Development of an oncology quality metric evaluation and prioritization tool (QMEPT).

260 Background: For reporting purposes and to enable ongoing quality improvement, it is essential that metrics reflective of quality oncology care delivery are tracked and reviewed on an ongoing basis. Collection of performance data and incorporation into a usable dashboard can require significant IT resources, both in personnel time and direct costs. The Tisch Cancer Institute (TCI) identified a myriad of cancer quality metrics that required prioritization in order to best allocate limited IT resources and a standardized process to facilitate comparison across different disease groups.

METHODS: Quality metrics were identified from various sources: CMS, PQRS, Commission on Cancer, QOPI, AHRQ and others recommended by TCI disease management teams (DMTs). All measures were evaluated with QMEPT according to the following domains: 1) Regulatory (CMS or other certifications), 2) Cost & Feasibility (resource intensiveness of the collection process), 3) Patient Outcomes - (existence of standard benchmarks or known underperformance) and 4) Financial - (influence on payor contracting). All metrics were scored to generate a composite score for each metric and then weighted with 40% for Regulatory, 20% for Cost & Feasibility, 40% for Patient Outcomes. Financial was not weighted but given a yes/no designation.

RESULTS: Metrics across all disease sites were scored, weighted and compared. Composite scores ranged from 1.56 to 2.67 (range 1 - 3). Weighted scores ranged from 1.4 to 2.8. In general, metrics related to breast, prostate, colorectal and lung cancers scored higher because of the required reporting and existence of evidence-based standardized benchmarks. Metrics proposed by the DMTs were frequently found to have high resource requirements for data collection. Following the scoring process, information was disseminated to the DMTs, leading to alteration of many of the quality metric requests. Metrics with the highest priority scores were submitted to the IT group for incorporation into the quality dashboard.

CONCLUSIONS: The QMEPT allowed comparison of quality metrics across disparate oncology disease groups, prioritization for incorporation into a quality dashboard and rational allocation of limited IT resources.