Description:
362 Informatics Tools to Measure Cancer Care Coordination
Fast-Track proposals will be accepted.
Direct to Phase II will not be accepted.
Number of anticipated awards: 2-3
Budget (total costs, per award):
Phase I: up to $225,000 for up to 9 months
Phase II: up to $1,500,000 for up to 2 years
PROPOSALS THAT EXCEED THE BUDGET OR PROJECT DURATION LISTED ABOVE MAY NOT BE FUNDED.
Summary
The rapid adoption of Electronic Health Records (EHRs), increased patient engagement, rapid adoption of mobile technology, and shift to value-based care have contributed to an increased use of health information technology (IT) to improve quality and outcomes of patient care.
There is a need for more coordination in cancer care due to the growing complexity of cancer treatment and the increase in cancer survivors that need better coordination within and across clinical teams and care settings. Poorly coordinated care leads to avoidable hospital readmissions, preventable medical errors, harm to patients and higher costs. Care coordination strategies share seven essential tasks: assess patient, develop care plan, identify participants and specify roles, communicate with patients and other participants, execute care plan, monitor and adjust care, and evaluate outcomes. Health IT plays an important role in care coordination in diverse organizations like Kaiser Permanente and the VA.
The measurement process for care coordination is changing from the laborious process of manual chart reviews to EHR-based measurement. New EHR-based care coordination measures are being developed. The National Quality Forum recently endorsed five EHR-based care coordination measures, none in cancer care. At least 12 cancer-specific care coordination measures are available in the National Quality Measures Clearinghouse.
There is a need for informatics tools that automate measurement for existing care coordination measures and have the flexibility to add new measures as they are developed.
The interaction of people, technology, tasks, organization and environment creates a structure – a work system – that shapes workflows, which shape outcomes. Health IT-focused businesses understand (from experience) IT adoption changes workflows and work systems. This understanding coupled with the ability to innovatively use diverse data systems and methods is needed to create scalable informatics tools to measure care coordination to meet the marketplace needs.
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Project Goals
The goal is to create scalable health IT-based informatics tools that measure care coordination in order to assess and improve quality of care and patient outcomes, assist the ongoing healthcare delivery system transformation and improve research efficiency. The tools will help managers and clinical teams realistically assess the effectiveness of existing care coordination and patient engagement processes and help identify areas for improvement, which will help their efforts to transform delivery systems to meet the triple aim objectives of improving patient experience, improving population health and reducing costs. The researchers will gain access to tools that measure the variability in cancer care coordination and patient engagement in diverse settings, which will help identify the characteristics of clinical teams, processes and health systems associated with delivery of high-quality care and to test interventions based on these characteristics.
Activities not responsive to announcement:
Tools that don’t measure care coordination; tools that don’t incorporate safeguards to protect privacy and confidentiality of information; design approaches that don’t account for scalability, interoperability or user-centered design; approaches that don’t plan for using tools in diverse sites and IT systems; validation of new measures.
Phase I Activities and Deliverables:
• Project team: Establish a project team, including proven expertise in: software development, user-centered design, care coordination measurement, team communication and clinical workflows, clinical oncology, and the design, deployment and use of health IT in a healthcare delivery organization. Knowledge and design of systems architecture, health IT interoperability, data security and HIPAA and other laws and regulations to protect privacy and confidentiality of patient information will be required.
• Develop a prototype platform to generate at least 5 cancer-relevant care coordination measures from EHRs and other relevant, IT platforms at one cancer care delivery site and to display them in the right format to the right user at the right time.
• Develop a prototype platform to assess clinical team composition; workflows and team interactions with health IT; flow of relevant data across diverse delivery sites; extent of patient engagement; type of health IT implementation, and organizational structure and policies relevant to the informatics tool development and implementation at one cancer care delivery site.
• Provide a report specifying approach to extend the platform by integrating additional
• care coordination measures and to scale the platform to multiple cancer care delivery sites with diverse IT systems.
• Provide a report detailing plans for implementation of technical assistance and delivery of software, platform, and measures developed, including a review of technical specifications for systems interoperability, within existing EHR and other health IT systems.
• Provide a report on the results of the first round of usability testing and the approach to modify the platform based on this user feedback. .
• Present phase I findings and demonstrate the functional prototype system to an NCI evaluation panel via webinar.
Phase II Activities and Deliverables:
• Enhance, beta test, and finalize system, data standards and protocols for a platform that measures and displays at least 12 existing cancer-related care coordination measures that are integrated within existing clinical workflows in at least three cancer care delivery sites that use at least two different IT systems.
• Enhance, beta test, and finalize system, data standards and protocols for a platform that assesses clinical team composition; workflows and team interactions; flow of relevant data across diverse delivery sites; extent of patient engagement; type of health IT implementation and organizational structure and policies relevant to informatics tool development in at least three cancer care delivery sites and at least two different IT systems.
• Provide a report that synthesizes feedback from all relevant categories of end-users (such as physicians, nurses, care managers and administrators) and summarizes the modifications made to the platform after each round of usability testing.
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• Provide a report specifying lessons learned and recommended next steps to extend the platform by adding a broad set of care coordination measures and to scale the use of the platform to multiple cancer care delivery sites and IT systems.
• Provide a report detailing plans for implementation of technical assistance and delivery of software, platform, and measures developed, including a review of technical specifications for systems interoperability, within existing EHR and other health IT systems.
• Develop systems documentation and user guides to facilitate commercialization, including citation and details of how systems align with current regulations and best practices in user-centered design, interoperability and protection of privacy and confidentiality of information.
• Present phase II findings and demonstrate the system via a webinar at a time convenient to the offeror and NCI program staff.
• In the first year of the contract, provide the program and contract officers with a letter(s) of commercial interest.
• In the second year of the contract, provide the program and contract officers with a letter(s) of commercial commitment.
