meeting coc standards - oncolog

Meeting CoC Standards

Chapter 4

Patient Outcomes

Sheryl Daugherty. RHIT, CTR

Senior Client Relationship Manager

Sharon Metzger, CTR

Director of Consulting Services

Welcome

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Goals for Today

Review the requirements to meet the standards in

Chapter 4

Identify requirements for documentation and compliance

Share examples, offer suggestions and provide clarification

Required Documentation

CoC accredited cancer programs document cancer program

activity using multiple sources, including policies, procedures,

manuals, tables and grids; however, cancer committee

minutes are the “primary source” for all documentation of

cancer program activities*.

All meeting minutes should contain sufficient detail to

accurately reflect the activities of the cancer committee, as

well as demonstrate compliance with the CoC standards.*

• *Cancer Program Standards: Ensuring Patient-Centered Care page 11

Chapter 4: Patient Outcomes

Standard 4.1 Cancer Prevention Programs

Standard 4.2 Cancer Screening Programs

Standard 4.3 Cancer Liaison Physician Responsibilities

Standard 4.4 Accountability Measures

Standard 4.5 Quality Improvement Measures

Standard 4.6 Monitoring Compliance with Evidence-

Based Guidelines

Standard 4.7 Studies of Quality

Standard 4.8 Quality Improvements

Standard 4.1 Cancer Prevention Programs

Each calendar year, the cancer committee organizes and offers

at least one cancer prevention program designed to reduce the

incidence of a specific cancer type and targeted to meet the

prevention needs of the community. Each prevention program is

consistent with evidence-based national guidelines for cancer

prevention.

Definition and Requirements

Cancer prevention requires cancer programs to identify risk factors

within their community and patient population, and use strategies

to modify attitudes and behaviors to reduce the chance of

developing cancer.

Annually, the cancer committee identifies the cancer prevention

needs of the community and offers at least one cancer prevention

program focused on reducing the number of diagnoses of a specific

type of cancer.

The prevention program must be consistent with evidence-based

national guidelines for cancer prevention.

The program can be provided on-site or may be coordinated with

other facilities and/or local agencies as long as it is under the

direction of the cancer committee.

Examples of Cancer Prevention Programs

Education material on risk awareness for a specific cancer

type

Skin cancer prevention (UV rays, tanning bed use)

Smoking/chewing tobacco cessation

Smoking prevention in adolescents

Radon education and testing (related to lung cancer

prevention)

Nutrition, physical activity, and weight loss programs

(specifically related to cancer prevention)

Vaccine/Human papillomavirus (HPV)

Role of the Community Outreach Coordinator

Appointed each calendar year

Required member of the Cancer Committee

Monitors the prevention and screening activities

Reports annually to the cancer committee

Recommends corrective action if activity falls below the

annual goal or requirements

Responsible for overseeing compliance for Standards 1.8, 4.1

and 4.2

A cancer registrar CANNOT be selected to fulfill this role

Resources for Evidence-Based National Guidelines

Related to Cancer Prevention

Agency for Healthcare Research and Quality

American Cancer Society

Cancer Control P.L.A.N.E.T.

Centers for Disease Control and Prevention

National Cancer Institute

The Community Guide

Clarification

The need and planning discussion of the Prevention program must be documented

in the cancer committee minutes prior to the event and include evidence-based

guidelines.

The impact of the prevention program is evaluated and documented.

Prevention programs count for the year in which the event is held.

Prevention programs may be repeated if justified by a review of the community

needs assessment.

Prevention education provided via newspaper article, television interview, or

social media without any actual interaction with the participants is not compliant

with this standard.

SAR Documentation

For each year of the survey cycle complete the following information:

PREVENTION PROGRAM ACTIVITY

Year: 2016

Date Prevention needs assessed by the cancer committee: 1/15/16

Cancer site selected based on prevention needs Breast

Type of prevention activity offered: Education and cancer

risk assessment

Date prevention activity held: 10/22/16

Number of participants 465

National Guidelines used to design the prevention activity American Cancer

Society

Rating Compliance

Each calendar year, the program fulfills all of the

following compliance criteria:

The cancer committee assessed the cancer prevention needs of the

community and patient population.

The cancer committee organizes and offers at least one cancer

prevention.

The cancer prevention program is consistent with evidence-based

national guidelines and evidence-based interventions.

