QOPI is a free quality assessment and improvement program, developed by ASCO, which allows an oncology practice to compare the performance of its providers in more than 90 areas to the performance in other practices across the country.

What Is Measured?

QOPI collects data on measures adapted from evidence-based guidelines such as those of the National Initiative on Cancer Care Quality. All practices report on 25 core measures, such as those related to pain assessment and control, smoking cessation, and psychosocial support. In addition, each practice chooses at least two other categories of data to report. These categories relate to management of disease areas (breast cancer, colorectal cancer, etc.), end-of-life care, or symptoms and toxicity management.

Up to twice a year, participating practices submit data from a sample of charts of patients seen in the office in the previous six months. The number of charts abstracted depends on the number of full-time-equivalent medical oncologist/hematologists at the practice. Practices that have multiple locations may abstract charts from selected sites or from across the practice as a whole. Practice personnel enter the data through a secure web portal that prompts the chart abstractor for data to input for each measure.

Within 30 days of the close of the collection round, each participating practice can view its own confidential performance report online. QOPI reports the practice's score for each measure (eg, the percentage of times the practice documented cigarette smoking status by the second office visit) and the national mean, minimum, and maximum scores, including detail on number of charts and practices reporting. Practices can customize reports in a number of ways. For example, they can compare their scores to those of practices of a similar type, such as academic center or private/independent practices.

Required: A Culture of Self-Examination and Improvement

Why have hundreds of oncology practices voluntarily chosen to participate in ASCO's quality measurement program? Sharon M. Ondreyco, MD, of Palo Verde Hematology Oncology in Phoenix, AZ, gave three reasons right off the bat:

• We wanted to make sure our group was practicing the best hematology/oncology care possible.
• In anticipation of the possibility that CMS [Centers for Medicare & Medicaid Services] or insurance companies will require a performance program.
• It's an excellent way to benchmark our community practice's performance compared to others, including major academic centers.

Lynn Ratzlaff, CHSM, the practice administrator with Dr. Ondreyco's group, adds, "QOPI provides an excellent tool for evaluating new physicians' documentation and practice standards. The return in knowledge gained is worth the time spent abstracting charts."

Many QOPI participants point to the fact that the process "shines a light" on areas needing attention, prompting the clarification of protocols or initiation of new patient information programs, for example. "Our doctors are now better at documenting what they are doing, especially in areas such as staging and pain assessment and treatment," Dr. Ondreyco notes.

Additional QOPI Benefits

Recertifying oncologists can use QOPI data in the self-directed Performance Improvement Module for Maintenance of Certification  requirements of the American Board of Internal Medicine (ABIM). ABIM awards 20 points for completing an improvement plan based on QOPI data.

Physician participants can also use QOPI data to earn up to 20 continuing medical education credits. Nonphysican QOPI participants can receive a certificate of participation from ASCO to obtain continuing education units from their respective certification bodies.

Many health insurance programs recognize QOPI participation by actions such as giving practices special designation in their physician directories, providing financial support for chart abstraction, or waiving prior authorization requirements.

"I recommend QOPI to all groups," Dr. Ondreyco stresses. "With insurance companies looking over our shoulders so much, this is another way we can prove quality and standardization."

For more information, visit qopi.asco.org. ■

© 2011. American Society of Clinical Oncology. All rights reserved.