Prostate cancer

Launched in 2012, the Michigan Urological Surgery Improvement Collaborative works to improve the quality of care for men with prostate cancer.  Urologists statewide review data including cancer severity, utilization and care patterns for various cancer therapies and treatments.

By comparing data and sharing observations, participants can identify best practices associated with improved patient outcomes, as well as share these best practices with other physicians throughout Michigan.  Objectives include reducing complications from biopsy, improving outcomes after prostatectomy, and reducing variation.

MUSIC is now in the early stages of expanding into other urologic diseases with quality improvement initiatives underway for kidney stones and small renal mass.  MUSIC recently launched a pilot program focused on reducing operative complications from kidney stones, or MUSIC ROCKS.  The initial goal is to reduce ED visits after ueteroscopy and shockwave lithotripsy.  A pilot program focused on small renal mass is tentatively slated to begin in mid-2017.

For more information, go to musicurology.com.

Results

  • Collected data on more than 34,000 patients in nearly 5 years of data collection
  • Participation from more than 240 urologists, representing 43 practices
  • Partner with four patient advocates. These individuals are in involved in all of the consortium’s activities and offer the patient perspective, which is critical to the program’s success.
  • Approved by CMS as a PQRS Qualified Clinical Data Registry (QCDR)
  • Approved by the American Board of Urology that participation in MUSIC qualifies urologists for Part IV Maintenance of Certification (MOC) credit. Urologists who participate in MUSIC QI projects the prior year are exempt from the Part IV Practice Assessment Protocols the following year.
  • Integrated MUSIC participation and performance on specific statewide metrics as part of the Value-Based Reimbursement (VBR) model.
  • Achieved a statewide decrease in the utilization of both bone scans and CT scans for men with low-risk prostate cancer, through the use of comparative performance feedback, review of current guidelines, and dissemination of best practices.
  • Created a risk calculator that is based on MUSIC data and gives a provider the patient’s risk of finding prostate cancer on a prostate biopsy.
  • Used MUSIC data to subsequently develop and implement evidence-based appropriateness criteria for radiographic staging of all men with newly-diagnosed prostate cancer.
  • Achieved a fifty percent reduction in prostate biopsy-related hospitalizations by implementing process changes for antibiotic prophylaxis focused on addressing fluoroquinolone resistance.
  • Established a novel metric (MUSIC NOTES) that defines an uncomplicated early post-operative recovery, and compares these outcomes across diverse urology practices.
  • Created a statewide, electronic infrastructure for measuring and improving patient-reported functional outcomes after radical prostatectomy.
  • Developed an infrastructure for video-based assessment of surgical technique with the aim of linking such assessments with patient-reported outcomes and peri-operative morbidity data; established a robotic prostatectomy skills workshop program that allows for peer-to-peer video review and mentorship.
  • Through the assembly of a panel of MUSIC experts, and with the inclusion of patient advocates, developed appropriateness criteria and a standardized roadmap for recommending treatment for patients with low-risk prostate cancers. This tool can be combined with the assessment of patient preferences to facilitate shared decision making.
  • Published numerous peer-review manuscripts and abstracts, and gave presentations on MUSIC’s work and QI successes at both a national and international level.
  • Winner of the inaugural Clinical Innovator Technology (CIT) Accelerator Award.
  • Awarded the Blue Cross Blue Shield Association Best of Blue award for clinical distinction for the MUSIC program