The cancer committee minutes document the assessment of

community needs, the prevention program offered and the number

of participants.

Standard 4.2 Cancer Screening Programs

Each calendar year, the cancer committee organizes and

offers at least one cancer screening program that is designed

to decrease the number of patients with late-stage

disease and is targeted to meet the screening needs of the

community. Each screening program is consistent with

evidence-based national guidelines and interventions and

must have a formal process developed to follow up on all

positive findings.


Cancer screening programs apply screening guidelines to detect cancers at

an early stage, which improves the likelihood of increased survival and

decreased morbidity.

Each calendar year, the cancer committee organizes and offers at least

one cancer screening program focused on an identified cancer screening

need within the community, and designed to decrease the number of

patients with late-stage disease.

The screening program must be consistent with evidence-based national

guidelines and interventions.

The cancer committee and designated community outreach coordinator

must have a mechanism in place to ensure that all positive findings

identified are addressed.

Cancer screening programs may be provided on-site or coordinated with

other facilities or local agencies as long as it is under the direction of the

cancer committee.

Examples of Cancer Screening Programs

Breast: Screening Mammograms and Physical Examination

Colon: Colonoscopy, Flexible Sigmoidoscopy, or Fecal Occult

Blood Testing (FOBT)

Cervical: Papanicolaou (PAP) testing with or without Human

Papillomavirus (HPV DNA) testing

Skin: Total-body Skin Exams

Lung: Low-dose computed tomography

Resources for Evidence-Based National

Guidelines and Evidence-Based Interventions

Agency for Healthcare Research and Quality

American Cancer Society

American Society of Clinical Oncology

National Comprehensive Center Network

National Cancer Institute

National Colorectal Cancer Roundtable

Clarification

The need and planning discussion of the screening program must be documented in

the cancer committee minutes prior to the event and include evidence-based

guidelines.

The impact of the screening program is evaluated and documented and must

include how positive findings will be addressed.

Screening programs must screen for the detection of actual cancer- not just a risk.

Screening programs may be repeated if justified by a review of the community

needs assessment.

The standard does not require that a physician perform screenings and follow-up.

That decision should be made by the cancer committee based on the site,

screening procedures, staff’s clinical experience and follow-up process

SAR Documentation

For each calendar year within the survey cycle, the following data items must be documented in

the SAR:

Cancer Screening Program Activity

Year: 2016

Date screening needs were assessed by the cancer

committee:

2/15/16

Type of screening activity: Mammography

Cancer Site selected based on screening needs: Breast

Date activity held: 10/14/16

Number of participants: 254

National guidelines used to design screening activity; NCCN

Define follow-up process for positive findings: Results of mammogram were mailed to

each participant and the primary physician

identified by the patient. All BIRAD 4s

were contacted by the Breast Center and

follow-up was documented

Rating Compliance

The cancer committee identifies the cancer screening needs of their

community and patient population annually.

The cancer committee organizes and offers at least one cancer screening

program per calendar year.

The screening program is consistent with evidence-based national

guidelines and evidence-based interventions.

Each screening program has a process developed to follow up on all

positive findings.

Each calendar year, the program uploads cancer committee minutes

documenting the planning and provision of at least one annual cancer

screening program organized and offered by the cancer committee.

Standard 4.3 Cancer Liaison Physician Responsibilities

A Cancer Liaison Physician (CLP) serves in a leadership

role within the cancer program and is responsible for

evaluating, interpreting, and reporting the cancer

program’s performance using National Cancer Data Base

data. The CLP, or an equivalent designee, reports the

results of this analysis to the cancer committee at least

four times each calendar year.

Liaison Physician Selection Criteria

The Cancer Liaison Physician (CLP) is a required role in CoC-

accredited cancer programs.

Serves a three-year term with eligibility to serve an unlimited

number of terms based on performance as assessed by the

CoC and the cancer committee.

Is an active member of the medical staff.

Authorized to access facility-specific information that is

maintained in CoC Datalinks.

May also fulfill a leadership position on the cancer committee

such as chair, vice-chair, or quality improvement coordinator.

Liaison Physician Educational Requirements

Required to complete CLP orientation within three months

of initial appointment and on reappointment every three

years.

Will view all web-based CLP education programs provided

by the CoC each year. All CLP education is located in the

Cancer Liaison Program section of the CoC website.

