Abstract Details

Title Driving Continuous Improvement of MS Care Quality –Year One Experience and Findings from the Multiple Sclerosis Continuous Quality Improvement (MS-CQI) Research Collaborative

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-077

Objective To report baseline patient reported outcomes (PRO) and electronic health record (EHR) results from year one from four participating multiple sclerosis centers from varied settings (academic, private practice, community hospital).

Background

The MS-CQI Collaborative is the first multi-center learning health system (LHS) for quality improvement (QI) research in multiple sclerosis (MS) in the United States. Initiated in June 2017, the MS-CQI Collaborative aims to leverage continuous QI methods to improve MS care quality by benchmarking system-level performance indicators and testing QI interventions across centers.

Design/Methods

Measures including real-time PRO, administrative data, and clinical EHR data were collected to establish baseline and conduct benchmarking analyses in the first year. In years, two and three, one site per year will be randomized to an improvement intervention following a step-wedge randomization design.

Results In all, 6,380 PRO responses were collected in the first year, representing 280 participants (85% female, 92% White). Twenty-One PRO measures are being collected, including but not limited to (mean, SD): PHQ-9 (6.0, +/-5.0) Neuro-Qol Cognitive (31.0, +/− 7.0), PDDS (2.0 +/− 2.0), and PROMIS FatigueMS (22.0, +/-8.0). In addition, 5,661 clinical encounters across 11 EHR measures were collected. Overall collaborative utilization proportion of: (1) disease modifying treatment (DMT) = 79% (range: 65-86%); (2) MRI in past year = 67% (range: 59-73%); (3) hospitalizations= 8% (range: 2-16%); and (4) Emergency Room visits = 9% (range: 5-13%). Longitudinal statistical process control (SPC) analyses reveal that the point estimates for collaborative utilization are currently in statistical control. Cross-sectional SPC analyses found non-random variation in utilization between centers. Longitudinal analyses for DMT, MRI, hospitalizations, and ER utilization will also be presented.

Conclusions The MS-CQI Collaborative has demonstrated feasibility and acceptability in year one. Benchmarking analyses have identified performance variation patterns in utilization that will inform system-level improvement interventions in year two.

Authors/Disclosures
Brant Oliver PRESENTER	Brant Oliver has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for @ Point of Care. The institution of Brant Oliver has received research support from Biogen.
	No disclosure on file
	No disclosure on file
Michelle Patel	No disclosure on file
Caroline Geremakis	No disclosure on file

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