introduction to the qopi ® certification program

Introduction to the QOPI® Certification Program

Using National Standards to Align Policy and Practice

QCP adds the goal of meeting standards in the delivery of

care.

The process to get certified causes practices to implement

structural changes in the process components of oncology

care

The Result is a recognized achievement of excellence

demonstrating to payors, patients and your colleagues your

practice’s level of quality cancer careCopyright © 2012 American Society of Clinical Oncology. All rights reserved

Closing the Quality Gap: Aligning Evidence-Based Guidelines with

Standard Work

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Copyright © 2012 American Society of Clinical Oncology. All rights reserved

QOPI Certification Process – Timeline

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QOPI Certification Process – Overview

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Application Process Timing, 0-6 weeks

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Practice DefinitionFor purposes of the QOPI Certification Program, a practice is a group of oncologists that share a common business address and tax ID number.

Only U.S. outpatient practices that provide hematology-oncology or medical oncology care

are eligible to apply for QOPI Certification. Oncologists or oncology groups that have unique practice arrangements and would like to apply for Certification should contact QOPI Certification Program staff at [email protected].

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QOPI Chart Abstraction•The pathway to the QOPI Certification Program is participation in a QOPI data abstraction round in accordance with the QOPI methodology. A practice must first meet the QOPI Certification measures scoring requirements to be eligible to apply for QOPI Certification. •A detailed QOPI Users Manual is available to assist practice staff in appropriately selecting charts for review and successfully completing the chart abstraction.

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Which Sampling Approach?

Practice-wide + Allows use of combined

appointment schedules to identify charts

+ Module targets apply across entire practice, rather than at each site (smaller overall sample size)

+ Provides QI data at the practice level

– May not provide sufficient charts at each site to allow meaningful site comparisons

– Certification application can be made at the practice-level only

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Office-specific + Provides a larger sample at each

site for comparison of reports across sites and QI

+ Matches sampling methodology used in previous rounds

+ Certification application can be made at practice-level or at individual office sites

– Requires identification of charts at each office

– Module targets apply to every site (larger overall sample size)


Module Requirements for QOPI Certification •Certification measures are included in the selected from Core measures

plus–Symptom/Toxicity Management– End of Life– Breast Cancer– Colorectal Cancer– Non-Hodgkin’s Lymphoma modules.

•All modules applicable to the practice’s patient population must be selected and completed for the practice to be eligible for Certification.

Practice selection of appropriate modules and sampling will be verified upon application to the QOPI Certification Program.

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QOPI Certification Measures

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Core measuresPathology report confirming malignancy

Staging documented within one month of first office visit

Pain addressed appropriately (defect-free measure)

Documented plan for chemotherapy, including doses, route, and time intervals

Chemotherapy intent (curative vs. palliative) documented

Cigarette smoking status documented by second office visit

Patient emotional well-being assessed by second office visit

Symptom/Toxicity Management Module measures

Corticosteroids and serotonin antagonist prescribed with moderate/high emetic risk chemotherapy

Infertility risks discussed prior to chemotherapy with patients of reproductive age


Colorectal Module measures

CEA within 4 months of curative resection for colorectal cancer

Adjuvant chemotherapy received within 4 months of diagnosis by patients with AJCC stage III colon cancer *

Adjuvant chemotherapy received within 9 months of diagnosis for patients with AJCC stage II or III rectal cancer*

Colonoscopy before or within 6 months of curative colorectal resection or completion of primary adjuvant chemotherapy

KRAS testing for patients with metastatic colorectal cancer who received anti-EGFR MoAb therapy

Anti-EGFR MoAb therapy not received by patients with KRAS mutation

NHL Module measures

Granulocytic growth factor administered with CHOP to patients over 65 with NHL

Rituximab not administered when CD-20 antigen expression is negative or undocumented

*adjuvant group measure


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End of Life Care Module measures

Pain assessed appropriately at EOL (defect-free measure)

Hospice enrollment and enrolled > 7 days before death (defect free measure)

Breast Cancer Module measures

Combination chemotherapy received within 4 months of diagnosis by women under 70 with AJCC stage I (T1c) to III ER/PR negative breast cancer *

Test for Her-2/neu gene overexpression

Trastuzumab not received when Her-2/neu is negative or undocumented

Trastuzumab received by patients with AJCC stage I (T1c) to III Her-2/neu positive breast cancer*

Tamoxifen or AI received within 1 year of diagnosis by patients with AJCC stage I (T1c) to III ER or PR positive breast cancer *

*adjuvant group measure


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QOPI Certification Scoring Calculation

The QOPI Certification Program Scoring calculation involves two components: 1. An Overall Quality Score calculated by aggregating the

practice’s data for the 24 quality measures included for Certification.

AND2. An Adjuvant Treatment Score based on 5 adjuvant

treatment measures included for Certification.

