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Providing real time online reports for local quality assurance

Providing real time online reports for local quality assurance. Pär Stattin 1 Fredrik Sandin 2 David Örtquist 2 Lena Damber 3 Erik Holmberg 4 Håkan Cederberg 4 Mats Lambe 2 Dept of Urology , Umeå University 1 Regional Cancer Centers Uppsala 2 Umeå 3 Göteborg 4.

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Providing real time online reports for local quality assurance

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  1. Providing real time online reports for localqualityassurance Pär Stattin1Fredrik Sandin2 David Örtquist2 Lena Damber3 Erik Holmberg4 Håkan Cederberg4 Mats Lambe2 DeptofUrology, Umeå University1 Regional Cancer Centers Uppsala2 Umeå3 Göteborg4

  2. Disclosureconflictofinterest • I have not beenpaid for talks • I have given adviceto Ferring Pharmaceuticals • The Swedish Association ofLocalAuthorities and Regions and The Swedish Regional Cancer Centres funded NPCR and the real time online reportproject • The Swedish Research Council, The Swedish Cancer Society& Västerbotten County council, Umeå funded my research • The Swedish Research Council funded my costs for thisconference

  3. Outline • introductionto National Prostate Cancer Register of Sweden • current status real time online reports • work in progress

  4. National ProstateCancer Register of Sweden • nation-wide 1998 • 98% prostate cancer cases Swedish Cancer Registry • tumourcharacteristics, waitingtimes, diagnosticwork-up primarytreatment • from quantity register toquality register • necessary vs. nicetoknow • annualreport • long time date ofdiagnosistoregistration • online forms for registrationsince 2007 • differencesin manyaspectsof cancer carebtw hospitals Van HemelrijckInt J Epidemiol 2013

  5. Reportedto NPCR within 1 monthafter date diagnosisrange 0-93% Sweden 27% 0 20 40 60 80 100%

  6. Curativetreatment for locallyadvancedPca < 80 years, range 0-88% Sweden 50% 0 20 40 60 80 100%

  7. Improveimpactof register data by useof real time online reports • qualityassurance& benchmarkingrequiresrapid registration short shelftime for manyvariables • comprehensive data set requiresinteractionwith data

  8. Comparedwithwhat? Data in relation to • results by otherhealthcareproviders • goals for selectedqualityindicators

  9. INCA Information Network for Cancer Care platformall cancer quality registers data registration and display personal information on 100 000+ prostate cancer cases authentization for access

  10. Diagnostics No cases Risk category, trend Risk category, 6 months Risk categoryselection Bone scan 6 months Bone scanselection Waitingtimes Waitingtimes last 6 months Waitingtimesselectiontime 6 Treatment Capture 6 months Captureselection TreatmentlocalizedPca No RP at clinic 6 months No RP selection Nervesparing intention 6 months Nervesparing intention selection Positive margin 6 months Positive marginselection Neoadjuvant ADT & RT6 months Neaoadjuvant ADT & RT selection

  11. Range hospitals 24-75 days

  12. median all 35 days range 24-75 days median metastases 19 days range 9-25 days

  13. Sweden 82% range 25-100%

  14. Sweden 55% range 12-75% Sweden 77% range 60-90%

  15. Howcanweprovidemoreactionable data? selectindicators, cutoffs for 3 levelsofquality subpar red under lowercutoff  acceptable yellow over lowercutoff  good green over uppercutoff  30% 60%

  16. Qualityindicators 10 indicatorsselected National Guidelines for Prostate Cancer care Capture, administration, and waitingtimes proportion ofmen reportedto NPCR < 1 monthafterdiagnosis (6%) 30%, 60% designatedcontactnurse (new) 45%, 90% multidisciplinaryconferencehigh risk cancer (32%) 30%, 60% timereferraltofirstconsultation < 60 days (74%) 70, 90% timebiopsyto cancer information < 18 days (17%) 30%, 60%

  17. Qualityindicatorscont´ Treatmentstrategies proportion of men verylow risk Pcaactivemonitoring (78%) 70%, 95% • high risk PcaeligiblecurativeTxwhoundergobonescan (75%), 70%, 95% • high risk Pca & lifeexpectancy > 5 yearswhoreceive curativetreatment(72%) 70% 95% Treatmentdocumentation & execution proportion of men Documentednerve-sparing intention (88%) 70%, 95% negative surgicalmargins (76%) 70%, 90%

  18. Conclusion real time online reporting from quality register feasible valuabletoolfor qualityassurance linkagescanefficientlyprovide data for audits

  19. Timelinessregistration in NPCR Cumulative proportion captured Monthsafterdiagnosis

  20. Timelinessregistration in NPCR Cumulative proportion captured Monthsafterdiagnosis

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