The authors identified missed opportunities for improving patient outcomes and, with the help of professionals whose views they solicited, offered ideas to get back on track.
Experts at the National Pharmaceutical Council (NPC), Discern Health, the Duke-Margolis Center for Health Policy and the American Society of Clinical Oncology (ASCO) conducted the study, “Improving Oncology Quality Measurement in Accountable Care: Filling Gaps in Cross-Cutting Measures.” It was published in the Journal of Managed Care & Specialty Pharmacy.
Quality measures are used to identify treatment-improvement opportunities, track effectiveness of improvements over time, and reward those who maintain high-quality standards.
To evaluate gaps between oncology guidelines and practice, the authors analyzed the effectiveness of tools used to measure cancer-treatment quality. In addition to non-Hodgkin lymphoma, the cancers in the study included chronic myelogenous leukemia and non-small cell lung cancer.
Cancers were selected based on their prevalence, cost and disparities in care.
“We focused on cancer because of the complexity of the treatment landscape. Diagnostics and treatments are increasingly targeted to genotypes. Patient needs and preferences are incredibly varied,” Kimberly Westrich, one of the study authors, said in a press release.
The team compared quality guidelines developed by oncology experts to treatment practices. Then they convened a roundtable session to discuss what they found with doctors and other professionals connected with treatment. At the meeting they offered recommendations to overcome the gaps they had identified, and asked for a response from the roundtable participants.
The participants’ primary recommendation was shifting the measurement emphasis from disease-specific processes of care to cross-cutting measures. Cross-cutting measures cover multiple treatment settings and medical professionals.
The participants said cross-cutting measures should include patient-reported outcomes (PROs), treatment outcomes, safety, disease evaluation and management, and structural measures.
“The oncology community’s understanding of cancer has become vastly more sophisticated and complex in recent years. Treatment options, fortunately, continue to increase at a rapid pace and current measures simply aren’t adequate to reliably improve patient outcomes and increase value,” said Mark McClellan, MD, PhD, a co-author of the study. “This study provides clear direction on how to overcome barriers to better measures and ensure that value-based payment incentives work the way they’re intended.”
This study is a follow-up to the Mind the Gap research series, which explored ways to close healthcare quality measurement gaps.