May 06, 2019
2 min read

More evidence needed from dermatologic surgical registries to define best practices

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Conroy Chow 
Conroy Chow
Sarah Arron 
Sarah T. Arron

Better performance measures will improve the quality of care for dermatologic surgery patients, according to researchers in Dermatologic Surgery.

“We were surprised by how little has been done to define ‘quality’ in dermatologic surgery. Our goal for this review is to raise awareness so that dermatologic surgeons will take an active role in developing relevant definitions of quality care to benefit patients,” Conroy Chow, MD, of the department of dermatology, Loma Linda University, said in an interview with Healio Dermatology.

“Many other specialties have developed national databases to promote patient care, inform research and stimulate continued quality improvement, and we will need to do the same in dermatologic surgery,” he added.

The American Academy of Dermatology created the DataDerm registry, with 35 dermatology-specific performance measures; however, it lacks many surgery-specific measures, according to the researchers.

The American College of Mohs Surgery (ACMS) instituted the Mohs Advancing and Improving Quality (MohsAIQ) registry.

“Active participation in qualified clinical data registries such as DataDerm and MohsAIQ will enable dermatologists to report quality measures to CMS while also contributing to the data collection that is needed for additional measure development,” Sarah T. Arron, MD, PhD, of the department of dermatology, University of California, San Francisco, and the San Francisco VA Health System, said in the interview.

Performance quality measures are often defined as structure, process or outcome measures through the Donabedian model.

Physicians can take an active role in defining and choosing clinically relevant performance measures. Researchers have an important component in performance measures as well, the review said, by identifying practice gaps, describing current practice and measuring effectiveness of interventions.

“DataDerm currently contains several quality metrics pertaining to skin cancer management, coordination of care and outcomes,” Chow said. “However, the registry doesn’t have the scope to include detailed metrics on delivery of surgical care. Over time, we hope that the data collected by the ACMS MohsAIQ registry will generate additional quality measures and categories relevant to the specialty to improve patient care.”

In addition, the researchers proposed structure measures centered around effective use of EHR systems.

The research group continues to work on identifying interventions that can improve skin cancer care and recently published a manuscript investigating the utility of antibiotics in reducing surgical site infection after Mohs surgery, Arron said. – by Abigail Sutton


Disclosures: Chow and Arron report serving as members of the American College of Mohs Surgery National Registry and Outcomes Committee, Performance Measures Subcommittee. Please see the study for all other authors’ relevant financial disclosures.