Improving Patient-reported Measures in Oncology: A Call to Action

Published

This study explores the current landscape of oncology patient-reported measures (PRMs), which are tools that capture patients’ voices related to their care experience and outcomes, and patient-reported performance measures (PR-PMs), which translate PRM responses into metrics that may be used to assess healthcare performance, compare entities, and measure changes over time. The article also identifies barriers to implementation and recommends actions payers can take to advance the use of these measures.

The article leverages a multi-method research approach that included a literature review, landscape scan, stakeholder interviews and survey, and a multi-stakeholder roundtable.

Key findings include:

  • Within a universe of over 800 available PR-PMs, 515 crosscutting measures are applicable to oncology; and only 18 oncology-specific PR-PMs were identified. Some of this small number are already used in VBP programs.
  • Gaps in available oncology PRMs and PR-PMs include (but are not limited to) goal attainment, personalized medicine, socioeconomic status and survivorship.
     
  • Barriers to implementing further PRMs and PR-PMs in VBP include:
    • Existing PRMs and PR-PMs available for use in VBP may not be meaningful to patients and caregivers.  
    • PR-PMs selected for VBP use must be held to high methodological standards to ensure validity, reliability, and fitness for the purpose they serve.
    • Patient burden and survey fatigue arises from ongoing encounters with multiple providers. This could be exacerbated by irrelevant and/or complex questions.
    • Resource constraints and competing priorities increase the burden on providers from implementing PRMs and reporting PR-PMs. Program incentives may be insufficient to offset the needed investment.
       
  • Recommendations for public and private payers include:
    • Identifying or developing meaningful measures that fill gaps,
    • Engaging patients throughout measure and program development and evaluation,
    • Designing programs that include scientifically sound measures standardized to reduce patient and provider burden while supporting care, and
    • Engaging providers using a stepwise approach that offers resources and incentives to support implementation.