Real-Time Performance Tracking Improves Patient Care at 64 Cancer Centers
San Diego, CA—A real-time performance tracking system that monitors adherence to quality care metrics significantly improved adherence to quality standards over a 4-year period for 64 cancer centers participating in the Rapid Quality Reporting System (RQRS) “beta test,” according to researchers who are pioneering the program.
Real-time performance tracking uses the same standard reporting procedures that hospitals already use to submit patient data to cancer registries. But unlike other quality tracking systems that conduct performance assessments retrospectively, the RQRS provides feedback in real clinical time, while the patient is still under active treatment. When the system identifies gaps in care, the RQRS proactively alerts healthcare providers with a color-coded information system so that they can take corrective action, explained Erica McNamara, MPH, of the Commission on Cancer (CoC) at the American College of Surgeons, which conducted the research that was presented at ASCO’s inaugural 2012 Quality Care Symposium.
She said that the program “improves the completeness of reported adjuvant therapy data. By tracking through the entire course of treatment, the hospital can be confident that it has an accurate reflection of the quality of its care compared with traditional registry data.”
“The benefit to patients who go to hospitals that are participating in the RQRS is that their providers are utilizing an additional resource outside of the traditional patient-physician relationship to enhance the coordination of patient care,” Ms McNamara added.
The RQRS was initiated in 2006 with 6 alpha test hospitals. The beta test of the system began in 2009 with 64 participating cancer centers. In 2011, the system was released on a voluntary basis to all hospitals accredited by the CoC, and approximately 350 programs are currently using the system, she said.
Performance rates were based on the adherence to specific quality care measures for 67,448 patients, including 24,520 in the National Cancer Data Base who were diagnosed in 2006 and 2007, and 42,928 in the RQRS program who were diagnosed between 2008 and 2011, and were stratified by patient demographics.
Between 2006 and 2010, the greatest changes were reported in the receipt of hormone therapy for breast cancer, which increased from 47% in 2006 to 85% in 2010; adjuvant therapy for colon cancer increased from 68% to 86% during this period; and the assessment of 12 regional lymph nodes increased from 70% to 90%, Ms McNamara reported.
Performance rates differed by patient age, race, and payer (private insurance vs Medicare), but these relative disparities were smaller among patients seen in the participating RQRS programs 2 years after implementation compared with baseline data.
Ms McNamara said that the feedback has been positive. One RQRS participant commented, “We have prevented at least 2 patients from slipping through the cracks. The oncology providers now ask for the reports to be given to them monthly so that they can review the yellow and orange alert cases and prevent any red alerts.”
Ms McNamara said that “The RQRS promotes the coordination of quality patient care and better documentation for programs to demonstrate the quality of care they are providing.” She and her team are developing additional clinical process measures to expand the use of RQRS to patients with lung, stomach, and esophageal cancers.