1 University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL.
2 University of Alabama at Birmingham, Birmingham, AL.
J Oncol Pract. 2019 Mar;15(3):e271-e276. doi: 10.1200/JOP.18.00390. Epub 2019 Jan 31.
The Center for Medicare & Medicaid Innovation Oncology Care Model (OCM) requires documentation of a 13-point Institute of Medicine care management plan for Medicare patients. In addition, OCM includes evaluation of quality using key performance measures that align with the ASCO Quality Oncology Practice Initiative (QOPI). Both efforts are designed to improve patient-centered care and foster patients' engagement in their care plan.
A multicenter quality improvement project was conducted to develop a strategy to meet the OCM treatment planning (TP) requirement (Plan), pilot clinician education coupled with use of electronic TP in early-stage breast cancer (Do), evaluate the impact of TP on QOPI measures (Study), and develop recommendations for future implementation (Act).
Thirty-three clinical providers and 171 women with breast cancer were included. Improved performance on several QOPI measures was observed for the intervention group compared with the historical control group.
Meeting the OCM TP requirement through incorporating a technology solution provided an opportunity for quality improvement and preparation for full-scale TP within the OCM. TP delivery was associated with improved performance on select ASCO QOPI measures, which is likely to correspond with improved performance on quality measures within OCM.
医疗保险和医疗补助创新中心肿瘤护理模式(OCM)要求对 Medicare 患者的 13 点医学研究所护理管理计划进行记录。此外,OCM 还包括使用与 ASCO 肿瘤质量实践倡议(QOPI)一致的关键绩效指标来评估质量。这两项工作旨在改善以患者为中心的护理,并促进患者参与他们的护理计划。
进行了一项多中心质量改进项目,以制定一项策略来满足 OCM 治疗计划(TP)要求(计划),试点临床医生教育并在早期乳腺癌中使用电子 TP(执行),评估 TP 对 QOPI 措施的影响(研究),并为未来的实施提出建议(行动)。
纳入了 33 名临床提供者和 171 名乳腺癌患者。与历史对照组相比,干预组在几项 QOPI 措施上的表现有所提高。
通过纳入技术解决方案来满足 OCM 的 TP 要求,为质量改进和在 OCM 内全面实施 TP 提供了机会。TP 交付与某些 ASCO QOPI 措施的表现改善相关,这可能与 OCM 内质量措施的表现改善相对应。