Dr. Robert S. Miller Discusses His New Role with ASCO’s Institute for Quality

Apr 25, 2015

By Jack Lambert, Staff Writer

When ASCO named Robert S. Miller, MD, FACP, FASCO, Medical Director of the Institute for Quality (iQ; instituteforquality.org) in September 2014, the appointment felt like a perfect fit. After 23 years assisting patients in private practice and serving as an Assistant Professor of Oncology and Oncology Medical Information Officer at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Dr. Miller welcomed the chance to work with a wider audience.

“It was the opportunity to do things at a level where I could help more customers,” Dr. Miller said. “Whether it’s a patient or a colleague, I could help more than one person at a time.”

In the following interview, Dr. Miller discusses his role with iQ and the future of oncologic care.

AC: What is your role in facilitating the Quality Oncology Practice Initiative (QOPI®; qopi.asco.org)?

Dr. Miller: My role is to tie together our content development. Generally, all of QOPI and quality starts with a clinical practice guideline. There are levels of medical evidence, and these get codified and analyzed by our content experts. The content experts analyze the science and say what the right answer should be, but it doesn’t stop there.

Then they have to create a measure, which is a question about some aspect of the care a patient received or a process that took place in the clinic. This has to be worded in a very specific way, so my team has to be experts in the language and wording.

Then content experts have to create the technical specifications to make sure that the question is being asked in the right way and that the answer it produces truly reflects the care delivered and what happened clinically.

Then team members field test the measures to see how well they perform in actual patient populations, before incorporating them into some type of an assessment program, such as QOPI.

AC: What do you see as the future of cancer care?

Dr. Miller: So many of the challenges we are facing today are tied to fundamental flaws in our health care system reimbursement. Historically, we have always just reimbursed based on episodes and quantity. The more services you deliver, the more fees you can collect, regardless of what you do within that service or patient encounter.

That’s changing, although it’s not changing as fast as we expected it to a few years ago. But there are plenty of examples of this already happening. If you’re going to be reimbursed on the quality of care you deliver, you have to be able to measure it. That’s what our QOPI program is about.

AC: Why should doctors consider enrolling in QOPI?

Dr. Miller: It’s inevitable that doctors will be measured on their ability to meet quality metrics, so they should start preparing for that now. Physicians better learn to adjust their practice so that they can demonstrate the quality of their care and adherence to guidelines because they can’t get away with not doing that for much longer; soon they’re not going to get reimbursed for their services without doing so. Of course, the most important reason to enroll in QOPI is that it is the right thing to do for our patients and to improve cancer care.

This article appears courtesy of ASCO Daily News.

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