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Annals of Surgical Oncology

, Volume 23, Issue 8, pp 2385–2390 | Cite as

Value-Based Breast Cancer Care: A Multidisciplinary Approach for Defining Patient-Centered Outcomes

  • Oluwadamilola M. Fayanju
  • Tinisha L. Mayo
  • Tracy E. Spinks
  • Seohyun Lee
  • Carlos H. Barcenas
  • Benjamin D. Smith
  • Sharon H. Giordano
  • Rosa F. Hwang
  • Richard A. Ehlers
  • Jesse C. Selber
  • Ronald Walters
  • Debu Tripathy
  • Kelly K. Hunt
  • Thomas A. Buchholz
  • Thomas W. Feeley
  • Henry M. KuererEmail author
Healthcare Policy and Outcomes

Abstract

Purpose

Value in healthcare—i.e., patient-centered outcomes achieved per healthcare dollar spent—can define quality and unify performance improvement goals with health outcomes of importance to patients across the entire cycle of care. We describe the process through which value-based measures for breast cancer patients and dynamic capture of these metrics via our new electronic health record (EHR) were developed at our institution.

Methods

Contemporary breast cancer literature on treatment options, expected outcomes, and potential complications was extensively reviewed. Patient perspective was obtained via focus groups. Multidisciplinary physician teams met to inform a 3-phase process of (1) concept development, (2) measure specification, and (3) implementation via EHR integration.

Results

Outcomes were divided into 3 tiers that reflect the entire cycle of care: (1) health status achieved, (2) process of recovery, and (3) sustainability of health. Within these tiers, 22 patient-centered outcomes were defined with inclusion/exclusion criteria and specifications for reporting. Patient data sources will include the Epic Systems EHR and validated patient-reported outcome questionnaires administered via our institution’s patient portal.

Conclusions

As healthcare costs continue to rise in the United States and around the world, a value-based approach with explicit, transparently reported patient outcomes will not only create opportunities for performance improvement but will also enable benchmarking across providers, healthcare systems, and even countries. Similar value-based breast cancer care frameworks are also being pursued internationally.

Keywords

Breast Cancer Electronic Health Record Electronic Health Record System Breast Cancer Care Epic System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

Supported in part by the P. H. and Fay Etta Robinson Distinguished Professorship in Research (to H.M.K.) and U.S. National Institutes of Health Cancer Center Support grant CA16672.

Disclosure

The authors declare no conflict of interest.

Supplementary material

10434_2016_5184_MOESM1_ESM.docx (36 kb)
Supplementary material 1 (DOCX 31 kb)

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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Oluwadamilola M. Fayanju
    • 1
  • Tinisha L. Mayo
    • 2
  • Tracy E. Spinks
    • 2
  • Seohyun Lee
    • 3
  • Carlos H. Barcenas
    • 4
  • Benjamin D. Smith
    • 5
    • 6
  • Sharon H. Giordano
    • 4
    • 6
  • Rosa F. Hwang
    • 1
  • Richard A. Ehlers
    • 1
  • Jesse C. Selber
    • 7
  • Ronald Walters
    • 4
    • 8
  • Debu Tripathy
    • 4
  • Kelly K. Hunt
    • 1
  • Thomas A. Buchholz
    • 5
    • 8
  • Thomas W. Feeley
    • 3
    • 9
  • Henry M. Kuerer
    • 1
    • 2
    Email author
  1. 1.Department of Breast Surgical Oncology, Division of SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Office of the Senior Vice President (SVP), Hospital and ClinicsThe University of Texas MD Anderson Cancer CenterHoustonUSA
  3. 3.The Institute for Cancer Care Innovation (ICCI)The University of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Department of Breast Medical Oncology, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA
  5. 5.Department of Radiation Oncology, Division of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  6. 6.Department of Health Services Research, Division of the Office of the Vice President (OVP), Cancer Prevention and Population SciencesThe University of Texas MD Anderson Cancer CenterHoustonUSA
  7. 7.Department of Plastic Surgery, Division of SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA
  8. 8.Office of the Executive Vice President (EVP) and Physician-in-ChiefThe University of Texas MD Anderson Cancer CenterHoustonUSA
  9. 9.The Institute for Strategy and CompetitivenessHarvard Business SchoolBostonUSA

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