VA announces new ROPA program to improve radiation therapy cancer care for Veterans

The Department of Veterans Affairs (VA) today announced a new Radiation Oncology Practice Assessment (ROPA) program to leverage recent advances in information technology to improve radiation therapy cancer care for our nation's Veterans.

VA is working with the American Society for Radiation Oncology (ASTRO) and Washington University to provide radiation oncologists for the first time with continuous feedback on the progress of cancer therapy.

"We are pleased to be working with this country's leading-class organizations on this innovative program, the first of its kind nationwide. Our Veterans deserve nothing less," said Dr. Maureen McCarthy, VA acting assistant deputy undersecretary for health and patient care services.

Radiation is one of the three major treatments for cancer along with surgery and chemotherapy, with about 60% of cancer patients receiving radiation therapy. In recent years, there have been substantial clinical and technical advances in radiation oncology, resulting in new regimens with increased survival and improved quality of life.

Under ROPA, data will be abstracted from the VA's highly-sophisticated electronic medical record (EMR) system and the treatment management systems used to control radiation therapy delivery. Feedback reports will be provided to VA radiation oncologists with a detailed analysis of each patient treatment compared against national standards. Combined with the traditional cancer outcome measures of recurrence and patient survival, this assessment will provide the oncologist with a complete picture of the accuracy of each patient's therapy and the patient's response to therapy.

Washington University is excited to take the lead role in managing the program. "We have significant experience working with the National Cancer Institute to provide the platform we will use for these assessments. We are excited to bring that experience to bear on this landmark project on behalf of our nation's Veterans," said Jeff Michalski, MD, Washington University's vice-chair of radiation oncology. "We are also pleased to engage a local radiation oncology informatics company, Radialogica LLC, who will provide a platform and services for data security, extraction and management."

In the first year of the project, ASTRO's disease-site specific experts will review measures for prostate and lung cancers, identifying metrics from the EMR to assess each one. "ASTRO is deeply committed to improving the quality of cancer care for our Veterans and all Americans. Our cancer experts are enthusiastic about this new opportunity to better measure and enhance radiation delivery with the goal of producing high quality patient outcomes," said Bruce D. Minsky, MD, FASTRO, chair of ASTRO's Board of Directors.

Once ROPA is fully implemented, VA radiation oncologists will receive continuously updated electronic peer reviews of each patient's cancer evaluation, treatment and treatment outcome. Currently, VA hospitals, similar to community hospitals, use traditional, sporadic peer-reviews in a process referred to as On-going Professional Peer Evaluation (OPPE). ROPA peer reviews go well beyond the traditional OPPE and practice accreditation to create comprehensive, patient-centered reports in a web-based environment. VA radiation oncologists will see how changes in their clinical practice impact the success of each Veteran's cancer treatment.

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