The data reports generated by QOPI give the West Michigan Cancer Center (WMCC) in Kalamazoo valuable information to improve patient care, according to Terry ­McKay, President and CEO of the practice, which has seven medical oncologists. "If you give physicians data, they will change behavior," she says.

QOPI is the quality assessment and improvement program launched by ASCO in 2006 and available at no charge to all ASCO members. Practices registered in the QOPI program submit data from a sample of charts of patients seen in the office in the previous 6 months. Within 30 days after the data collection period, participating practices can access reports comparing their performance in more than 90 areas to the scores of other practices across the country. Michigan is one of two states in which practices also receive the average scores of practices within the state.

"I enthusiastically endorse QOPI," Ms. McKay declares. "It's very hard to get comparable data, and the QOPI data is valuable because it has a significant number of participating physicians. Also, we are compared only with practices like ours."

QOPI has five categories for practices: academic center, employed physician practice, fellowship program, private independent practice, and private with academic affiliation practice.

Reports Provided by QOPI

A mainstay of the data that practices receive is the QOPI Measures Summary Report, which gives the practice's performance on each indicator along with the national averages and ranges for the same indicators. For instance, for the indicator "Staging documented within 1 month of first office visit," a practice may have met that criterion in 74 of 85 cases, for an 87% performance rate. This may compare with a national aggregate rate, based on 4,500 charts, of 76%, with a range from 34% to 100%. (These rates are hypothetical and do not reflect an individual practice or aggregate QOPI data.)

For each indicator, the practice can also access detailed reports that show all charts abstracted by QOPI chart ID number and whether each chart met the indicator. This allows practices to review specific charts for educational or verification purposes.

Practices can customize QOPI reports and download them in a number of formats, such as PowerPoint files. The bar graph shows an example of how the data can be manipulated for specific comparisons and for presentation. Ms. McKay presents data to all physicians in the practice as well as to the Board of Directors

Using the Data to Improve Quality of Care

Ms. McKay reports that the board chose two QOPI indicators for improvement this year: "pain addressed appropriately" and "action taken to address problems with emotional well-being by the second office visit." Improving the percentage of times these measures are done is tied to compensation levels.

Noting that the board sets goals that "are a stretch" to achieve, Ms. McKay offered hypothetical numbers as an example. If the practice's rate was 64%, and the national average was 73%, the practice must achieve a rate of 69% to "meet requirements," a rate of 70% for "exceeds requirements," and a rate of  more than 70% for "far exceeds" requirements. Each level of performance is attached to a larger amount of at-risk income. Ms. McKay adds, "Although these new goals are below the national average, they represent real improvement challenges, because it takes considerable effort for a practice to 'move that needle' in 1 year. The great thing about QOPI is that it identifies these areas to improve."

Ms. McKay is also held accountable and has an at-risk portion of her salary tied to performance on the quality measures. To help the physicians improve their performance in addressing pain, the medical assistants take the pain score every time the patient comes in and put the score in the electronic medical record. "If the pain level is 4 or more, the doctor had better do something about it," she says. "In addition to having the score in the computer, we put it on a customized sticky and circle it in red so the doctor can't miss it."

Ms. McKay says she is a big fan of QOPI because of its role in helping to improve quality. "It's so enlightening and helpful to do your own self-examination, because you get affirmation that you're doing things appropriately and also see where there is room for improvement.

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

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