Established in February 2015 with funding from the Partnership for Patient Care, PURC is a quality improvement initiative that brings urology practices together in a physician-led, data-sharing and improvement collaborative aimed at advancing the quality of diagnosis and care for men with prostate cancer. HCIF serves as the coordinating center, providing administrative, clinical, and database support for program members.
PURC offers a unique opportunity to conduct a regional prostate cancer care improvement collaborative, providing urology practices across the region with a mechanism for performance measurement and reporting. Comparative, risk-adjusted data displayed in our portal allows participating practices to use real-time information to determine best practices and drive quality improvement. PURC currently brings together 140 practicing urologists from 11 major urology practices across Pennsylvania and two New Jersey practices in a multiyear data-sharing and QI collaborative aimed at advancing the quality of care for men with prostate cancer. By the close of 2020, over 16,000 cases were entered into the PURC Registry.
1. To reduce variation in care delivery and utilization of services for men with newly diagnosed prostate cancer.
2. To measure, understand, and influence outcomes following treatment for clinically localized prostate cancer.
3. To improve patient-centered decision-making among men faced with treatment choices for clinically localized prostate cancer.
4. To provide a reliable, sustainable platform for prostate cancer data collection with
Value of PURC:
As evidenced by experience and early results, there are a number of benefits to urology practices and individual providers in participating in the PURC collaborative and clinical data registry:
- The registry has proven to be an invaluable practice management tool by allowing access to reports that trend and benchmark individual practice sites and practitioners to their peers in order to identify and address variations in care and outcomes. Specific care processes can be linked with higher quality and more efficient care, guiding important practice decisions and driving improvement efforts. A few early PURC collaborative improvements are as follows:
– Increased compliance with antibiotic prophylaxis for TRUS
– Decreased bone scan utilization for low-risk patients
- Practices and providers benefit from collaborative activities that promote innovation and the dissemination of best practices.
- Practices benefit from participating in a nationally-recognized program that leverages the data and experience of hundreds of clinicians.
- Practices are well positioned for future Medicare reporting requirements and pay-for-performance incentive plans.
- Robust PURC data provide participants opportunities to contribute to collaborative research and publications.
- Most importantly, participating practices will work together to advance prostate cancer care.
Robert G. Uzzo, MD, FACS
PURC Executive Director
Chair, Department of Surgical Oncology
Fox Chase Cancer Center – Temple University Health System
Marc Smaldone, MD, MSHP, FACS
PURC Associate Director
Associate Professor, Department of Surgical Oncology
Fox Chase Cancer Center – Temple University Health System
PURC is a division of the Health Care Improvement Foundation.
Kaynaat Syed, MHA
Clinical Registry Project Manager
Health Care Improvement Foundation
Participating Organizations and Physician Champions
Fox Chase Cancer Center: Marc Smaldone, MD, MSHP, FACS (Regional Clinical Champion)
Geisinger Health System: John Danella, MD
Einstein Health Network: Serge Ginzburg, MD, FACS
Hospital of the University of Pennsylvania: Thomas Guzzo, MD, MPH
MidLantic Urology/Main Line Health: Laurence Belkoff, DO & Ilia Zeltser, MD
Penn State Milton S. Hershey Medical Center: Jay Raman, MD, FACS
Temple University Hospital: Adam Reese, MD
MD Anderson at Cooper University Hospital: Jeffrey Tomaszewski, MD
Jefferson Urology Associates: Edouard Trabulsi, MD, FACS
University of Pittsburgh Medical Center: Bruce Jacobs, MD, MPH
Rutgers Cancer Institute of New Jersey: Eric Singer, MD, MA, FACS
Physician champions are representatives from each participating practice site that
Executive Collaborative Team Meetings
Three times each year, in-person meetings are scheduled for individuals from practices that are participating in the collaborative. During these meetings, physician champions, collaborative teams, clinical abstractors, and patient advocates come together to assess their progress, understand variability, share learning experiences, and assist one another in overcoming barriers and challenges. The committee provides expert input into the following:
- Continual analysis and evaluation of regional patterns of care and treatment outcomes;
- Identification of unwarranted variations in care and outcomes through working groups;
- Identification of specific care processes associated with better patient outcomes;
- Development and dissemination of improvement strategies and best practices;
- Periodic review of program activities and deliverables to ensure optimal support of participants.
