One of the key themes weaving through many of the discussions of health reform broadly, and accountable care more specifically, is this idea of value - that cancer providers will soon be required to demonstrate that the provide high quality care at a low cost. This is a particular concern for academic providers and some of the comprehensive cancer centers as their costs are often higher than their community counter parts. Thus, a one of their key priorities is ensuring they can demonstrate this extra cost is worth it as they achieve superior outcomes. Fox Chase has taken an important first step in this direction, announcing that they will be publishing cinical outcomes for patient use on their website. The key outcome they are featuring is five year survival.
The main website for this information is www.foxchase.org/outcomes. Notably, they are focusing not on the more complex cancers, such as pancreatic and esophogeal - those more commonly associated with comprehensive cancer centers - but rather the most common sites - breast, colorectal, prostate and lung. The site compares Fox Chase's performance on five year survival, to community hospital comprehensive cancer programs and community hospital cancer programs (as defined by the Commission on Cancer). For an example of what these charts look like, see here.
Fox Chase Seeks to Demonstrate Value By Publishing Clinical Outcomes for Patient Use
A member recently emailed requesting guidance on how to conduct peer review for their radiation oncologist - their challenge is that he was the only radiation onoclogist at the hospital so lacks "peers". We didn't have any resources internally to provide, so I reached out to my colleagues in our Clinical Advisory Board research program, as they had just completed a study on the "Future of the Medical Staff Organization," which profiled best practices for elevating the effectiveness of core medical staff governance functions such as credentialing, physician performance improvement, and peer review. They put together the following response I wanted to share:
The challenge of conducting peer review within a hospital with a very small number of specialists or for a single specialist is one that was raised by many medical staff leaders. Through our research on this issue, we identified two primary strategies for conducting an effective and unbiased peer review for such specialists when there is a lack of available in-house expertise, contracting for an external peer reviewer and conducting system-wide peer review, both which are described below.
Peer Review for Solo Practitioners Within their Specialty