Oncology Centers Are Ready for Widespread Use in Healthcare Practices, Panelists Say


After 10 years of development and 2 years of piloting, the Oncology Medical Home (OMH) certification is ready for implementation. This could provide payers and providers alike with a much-needed framework for standardizing ongoing care transformation.

A joint project of the American Society of Clinical Oncology (ASCO) and the Coalition of Community Oncology (COA), OMH has completed a pilot phase across 12 sites, including both academic institutions and community oncology clinics. FASCO Vice President Stephen S. Grubbs, M.D., said:

According to ASCO’s Division of Clinical Operations, OMH is expected to be announced during sessions at the 2023 ASCO Annual Meeting before being converted into a program available to other medical sites in July 2023.

Grubbs, a former community oncologist from Newark, Delaware, provided an update on OMH on April 4 during the Philadelphia Health Care Coalition’s (GPBCH) day-long Oncology Management Summit. Participating in Grubbs’ discussion was:

  • Bo Gamble, Director of COA Strategic Practice Initiatives.
  • Rhonda Bowman, Senior Director of Care Delivery, MHA, RN, OCN, ASCO.and
  • Andrew Chapman, PhD, FACP, Director, Sidney Kimmel Cancer Center (SKCC), Executive Vice President, Oncology Services, Jefferson Health. Mr. Jefferson was one of his 12 participants in the OMH pilot.

OMH grew out of the same line of research that gave rise to the COME HOME initiative and the Oncology Care Model (OCM).1,2 This started with a call for an oncology-focused, patient-centered healthcare home model as defined by the Agency for Medical Research and Quality.3 Attributes of this model, which began in pediatrics, include being patient-centric. Provide comprehensive and coordinated care. 24/7 access for urgent needs. and focus on patient safety.

OMH’s developers also wanted to meet a long-expressed need by oncologists. Many say they want to move from service-based reimbursement to value-based care, but running multiple payment models simultaneously is too burdensome.

Instead, the OMH will focus on 17 health care practices across seven different areas: patient engagement, availability and access to care, use of evidence-based health care, equitable and team-based care, and continuous quality improvement. We certify practices that can prove they meet site standards and 22 safety standards. , end-of-life discussion/goals of care, and chemotherapy safety. The idea is that OMH certification will become a global standard for payers to accept when redeeming.

“We don’t need to have different standards for different payers across the country,” Grubbs explained. The standard will be the distribution platform, he said. “We want to do all we can when it comes to cost control, and we want to be transparent.”

Domains and standards will be detailed for the first time in July 2021, Journal of Clinical Oncology, A pilot version will start in the same month.Four The following year, Mr. Gamble, Mr. Bowman and others visited the site for a series of measures and compliance checks. The first accreditation award will be presented to him in July 2022 and the evaluation will continue through this year. During OMH’s pilot phase, he also worked with two payers.

Grubbs said once the OMH is up and running, participating establishments have one year to qualify and must recertify every three years.

Built for oncology medicine. OMH asks practitioners to demonstrate that they have policies in place and then to demonstrate how those policies are utilized in the delivery of routine care. OMH uses electronic medical records to monitor quality and asks medical institutions to monitor when patients are treated outside the clinical pathway, Grubbs said. Health-care workers need to reconsider why patients are off course, but “we don’t expect every patient to be on course.”

“This is part of our continuous quality improvement,” he said.

Grubbs noted that ASCO is developing better electronically collected measures to support practice in this area. He said OMH will investigate health equity both in health settings and in the community.

“I want to emphasize that although it was built for medical oncology, it can be extended to radiation oncology,” Grubbs said.

“show me.” Gamble emphasized that OMH will require the ASCO/COA team to certify that operations or facilities meet standards through an audit process. “Show me,” he said, explaining that OMH spends a lot of time on chemotherapy safety processes. But the focus is not on punishment, but on helping improve practices, he added.

For example, patient satisfaction surveys should be shared and discussed with physicians. “What are we doing to improve these areas?” Gamble asked.

He described the “light bulb” that goes out when practice addresses weak areas. “They become proud and excited about what they do because they can prove it to the world.”

Clinical path and savings. Chapman explained how the SKCC had participated in other quality improvement efforts, including OCM, but said participating in the OMH pilot provided an opportunity to “transform the healthcare system.” explained.

“It allowed us to build on all the work we’ve done so far,” says Chapman. This has enabled SKCC to acquire his ASCO and COA standards, including quality and safety, and deploy them throughout the healthcare system. So we took it from an academic medical center and disseminated it to teams across 18 hospitals. “

This year…we’ve done a lot in supportive care, especially mental health care,” Chapman said. “And … the private payers are very interested in the work that we have done, because we are making a big difference in terms of readmission and in terms of service uptake, service uptake. We were able to show it worked.”

The use of clinical paths has become a success story for Jefferson. “He cut the average cost of medicines by 10 percent,” he said. “It has led to about $3 million in cost savings each year for the past three years. We are working on it, but keep in mind that this is not 100% applicable…We have been able to recover a lot of money in providing cancer care.”

At the time of the GPBCH session, many practitioners were wrestling with what to do about enhancing the oncology model. Chapman notes that a “good” feature of OMH is that it works equally well in academic centers and community practices, but “it’s about all practices, all sizes, all different places.” I have,” he admitted. “Nobody can’t do this, and that’s what really matters.”

Opportunity for improvement. As with gambling, Mr. Bowman also emphasized that OMH requires participants to live up to its standards. “What differentiates these 12 practices is the adoption and implementation of these standards.”

Visiting clinics allowed the ASCO/COA team to interact with clinics and educate doctors about transforming practices, she said. “There was something to be said for all the practices. These are high-level practices and they are doing great things. There was still room for improvement, such as how to fill it in. All practices took advantage of this opportunity to meet all standards.”

“What’s different about this program?” [is that] It’s not a one-time thing,” Bowman said. “We are associated with these practices. We meet with them regularly to review their continuous evaluation, improvement and sustainability. I really do.”

References

  1. COME HOME model. Come home program. Accessed May 16, 2023. http://www.comehomeprogram.com/index.php/come-home-practices/
  2. Oncology care model. Medicare and Medicaid Innovation Center. Updated 11/18/2022. Accessed May 16, 2023. https://innovation.cms.gov/innovation-models/oncology-care
  3. A patient-centered medical home. Medical Research and Quality Agency. Updated August 2022. Accessed May 16, 2023. https://www.ahrq.gov/ncepcr/research/care-coordination/pcmh/index.html
  4. Woofter K, Kennedy EB, Adelson K, et al Oncology Medical Home: ASCO and COA standards. JCO Oncol Practicum. 2021;17(8):475-492. Doi: 10.1200/OP.21.00167



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