Understanding value across pathways of care

Transcription

1 Understanding value across pathways of care Donna Chung Head of Centre for Cancer Outcomes Cancer Alliance Event 17 Jan 2018

2 Outline Overview of cancer landscape in north central and East London Understand value across pathways of care Evaluate data as close to real time as possible Visualise whole pathway of care in prostate cancer Capturing outcomes Points for discussion

3 Incidence & mortality by cancers in NCEL (2015) Number of cases 2500 Incidence and mortality by cancer in north central & east London (2015) Incidence Mortality Source: PHE There were 1,981 cases of breast cancer diagnosed in 2015, and deaths were 401. The highest number of deaths was for lung cancer (1049).

4 1 year survival index for cancers diagnosed in 2015 We have some of the best CCGs, but also the worst. Source: PHE

5 Data sources COSD InfoFlex, EPR Cancer Waits Breast InfoFlex Patient Reported Outcomes Spreadsheets HNA Spreadsheets Patient Experience FFT / Vanguard questions Stratified follow-ups Spreadsheets / InfoFlex Pathology Biochem, Haem, Micro, Cellular SACT ChemoCare, InfoFlex, EPR RTDS ARIA Challenge - multiple data sources Prostate - clinical input National audits Lung, Bowel, OG, Prostate and Breast

6 MDT Balanced scorecard core aim Be the one stop shop to motivate MDTs to collect, review and act on data relating to Activity, Performance and Outcomes Breast Improve understanding of value across whole pathways of cancer care and their components Enable clinical teams to validate data as close to real time as possible Prostate Evaluate whether patients are on the best desired pathways Evaluate clinical outcomes of treatment / treatment pathways

7 MDT Balanced Scorecard in Lung, Prostate, Head & Neck, and Lymphoma Breast, Upper GI (OG) in development

8 Data quality improvement Head & Neck Breast Prostate

9 Focus efforts of data improvement

10 Prostate Pathway Visualisation Tool In collaboration with PHE Longitudinal view of historical data to provide context along whole patient journey. Datasets: CWT, DIDs, HES, SACT, RTDS, ONS, COSD

11 ICHOM was formed to drive systems towards value-based health care by defining global outcome standards Where we come from Our mission Three organizations with the desire to unlock the potential of valuebased health care founded ICHOM in 2012: ICHOM is a nonprofit Independent 501(c)3 organization Idealistic and ambitious goals Global focus Engages diverse stakeholders Our mission Unlock the potential of value-based health care by defining global Standard Sets of outcome measures that really matter to patients for the most relevant medical conditions and by driving adoption and reporting of these measures worldwide Patient health outcomes achieved Value = Cost of delivering those outcomes Copyright 2017 by the International Consortium for Health Outcomes Measurement. All rights reserved. 16

12 ICHOM Implementation Localised prostate: UCLH Lung: UCLH & Barts Purpose of collecting ICHOM datasets: to collect outcomes other than overall survival that matter to patients, providers and purchasers to evaluate in more detail the clinical benefits of treatments and treatment pathways real world outcome data to develop an understanding of the value of interventions and care assisting choice To allows for international comparisons

13 Outcomes as the lever to allow the development of a value-based healthcare system Value = Patient health outcomes achieved Cost of delivering those outcomes Improve outcomes Starting point is to measure and improve the health results that matter most for a patient's condition Reduce costs Streamline care delivery to only those services that improve outcomes Increase value Better outcomes at equal or lower cost leads to higher value

14 Points for discussion Data completeness: system-wide poor compliance with uploading data to COSD e.g. staging, performance status, morphology codes Role of clinical information lead for each MDT quality improvement in patient care & outcomes inform clinical decision making Value-based health care is not an overnight journey