ASCO Unveils New OMH Guidelines

The American Society of Clinical Oncology (ASCO) and the Community Oncology Alliance (COA) released new Oncology Medical Home (OMH) standards that are designed to help guide care providers as they treat patients, according to a press release by ASCO.¹

The OMH standards address the safe use and delivery of oncology drugs, patient-centered care coordination, effective patient communication, along with informed decision making and planning. They are meant to establish a benchmark for quality care delivery.¹

“Every single patient has the right to high-quality, evidence-based, and cost-effective cancer care. However, our challenge as clinicians and as a broader oncology community has been to define what that high-quality cancer care looks like,” said ASCO President Everett E. Vokes, MD, FASCO in the press release. “These new, comprehensive standards will remove ambiguity and serve as a strong foundation for all stakeholders to work together to ensure that every single person receives the care they deserve, throughout the entire patient journey.”¹

The recommendations were derived from 3 comparative peer-reviewed studies about OMH, 16 clinical pathway studies, and 1 systematic review of survivorship. The studies had several limitations, such as the small number of studies and the lack of long-term data outcomes. According to the standards practices should be encouraged to publish the results of OMH interventions in peer-reviewed journals in order to boost the evidence base.²

The suggestions are broken down into 7 parts: patient engagement, availability and access to care, evidence-based medicine, equitable and comprehensive team-based care, quality improvement, goals of care and palliative and end-of-life care discussions, and chemotherapy safety.²

Four standards fall under the subheading of patient care, according to findings. First, all patients should be granted an initial orientation to the OMH model and how that model is being enforced. Patients should also be made aware of policies related to the OMH model. Standard 2 indicates that patients should always be provided with the best estimate of out-of-pocket expenses for any new therapy they are offered. Patients should be offered financial counseling services and assistance programs. Standard 3 is that all patients should receive education on their cancer diagnosis along with the goals of treatment and an individualized plan. Standard 4 is that all patients should have a team-based survivorship care program. Survivorship care programs should have a plan, but this is not required.

In terms of availability and access to care, practices should make an effort to expand their services as much as possible and ensure that patients and providers are able to accesses these services easily. Patient’s emergency department visits, hospital admissions and readmissions, must also be tracked. These data should be evaluated in order to devise the best course of action for the patient. Documentation and follow-up should also be utilized for any patient who misses or cancels an appointment or chemotherapy treatment.

Standard 3 is evidence-based medicine. The guidelines suggest that patients always have access to value-and evidence-based care. Additionally, patients should be provided information on clinical research study information that is appropriate for the patient’s condition.

Standard 4, is equitable and comprehensive team-based care standard, and has 4 subparts. Subpart 1 is that in most instances, a medical oncologist should direct the patient’s care team within the practice and coordinate care with the patient’s primary physician. Subpart 2 suggests that the OMH prioritize team-based care with clearly defined roles and responsibilities while also sharing information between one another. Subpart 3 details that OMHs provide patients with a navigation system for support services and community resources. Subpart 4 indicates that health equity should be a priority for the practice and the cancer care space as a whole. 

Standard 5 is quality improvement. In order to meet this standard, OMHs should administer patient experience surveys at least twice a year or more. The results should help to guide practice. Additionally, OMHs should regularly evaluate how care can be approved.

Standard 6 is the goals of palliative and end-of-life care discussion. The standard suggests that practices routinely offer advanced care planning and discuss the goals of care. For patients with advanced or metastatic disease, consideration should be taken surrounding medical decision making and goals for end-of-life care.

Standard 7 is ensuring that any chemotherapy a patient receives is safe. Patients should have detailed treatment options.

“These new OMH standards provide oncology practices with a single set of cancer care delivery expectations that benefit patients, practices, and other stakeholders,” said COA President Kashyap Patel, MD in a press release. “As practices transition into value-based care delivery, those that adopt this framework will be able to focus on a standardized process that measurably demonstrates high-quality, patient-centered, and efficient care.”¹

Details about an ASCO-led OMH certification pilot will be announced in the coming months.

_REFERENCE:

_{1.New ASCO-COA oncology medical home standards set high bar, offers roadmap for comprehensive high-quality, patient-centered cancer care delivery. News release. July 13, 2021. Accessed July 14, 2021. https://bit.ly/3idPWkW.}

_{2.Woofter K, Kennedy E, Adelson K, et al. Oncology Medical Home: ASCO and COA Standards. Jour Clinc Onc Prac. DOI: 10.1200/OP.21.00167}