Liaison Physician Primary Responsibility

At least four times each calendar year, the CLP reports and discusses

the facility’s performance as related to the accountability and quality

improvement measures in the Cancer Program Practice Profile Reports

(CP3R), and on data from additional NCDB reporting tools such as the

Cancer Quality Improvement Program (CQIP), the Rapid Quality

Reporting System (RQRS), Hospital Comparison Benchmark Reports, or

Survival Reports.

A quality-related audit is initiated for any of the accountability and

quality improvement measures that fall below required levels of

compliance.

Discussions related to facility performance are documented in the

cancer committee minutes and subsequently shared with the medical

staff and administration.

CLP reports do not fulfill the requirements for Standards 4.6 or 4.7.

Liaison Physician Secondary Responsibilities

Reports on CoC activities, initiatives, and priorities to the

cancer committee

Serves as liaison between the cancer program, the CoC, and

the American Cancer Society

Attends the CoC accreditation on-site survey and meets

with the surveyor to discuss the NCDB Quality Reporting

Tools and CLP responsibilities

Completes the CLP Activity Report annually

Uploads a copy of each CLP report presented to the cancer

committee into the SAR

Clarification

CLP or designee, MUST report at 4 separate meetings per

calendar year. If the CLP prepares the report, he/she can

designate another physician member to give the verbal

report.

The CLP can fulfill one additional leadership position within

the cancer committee(chair, coordinator) and represent one

of the required physician specialties.

Your CLP’s cancer committee report must include your

facilities data from the NCDB Reporting Tools (CQIP, CP3R,

RQRS, Survival Reports, or Hospital Comparison Benchmark

Reports).

SAR Documentation

Each calendar year, the CLP must complete the CLP Activity Report

with in the SAR.

The CLP uploads a copy of each CLP report presented to the cancer

committee into the SAR.

Complete required documentation on all CLP cancer committee

presentations.

Cancer Liaison Physician (CLP) Year: 2014 Year: 2015 Year: 2017

Cancer Committee meeting dates 1/15/2014 1/15/2015 1/15/2016

Which NCDB tool was used in the analysis report?Cancer Program Practice

Profile Reports (CP3R)Rapid Quality Reporting

System (RQRS)Cancer Program Practice

Profile Reports (CP3R)


Which NCDB tool was used in the analysis report?Hospital Comparison Benchmark Reports

Cancer Program Practice Profile Reports (CP3R)

Cancer Quality Improvement Program

(CQIP)


Which NCDB tool was used in the analysis report?


(CQIP)Hospital Comparison Benchmark Reports

Rapid Quality Reporting System (RQRS)


Which NCDB tool was used in the analysis report?


(CQIP)Rapid Quality Reporting

System (RQRS)Hospital Comparison Benchmark Reports

Rating Compliance

For each calendar year:

The CLP generates reports that evaluate and interpret the

cancer program’s performance using NCDB data.

The CLP, or an equivalent designee, reports this information

to the cancer committee a minimum of four times.

The CLP is present during the CoC accreditation survey and

meets with the surveyor to discuss CLP activities and

responsibilities.

Cancer committee minutes are uploaded that document at

least four CLP reports on NCDB data, including actions and

response.

Standard 4.4 & 4.5 Accountability and Quality

Improvement Measures

Each calendar year, the expected Estimated Performance

Rates (EPR) is met for each accountability and quality

improvement measure as defined by the Commission on

Cancer


Facilities are required to treat cancer patients according to nationally

accepted accountability and quality improvement measures as described

by the Cancer Program Practice Profile Reports (CP3R).

Accountability measures are standards of care derived from evidence-

based data and promote improvements in care delivery by demonstrating

provider accountability and promoting transparency.

Quality improvement measures are supported by evidence from

experimental studies. They monitor the need for quality improvement or

remediation of treatment provided. QI measures are intended for internal

monitoring of performance within a cancer program.

A corrective action plan must be developed and executed for any measure

not meeting the estimated performance rate (EPR).

Monitoring of all is measures documented in the cancer committee

minutes.

