BackgroundQuality measures are important because they can help improve and standardize the delivery of cancer care among healthcare providers and across tumor types. In an environment characterized by a rapidly shifting immunotherapeutic landscape and lack of associated long-term outcome data, defining quality measures for cancer immunotherapy is a high priority yet fraught with many challenges.MethodsThus, the Society for Immunotherapy of Cancer convened a multistakeholder expert panel to,first, identify the current gaps in measures of quality cancer care delivery as it relates to immunotherapy and to,second, advance priority concepts surrounding quality measures that could be developed and broadly adopted by the field.ResultsAfter reviewing the existing quality measure landscape employed for immunotherapeutic-based cancer care, the expert panel identified four relevant National Quality Strategy domains (patient safety, person and family-centered care, care coordination and communication, appropriate treatment selection) with significant gaps in immunotherapy-based quality cancer care delivery. Furthermore, these domains offer opportunities for the development of quality measures as they relate to cancer immunotherapy. These four quality measure concepts are presented in this consensus statement.ConclusionsThis work represents a first step toward defining and standardizing quality delivery of cancer immunotherapy in order to realize its optimal application and benefit for patients.

Funding for this project was provided by the National Pharmaceutical Council (NPC). Westrich and Dubois are employees of the NPC. Valuck is a partner with Discern Health. Blaisdell and Dugan are employed by Discern Health. McClellan reports fees for serving on the Johnson & Johnson Board of Directors. Dugan reports consulting fees from the National Committee for Quality Assurance and Pharmacy Quality Alliance. The remaining authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article. Study concept and design were contributed by Blaisdell, Valuck, Dugan, and Westrich. Blaisdell took the lead in data collection, along with Valuck and Dugan, and data interpretation was performed by Valuck, Blaisdell, Westrich, and Dubois. The manuscript was written by Blaisdell, along with Valuck and Dugan, and revised by Valuck, Westrich, Miller, and McClellan.

Genetic counselors strive to provide high-quality genetic services. To do so, it is essential to define quality in genetic counseling and identify opportunities for improvement. This Professional Issues article provides an overview of the evaluation of healthcare quality in genetic counseling.

Background: There is 1 multiple myeloma (MM) quality metric available (treatment with bisphosphonates, developed by the American Society of Hematology) to evaluate the quality of cancer care delivered to improve patient experience and outcomes. As many community practices integrate specialty pharmacy (SP) services into their practice, patient education, treatment adherence, and visit scheduling coordination are becoming increasingly complex, particularly for treatments with Risk Evaluation and Mitigation Strategies (REMS) programs. We sought to understand the fundamental challenges facing a multisite community oncology practice undergoing SP centralization to identify potential quality gaps for patients with MM. Methods: Structured, in-depth interviews were conducted with physicians treating the highest volume of MM patients across 5 different urban and rural sites of a single multisite community practice. The interviews covered 6 domains: access to care or clinical advice/communication (ACC/AC); care coordination (CC); disease management for MM (DMMM); patient education (PE); medication management (MedMgmt); and data and quality improvement (DQI). Results: Five providers treating 304 MM patients from January 2016 through April 2018 identified several key issues related to the interaction between the SP and clinical sites: ACC/AC, coordination of efforts to ensure patient affordability of both oral/intravenous components; CC, centralize pharmacy workflow processes (specifically REMS enrollment) to ensure timely receipt of medication (high priority); DMMM/PE, inconsistent patient education regarding the role of the centralized pharmacy in the REMS programs, side-effect management, and intent of therapy; MedMgmt, limited concern/understanding of the impact of oral therapy adherence; DQI, no set standards for MM-specific quality measures for benchmarking performance between SP and practices. Conclusions: This qualitative survey identified several areas for improving MM-related quality of care in terms of the relationship between a centralized SP and satellite offices. To address these themes, the practice further integrated licensed practical nurses into the SP. Additionally, 2 quality improvement measurement opportunities were proposed: (1) measuring adherence using pharmacy refill data and (2) overall treatment delay (number of days from prescribing to pick-up/ship to patient).

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