Automating Quality Oncology Practice Initiative Quality Measure NHL78a

Quality measurement and improvement is a focus of ASCO. In the era of electronic health records (EHRs), computerized order entry, and medication administration records, quality monitoring can be an automated process. The EHR data are usually stored within tables in a relational database management system. ASCO Quality Oncology Practice Initiative measure NHL78a (hepatitis B virus antigen test and hepatitis B core antibody test within 3 months before initiation of obinutuzumab, ofatumumab, or rituximab for patients with non-Hodgkin lymphoma) presents an opportunity for automation of a quality measure using existing data in the EHR.

We used a locally developed Structured Query Language (SQL) language procedure in the Microsoft SQL Query Manager to access the EPIC CLARITY database. Access to the relational database management system of the EHR permits rapid case identification (the denominator set) of the unique ID of all of the patients who have received one of the target medications (ie, obinutuzumab, ofatumumab, or rituximab). Then, we went through a six-step process to find the number of patients who passed or failed the quality measure.

When the final SQL procedure executes, it takes < 5 seconds to see the result set for a 12-month period. The procedure can be changed to incorporate a desired date range. Once the SQL procedure is created, there is essentially no labor and low costs to run the procedure at specific time intervals.

Our method of quality measurement using EHRs is cost effective, fast, and precise, and can be reproduced at other centers.