Standard 4.4 Accountability Measures

2012 2013 2014

BCSRT - Radiation is administered within 1 year (365 days)

of diagnosis for women under the age of 70 receiving breast

conservation surgery for breast cancer

90% 90% 90%

HT – Tamoxifen or third generation aromatase inhibitor is

considered or administered within 1 year (365 days) of

diagnosis for women with AJCC T1c or Stage II or Stage III

hormone receptor positive breast cancer

90% 90% 90%

MASTRT- Radiation therapy is considered or administered

following any mastectomy within 1 year (365 days) of

diagnosis of breast cancer for women with >= 4 positive

regional lymph nodes

90% 90% 90%

MEASURE EXPECTED EPR

Standard 4.5 Quality Improvement Measures

2012 2013 2014

nBx- image or palpation-guided needle biopsy (core or

FNA) is performed to establish diagnosis of breast cancer

80% 80% 80%

G15RLN-At least 15 regional lymph nodes removed and

pathologically examined for resected gastric cancer

N/A 80% 80%

12RLN-At least 12 regional lymph nodes are removed and

pathologically examined for resected colon cancer

85% 85% 85%

LCT- Systemic chemo is administered within 4 months to

day preoperatively of day of surgery to 6 months

postoperatively, or is considered for surgically resected

cases with (pN1) and (pN2) NSCLC

N/A 85% 85%

LNoSurg- Surgery is not the first course of treatment for

cN2, M0 lung cases

N/A 85% 85%

RECRTCT – Preop chemo and radiation are administered

for clinical AJCC T3N0, T4N0 or Stage III; or treatment is

considered; for patients under the age of 80 receiving

resection for rectal cancer

N/A 85% 85%

MEASURE EXPECTED EPR

Compliance Based on the Upper Limit of the

Confidence Interval

.

Non- Compliance Based on the Upper Limit of the

Confidence Interval

.

Specifications & Exceptions by Category

All programs fulfill both standards as written except programs in all

categories undergoing initial survey and PCP facilities.

Programs undergoing initial survey and PCP facilities are exempt from

these standards.

Expected EPRs for facilities that are part of an Integrated Network Cancer

Program (INCP) are evaluated individually and as an INCP as a whole.

Standard 4.4 and 4.5 Clarifications

All quality and accountability measures do not need to be

discussed at the same cancer committee meeting.

The Surveillance measures do not need to be discussed by

the cancer committee to meet Standards 4.4 and 4.5.

If the measure compliance issue is due to low patient

volume or the patient refused that piece of the treatment,

then noting that the issue was investigated and a reason

identified would be appropriate documentation in

replacement of an action plan.

SAR Documentation Std. 4.4

.

SAR Documentation Std. 4.5

.

Rating Compliance

For Each calendar year:

The cancer committee monitors the program’s expected EPR

for all accountability and quality improvement measures using

the CP3R.

The monitoring activity is reported and documented in the

cancer committee minutes.

For each, the quality reporting tools show a performance rate

equal to or greater than the expected Estimated Performance

Rates specified by the CoC, or the program has implemented

an action plan that reviews and addresses program

performance below the expected EPR.

Standard 4.6 Monitoring Compliance with

Evidence-Based Guidelines

Each calendar year, the cancer committee designates a

physician member to complete an in-depth analysis to

assess and verify that cancer program patients are

evaluated and treated according to evidence-based

national treatment guidelines. Results are presented to the

cancer committee and documented in cancer committee

minutes.


Each calendar year, a physician member of the cancer committee

performs an in-depth review to examine the evaluation and

treatment of patients and ensure that it is compliant with evidence-

based national guidelines using AJCC stage or other appropriate

staging system, including prognostic indicators.

The analysis must aim to determine if the diagnostic evaluation is

adequate and the treatment plan is concordant with a recognized

guideline.

Any problems identified with the diagnostic evaluation or treatment

planning process may serve as a source for performance

improvement.

The completion of this analysis and treatment discussions of

patients at cancer conferences do not fulfill the requirement for

this Standard.

Annual In-Depth Analysis

Sources for the Assessment

A cancer site-specific sample

Review of a single treatment regimen for a specific cancer site

A determination that the first course of therapy is concordant

with evidence based national treatment guidelines and/or

prognostic indicators.

A reporting format that permits analysis and provides an

opportunity to recommend performance improvements based

on data from the analysis.

The formal report with the analysis results is presented to the

cancer committee and documented in the cancer committee

minutes.

Clarifications

Studies can be completed by any physician on the cancer

committee.

Studies count for the year they are completed and reported to

the cancer committee.

Review of data that are required for Standards 4.4 and 4.5

cannot be used to satisfy this requirement.

