QOPI Overview and Frequently Asked Questions
What is QOPI™?
ASCO's Quality Oncology Practice Initiative (QOPI) is an oncologist-led, practice-based quality improvement program. QOPI's goal is to promote excellence in cancer care by helping practices create a culture of self-examination and improvement.
"QOPI for Fellows" is solely a designation; there is not a separate QOPI. Fellowship programs would be using the same QOPI system and guidelines as all other participating practices.
Practices participating in QOPI conduct retrospective chart reviews, twice each year, of oncology care delivered in the outpatient setting. QOPI includes a menu of measure sets, customizable by the user; a specified chart selection strategy; a secure, web-based application for data entry; automated data analysis and reports that provide practice-specific and aggregate comparison data; and a network of resources for improvement.
To register for "QOPI for Fellows," please visit http://www.asco.org/qopi.
How can training programs use QOPI for their fellows?
Data collection occurs in the spring and fall of each year. During data collection periods, participating fellows will identify outpatient charts according to the methodology described in the QOPI User Manual and conduct a retrospective abstraction of data from the selected charts. The number of charts abstracted will depend on the measure modules selected by the practice (a minimum of two); the minimum number of charts required for participating is 48 (24 per module) for a practice with one medical oncologist FTE. Participating physicians should not abstract their own charts.
QOPI practices submit de-identified data via a secure ASCO website. Within the QOPI Data Entry and Reporting Tool, a web-based data entry form prompts abstractors through the chart abstraction process.
Following every data collection period, the QOPI system generates a report for each practice comparing their results to the aggregate data of all other participants. Practice-specific data are kept strictly confidential. If requested, ASCO staff will provide additional reports to fellowship programs that compare fellowship data to other participating fellowship programs for each measure assessed during the collection period.
This early exposure to quality improvement positions physicians to incorporate QI into their practice from the onset. Additionally, QOPI data can be used to satisfy the requirements of the American Board of Internal Medicine's Self-Directed Practice Improvement Module which provides 20 points towards Maintenance of Certification.
After the successful piloting of fellowship program participation in QOPI during the last three data collections, ASCO invites all medical oncology fellowship programs to register for QOPI and participate in the fall collection.
How the ACGME competencies are addressed by participating in QOPI:
- Review and improve patient care through application of quality indicators.
- Apply current medical knowledge to patient care through selection, discussion and updating quality indicators.
- Utilize interpersonal and communication skills in peer review discussion.
- Assess and demonstrate professional ethical behavior, through peer review and concern for patients.
- Assess and demonstrate awareness of systems-based practice as manifested by knowledge and development of quality indicators and application of uniform standards.
- Demonstrate practice-based improvement through initial chart review, review of QOPI data, improvement of challenging areas, and follow-up on QOPI data.
Amye Tevaarwerk, MD, a fellow at the University of Wisconsin, published her experience with QOPI in the July 2008 issue of ASCO News & Forum. You can read her perspective here.
Please visit the presentation on QOPI from the 2007 Training Program Directors' breakfast here. This presentation will give you a better idea of how the program works and how it may help your fellows.
To learn about Dr. Laurie Lyckholm's experience with the "QOPI for Fellows" Pilot Program during Spring of 2007, please visit here.
Frequently Asked Questions
- What are the registration requirements for QOPI to participate as a fellowship program?
Register at www.asco.org/qopi. There is a registration document at this site that will provide all questions that will need responses, prior to actually entering data into the on-line registration tool. Key information requested includes the following:
- ASCO member ID for training program administrator, medical director, or other representative of the fellowship program
- Consent with a Data Use Agreement
- Responses to general questions regarding participation in QOPI (voluntary participation, consent to fellow methodology, promote participation in two rounds of QOPI, etc.)
- Practice specific information - name, address, practice characteristics (number of medical oncologists, number of new patients seen annually, practice affiliation.) Please include "Fellow" or "Fellowship" in the practice name, to facilitate identification of the fellowship programs.
- Key participation information - corresponding physician name and email, administrator name and email, abstractor's name and email, fellows' name and email
- Create login and passwords for each registered participant
Practices and fellowship programs must be registered by late August to participate in the Fall data collection and late February to participate in the Spring data collection. Programs only need to register one time to be eligible to participate in multiple data collection periods.
2. Do I need IRB approval to participate in QOPI as an academic center?
As QOPI collects de-identified data for quality assessment and improvement rather than research, most practices and institutions do not require IRB approval for participation. Each institution, however, must determine its own requirements and plan for sufficient time to gain approval, if required.
3. How many charts are required per fellow or fellowship program to participate?
Target sample size is based on the number of medical oncologist FTE at a particular office/clinic location.
For the Fall 2007 data collection, sample size targets are listed below. Please see the QOPI User Manual for a detailed explanation of chart selection methodology.
|
Modules
(Select 2 at a minimum)
|
Target # Charts Per Site
|
|
# medical oncologist clinical FTE
|
|
1
|
2-3
|
4-6
|
7 or more
|
|
Disease Specific
|
|
|
Breast cancer
|
24
|
32
|
34
|
40
|
|
Colon and rectal cancer
|
24
|
32
|
34
|
40
|
|
Lung cancer
|
24
|
32
|
34
|
40
|
|
Non-Hodgkin’s Lymphoma
|
24
|
32
|
34
|
40
|
|
Domain Specific
|
|
|
Care at End of Life
|
24
|
32
|
34
|
40
|
|
Clinical Trial Assessment
|
24
|
32
|
34
|
40
|
|
Symptom / Toxicity Management
|
24
|
32
|
34
|
40
|
|
Total for 2 Modules
|
48
|
64
|
68
|
80
|
We recommend that you base the number of charts on the percentage of time fellows spend treating patients. As an example, if you have 7 fellows who may participate in QOPI and combined they treat patients three full days a week - they would equate to .6 FTE - so you could use 1 FTE sample sizes. If only two modules were selected, then 48 charts (24 per module) is the requirement - roughly 7 charts per fellow over the 5 week collection period. We do recommend that physicians/fellows do not abstract their own charts.
4. What is the time requirement for a fellow to participate in QOPI?
Based on feedback from participants, the following provide average time requirement estimates:
| Time to identify and pull chart |
6 minutes |
| Time to abstract data |
25 minutes |
| Time to enter data in web tool |
15 minutes |
| Total time per chart |
46 minutes |
5. How long is the data collection period open?
Five weeks
6. Will I receive reports for each fellow who participates in the program?
Generally, reports for the fellows are provided as a collective group given the small sample size of charts. If, however, you would like to receive reports for each fellow, for each chart abstracted, the fellow that treated the patient would be selected from a drop down menu of pre-entered fellow names in the QOPI Data Entry and Reporting Tool. For each fellow, the target sample size would be 48 charts (24 per module). The program director may choose to adjust target sample size based on FTE estimation for the fellows.
7. When is the next QOPI data collection?
The Fall 2009 collection round is tentatively scheduled for September 24 through October 29.
Please contact
qopi@asco.org with any questions.
