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Disease-Specific Clinical Performance Groups

High-quality, patient-centered cancer care is highly dependent upon coordination of multiple specialties, including surgery, radiation oncology, medical oncology, pathology, radiology, and other ancillary staff. Equally important is the timely and consistent exchange of clinical information among the care team.

Multidisciplinary care teams or Disease-Specific Clinical Performance Groups (CPGs) create a structure for cancer care providers to exchange such information related to a specific cancer disease state on a consistent basis and to utilize this information to set goals driving continuous quality improvement. CPGs, along with tumor conferences, are the backbone of a truly multidisciplinary program in a specific disease site, such as breast, head & neck, colorectal, thoracic and others, elevating the level of care provided to patients affiliated with these diseases.

Of particular importance is advancing CPGs in the era of value-based cancer care in which payment will be directly attributed to the management of care episodes or disease states. We explore CPGs in more detail, considering their characteristics, purpose, process, and critical success factors.

What are the key characteristics of a CPG?

CPGs should be a collaborative and multidisciplinary approach to assessing, planning, managing, monitoring, coordinating, and evaluating the delivery of cancer care services. Centered on a specific disease site, CPGs are characterized by:

  • Disease-site specific expertise
  • A focus on creating a differentiated patient experience
  • Alignment of physicians and all ancillary staff who educate, diagnose, stage, treat, and follow cancer patients
  • Physician-driven recommendations across the continuum of care
  • Development of process improvement systems

In the figure below, physician specialties and ancillary staff coordinate across the continuum of care with the patient always in the center of the process.

What is the purpose of a CPG?

The principal objective of a CPG is process and quality improvement for cancer patients and providers. Specific objectives outlined below relate to the primary focus of lessening barriers to care across the cancer continuum. CPG participants should expect to:
  • Define the scope for the disease-specific program
  • Collect data to evaluate and support development of the program
  • Process map the patients’ cancer care journey
  • Develop and implement appropriate clinical pathways and treatment plans
  • Develop clear strategies and tactics in cancer management
  • Identify opportunities to improve detection, treatment, and overall process
  • Identify opportunities to increase enrollment in clinical trials
  • Evaluate latest treatment options
  • Develop quality indicators (dashboards) and monitor and evaluate outcomes
  • Work to prepare the tumor-specific program for value-based reimbursement

What is the overall process of a CPG?

Regardless of disease site, CPGs follow a similar process of program improvement. Phases include: (1) determining a baseline for a specific program component (i.e., patient or physician education, screening, diagnosis, or treatment); (2) identifying gaps, barriers, or opportunities for that program component; and (3) developing an implementation plan with steps to address the identified gaps or opportunities.

As with any project plan, the team must periodically monitor implementation activities to ensure effectiveness and alignment with goals set forth by the team. This periodic monitoring is often completed through a bi-annual dashboard.

Ongoing CPG meetings are then utilized to continuously define best practices or pathways for the program, to implement actions toward reducing variations in care or improving patient experience, and to address any additional real-time issues related to broader oncology services and patient care.

Who should participate in a CPG?

Team membership often includes the following disciplines: medical oncology, radiation oncology, surgery, primary care, pathology, radiology, social services, patient navigators/care coordinators, nursing, tumor registry, clinical research, and nutrition. The CPG is led by a physician chair or co-chairs with administrative support.

The typical time commitment for a CPG may be monthly orbi-monthly meetings with the entire team and periodic calls with specific group members to work on identified action items from group meetings.

What are critical success factors of a CPG?

Oncology Solutions has directly facilitated more than 75 CPGs and has identified the following critical success factors:

  1. A CPG must be committed to the ongoing assessment of quality and patient care of the disease-site program. CPG members must be flexible in order to adapt to or make changes that achieve the highest quality outcomes and processes for patients.
  2. A CPG must have administrative support and institutional leadership buy-in. The ability of all parties to come together to develop a unified approach through a consensus driven process—integrating private practice physicians where appropriate—will be a critical success factor.
  3. Administrators may facilitate CPG meetings and handle follow-up action items, but a CPG’s success is heavily dependent on the leadership of the physician chair or co-chairs. When selecting a physician chair or co-chairs, it is important for the physician(s) to be committed to and engaged in the future direction of the team and disease-site program.

Oncology Solutions is a trusted advisor and operational partner providing strategic and business planning, physician integration program development, and facilities planning assistance, spanning 43 years and 1,800 projects. We work for small and large community hospitals and health systems as well as academic medical centers and NCI centers. Let us work for you to develop disease-specific Clinical Performance Groups. Call us today at 404.836.2000 or email us at [email protected] to inquire about our CPGs or broader oncology consulting capabilities. At Oncology Solutions, we are reimagining cancer care—one program at a time.