Top challenges in measuring cancer care quality

The rates at which cancer patients receive recommended care vary between cancer centers, contributing to avoidable disparities in patient outcomes. Cancer care quality metrics are under ongoing development and refinement to better measure and compare the quality of care at different cancer centers, and to identify and correct problems in a timely manner.

However, determining what to measure, and how best to measure it, can be surprisingly complex-and appropriate metrics can vary between cancer types and patient populations. 

During the American Society of Clinical Oncology (ASCO) 2016 Annual Meeting in Chicago, attendees heard more about metrics for assessing quality of cancer care during the June 5 session, “Defining and Measuring Quality.”

HassettSession presenter Michael Hassett, MD, MPH, a physician at Dana-Farber Cancer Institute and assistant professor, Medicine, Harvard Medical School, recently spoke with Managed Healthcare Executive (MHE) about the top challenges associated with developing appropriate quality metrics.   

MHE: You have been closely involved in cancer care quality and the promulgation of cancer care-quality metrics. What are the most important challenges in measuring quality of cancer care today?

Hassett: I think that the first challenge I would highlight is deciding what exactly we want to measure. There is a lot of stuff that we can measure, and the resources we have to measure those things are unlimited. Trying to figure out where our focus should be is tricky. There are a lot of efforts underway to come up with measures, put together by professional societies like ASTRO [the American Society for Radiation Oncology] and ASCO and efforts to correlate measures by organizations like AHRQ [the U.S. Agency for Healthcare Research and Quality]. But we’re still facing some difficult choices about what we want to measure.

The second challenge is to really understand why we’re measuring something-what is the purpose of that measurement. That seems simple but I think there are different reasons why we want to measure quality.

Let me give you an example: a hospital may be very interested in doing a quality-improvement program. And that quality-improvement program is designed to get from one level of quality performance to another level. Then the healthcare system as a whole may be interested in reducing disparities in healthcare-trying to reduce the likelihood that a particular sociodemographic group is less likely to receive a recommended treatment than other groups.

The way that you measure, and the priorities that you set, really influence the choices that are made at those organizations. I think we want to be clear about how and why we’re using particular measures.

The third one is the technical challenge of making sure we have the data that we need to really assess quality of care.

So it comes down to choosing what to measure, figuring out why we are measuring it, and then getting the data we need to measure.

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