SAR Documentation

Cancer committee minutes that document presentation of the results of

the analysis are uploaded to the SAR.

The site included in the analysis, the name of the physician completing the

analysis and the date of presentation to cancer committee are

documented in the SAR.

All studies are uploaded to the SAR.

Date Analysis was

Reported to the

Cancer Committee

Name of Physician

Member from the Cancer

Committee Selected to

Complete Analysis

Cancer Site

Reviewed

4/11/2014 Stan Smith, MD Breast

10/14/2015 Mark Brewer, MD Prostate

10/12/2016 Leslie Carpenter, MD Colorectal

Rating Compliance


A physician member of the cancer committee is selected to

conduct an in-depth analysis to ensure that evaluation and

treatment provided to patients is compliant with evidence-

based national treatment guidelines and is appropriate for

AJCC stage or other appropriate staging system, including

prognostic indicators.

The analysis results are reported to the cancer committee.

The analysis results are documented in the cancer committee

minutes.

Standard 4.7 Studies of Quality

Each calendar year, the cancer committee, under the

guidance of the Quality Improvement Coordinator,

develops, analyzes, and documents the required number of

studies (based on the program category) that measure the

quality of care and outcomes for cancer patients.

Quality Improvement Coordinator

Monitors, reports and recommends activity related to the

quality improvement program

Reports regularly to the cancer committee

Recommends corrective actions if any area falls below

acceptable norms or when undesirable performance is

identified

The recommendations and improvements are reported to the

cancer committee and documented in the minutes

A Cancer Registrar CANNOT be named as your Quality

Improvement Coordinator


Annual evaluation of care provides a baseline to measure quality

and an opportunity to correct or enhance care and quality

outcomes.

Quality improvement efforts focus on evaluating areas of cancer

care and must include multidisciplinary representation from

clinical, administrative, and patient perspectives.

Study topics must be selected based on a problematic quality-

related issue relevant to the cancer program and local cancer

patient population, and used as a means to identify a potential

issue or understand why a problem is occurring.

Quality studies can evaluate various spectrums of cancer care,

including diagnosis, treatment, and supportive care of patients.

Includes issues related to structure, process, and outcomes.

Required Quality Study Components

Study topic that identifies a problematic quality-related issue

within the cancer program

Define methodology and criteria for evaluation, including data need

to evaluate or answer the quality-related question

Conduct the study according to the identified measures and

methodology

Summary of the study findings

Comparison to national benchmarks or guidelines

Corrective action plan based on evaluation of the data

Follow-up steps to monitor the actions implemented

Specifications

Studies that do not meet the requirements for this standard

include:

Quality studies that duplicate topics or studies from year-to-year

Ongoing monitoring activities following a completed quality study

Survival studies and the in-depth analysis used in Standard 4.6

Review of data presented in the NCDB data reports and tools

A study that is required by an outside, recognized

organization related to oncology is acceptable if it follows the

required study criteria outlined in the previous slides.

Specifications by Category

All programs fulfill the standard as written. The number of studies

required is based on Program Category.

7 Steps to Completing a Study of Quality

Appoint a Quality Improvement Coordinator (QIC) to oversee study

activities.

Identify a Problem.

Define how the study will be conducted.

Conduct the study according to the identified. methodology and

measures, and organize the data collection.

Prepare an analysis summary of the study findings and results.

Compare the data results obtained following the completion of the

quality study with an applicable national benchmark or guideline.

Design a corrective action plan (quality improvement) based on

evaluation of the data.

Clarifications

Standard 4.7 is about identifying a problematic quality-related issue

and conducting a study to understand what is causing the problem.

Studies count for the year they are completed and reported to the

cancer committee. Discussion at a sub-committee does not fulfill

this requirement.

Studies that are duplicative of a previous quality study or ongoing

monitors done over multiple years do not meet the requirements for

this standard.

A benchmark is a standard or a measure against which the

performance/data can be compared. If national benchmarks such as

NCCN Guidelines are not available, related published articles may

be used.

SAR Documentation

Rating Compliance


Based on category, the Quality Improvement Coordinator,

under the direction of the cancer committee, develops and

conducts the required number of quality studies.

The results of the required number of quality studies are

analyzed.

The results of the required number of quality studies are

reviewed by the cancer committee and documented in the

meeting minutes.

