Wisconsin Collaborative for Quality Healthcare

2016 News

WCHQ partnering with the Medical College of Wisconsin to study the use of ineffective and unproven breast cancer treatments.

July 11, 2016

The Medical College of Wisconsin (MCW) is launching a study that will provide more insight into breast cancer care across the state.

The study is backed by a federal grant, which was awarded in 2014 to investigators at MCW by the National Cancer Institute (NCI). The grant is part of NCI’s Provocative Questions Initiative, an effort seeking “new approaches to reduce use of ineffective or unproven cancer treatments.”

Based on Choosing Wisely® lists from the American Society of Clinical Oncology, American College of Surgeons, American Society for Radiation Oncology and Commission on Cancer as well as recommendations from the National Comprehensive Cancer Network, MCW’s research team identified eight breast cancer tests and procedures that do not provide meaningful benefit to most categories of patients for whom they are commonly ordered.

The study is being carried out in partnership with the Wisconsin Collaborative for Healthcare Quality (WCHQ), a statewide consortium of 38 organizations focusing on quality reporting, WCHQ provides an ideal laboratory in which to test the proposed interventions.

“This research aligns with the mission of WCHQ to publicly report and bring meaning to performance measurement information that improves the quality and affordability of health care in Wisconsin, in turn improving the health of individuals and communities” said Judy Nowicki, Quality Improvement specialist for the Wisconsin Collaborative for Healthcare Quality. “We hope this data encourages conversations between providers and patients aimed at curbing certain tests and procedures that are not supported by clinical research.”

“WCHQ is already providing quality metrics for certain conditions or procedures, such as colonoscopy and mammogram rates for patients in our state,” said Ann Nattinger, MD, of MCW. “That was an advantage for us. It’s an uncommon resource we have. We didn’t have to start from scratch.”

Seven WCHQ health systems have agreed to participate in the study, which kicks off in July 2016. Investigators will measure how frequently the selected procedures are prescribed for breast cancer patients among participating practices and will report those metrics through WCHQ’s website. There will be four snapshots of utilization rates during a 30-month study period.

MCW will launch the second phase of the project in January 2017. In addition to the creation of an app – designed to provide just-in-time information, patient education materials and decision tools to providers – investigators will host educational presentations on the app and will encourage participating practices to promote the app via email reminders and updates.

At the conclusion of the second phase, MCW will examine whether the availability of the app coupled with public reporting had a greater impact than the public reporting alone—and if so by how much.

Researchers hypothesized that, over time, public reporting and the subsequent introduction of the app will lead to a change in practice patterns and the reduction in the utilization of unproven metrics.

“We are very hopeful, as things are proceeding well during the early stages of the work,” said Liliana E. Pezzin, PhD, of MCW’s research team. “We have had some early successes.”

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