Enhancing Data Systems to Improve the Quality of Cancer Care (2000) / Chapter Skim
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How are Healthcare Systems Monitoring Quality Today?
How are Healthcare Systems Monitoring Quality Today?
Pages 18-36
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From page 18... ...
Other quality monitoring activities are externally driven and have an accountability function the government may want to ensure that publicly funded healthcare programs are adhering to best practices, or professional societies may want to demonstrate to the public that their care meets or exceeds accepted standards of care. This chapter first illustrates with a series of case studies the diversity of approaches to cancer care quality monitoring taken by selected individual providers, hospitals, health plans, provider groups, physician practice management companies, insurers, and purchasers.
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From page 19... ...
Monitor a&erence to Medical chart guidelines regarding screening, treatment, follow-up, supportive, and end-of-life care Monitor a&erence to Electronic medical chart guidelines regarding treatment, follow-up, and end-of-life care Monitor patterns of care and Medical chart abstraction a&erence to treatment guidelines from a national sample of radiation oncology providers Monitor a&erence to breast Hospital cancer registry, cancer treatment guide- administrative data, lines medical charts, patient surveys Monitor a&erence to breast Hospital cancer registry, cancer treatment guide- administrative data, lines medical charts, pahent surveys Monitor a&erence to breast Medical charts; reporting cancer treatment guide- according to a unilines form data set Monitor a&erence to breast Insurance claims, medicancer treatment guide- cat charts lines Monitor use of adjuvant therapies for breast and colorectal cancer Monitor quality of care for individuals with selected conditions including cancer 10. National Cancer Data Monitor quality of care for Base (database maintained individuals with cancer by the American College of Surgeons and the American Cancer Society)
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From page 20... ...
Such support systems for clinical decision making can significantly improve the quality of patient care (Classen, 1998; Hunt et al., 1998~. Other physician practice management companies and disease management companies are developing electronic medical record systems, and most have a central shared database of clinical, patient, financial, and administrative information.
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From page 22... ...
Case Study 3 provides another example of the centralization of quality improvement activities for a particular group of providers. The American College
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From page 24... ...
Cancer care is multidisciplinary and, within larger systems of care, quality improvement programs need to address the range of services needed by individuals with cancer. Case Study 4 illustrates how such cross-cutting quality measures can be applied within a large integrated system of hospitals and medical groups.
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From page 25... ...
Case Study 5 illustrates how Providence Health System, a large integrated delivery system, has adopted measures originally developed by the Foundation
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From page 26... ...
Cases are first identified through insurance claims; then medical records are abstracted to obtain information on stage of illness. Analyses of the supplemented claims data provide information on the quality of breast cancer care.
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From page 27... ...
Case Study 8 comes close to achieving this by providing information on some aspects of the quality of breast and colon cancer care for the elderly residents of Colorado. This case study illustrates the potential for collaborative efforts involving cancer registries, universities, and Peer Review Organizations (PROs)
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From page 29... ...
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From page 30... ...
included n ty-based hospitals, but a few freestanding cancer programs are also (Table 3.4) (Morrow, 1999)
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From page 34... ...
Some programs depend entirely on retrospective reviews of medical charts or hospital cancer registries while others rely on-multiple sources, for example, administrative claims data linked to cancer regis~yidata. The case studies are, in fact, a testament to creativity—data intended for other purposes have in several instances been manipulated to monitor quality care, and sometimes appear to have been used within programs to effect improvements in care.
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From page 35... ...
1,479 631 465 314 23 46 100 3 31 21 2 3 SOURCE: Morrow, 1999. guidelines through NCCN seems to have spurred quality monitoring activities beyond the cancer centers that developed them (e.g., the Roswell Park Cancer Institute initiative)
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From page 36... ...
. If an available set of core cancer care measures were available, it would likely be adopted.
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