QOPI, EHRs, and Quality Measurement

Abstract

laudable, and the results are encouraging. That the indicators largely improved between the two survey rounds was encouraging, especially given that the project is in its infancy. What was disheartening, however, was that the capability for collecting quality indicators using EHR systems was neither entertained in the conception of the study nor in the associated article discussions. While this is understandable given the limited penetration of EHR systems, it neglects considerations for scaling and evolving the QOPI program. Oncology-specific EHR systems are currently available, and are capable of providing a robust infrastructure for support of such projects. These systems will likely render manual data abstraction and collection methods obsolete, and help reduce the $1,000 per practice cost for the QOPI assessment, a cost that scales dramatically when one considers a nationwide system. Further, the market penetration and use of EHR systems in oncology will undoubtedly increase over time, with their costs offset by their proclivity for promoting efficiency, reducing medical errors, and enhancing quality care. Incentives launched by the Office of the National Coordinator for Health Information Technology, the promotion of the Oncology Demonstration Programs by the Centers for Medicare and Medicaid Services, and proposed legislation to incentivize pay for performance, as well as potential patient demands, all suggest that widespread adoption of EHR systems by oncologists is imminent. Advantages of embedding quality measures into the core of an EHR system abound. Indicators can be calculated based on data entered in the course of routine care, and reports of quality could become routine. Quality for all patients, not just a random few, could be tracked and quantified in real time. Using EHR systems, aggregation across practices along with centralized collection, comparison, and analysis is more readily supported as may be methods for abstracting, reviewing, auditing, and identifying other leading and lagging quality indicators. By promoting and standardizing QOPI measures, data from disparate EHR systems could be compared, and otherwise leveraged in support of quality management. Perhaps most importantly, an EHR can help promote the very quality it is tasked with measuring by enforcing rules such as no chemotherapy administration unless a consent is present.