Improving quality of prostate cancer care in an integrated care delivery system.

Abstract

147 Background: Kaiser Permanente (KP) is an integrated care delivery system that provides clinical services to over 9 million members in nine states and the District of Columbia with the goal of providing high-quality and affordable health care to our patients. Over the last decade, the rapid adoption of prostate cancer (Pca) screening practice and technology have resulted in increased detection of Pca and helped identify opportunities for care improvement. KP initiated improvements of continuum of services provided to Pca patients. Methods: Transforming the care provided to Pca patients evolved into the first population-based cancer program that manages the entire continuum of care by taking advantage of our integrated health delivery system. Major accomplishments include appropriate Pca screening to prevent over-diagnosis (Prostate Cancer Screening), improved patient safety and claims reduction to prevent missed abnormal cancer screening (PSA Safety Net), comparative effectiveness of cancer treatment choices to improve quality, and benchmark outcomes in efficiency and clinical quality utilizing a new technology (Robotic Surgery). In addition, the program has achieved superior outcomes and value through innovative chemotherapy management for advanced disease (Lupron Management). Evidence-based medicine, research, analytics and continuous quality improvementare cornerstones of the program, while the pinnacle is our patients, who receive informed, shared decision making and equitable unbiased care. Results: We strongly believe that measures of how well our patients are living with Pca are as important as the cancer-specific survival measures; because of this, we established a prospective registry to measure quality of life for every newly diagnosed patient and stratified by all treatment types. This practice is being disseminated across the Program. Conclusions: By systematically stratifying this diverse population, we have been able to achieve efficient reliable care, and spread each successful process to other regions through collaboration with KP’s Interregional Chiefs of Urology.