HERC Tool Demonstrates Feasibility in Advancing Equitable Cancer Care

"We are proud to announce that every participating site reported HERC implementation would either inform or reinforce necessary changes in institutional practices and processes," according to study author Taneal D. Carter, MS, MPA.

The Health Equity Report Card (HERC) tool, a measure used to evaluate equitable cancer care delivery, was found to demonstrate feasibility across 5 academic cancer centers, according to preliminary study data presented at the American Public Health Association (APHA) 2024 Annual Meeting and Expo.¹

Data from the study show that all evaluated sites either strongly agreed or agreed that HERC performance measures, metrics, and sources of evidence were applicable to their institution. Additionally, 4 of 5 institutions strongly agreed or agreed that meeting benchmark metrics through the collection of sources of evidence was feasible.

Furthermore, 3 sites reported feasibility with the REDCap tool data collection and self-scoring, with 2 sites reporting no opinion. REDCap was used to collect data on feasibility and usability of the HERC tool.

“Studies clearly show that unequal experiences and opportunities in cancer care result in worse outcomes and shorter life-expectancies for people in underserved communities,” Taneal D. Carter, MS, MPA, manager of the National Comprehensive Cancer Center (NCCN) Cancer Care Equity Program, said in a news release on the study.² “The HERC was initially designed as an objective approach to increase equity in cancer care through attainable and measurable change. These initial pilot study data illustrate just how attainable these goals really are. We are proud to announce that every participating site reported HERC implementation would either inform or reinforce necessary changes in institutional practices and processes.”

Created by the Elevating Cancer Equity collaboration among the NCCN, the American Cancer Society Cancer Action Network (ACS CAN), and the National Minority Quality Forum (NMQF), the HERC features 19 practice evaluation and change recommendations. These items are designed to help providers and healthcare organizations identify and address care delivery disparities, bias, and social determinants of health, and navigate systemic barriers to optimal care.

The HERC tool evaluates equitable practices by 4 domains: community engagement, accessibility of care and social determinants of health, addressing bias in care delivery, and quality and comprehensiveness of care. Investigators of the study gathered feedback from 5 leading academic cancer centers. Semi-quantitative surveys were utilized to assess perceptions of HERC feasibility and usability prior to implementation and following initial scoring.

Additional findings from the study reveal that prior to implementation, 3 of 5 sites believed HERC implementation would be somewhat difficult. One site thought HERC would reinforce change, and 4 sites thought it would inform change in practices and policies.

“These preliminary findings demonstrate the HERC’s usability and underscore its potential as a transformative tool for measuring and improving equity in cancer care,” Crystal S. Denlinger, MD, chief executive officer of NCCN, said in the news release.² “We are happy to be able to share this initial data, showcasing how participating sites found the HERC’s performance measures to be relevant to their institutions. We look forward to additional analysis of the data and ongoing feedback to further improve the utility of this tool.”

Although the usability of HERC has been demonstrated, further scoring, feedback, and impact evaluation is ongoing. Further HERC evaluation, including a separate pilot project evaluating equitable cancer care practices in the community cancer care setting, will serve to enhance its ease of use in assessing equitable practices.

An article with the full results after initial scoring will be published in the coming months, according to the news release.² These results will also include a subsequent score and improved scorecard.

References

1. Carter T, Schatz A, Orr A, et al. Health equity report card (HERC) in the academic oncology setting. Presented at American Public Health Association 2024 Annual Meeting and Expo. October 27-30, 2024; Minneapolis, MN. Abstract 3037.0
2. NCCN cancer center study demonstrates usability of health equity report card (HERC) tool for driving fair access to care. News Release. NCCN. October 28, 2024. Accessed October 28, 2024. https://tinyurl.com/yc7jcp3a