Standard 4.8 Quality Improvements

Each calendar year, the cancer committee, under the

guidance of the Quality Improvement Coordinator,

implements two cancer care improvements. One

improvement is based on the results of a quality study

completed by the cancer program that measures the quality

of cancer care and outcomes. One improvement can be

based on a completed study from another source. Quality

improvements are documented in the cancer committee

minutes and shared with medical staff and administration.


Quality or performance improvements are the actions taken,

processes implemented, or services created to improve cancer

care.

Sources for quality improvements may include:

Actions based on analysis and findings of a quality study under Standard

4.7

Actions to address substandard patient care or process performance

Changes to improve upon acceptable patient care or process

performance

Each year, one improvement must be based on the results of a

quality study completed by the cancer program that measures

the quality of cancer care and outcomes.

Clarifications

A quality improvement is an improvement affecting cancer

patient care that has been implemented based on evidence from

either a quality study or another relevant data source.

Quality improvements count for the year in which they are

implemented.

Documentation in the cancer committee minutes must include

when the improvement was implemented and when the

improvement was communicated to administration and the

medical staff.

SAR Documentation

.

Rating Compliance


The cancer committee, under the guidance of the Quality

Improvement Coordinator, implements one cancer care

improvement based on the results of a completed quality

study.

The cancer committee, under the guidance of the Quality

Improvement Coordinator, implements on cancer care

improvement based on any study or data source.

The quality improvements are reviewed by the cancer

committee and documented in the minutes.

The quality improvements are shared with medical staff and

administration.

Required Documentation for Chapter 4: Patient Outcomes

STANDARD DOCUMENTATION COMMENT

4.1: Cancer Prevention Programs Cancer committee minutes documenting the cancer

committee identifying the cancer prevention needs of the

community and documentation that the committee offered

at least one cancer prevention activity that is focused on

decreasing the number of diagnoses of a specific type of

cancer. The documentation includes references to the

national guidelines used.

Complete and upload for each

calendar year.

4.2: Cancer Screening Programs Cancer committee minutes documenting the cancer

committee identifying the cancer screening needs of the

community and documentation that the committee offered

at least one cancer screening activity focused decreasing

late stage disease of a specific type of cancer. The

documentation includes references to the national

guidelines and interventions used and the process in

place to follow up on positive findings.


calendar year.

4.3: Cancer Liaison Physician

Responsibilities

Cancer committee minutes and the CLP reports on

NCDB data that are presented to the cancer committee at

four separate meetings each calendar year.


calendar year.

4.4 and 4.5: Accountability

Measures & Quality Improvement

Measures

• Cancer committee minutes that demonstrate the

monitoring of the accountability and quality improvement

measures from the CP3R.

• If necessary, the action plan that was developed and

executed if the program’s performance rates were

observed to be below the expected EPRs established by

the CoC.


calendar year

Required Documentation for Chapter 4: Patient Outcomes

STANDARD DOCUMENTATION COMMENT

4.6: Monitoring

Compliance with Evidence-

Based Guidelines

• Documentation of the site-specific in-depth

analysis, including the methodology, summaries,

analyses, national treatment guidelines,

recommendations, and follow-up.

• Cancer committee minutes in which the results of

the analysis were reported.

Complete and upload for each calendar year.

4.7: Studies of Quality • Documentation for the required number of quality

studies, including the methodology, summaries,

analyses, national benchmarks, recommendations,

and follow-up.

• Cancer committee minutes in which the results of

the studies were reported (in the same calendar

year). Studies count for the year they are

completed and reported to the cancer committee.


4.8: Quality Improvements • Documentation for the implementation of the

quality improvements.

• Cancer committee minutes in which the

implementation of the improvements were

reported.


Documentation Requirements Resources

CAnswer Forum http://cancerbulletin.facs.org/forums/

Standards Resource Library

http://cancerbulletin.facs.org/forums/CAnswerForumHome/StandardResourc

eLibrary

Cancer Program Standards: Ensuring Patient-Center Guidelines 2016

QUESTIONS

FYI

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Certificate of Attendance which will be emailed to you

within 3 weeks

This webinar is being recorded and the recording, slide

deck and Q&A will be made available at our website:

Oncolog.com “VIEW OUR WEBINARS” within 2 weeks

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Meeting CoC Standards

Chapter 5

Data Quality

February 21, 2018

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