Oncology
Conditions
Brief summary
Documenting cancer stage is the most important determinant of treatment approach and survival for cancer patients. However, oncologists do not routinely document a patient's cancer stage in the structured field in electronic health records. This quality improvement pilot study evaluated the impact of sending an email to physicians at a cancer center of a large academic hospital with individualized data on their rates of cancer stage documentation using a structured field. The investigators assessed patient-level documentation and physician-level rates of staging documentation over 15 months including a three-month pre-period, a six-month pilot phase and a six-month follow-up period. The investigators also estimated staging documentation rates separately for each physician's new versus established patients.
Interventions
OTHERNo peer comparison email
The comparison group received no email communication on their cancer stage documentation activity.
OTHERPeer comparison email
The intervention group received three separate emails with individualized data on their cancer stage documentation activity in the previous 1-3 months. The email described the number and percent of attributed patients for whom cancer stage was documented, and included a figure showing their staging documentation rate compared to their peers.
Sponsors
Massachusetts General Hospital
Harvard School of Public Health (HSPH)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Attending physicians who had been at one of three sites of hospital between January - August 2018
Exclusion criteria
* Physicians treating cancer patients where American Joint Committee on Cancer (AJCC) staging modules were less clinically relevant * Physicians with low clinical volume (\<5 patients over 3 months) * Physicians without any outpatient visits
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Measuring if a patient's cancer stage was documented in a structured field in the Electronic Health Record on the date of the patient's first ambulatory care visit | 15 months | Indicator of whether the structured field for cancer stage in the patient's electronic health record (EHR) was populated on the date of the first outpatient encounter that a patient had during the study period (1=yes, 0=no) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Staging documentation rate (monthly) | 15 months | Percentage of patients whose first outpatient encounter occurred in a given month for whom cancer stage was documented |
Countries
United States
Outcome results
None listed