Colorectal Cancer Care: A Quality Measurement System - A Partnership Between VA and the Department of Defense pilot the Colorectal Cancer Care Quality Measurement System (CCQMS), a quality of care measurement and monitoring system which has recently been developed, tested and validated by investigators in the VA health care system, with the support and collaboration of the NCI. The CCQMS is a medical record abstraction tool that measures cancer care quality across multiple care quality dimensions, and in a patient-centric manner incorporating data from the medical record as well as patient and caregiver surveys. The CCQMS has been tested and disseminated in the VA health care system, but not in other health care systems. The current study will pilot the CCQMS in the DOD health care system in order to test its feasibility, transportability, and performance in this setting, to refine the CCQMS, and to collect multidimensional data on the quality of care received by colorectal cancer patients in the DOD system. The CCQMS is a client/server database application that is designed to be both extensible and scalable. Extensibility allows for seamless addition of new functionality. Scalability allows for large scale concurrent user volume that can be expanded as needed. The tool has been distributed to DOD partners at the US Military Cancer Institute. The proposed project will modify the CCQMS for use with the DOD electronic medical record system (Alta), and to implement tool use into pilot facilities in the DOD. DOD facilities will identify patients with newly diagnosed CRC and will apply the tool to examine care received based on NCCN guidelines. The project also implements a patient and caregiver survey component, which has been developed and piloted by VAMC investigators. The project will identify 2,000 patients who have received a new colorectal cancer diagnosis in the past 12 months. Patient surveys will be administered 4-12 months post-diagnosis. CCQMS and completed survey data are expected for 1300 (65% response rate) to 1500 (75% response rate) patients and between 728-1200 caregivers. Initial statistical analyses will focus on descriptive statistics and appropriate graphical displays to summarize all quality indicator variables. Later analyses will involve the use of multiple univariate and multivariable modeling strategies to arrive at a more complete understanding of the structure and relationships of interest in the data. The primary product for the first year of the study will be the comprehensive and portable cancer care quality measurement tools and system;a well defined network of DOD investigators to test the abstraction tool;a well defined set of procedures for measuring quality of care through medical record abstraction;raw data from the CCQMS and from the surveys of 1300 patients and questionnaires sent to over 700 caregivers, and a manual containing the CCQMS and the survey instruments that will be portable, scalable and expandable for use in other health care systems.
