Effect of implementing an integrated oncology dashboard on clinical and operational quality in a community-based cancer network.

Abstract

420 Background: MaineHealth Cancer Care Network (MHCCN) encompasses nine regional cancer centers and one affiliate cancer center located in rural south-central Maine and New Hampshire. MHCCN developed an integrated operational dashboard to improve clinical and operational performance. In this report, we detail improvements in a variety of quality metrics after implementation of the dashboard. Methods: Extracts from various non-interoperable data sources were integrated using a MS Power BI platform to create the dashboard. Divided into pages— summary, growth, service excellence, innovation and transformation —the dashboard provides searchable and regularly updated snapshots of numerous relevant metrics in these domains. Access to the dashboard was extended to all clinical and operational staff, with data reviewed bi-monthly in provider and operational meetings. The dashboard played a pivotal role in identifying MHCCN’s 2023 key performance indicator, specifically the electronic health record (EHR)-based TNM staging, along with notable care gaps such as underutilization of the NCCN distress thermometer (DT) for psychosocial distress assessment. Bottlenecks to timely care delivery were similarly identified by leveraging time to treatment data in the service excellence page. Targeted quality improvement initiatives were devised to address the gaps. Results: EHR-based structured TNM staging by providers improved from 29% in Fiscal Year (FY) 2022 to 47% in FY 2023 and 64% in FY 2024 year-to-date (YTD). Use of the NCCN DT improved from 1.1% in FY 2022 to 30.9% in FY 2023 and 49.9% in FY 2024 YTD. Process changes resulting from identifying delayed scheduling of PET scans as a bottleneck reduced the lead time from scan ordering to scan appointment from 18 days (January-July 2023) to 9 days (January-April 2024). Leveraging access to monthly productivity data through the dashboard, provider compensation reform incorporating production-based incentives was launched in July 2023, improving throughput and access as well as provider recruitment and retention. Information transparency from a freely accessible dashboard contributed to a 0.67-point gain in the 2023 Gallup provider core engagement CE3 score, reaching 3.45 (on a five-point scale). Conclusions: Clinical and operational metrics are often fragmented across different platforms, leading to inefficiencies and limited insights. Creating a system-wide integrated quality dashboard improved data visibility, provider engagement and led to measurable improvement in quality metrics across various domains.