Evidence-Based Practices Improve Value-Based Care Across Hospitals

The implementation of evidence-based treatment strategies has improved cost-savings and supported value-based care models across three distinct oncology practices within Cedars-Sinai Medical Center, according to data presented at the ASHP 2017 Midyear Clinical Meeting and Exposition.

Bruce Vinson, PharmD, BS, FASHP, associate director of pharmacy services at Cedars-Sinai Medical Center, presented findings on how collaborative infrastructure practices have fostered standard treatment approaches and utilized pharmacy resources, while still allowing for deviation from standardized protocols when appropriate.

In order to accommodate the growth of their institution’s oncology practices and account for practice changes—such as the introduction of immunotherapies and the expansion of targeted chemotherapies—Dr Vinson and colleagues created a shared decision-making infrastructure that uses evidence-based medical practices to facilitate cost-savings measures within the cancer treatment arena.

The hospital system developed a subcommittee to approve guidelines, policies, and quality initiatives that could be used to influence treatment decisions. Practice leaders in oncology and pharmacy developed guiding principles for 14 disease-specific review groups (DRG), which utilized expertise from specialists across disease states to develop specific treatment guidelines and a value-based framework.

Clinical oncology pharmacists were engaged to create disease-specific recommendations from existing guidelines, using Level 1 and Level 2A published literature as acceptable criteria. Participating DRG groups evaluated new therapeutic recommendations on a quarterly basis.

Dr Vinson and colleagues reported that the DRG allowed Cedars-Sinai Medical Center to standardize treatment patterns in 32 disease states by implementing 520 evidence-based practices. The hospital center created a chemotherapy stewardship program overseen by pharmacists, which evaluated patients based on treatment algorithms and performance status.

A reduction in supportive care therapies through this initiative resulted in a cost-savings of $3,000,000 over the course of 2 years. 

“A collaborative infrastructure across diverse oncology practices using evidence-based practice enabled us to achieve consensus across three very different oncology practices,” Dr Vinson and colleagues wrote.

—Cameron Kelsall