Implementation of the IOM 13 point care plan by Oncology Care Model (OCM) practices.

Abstract

e18279 Background: The completion of the IOM 13 point care plan is mandatory for all patients enrolled in the OCM. We built an integrated care plan into the electronic medical record, with 9 points being auto-populated by data documented elsewhere in the EMR and 4 points requiring completion by the caregiver. We report on preliminary experience with care plan completion. Methods: Of the 190 practices selected by CMMI for the OCM, 32 practices utilized the embedded care plan. Patient eligibility for the OCM was determined by identification of a qualifying episode by an electronic algorithm. Initiation of a care plan was determined by physician completion of any field in the care plan field. Completion of the care plan was defined by the act of printing and distributing the care plan to the patient. Correlations between number of eligible patients and completion rates were calculated using Pearson’s product moment correlation coefficient (r). P-values were calculated using a t-distribution and null hypothesis of 0. Results: Over the first 6 months, 15,705 patients were identified as eligible for the OCM. At these practices, 69% (10,851) of patients had care plans initiated (range 0-100%) and 34% (5,290) had a care plan printed (range 0-100%). Within the care plans initiated, 53% (5,711) had the advance directive field completed (range 0-87%). There was no correlation between percent of care plans initiated or percent of care plans printed and number of eligible patients in the practice (r = -0.16, p = 0.51 and r = -0.13, p = 0.44); likewise, advance directive field completion percent was not correlated with the number of eligible patients (r = -0.16, p = 0.37). Conclusions: Completion of the IOM care plan has proven challenging for practices in the OCM irrespective of practice size. This suggests technological solutions represent only one component needed for success in this component of the OCM.