The value of clinical decision support

Published 9 January 2019, updated 7 June 2019

Nothing about cancer is simple. With such a life-changing diagnosis, patients need confidence that their doctors are considering all the relevant data and making the best possible diagnostic and treatment decisions in a timely fashion.

However, clinicians face enormous time pressure and have to sift through a staggering amount of information. For example, more than a million medical papers are added each year to data sources like PubMed, which roughly equals a new paper published every two minutes. Every day, nearly 100 clinical trial reports and reviews are added.1 And in 2018, more than 1000 new cancer drugs were being studied in clinical trials or awaiting FDA review.2,3

Taken on their own, these vast amounts of data don’t automatically add up to improved patient outcomes. No clinician has enough time to delve deeply into the latest and increasingly complex research to confidently decide which diagnostics and therapies are the right choice for an individual patient. And, the challenges in healthcare today are so complex that no one player can tackle them alone.

When companies with complementary expertise in advanced medical technology and science form partnerships, they can provide clinicians with much needed clinical decision support tools. By addressing information complexity through easier access to and assembly of all relevant data across disciplines in diagnostics, these tools enable clinicians to make more confident and timely decisions throughout the course of care. Having a more comprehensive view of each patient helps specialists use the limited time they have during tumour boards to review all necessary files quickly and align on the best possible treatment plan for each cancer patient – an important step in delivering more personalised care to patients with a life-threatening disease like cancer.

“It’s extremely important to have an accurate diagnosis, which means we need all the information about what is going on with the patient – from all the studies, all the radiology reports, all the lab tests,” says Richard Hammer, MD, Director Anatomic Pathology, University of Missouri, School of Medicine. “We need to have that all present in one place to make an accurate diagnosis and decide what the best treatment is.”

Improved workflow with easy access to essential information

Multi-disciplinary team meetings, or tumour boards, bring together specialists such as oncologists, radiologists, surgeons, pathologists, and nurse navigators playing a key role in a patient’s cancer care. In under 90 minutes, a typical tumour board needs to review all the clinical perspectives to determine the best possible individual treatment plans. This includes relevant medical information such as laboratory tests and medical imaging files, essential to fully understanding an individual cancer patient’s disease.4

So, tumour board discussions and recommendations represent some of the most important minutes in a cancer patient’s life, affecting their treatment and potential outcome. But tumour board participants have demanding caseloads with limited time to investigate all possible treatment options. And, running a tumour board is both time and labour intensive. Meetings have to be coordinated and patients’ medical information such as medical history, biomarkers and tumour information has to be collected from various sources and organised.

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With cancer care becoming ever more complex, oncology care teams need a better approach to clinical workflow and information management. Latest clinical decision support solutions enable experts from various disciplines involved in cancer care to upload their patient records in the same dashboard. Not having to switch anymore between systems saves time. Fast and comprehensive access to this combination of laboratory test results, medical imaging and other data, including handwritten notes, helps tumor board teams optimise their limited time. Having all this information available in a single dashboard that can be viewed by the entire team “facilitates our discussions and leads us to make the best decision regarding therapy for the patient,” Dr Hammer says.

The benefits of enhanced clinical workflow, decision support and data quality help enable teams to improve quality of care, provide more timely answers for patients, potentially include more patients in tumour board meetings. Research shows that patients reviewed in a tumour board are more likely to be enrolled in clinical trials, yielding benefits for both participating patients and future patients.5

Hope through confidence in data-driven decision making

“For patients, a cancer diagnosis changes everything,” says Dr. Tim M. Jaeger, Global Head Diagnostics Information Solutions. “And one thing these patients really want is certainty. Clinical decision support tools can help them get that: certainty that they’re getting the best possible diagnosis, certainty that the best possible treatment course is decided for them, and certainty that all of this happens in a timely fashion.”

In the end, decisions stay with people, but clinical decision support tools can help make them in a more accurate, personalised and timely fashion.
 

References:

  1. Landhuis, E. Scientific Literature: Information Overload. Nature. 2016 July 21;7612:457-58.
  2. Food and Drug Administration, Center for Drug Evaluation and Research: Advancing Health Through Innovation: 2017 New Drug Therapy Approvals. January, 2018. Available from: https://www.fda.gov/downloads/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ReportsBudgets/UCM591976.pdf
  3. Statista. The Statistics Portal: Number of cancer drugs in development in the United States in select years between 2005 and 2018. Pharmaceuticals Products & Market. May 2018. Available from: https://www.statista.com/statistics/268805/number-of-cancer-drugs-in-development-since-2005/
  4. World Health Organization, https://www.who.int/diagnostic_imaging/en/ and https://www.who.int/cancer/prevention/diagnosis-screening/en/
  5. Basse C, Morel C, Alt M, et al. Relevance of a molecular tumour board (MTB) for patients’ enrolment in clinical trials: experience of the Institut Curie. March 2018. Available from: https://esmoopen.bmj.com/content/esmoopen/3/3/e000339.full.pdf

Tags: Personalised Healthcare, Digital health, Diagnostics