Key lessons learnt at the National Comprehensive Cancer Network's policy meeting: Redefining Quality Measurement in Oncology.
The National Comprehensive Cancer Network (NCCN) chose a very appropriate topic for this year’s meeting: Redefining Quality Measurement in Oncology. While "measure, measure, measure" has been the mantra in healthcare, defining what, when, and how to measure remains a challenge. However, with value-based care and alternative payment models experimenting with identifying appropriate quality measures, defining the right metric has become more urgent than ever.
Here are a few takeaways from the NCCN summit, which was held September 25, 2017, in Washington, DC.
1. A voice for the patient
Ronald Walters, MD, MBA, MHA, MS, associate vice president of medical operations and informatics, The University of Texas MD Anderson Cancer Center, said that the value-based care movement has finally moved away from being provider-centric to being patient-centric. While provider-centric measures of care are important, patient-centric measures of value, including patient experience (eg, satisfaction), engagement, and outcomes, are vital, he said.
2. Quality for whom?
During her presentation at the meeting, Mary Lou Smith, JD, MBA, cofounder, Research Advocacy Network, asked who was at the receiving end of the quality measures: the care provider, the patients, or the healthcare system? “Patients know when they have answers to their questions, but patients don’t know what questions to ask,” Smith said. This then pushes the onus on the stakeholders responsible for patient care to identify the right measures that can ensure good health outcomes.
3. Challenges with identifying the right measures
On a panel that saw representation of patient advocates, oncologists, health policy researchers, health plans, and the pharmaceutical industry, the discussion revolved around ways to gather the right evidence for quality measurement to improve outcomes. “We don’t just have to measure everything, but we do need to understand the accuracy of what we are measuring. We definitely need a quality measure to understand patients’ comprehension of their treatment and disease,” said John Fox, MD, MS, medical director, Priority Health.
Panelists agreed, however, that accountability for quality care rests on all stakeholders.
4. Best practices in quality measurement
Kerin Adelson, MD, medical oncologist, Yale Cancer Center/Smilow Cancer Hospital, presented her research on how their health system grappled with teasing out the right structured and unstructured data in collaboration with Flatiron Health. She pointed out that while provider attribution is hard, particularly when mapping out care delivered to a patient in the oncology space, they have been using information extracted via Flatiron’s technology platform.
“Provider level view will lead to change,” Adelson said, adding that their research team plans to develop national benchmarks for quality using Flatiron’s database.
5. Looking to the future
Adelson then sat on a panel with Basit Chaudhry, MD, PhD, Tuple Health; Joanne Buzaglo, PhD, Cancer Support Community; Virginia Calega, MD, MBA, Independence Blue Cross; Peter Ellis, MD, University of Pittsburgh Cancer Institute; and Marcus Neubauer, MD, McKesson Specialty Health. The experts discussed how providers in the community and health systems are working in tandem with health plans and technology companies to navigate the maze of value-based care.
Panelists agreed that healthcare providers cannot shy away from changes within our care delivery system and that they need to keep up with the dynamic nature of payment reform.