The value of clinical decision support

Published 9 January 2019, updated 7 June 2019, updated 20 March 2020

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. More than a million medical papers are published each year, nearly 100 clinical trial reports and reviews are added every day.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 and prepare all patient diagnostic information for review with other experts to confidently decide on the right therapy for each individual patient.

The challenges in healthcare today are so complex that no one player can tackle them alone. When companies with complementary expertise in medical technology and science form partnerships, they can provide clinicians with much needed clinical decision support tools. By addressing information complexity through easier management of relevant diagnostic data, these tools enable clinicians to make more confident, timely decisions throughout the course of care. Having a comprehensive view of each patient helps specialists use the limited time they have to quickly review all necessary files and align on the best possible treatment plan – 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.”

Another benefit of such cloud-based software is that participating clinicians don’t have to be in the same room anymore. Instead, they can login remotely to upload, review and discuss patient information from any place, which further supports easier, more confident and timely decision- making by oncology care teams.

Improved workflow with easy access to essential information

Tumour boards, or multi-disciplinary team meetings, bring together specialists such as oncologists, radiologists, surgeons, pathologists, and nurse navigators who all play a key role in cancer care. In under 90 minutes, a typical tumour board needs to review all the clinical perspectives required to fully understand a cancer patient’s disease4 and determine the best possible individual treatment plan. So, tumour board discussions represent some of the most important minutes in a cancer patient’s life.

But tumour board participants have demanding caseloads. And, running a tumour board is both time and labour intensive. Coordinating meetings, getting all experts in the same room and organising patients’ medical information such as laboratory tests, medical imaging files, medical history, biomarkers and tumour information can be challenging.

value-of-clinical-decision-support-740

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 in cancer care to upload their patient records in the same dashboard from whereever they are. Virtual tumor boards bring flexibility to meeting logistics and allow oncology experts to connect to a broader network for consultation, second opinion and knowledge sharing. And, not having to switch anymore between systems with all information available in one place for review by the entire team saves time. It also “facilitates our discussions and leads us to make the best decision regarding therapy for the patient,” Dr Hammer says.

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

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