Insights from initial scoring in the Health Equity Report Card (HERC) pilot in community oncology settings.

Abstract

11094 Background: The Health Equity Report Card (HERC) is an innovative tool designed to assess and promote equity in cancer care. Standardized scoring is performed in four domains: Community Engagement, Accessibility of Care and Social Determinants of Health, Addressing Bias in Care Delivery, and Quality and Comprehensiveness of Care. Initial scoring is reported. Methods: Five diverse community oncology sites were recruited to evaluate the HERC's feasibility and usability in this setting. The primary objective is to evaluate the feasibility of implementing the HERC with scoring at community oncology sites. Key metrics include the ability to collect HERC data and complete self- and third-party scores. Baseline scores were calculated using data from prior six months. Quantitative and qualitative feedback was collected via surveys and semi-structured interviews. Results were summarized using descriptive statistics. This study was granted Institutional Review Board exemption by Pearl IRB and sites received funding support. Results: All sites completed self- and third-party scores (Table 1). Average self-scores and third-party scores were similar, with third party scores slightly lower across all domains. There was a wide range in scores across all domains. All sites felt the HERC was easy to understand. Sites requested clarification on four measures and expect the final round of scoring to be easier and faster. 4/5 sites stated collecting sources of evidence was feasible. Key challenges included: a lack of formal documentation and processes not implemented consistently across the practice. Best practices included: 5/5 used tracking logs, 5/5 used a team approach, and 4/5 utilized provided materials to orient staff to the project. All sites stated the HERC was a helpful resource for community practices, was useful to learn about health equity initiatives across the site, and was helpful to identify or prioritize quality improvement projects. All sites felt the HERC would inform changes to site processes and plan to identify improvement strategies based on their baseline scores. Conclusions: Initial implementation of the HERC in community oncology practices was feasible with completion of scoring across all practices. Score variation across sites and domains highlight differences in resources, documentation, and practice. Sites confirmed the HERC is a helpful resource and catalyst for quality improvement. The project remains ongoing. The HERC is a promising tool to foster equitable care delivery for all cancer patients. Summary statistics of baseline self- and third-party scores. Domain Max Score Self-Score Third-Party Score Mean SD Range (Max-Min) Mean SD Range (Max-Min) Community Engagement 4 3 1.1 3 (1-4) 2.2 1.5 4 (0-4) Accessibility 6 3.9 1.7 4.5 (1-5.5) 3.7 1.5 4.5 (1-5.5) Bias 5 1.9 1.3 3 (0.5-3.5) 1.5 1.2 3.5 (0-3.5) Quality of Care 4 2.6 1.7 4 (0-4) 2.4 1.6 4 (0-4)