In 2015, the Commission on Cancer (CoC) completed an initial OMH pilot and accredited nine practices. In January 2016, the CoC conducted additional pilot surveys as part of the OMH accreditation process. The two key expenses targeted by most OMH plans are:
- Emergency room visits and inpatient hospitalizations – with smaller savings expected from evidence-based regimes and
- Earlier transitioning of applicable patients to hospice care.
Is it an insurmountable task to become an accredited Oncology Medical Home? Not at all. Here are the characteristics of the accreditable oncology medical home, with relevant tips for helping to meet the goal.
Basic Eligibility: physician commitment to the OMH model, electronic health records (EHR), and using data to measure performance.
- Tip: The OMH needs to have access to both hospital and office records 24 hours a day from anywhere. This means a central platform is required to house all of the records for the patient, so nothing is missing. Use your oncology care coordination platform here.
Patient Engagement: Empower and educate patients to understand their treatments and the side effects, where to go for medical care, and financial counseling.
- Tip: Have a patient engagement partner here, because it is difficult to do this yourself. Again, oncology care coordination platforms can help enormously in this regard by combining patient engagement activities with care coordination, which go hand in hand. This also increases patient satisfaction and helps control patient over utilization of ED services.
- Tip: Financial counseling is crucial for most cancer patients. If one is not available through a local Cancer Center or hospital campus, use Cancercare or another non-profit.
Expanded Access: Provide patients with same-day (24/7) urgent care on weekdays, weekends, holidays, and evenings to avoid emergency department visits.
- Tip: Most OMHs have a 24-hour-a-day call service. During office hours, the triage nurses on the phone should politely insist that your patients come to the office at any time for IV hydration or urgent symptoms, rather than report to the emergency room. Some OMHs go as far as offering evening or weekend hours: the key is to watch when call volumes increase after 5pm or on weekends. This is where reporting on OMH metrics can really pay off.
Evidence-Based Medicine: Follow standardized evidence-based guidelines consistent with National Comprehensive Cancer Network (NCCN) or American Society for Clinical Oncology (ASCO); demonstrate safe medication usage and appropriate utilization of laboratory and imaging study resources and encourage clinical trial enrollment.
- Tip: Most use the NCCN guidelines. Do not forget, however, that scientific breakthroughs outpace the guidelines so it’s important that bureaucracy within the practice or standard protocols not pin you to outdated treatments. Evidence-based medicine means using what works the best, for the best value. Occasionally a patient will require a unique solution. You should be ready to make those one-off decisions. There are providers of such "pre-auth regime medical review services” on the market today. If you need a referral, contact us.
Comprehensive Team-Based Care: Focus on addressing the full scope of patient needs (medical, economic, and psychosocial) and developing relationships with external providers and hospitals providing care to the OMH’s patients.
- Tip: Navigators are essential here as they play a crucial role in keeping the team on point and also triage personnel for incoming requests (see expanded access). One OMH uses non-medical personnel to follow scripts for 22 common complaints in order to triage patients and direct them to the appropriate level of care, including empowering nurse navigators to solve problems without checking with the doctor first.
- Tip: Having a platform like Cordata to bring the team together virtually makes this a fairly easy item to check off.
Quality Improvement: Continually review and measure the care within the practice and compare performance to other practices. Demonstrate the provision of high-quality care through performance summaries and data submission.
- Tip: This requires a care coordination platform that is designed for oncology specifically. Such a platform will alert the care team and care coordinators running the OMH as to daily, weekly and monthly measures. If you don't measure it, you cannot control it, change it or improve it.