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Biannual Summary

The MOQC June Biannual meeting was held at the H Hotel in Midland, Michigan on Friday, June 16, 2023. The meeting featured interesting speakers and great discussion. It was a great opportunity to see one another in person. In addition to the update on MOQC measure performance and initiative updates, topics included palliative care, the palliative radiation pathway, patient-reported outcomes (PROs) at Henry Ford Health, the palliative care landscape in Michigan, and an update on POEM and cancer drug repositories.

Thomas LeBlanc, MD, MA, MHS presented on the topic of palliative care with a focus on the benefits of early concurrent specialist palliative care. He explained the difference between primary palliative care and specialty palliative care and stressed the concept that palliative care provides an extra layer of support for people facing serious illness. Dr. LeBlanc reviewed a number of clinical trials demonstrating that improved outcomes of integration of palliative care have included quality of life, symptom management, mood/depression, prognostic understanding, caregiver outcomes, utilization/costs, satisfaction, end-of-life outcomes, and survival.

Jennifer Griggs, MD, MPH presented an update on the Palliative Radiation Pathways and reminded attendees of the history of their development. Please see the section in this newsletter on Palliative Radiation Pathways for People on Hospice or Considering Hospice for more information.

Steven Chang, MD and Samantha Tam, MD presented on the PROs initiative at Henry Ford Health (HFH). They described how PROs have been incorporated into the standard of care for oncology patients at HFH and shared several stories illustrating the benefits of embedding PROs in their electronic health record. Additionally, Dr. Tam shared several analyses on the PRO data collected from patients. Results show that as a patient approaches the end of life, patient-reported quality of life (QOL) worsens and the number of domains that fall into a severe range increases. Patient-reported QOL was also seen to be predictive of health care utilization and may be predictive of overall survival.

Andrew Russell, MD, MPH presented findings from two separate surveys aiming to describe the current landscape of access to clinic-based palliative care (CBPC) and describe how oncology practices in Michigan utilize referrals to palliative care (PC) clinics. The conclusions presented included that most MOQC practices have no access to palliative care within their health system or group practice, that wide geographic disparities exist in access to palliative care clinics, and that despite this, 43% of MOQC practices would not use e-consults.

The final presentation was by Mark Wagner, PharmD, BCOP and Katie Sias, PharmD, BCOP on the POEM initiative. They described the current state of POEM – to date 6 clinical pharmacists, 24 oncology sites, and 72 physicians participate in POEM. They discussed the benefits that having a POEM pharmacist offers and the ways in which they have impacted patient care. They also shared that 3 practices have created local Cancer Drug Repositories (CDR) and that POEM, MOQC, MICMT, and other stakeholders are working to develop a new, non-profit, state-wide repository called YesRX.