Today, ASCO and the Community Oncology Alliance (COA) jointly released new Oncology Medical Home (OMH) standards, which provide a comprehensive roadmap for oncology practices to deliver high-quality, evidence-based cancer care. These standards, which were published by Woofter et al in JCO Oncology Practice, establish core elements needed to deliver equitable cancer care. In releasing the new standards, ASCO and COA seek to achieve a broad consensus among all stakeholders—including patients, clinicians, payers, purchasers, and employers—on what patients with cancer should expect and receive from their cancer care teams.
Everett E. Vokes, MD, FASCO
“Every single patient has the right to high-quality, evidence-based, and cost-effective cancer care. However, our challenge as clinicians and as a broader oncology community has been to define what that high-quality cancer care looks like,” said ASCO President Everett E. Vokes, MD, FASCO. “These new, comprehensive standards will remove ambiguity and serve as a strong foundation for all stakeholders to work together to ensure that every single person receives the care they deserve, throughout the entire patient journey.”
According to ASCO and COA, implementation of the OMH standards will address issues such as appropriate use and safe and efficient delivery of oncology drugs, patient-centered care coordination, effective communication, informed decision-making, and planning. By establishing a universal benchmark for high-quality cancer care delivery, the ASCO/COA standards provide an opportunity for the entire oncology community to work towards a value-based model of care that will benefit all patients with cancer.
Kashyap Patel, MD
“These new OMH standards provide oncology practices with a single set of cancer care delivery expectations that benefit patients, practices, and other stakeholders,” said COA President Kashyap Patel, MD. “As practices transition into value-based care delivery, those that adopt this framework will be able to focus on a standardized process that measurably demonstrates high-quality, patient-centered, and efficient care.”
The ASCO/COA standards will form the foundation of a 2-year, ASCO-led OMH certification pilot. More details about the pilot will be announced in the coming months.
More About the OMH Standards
The new OMH standards feature seven domains of cancer care. Specifically, the standards include:
- Patient engagement in and empowerment to share in decision-making about their cancer care. This includes individualized treatment plans, survivorship plans, and access to financial navigation.
- Patient access to cancer care at the right time, in the right setting. Providers should use a symptom triage system and offer expanded access to timely office care to minimize emergency room visits.
- Evidence and value-based treatment: providers should adhere and document their adherence to comprehensive clinical pathways that reflect the latest clinical research and should recommend and refer patients to clinical trials (as appropriate).
- Patient access to equitable, comprehensive, and coordinated team-based care. Oncology care teams should closely coordinate each patient’s care, and include patient navigation, psychosocial care, and support services as part of the care team. Practices must have policies in place to address health equity, including awareness of conscious/unconscious bias.
- Continuous practice quality improvement using data, including patient surveys and patient-reported outcomes, to evaluate and improve processes and outcomes.
- Patient access to advance care planning discussions, palliative, and end-of-life care. Practices should also hold a ‘goals of care’ discussion with all patients.
- Practice adherence to the highest-level chemotherapy safety standards (as per QOPI® Certification Program (QCP) Standards).
An Oncology Medical Home is a system of care delivery that features coordinated, efficient, accessible, evidence-based care and includes a process for measurement of outcomes as a means of facilitating continuous quality improvement. The concept of a patient-centered medical home (PCMH) model, upon which the OMH is based, was first introduced by the American Academy of Pediatrics in 1967. Over time, the PCMH has come to be viewed as a system for health-care transformation, designed to achieve the triple aim of controlling health-care costs while improving quality of care and the patient experience. In oncology, several OMH models have been piloted, including the COME HOME demonstration project and the Center for Medicare and Medicaid Services Innovation Center Oncology Care Model. In addition, ASCO’s Patient-Centered Oncology Payment model incorporates concepts consistent with the OMH.
The ASCO/COA OMH standards were developed based on a systematic review of evidence, including comparative peer-reviewed studies, studies of clinical pathways, and a systematic review of survivorship care plans, along with consensus of a multidisciplinary Expert Panel comprised of clinicians, health system administrators, and patient advocates. Prior to publication, the standards were approved by COA’s Payment Reform Committee and the ASCO Board of Directors.
Practices interested in implementing OMH standards can contact: patientcenteredcare@asco.org.