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Eligibility RequirementsTo be eligible to apply for Certification – Submit data for all 5 modules during one collection round– Achieve Overall Quality Score: 72.62% or higher– Achieve Adjuvant Treatment Score: 80% or higher– Comply with the QOPI chart selection and sampling methodology

• Meet module chart sample size requirements or select all eligible charts if targets are not met

• Meet the minimum unique chart requirement

Modules selected, sample size submitted, and data submitted are subject to audit prior to determining QOPI Certification status.

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After You Determine Eligibility

• To get your password go to: https://webapp.asco.org/qopicertification

• Click “password help” and enter your QOPI user ID and your new password will be emailed to you

• Pay program fee online or by check to progress to the application

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https://webapp.asco.org/qopicertification

https://webapp.asco.org/qopicertification

2012 Certification Pricing

Practice* Base Price per Number of Physician FTEs

• 1-7 FTEs $3,000 + • 8-25 FTEs $6,000 +• 26-50 FTEs $10,000 +• 51+ FTEs Contact

QOPI Certification Program staff

Additional Office Location Fees**

• 1-4: No additional fee • 5-9: $500 • 10-14: $1,000 • 15-19: $1,500Number of Office Locations**

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Application Process

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Application continued …

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Site Assessment Questionnaire

•Assessment of practices’ concordance with safety quality standards derived from the ASCO/ONS Standards for Safe Administration of Chemotherapy

–Site Assessment Questionnaire is available after Certification application is complete–Practices attest to their degree of compliance with the safety standards.–Later in the process Practices will be asked to provide supportive documentation for a random subset of the standards

A practice must meet all the QOPI Site Assessment standards to achieve QOPI Certification 23

Application Process: Questionnaire

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QOPI Certification Process – 6-12 weeks

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QOPI Certification Audit/Review

• All sites applying for QOPI Certification will undergo centralized and on-site audit reviews. Audits will occur as part of the QOPI Certification Reviewers’ evaluation process before the full QOPI Certification is awarded.

• This review is conducted by advanced

degree oncology nurses, ASCO staff, and QOPI Steering Group composed of ASCO Members.

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Our goal is to act as coach to mentor the improvement and learning opportunities that are an inherent part of the QOPI Certification Program process.

QOPI Certification Review Process

Verification of Compliance with Standards: All Certification applicants send copies of documentation to support compliance with 5 or more of the 17 standards which are randomly selected.

ASCO will provide a guidance manual to help you identify what documents are considered proof of compliance.

Verification of chart data: •All Certification applicants send copies of documentation from 3 charts to verify data entered during QOPI abstraction. •ASCO will send unique identifiers for the charts to be audited

QOPI Certification On Site Review•All Practices are eligible for On-Site Reviews•We currently conduct On-site reviews for greater than 75% of applicants.•We will review policies, practice HR records, follow patients, visit pharmacy, interview practice personnel to verify standards implementation.

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QOPI Certification On Site Reviewers

Certification On-Site Review Experience

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On- Site Reviewer Wrap-Up What to Expect

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Certification Term• The complete certification term is 3 years from designation of QOPI

Certification status.

Maintaining Certification Status– practice must participate in QOPI chart abstraction by

submitting data for at least two modules once per year. • Core plus 2 modules of your choice• No scoring requirements• Allows practices to try other modules

– Must Complete 5 modules in 1 round of QOPI chart abstraction for scoring prior to applying for recertification.

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Good Advice: No One Can Do it Alone*

• Form a team because it is a lot of work.• Find a champion (one doctor and one nurse).• Use nurses with good computer skills.• Give honest feedback to doctors who will want to see

their own scores in relationship to the group and national benchmarks.

• Break it down to smaller tasks.• See the process as opportunities for improvement

rather than character deficiencies.• Fix problems not fix blame on others.• Reward with chocolate.

* Dr. Loui is a medical oncologist with OnCare Hawaii and Chief of the Oncology Department at the Queen’s Medical Center, in Honolulu.

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Why Participate in the QOPI Certification Program?

Your practice will receive recognition from ASCO for commitment to high quality care and demonstration that a certain level of performance has been met

Your Certification may satisfy requirements by health plans for demonstration of quality oncology care and participation in quality improvement activities

Your Certification will be a clear designation from ASCO that you can refer to in practice communications and marketing materials

The QOPI Certification program is the first of its kind for outpatient hematology-oncology practices. Your practice can be out in front in your commitment to delivering high quality oncology care


Help Desk is available: 9:00 am – 5:00 pm Eastern

Tel: 571-483-1669or

E-Mail : QOPICERTIFICATION @ASCO.org

QOPI Certification Program is operated by ASCO affiliate, Institute of Clinical Excellence

introduction to the qopi ® certification program

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