Oluwadamilola M Fayanju1, Tinisha L Mayo2, Tracy E Spinks2, Seohyun Lee3, Carlos H Barcenas4, Benjamin D Smith5,6, Sharon H Giordano4,6, Rosa F Hwang1, Richard A Ehlers1, Jesse C Selber7, Ronald Walters4,8, Debu Tripathy4, Kelly K Hunt1, Thomas A Buchholz5,8, Thomas W Feeley3,9, Henry M Kuerer10,11. 1. Department of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 2. Office of the Senior Vice President (SVP), Hospital and Clinics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 3. The Institute for Cancer Care Innovation (ICCI), The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 6. Department of Health Services Research, Division of the Office of the Vice President (OVP), Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 7. Department of Plastic Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 8. Office of the Executive Vice President (EVP) and Physician-in-Chief, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 9. The Institute for Strategy and Competitiveness, Harvard Business School, Boston, MA, USA. 10. Department of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. hkuerer@mdanderson.org. 11. Office of the Senior Vice President (SVP), Hospital and Clinics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. hkuerer@mdanderson.org.
Abstract
PURPOSE: Value in healthcare-i.e., patient-centered outcomes achieved per healthcare dollar spent-can define quality and unify performance improvement goals with health outcomes of importance to patients across the entire cycle of care. We describe the process through which value-based measures for breast cancer patients and dynamic capture of these metrics via our new electronic health record (EHR) were developed at our institution. METHODS: Contemporary breast cancer literature on treatment options, expected outcomes, and potential complications was extensively reviewed. Patient perspective was obtained via focus groups. Multidisciplinary physician teams met to inform a 3-phase process of (1) concept development, (2) measure specification, and (3) implementation via EHR integration. RESULTS: Outcomes were divided into 3 tiers that reflect the entire cycle of care: (1) health status achieved, (2) process of recovery, and (3) sustainability of health. Within these tiers, 22 patient-centered outcomes were defined with inclusion/exclusion criteria and specifications for reporting. Patient data sources will include the Epic Systems EHR and validated patient-reported outcome questionnaires administered via our institution's patient portal. CONCLUSIONS: As healthcare costs continue to rise in the United States and around the world, a value-based approach with explicit, transparently reported patient outcomes will not only create opportunities for performance improvement but will also enable benchmarking across providers, healthcare systems, and even countries. Similar value-based breast cancer care frameworks are also being pursued internationally.
PURPOSE: Value in healthcare-i.e., patient-centered outcomes achieved per healthcare dollar spent-can define quality and unify performance improvement goals with health outcomes of importance to patients across the entire cycle of care. We describe the process through which value-based measures for breast cancerpatients and dynamic capture of these metrics via our new electronic health record (EHR) were developed at our institution. METHODS: Contemporary breast cancer literature on treatment options, expected outcomes, and potential complications was extensively reviewed. Patient perspective was obtained via focus groups. Multidisciplinary physician teams met to inform a 3-phase process of (1) concept development, (2) measure specification, and (3) implementation via EHR integration. RESULTS: Outcomes were divided into 3 tiers that reflect the entire cycle of care: (1) health status achieved, (2) process of recovery, and (3) sustainability of health. Within these tiers, 22 patient-centered outcomes were defined with inclusion/exclusion criteria and specifications for reporting. Patient data sources will include the Epic Systems EHR and validated patient-reported outcome questionnaires administered via our institution's patient portal. CONCLUSIONS: As healthcare costs continue to rise in the United States and around the world, a value-based approach with explicit, transparently reported patient outcomes will not only create opportunities for performance improvement but will also enable benchmarking across providers, healthcare systems, and even countries. Similar value-based breast cancer care frameworks are also being pursued internationally.
Authors: Arvind Oemrawsingh; Nikki van Leeuwen; Esmee Venema; Martien Limburg; Frank-Erik de Leeuw; Markus P Wijffels; Aafke J de Groot; Pieter H E Hilkens; Jan A Hazelzet; Diederik W J Dippel; Carla H Bakker; Helene R Voogdt-Pruis; Hester F Lingsma Journal: BMC Med Res Methodol Date: 2019-12-05 Impact factor: 4.615
Authors: Jeffrey Landercasper; Lisa Bailey; Tiffany S Berry; Robert R Buras; Amy C Degnim; Oluwadamilola M Fayanju; Joshua Froman; Jennifer Gass; Caprice Greenberg; Starr Koslow Mautner; Helen Krontiras; Roshni Rao; Michelle Sowden; Judy A Tjoe; Barbara Wexelman; Lee Wilke; Steven L Chen Journal: Ann Surg Oncol Date: 2016-06-22 Impact factor: 5.344
Authors: Jeffrey Landercasper; Lisa Bailey; Robert Buras; Ed Clifford; Amy C Degnim; Leila Thanasoulis; Oluwadamilola M Fayanju; Judy A Tjoe; Roshni Rao Journal: Ann Surg Oncol Date: 2017-08-01 Impact factor: 5.344