2021 Collaborative Meeting Agendas
2020 Collaborative Meeting Agendas
Participating practices have the opportunity to connect to one another to discuss and compare results and innovations through networking calls. The collaborative has four active working groups. The working groups are as follows:
• Active Surveillance
Chaired by Adam Reese, MD, Temple University Hospital
Chaired by Serge Ginzburg, MD, FACS, Einstein Health Network
Chaired by Jeff Tomaszewski, MD, MD Anderson at Cooper University Hospital
Chaired by Daniel Lee, MD, MS, Hospital of the University of Pennsylvania
PURC Tools and Resources
- Imaging Pocket Card
- Patient Education Card
- In-office Transperineal Prostate Biopsy Utilizing PHAT Template Coaxial Technique
PURC Survey Reports
- Understanding the Variation in Ordering Practices of Opioid Prescriptions Post Prostatectomy (2019)
- Understanding Antibiotic Utilization and Prophylaxis Prior to Biopsy (2017)
- Understanding Active Surveillance as a Treatment Option for Men with Low-Risk Prostate Cancer (2017)
- Understanding Current Practice and Utilization of Prostate Cancer Biomarkers among PURC Providers
- Pennsylvania Prostate Cancer Coalition https://paprostatecancer.org/
- American Cancer Society https://www.cancer.org/cancer/prostate-cancer.html
- Michigan Urological Surgery Improvement Collaborative (MUSIC) https://musicurology.com/
- 17-Gene Genomic Prostate Score Test Results in the Canary Prostate Active Surveillance Study (PASS) Cohort
Collaborative Participants Only (Restricted)
- PURC Data Portal – login required
Published Research Articles
- Preventing Prostate Biopsy Complications: to Augment or to Swab? (Journal of Urology)
- Stakeholder Perspective on Opioid Stewardship After Prostatectomy: Evaluating Barriers and Facilitators From the Pennsylvania Urology Regional Collaborative (Journal of Urology)
- Utilization of Active Surveillance as Initial Management for Newly Diagnosed Prostate Cancer: Data from the Pennsylvania Urologic Regional Collaborative (Journal of Urology)
- Assessment of Prostate Cancer Treatment Among Black and White Patients During the COVID-19 Pandemic (JAMA Oncology)
2020 Accepted Mid-Atlantic American Urological Association (MAAUA) Abstracts
- Variable Clinically Significant Prostate Cancer Detection Rates on Magnetic Resonance Imaging Fusion Prostate Biopsy – Experience from the Pennsylvania Urologic Regional Collaborative
2020 Accepted American Urological Association (AUA) Abstracts
- Concordance Between MRI Fusion vs TRUS Prostate Biopsy and Final Pathology at Radical Prostatectomy: Data from PURC
- Factors Associated with Upgrading on Re-Biopsy in Active Surveillance in a Regional Multi-Institutional Cohort: Data from PURC
2019 Accepted Mid-Atlantic American Urological Association (MAAUA) Abstracts
- Factors Associated with Active Surveillance as Initial Management Strategy for Men
- Implications of AS eligibility among African American Men Analysis of the Pennsylvania Urologic Regional Collaborative Database
- Predictors of Prostate Cancer Reclassification Among Men Managed with Active Surveillance
- Progression to Definitive Treatment Among Men Undergoing Active Surveillance for Low-Risk Prostate Cancer in a Regional Collaborative
- Variation in the Time Interval from Diagnosis to Treatment of Prostate Cancer Across the Pennsylvania Urologic Regional Collaborative (PURC)
2018 Accepted Mid-Atlantic American Urological Association (MAAUA) Abstracts
- Factors Associated with Active Surveillance Utilization as Initial Management Strategy for Men with Newly-Diagnosed Prostate Cancer
- Practice Patterns for Use of Prostate Cancer Biomarkers in PURC
2018 Accepted American Urological Association (AUA) Abstracts
- Racial Variation in Use of Active Surveillance for the Management of Low Risk Prostate Cancer in a Regional Collaborative
- Correlation of mpMRI Findings and Prostatectomy Pathology across PURC
- Practice Patterns of Transrectal Prostate Biopsy Antibiotic Prophylaxis in almost 5,000 Patients from PURC
2017 Accepted American Urological Association (AUA) Abstracts
- Use of Duplicate Axial Imaging in Newly Diagnosed Prostate Cancer – Trends across the Pennsylvania Urologic Regional Collaborative (PURC)
- Variation in Active Surveillance Utilization for the Management of Prostate Cancer in a Regional Collaborative
2016 Accepted Mid-Atlantic American Urological Association (MAAUA) Abstracts