July 2013 Edition Vol.7, Issue 7

An OBR Survey: Ownership and Usage of Oncology Treatment and Diagnosis Data

An OBR Survey: Ownership and Usage of Oncology Treatment and Diagnosis Data (cont.)

Several respondent indicated that being able to leverage their EMR for higher payer reimbursement is the holy grail of data collection – that using data to tell a story of clinical success or demonstrate savings or validate that treatment decisions aided the patient is a vital, top priority for their group. 

“It’s our number one goal this year. We are making headway. The plans want this too,” a Florida-based oncologist said. “They don’t understand how to manage these patients so they’re looking to us.”

For oncology vendors and pharmaceutical companies, the biggest finding may the 44% (noted in Figure 8) who aren’t compensated for providing data, but believe they should be in some way. Most of them were also unaware that their treatment decision data are aggregated and sold, though OBR believes that some of these oncologists may be unaware of their practice’s compensation agreements with vendors.

“I collect a ton of data and could spend days and weeks providing it – there should be a value to all this data we collect and distribute,” according to a hem-onc from a four-doctor practice in Iowa.

A majority of respondents said the requests for data are increasing.

“We had a firm last week wanting $205 for reviewing/providing info from 5 patient charts. I don’t have that kind of time without being truly paid.”

A few (about 7% of those surveyed) are responding to these sorts of requests by actually hiring data managers.

“Just hired 1.5 FTEs to focus on handling data requests from any vendor,” said the executive director of a 15-physician oncology group in Texas.

Most of those who want to be compensated are somewhat unsure of the true dollar value of their data. OBR asked how much the data are worth – per patient – and the responses suggest that few, if any, have truly evaluated this and many are uncomfortable benefiting significantly from the data (Figure 10).

 

Ten percent (10%) would expect between $5,000 and $15,000 for sharing a single patient’s total data, including full history. The exception is one oncologist from a dominant group in Arkansas who valued his data at $1 million for all patients, an indication that he is uncertain about compensation, but also fed up.

“Everyone benefits from my data but me,” he said in a phone interview.

OBR believes the trend in asking or demanding compensation won’t accelerate significantly in the next year, but there’s clearly talk about it; 52% of those who will seek compensation said they have no formal plans this year to address this, but will probably hold an internal meeting to evaluate opportunities.

Aggregation Begets Quality

Financial benefits aside, oncologists also see quality of care value in pooling or aggregating data. About half of respondents think sharing clinical data with health plans could improve quality of care, if data are used to develop evidence based treatment protocols (Figure 11).

Nearly all of those who believe sharing patient data with health plans has quality of care benefits said they have already been involved in pay for outcomes “pilots” with various payers; there’s more skepticism about whether government and drug company access to data will improve quality.

Sharing data with health plans has for some already proven valuable, particularly larger groups; 6 groups who defined themselves as “the only show in town” said they are reimbursed based on a shared savings contract.

“We’ve move to an arrangement based on paying for quality – true collaboration.”

Several said they started exchanging information and building pathways with health plans as a means to improve outcomes.

“Cancer is complex and treatment must be tailored, but the more I know the more apt I am to treat more effectively,” revealed one respondent whose 5-physician oncology practice competes in a major Midwest market with academic centers.

There’s belief that sharing data could at least improve quality of life and perhaps on some small level survival (by weeks or a month or two). There are some (about half) who don’t see a true link yet between data and quality for cancer care; their thought is that government is most interested in cost control and standardization and that even a more open exchange will not ultimately improve quality.

Likewise, the primary perception is that drug manufacturers would not necessarily promote data unless it benefited their product.

“I don’t see very many head-to-head trials. I think there could be value in sharing clinical data with drug companies, as long as they are incented to help the patient – that’s a discussion that needs to happen.”

Key Takeaways

  • If the study reveals anything, it’s that demand for cancer patient data has clearly caught the attention of community oncologists. Over the next 2 to 3 years this demand will expand as EMR adoption accelerates and will likely spur some response from disenchanted oncologists.
  • To take control, OBR expects some groups will band together either in their local markets or within their practice sub-specialties. Vendors who touch oncology data (EMR and IT vendors) and those who stand to benefit or lose from the data’s findings like drug manufacturers should prepare for this evolving trend.
  • As oncologists share more data with payers in hopes of securing more favorable reimbursement, manufacturers and IT-related businesses should also, at a minimum, expect oncologists to be more vigilant than they have been in how much data they share.

If data pools develop as oncologists suggest, accessing cancer patient data will eventually come at a higher cost, though the patient benefits of data exchange will potentially be far greater.

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