Contributions
Abstract: EP1436
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Economic burden
Background: The Multiple Sclerosis Continuous Quality Improvement (MS-CQI) Collaborative is the first learning health system for quality improvement research in multiple sclerosis (MS) in the United States. It aims to leverage continuous quality improvement (QI) methods to improve MS care quality by benchmarking system-level performance indicators and testing QI interventions across MS centers. Four centers are currently participating (N=5,600) and four additional U.S. centers are currently in the process of joining (estimated new minimum N=10,000).
Objective: To report initial patient reported outcomes (PRO) and electronic health record (EHR) based outcomes from the MS-CQI study to date.
Design/Methods: This is a three year, randomized controlled study utilizing a step wedge design. Measures include real-time PRO, administrative data, and EHR data. PRO, administrative, and EHR data will be merged in analyses. First year data will be used to establish a baseline for benchmarking analyses. In year 2, two centers will be randomized to QI intervention. In Year 3, two additional centers will be randomized to the QI intervention.
Results: The collaborative has completed the second quarter of the first year of the study. 4,503 baseline PROs have been reported in the first three study quarters, by 203 of 243 active study participants (15% male, 94% white). Nineteen PRO measures are being collected, including (mean, SD): Patient Health Questionnaire-9 (PHQ-9) (7, +/-5), Quality of Life in Neurological Disorders (Neuro-QoL) Cognitive Scale (31, +/− 7), Patient Determined Disease Steps (PDDS) (2, +/− 2), NIH PROMIS FatigueMS (22, +/-8). Total EHR n=1162, including Disease Modifying Therapy (DMT) (n=842) and MRI utilization (n= 758). Overall collaborative proportion on DMT= 72.3% (range: 64.1-88.7%). Overall collaborative proportion receiving a MRI in past year= 65.2% (range: 58.6-78.5%). Full Year 1 (baseline) results will be reported at ECTRIMS.
Conclusion: MS-CQI has demonstrated initial feasibility, acceptability, and functional data analytic pathways. Ongoing investigation of system-level variation and the effect of improvement interventions on system and population level clinical, patient experience, and functional health outcomes is a new area of investigation in MS that has great potential to improve MS care.
Disclosure: Summary: MS-CQI is funded by Biogen through a Sponsored Research Agreement (SRA). MS-CQI is an investigator initiated study independently designed by the principal investigator and independently conducted. MS-CQI features an independent data analytics center separate from Biogen access or control and is overseen and advised by a research improvement advisory committee (RIAC) comprised of patients, quality improvement experts, multiple sclerosis clinicians and researchers. Biogen representatives participate in reviews of manuscripts but content, authors, analyses, and conclusions are independently determined and finalized by the principal investigator and MS-CQI Collaborative research team.Author disclosures:
(1) Dr. Oliver (PI): (1) MS-CQI research study funded by Biogen, includes salary support to perform functions of study principal investigator; and (2) educational consultant for a private healthcare CME/CEU company called @Point of Care (Annual compensation < $12,000). (2) Mr. Messier (Co-I): Nothing to disclose. (3) Ms. Hall: MSCQI research study funded by Biogen, includes salary support to perform functions of study program manager. (4) Ms. Patel: Employed by Biogen. (5) Dr. Livingston: Employed by Biogen.
Abstract: EP1436
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Economic burden
Background: The Multiple Sclerosis Continuous Quality Improvement (MS-CQI) Collaborative is the first learning health system for quality improvement research in multiple sclerosis (MS) in the United States. It aims to leverage continuous quality improvement (QI) methods to improve MS care quality by benchmarking system-level performance indicators and testing QI interventions across MS centers. Four centers are currently participating (N=5,600) and four additional U.S. centers are currently in the process of joining (estimated new minimum N=10,000).
Objective: To report initial patient reported outcomes (PRO) and electronic health record (EHR) based outcomes from the MS-CQI study to date.
Design/Methods: This is a three year, randomized controlled study utilizing a step wedge design. Measures include real-time PRO, administrative data, and EHR data. PRO, administrative, and EHR data will be merged in analyses. First year data will be used to establish a baseline for benchmarking analyses. In year 2, two centers will be randomized to QI intervention. In Year 3, two additional centers will be randomized to the QI intervention.
Results: The collaborative has completed the second quarter of the first year of the study. 4,503 baseline PROs have been reported in the first three study quarters, by 203 of 243 active study participants (15% male, 94% white). Nineteen PRO measures are being collected, including (mean, SD): Patient Health Questionnaire-9 (PHQ-9) (7, +/-5), Quality of Life in Neurological Disorders (Neuro-QoL) Cognitive Scale (31, +/− 7), Patient Determined Disease Steps (PDDS) (2, +/− 2), NIH PROMIS FatigueMS (22, +/-8). Total EHR n=1162, including Disease Modifying Therapy (DMT) (n=842) and MRI utilization (n= 758). Overall collaborative proportion on DMT= 72.3% (range: 64.1-88.7%). Overall collaborative proportion receiving a MRI in past year= 65.2% (range: 58.6-78.5%). Full Year 1 (baseline) results will be reported at ECTRIMS.
Conclusion: MS-CQI has demonstrated initial feasibility, acceptability, and functional data analytic pathways. Ongoing investigation of system-level variation and the effect of improvement interventions on system and population level clinical, patient experience, and functional health outcomes is a new area of investigation in MS that has great potential to improve MS care.
Disclosure: Summary: MS-CQI is funded by Biogen through a Sponsored Research Agreement (SRA). MS-CQI is an investigator initiated study independently designed by the principal investigator and independently conducted. MS-CQI features an independent data analytics center separate from Biogen access or control and is overseen and advised by a research improvement advisory committee (RIAC) comprised of patients, quality improvement experts, multiple sclerosis clinicians and researchers. Biogen representatives participate in reviews of manuscripts but content, authors, analyses, and conclusions are independently determined and finalized by the principal investigator and MS-CQI Collaborative research team.Author disclosures:
(1) Dr. Oliver (PI): (1) MS-CQI research study funded by Biogen, includes salary support to perform functions of study principal investigator; and (2) educational consultant for a private healthcare CME/CEU company called @Point of Care (Annual compensation < $12,000). (2) Mr. Messier (Co-I): Nothing to disclose. (3) Ms. Hall: MSCQI research study funded by Biogen, includes salary support to perform functions of study program manager. (4) Ms. Patel: Employed by Biogen. (5) Dr. Livingston: Employed by Biogen.