Better, Safer, Cheaper: Joseph V. Simone Award and Lecture

When the first medical oncology board examination was offered in 1980, the description of oncology as cut, burn, and poison was apt. Today, to deliver on high-value cancer care that is better, safer, and cheaper, we use big data, machine learning, and artificial intelligence to measure, innovate, and learn (Fig 1). Fig1. Quality of oncology care timeline, 1919 to 2017. ABMT, autologous bone marrow transplantation; HMO, Health Maintenance Organization; NICQ, National Initiative for Cancer Care Quality; QOPI, Quality Oncology Practice Initiative; RVU, relative value unit. Three principles define the science of improving the quality and value of cancer care: Measurement. Lord Kelvin’s original phrase “when you can measure [it]… and express it in numbers, you know something about it …”1(p 418) is often abbreviated to “you can’t improve what you can’t measure.” Definition. We have gone from “I know it when I see it” to Avedis Donabedian’s three pillars of quality: structure, process, and outcomes.2 Michael Porter’s writings help us quantify value as quality or a desired outcome divided by the cost of producing that value.3 BETTER, SAFER: MEASUREMENT, STRUCTURE, PROCESS, AND OUTCOME Section: ChooseTop of pageBETTER, SAFER: MEASUREMEN... <