Measuring Equitable Care Delivery: Insights From the Health Equity Report Card (HERC) Pilot in Academic Cancer Centers

BACKGROUND: The Health Equity Report Card (HERC) was developed to establish best practice recommendations and promote accountability among health systems in addressing care inequities. Recognizing the growing importance of health equity, particularly in cancer care, this study aims to evaluate the feasibility of implementing the HERC within academic cancer centers and to gather insights on its benefits and challenges during implementation to improve its usability. METHODS: This quality improvement study used a mixed-methods approach, collecting both quantitative and qualitative data over an 18-month period from April 2022 to October 2024 from 5 NCCN Member Institutions. Participants completed self- and third-party scores, as well as survey evaluations providing feedback on the process of using the HERC. Feedback from stakeholders was systematically collected to assess usability and identify areas for improvement. RESULTS: All participating sites successfully achieved the feasibility objectives by completing the self- and third-party scoring processes using the HERC, with unanimous agreement among the sites regarding the feasibility of the HERC for implementation. Site feedback indicated areas for enhancement, particularly in improving question clarity and simplifying the scoring process. Continuous feedback loops facilitated iterative improvements to the HERC, ultimately enhancing user experience and the scoring process. CONCLUSIONS: The HERC demonstrates strong potential as a viable framework for prioritizing and assessing equity in care delivery within academic cancer centers. The successful implementation across multiple sites, along with positive stakeholder feedback, underscores its utility in enhancing accountability and promoting best practices in addressing health inequities. Future studies should explore the long-term impacts of HERC implementation on patient outcomes and equity in care delivery. A study testing the HERC for applicability in community oncology settings is ongoing.