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Degree of Cancer Care Coordination among Primary Care, Gastroenterology, and Oncology through Service Agreements

Haggstrom DA, Doebbeling BM, Jones LE, Yano EM. Degree of Cancer Care Coordination among Primary Care, Gastroenterology, and Oncology through Service Agreements. Poster session presented at: AcademyHealth Annual Research Meeting; 2008 Jun 8; Washington, DC.


Objectives: The use of patient registries is an important tool in the promotion of high quality care. In the US, only 47% of physician organizations reported having a registry for at least 1 chronic illness. Our objective was to examine the extent of patient registry use in VHA. Methods: The 2006 VA Clinical Practice Organizational Survey, funded by Office of Quality and Performance and HSRandD, assessed organizational processes potentially related to performance. This national VA survey of 111 VA Chiefs of Staff (response rate, 88%) asked about the “use of established registries and the “creation of ad hoc registries”. Respondents were also asked whether their facility systematically identified patients with various chronic conditions through disease registries or patient panels, and how useful the registries had been in patient care. Results: Use of established VA registries was high (88%), while creation of ad hoc registries was lower (64%). The registries most commonly reported were for cancer (68%) and diabetes (52%), while the registries least commonly reported were for obesity (21%) and smokers (20%). Almost all registries were perceived to be “very” or “somewhat” useful in patient management (range, 81%-100%), including the cancer registry (89%). Conclusions: Barriers to the use of disease registries in the VA appear to occur in their initial development given that, once implemented, disease registries are widely perceived as useful. Clinical diseases were more likely to be the subject of registries than clinical risk factors. Established registries were more common than ad hoc registries, most likely because of the costs involved in developing a new, local registry tool. Implications for Policy, Delivery or Practice: From a VA perspective, this study provides information about what practice management resources are being utilized in the VA nationwide. From a non-VA perspective, this baseline data provides estimates as to what registry development is possible in an integrated delivery system and what types of registries initially may be most feasible.

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