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U-M to lead initiative to improve breast cancer treatment in Michigan

One of five major statewide initiatives to improve quality of caresee their cancer return

added 12/13/05

Ann Arbor - A new initiative led by the University of Michigan Comprehensive Cancer Center in coordination with Blue Cross Blue Shield of Michigan will expand a pilot program to improve the quality of care for the more than 7,000 Michigan women diagnosed with breast cancer each year. The expansion of the program will increase the number of participating Michigan hospitals from two to 17 over the next three years.

Working with researchers at the U-M Health System, the Michigan Blues will invite five additional hospitals to participate in the newly developed Michigan Breast Oncology Quality Initiative starting in 2006. Hospitals will be selected based on their volume of breast cancer cases, their past participation in BCBSM’s Oncology Care Program, which is a collaborative effort to identify opportunities to improve cancer care, and their commitment to tracking and providing data.

The Michigan Breast Oncology Quality Initiative will be directed by Samuel Silver, M.D., Samuel Silver, M.D.Ph.D., professor of internal medicine at the U-M Medical School and director of the U-M Cancer Center Network, who led the initial pilot project.

Silver said this collaborative project will bring together members of the breast cancer treating team: medical and surgical oncologists, radiation oncologists, radiologists and pathologists. They will exam patterns of care in their hospitals and practices and compare them to NCCN practice guidelines. Specific points of comparison will include the use of chemotherapy, hormonal therapy and sentinel node biopsy—a relatively new diagnostic tool to determine if cancer has spread--in women with early stage breast cancer.

“We hope that providing this data to heath care teams will improve the use of evidence-based, cost effective therapy in the treatment of breast cancer,” said Dr. Silver.

The breast cancer initiative began as a pilot project by researchers at U-M and St. Joseph Mercy Hospital in Ann Arbor.

“The statewide collaborative will build on the work already done at University of Michigan and St. Joseph Mercy, Ann Arbor hospitals,” said David Share, M.D., M.P.H., clinical director for the Blues’ Center for Health Care Quality and Evaluative Studies, who is leading the company’s participation.

“This effort teams Michigan physicians and other health care professionals across the state to compare breast cancer treatment practices and determine which practices produce the best results. We’ll be gathering data on diagnostic testing, chemotherapy, radiation therapy, and surgery,” Share said. “Our goal is to improve both the quality and efficiency of care for women suffering from breast cancer statewide.”

The collected data will be placed in a registry established by the National Comprehensive Cancer Network.

The data registry will be used by the medical community to learn what works best in breast cancer treatment. New breast cancer patients will be invited to allow information regarding their care to be anonymously entered into the data registry. The goal is to gather data on 150 to 500 cases each year from the participating hospitals and then analyze the data to identify best practices, and to compare current practice to established, national guidelines.

“Creating the collaborative will improve the care of patients with breast cancer by enabling hospital systems and physicians to examine their patterns of practice and compare them against their peers and against evidence-based, nationally accepted practice guidelines,” Share said.

“Discovering and sharing best practices in health treatment improves quality of care for the patient and helps control cost,” Share said. “These types of quality improvement projects are just one way the Michigan Blues are working to achieve these goals.”

The Blues will fund a portion of the data collection costs as well as the cost of training staff at the participating hospitals to uniformly gather and interpret the data. They also will pay for the cost of the coordination of the project, including generating reports and organizing quality improvement interventions carried out by participants in the collaborative.

The breast cancer project is modeled after a similar successful effort undertaken by hospitals and doctors participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. That project has enhanced the care and safety of patients undergoing artery-opening angioplasty procedures across the state while saving more than $8 million in medical care costs annually.

It is the fifth in a series of Collaborative Quality Initiatives underway with sponsorship of the Michigan Blues in partnership with various Michigan hospitals and physician groups. The other quality initiatives are aimed at assessing and improving the quality of care in bariatric surgery, general and vascular surgery, cardiac and thoracic surgery, and cardiac angioplasty.

To learn more about breast cancer on the Cancer Center's visit the Breast Cancer Information page or call the Cancer AnswerLine™ at 800-865-1125.

Written by Nicole Fawcett

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