Physician champions and clinical performance reports: Informing policy with race-specific findings on equity in cancer treatment outcomes

The Accountability for Cancer Care through Undoing Racism and Equity study is a partnership between communities and health systems to optimize transparency and accountability to achieve racial equity in cancer treatment among patients with early stage breast and lung cancer. The interventions designed to achieve these goals include development of a real time warning system fed by electronic health record data to signal patients’ missed appointments or delayed milestones in expected cancer care, health equity training for cancer center staff, a special navigator exposed to potential barriers to care through the lens of undoing racism training, and regular feedback sessions for cancer center clinicians using local race-specific treatment data. Note that as a baseline, 5 years of retrospective data were obtained at each cancer center. Two measures are being used to gauge the effect of the interventions: (1) completion of expected care of those patients enrolled in the real time registry system, and (2) ongoing, de-identified whole population data for early stage breast and lung cancer patients treated by the participating cancer centers. Feedback of both measures are being used in the clinician sessions. We will describe the role of the physician champion as a leader toward health equity and report on the early outcomes of patients enrolled in the warning system, the time trends of the whole population data relative to the retrospective data. We will also highlight some qualitative aspects of the feedback discussions and explain potential policy implications of this approach for cancer care and chronic disease.