The Effect of Peer Comparison Emails on Oncologists' Documentation of Cancer Stage

The Effect of Peer Comparison Emails on Oncologists' Documentation of Cancer Stage

Documenting cancer stage is the most important determinant of treatment approach and survival for cancer patients. However, oncologists do not routinely document a patient's cancer stage in the structured field in electronic health records. This quality improvement pilot study evaluated the impact of sending an email to physicians at a cancer center of a large academic hospital with individualized data on their rates of cancer stage documentation using a structured field. The investigators assessed patient-level documentation and physician-level rates of staging documentation over 15 months including a three-month pre-period, a six-month pilot phase and a six-month follow-up period. The investigators also estimated staging documentation rates separately for each physician's new versus established patients.

Inclusion Criteria:

• Attending physicians who had been at one of three sites of hospital between January - August 2018

Exclusion Criteria:

• Physicians treating cancer patients where American Joint Committee on Cancer (AJCC) staging modules were less clinically relevant
• Physicians with low clinical volume (<5 patients over 3 months)
• Physicians without any outpatient visits