BOSTON-Several initial takeaways from the Quality Care Symposium, held here last month:
* Frustration with electronic health record systems is increasing: One of the major drivers for EHR technology is that, at the theoretical level, it should improve the quality of patient care. Representatives from four major EHR vendors shared their perspective of how this works, but I got the sense that the audience wasn't with them. Session Chair Douglas Blayney, MD, asked why smartphones can be so easy to use when EHRs are so clunky. Barry Brooks, MD, said some EHRs are a patient-safety hazard. The vendors said they are working it, but nobody pushed back against the criticisms.
* Value (quality divided by cost) is not always intuitive. Although academic medical centers are considered the most expensive-and best quality-health care providers, Christine Marie Veenstra, MD, Clinical Lecturer in Hematology & Oncology at the University of Michigan Health System, presented results from a study that found that the cost of care for Stage II and Stage III colon cancer patients was not more expensive at an academic hospital than a community hospital (Abstract 6). And, by the way, overall survival time was the same, regardless of academic or community hospital.
* There are so many standards-and yet not enough. The importance of standardization in cancer care has been a drumbeat in recent years, but Monika Krzyzanowska, MD, MPH, of Princess Margaret Cancer Centre, made an excellent presentation on the lack of standards for oral therapies that are sent home with patients. Who knows if the medicines are taken as directed?
* Big data to the rescue? After seeing presentations about PCORnet, the Integrated Cancer Information and Surveillance System, the National Cancer Institute's Surveillance, Epidemiology and End Results program, the Commission on Cancer's National Cancer Database, and CancerLinQ, I was so dizzy I can't remember exactly what any of them do. However, the excitement by each of the presenters made a big impression on me; each believes that data gathered, analyzed, and shared in new ways will lead to cancer treatment breakthroughs heretofore unimaginable.