cancer care, challenges to meeting standards of cancer care set forth by national organizations, and referral experiences. Results: The major identified strength of rural hospitals was their geographic proximity to rural patients. Most hospitals provided outpatient chemotherapy, and a minority provide radiation oncology services. Common reasons for referral outside rural hospital networks were lack of specialized diagnostic procedures and complex surgical resections more commonly available at tertiary institutions. Other reasons for referrals include 1) lack of advanced technologies and treatments; 2) lack of certification secondary to inadequate staffing to support data infrastructure for quality improvement or to meet accreditation standards of national organizations; and 3) lack of ancillary patient services such as navigation, survivorship programs, genetic counseling, and education. A final important cause of referral is limited access to clinical trials, an impediment to rural patient participation in investigational treatments. Identified benefits of strengthening collaborations with larger urban/academic cancer centers were access to educational opportunities, tumor boards, shared resources and strategies for data management, clinical trials, patient navigation services and survivorship programs. Conclusions: Rural cancer care providers identified a number of challenges that could be addressed through resource sharing from larger cancer centers. Further research is needed to develop models and approaches that extend resources, services and expertise to rural providers to facilitate high-quality cancer care for all rural patients.

scholarly journals Evaluating Barriers and Opportunities in Delivering High-Quality Oncology Care in a Resource-Limited Setting Using a Comprehensive Needs Assessment Tool

2018 ◽  
pp. 1-9
Author(s):  
Chika R. Nwachukwu ◽  
Omobola Mudasiru ◽  
Lynn Million ◽  
Shruti Sheth ◽  
Hope Qamoos ◽  
...  
Keyword(s):  
Palliative Care ◽  
Needs Assessment ◽  
Cancer Care ◽  
Assessment Tool ◽  
Hospital Staff ◽  
Teaching Hospitals ◽  
High Quality ◽  
Middle Income ◽  
Quality Cancer Care ◽  
Oncology Care

Purpose Despite recognition of both the growing cancer burden in low- and middle-income countries and the disproportionately high mortality rates in these settings, delivery of high-quality cancer care remains a challenge. The disparities in cancer care outcomes for many geographic regions result from barriers that are likely complex and understudied. This study describes the development and use of a streamlined needs assessment questionnaire (NAQ) to understand the barriers to providing quality cancer care, identifies areas for improvement, and formulates recommendations for implementation. Methods Using a comprehensive NAQ, in-depth interviews were conducted with 17 hospital staff involved in cancer care at two teaching hospitals in Nigeria. Data were analyzed using content analysis and organized into a framework with preset codes and emergent codes, where applicable. Results Data from the interviews were organized into six broad themes: staff, stuff, system, space, lack of palliative care, and provider bias, with key barriers within themes including: financial, infrastructural, lack of awareness, limited human capacity resources, lack of palliative care, and provider perspective on patient-related barriers to cancer care. Specific solutions based on ability to reasonably implement were subcategorized into short-, medium-, and long-term goals. Conclusion This study provides a framework for a streamlined initial needs assessment and a unique discussion on the barriers to high-quality oncology care that are prevalent in resource-constrained settings. We report the feasibility of collecting and organizing data using a streamlined NAQ and provide a thorough and in-depth understanding of the challenges in this setting. Knowledge gained from the assessments will inform steps to improve oncology cancer in these settings.

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