A cancer diagnosis is an emotional struggle and the beginning of a challenging journey. Clinicians – their partners in this journey – 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.
Thanks to advances in technology, tools have been developed to provide the clinical decision support so critically needed. By addressing medical complexity through insights from assembled data, these new tools play a significant role in helping to deliver personalised medicine to patients with a life-threatening disease like cancer. The benefits of this decision support – offered in the form of cloud-based Software as a Service (SaaS) – become apparent well before patients have their first treatment.
“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. 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.
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. With cancer care becoming ever more complex, oncology care teams need a better approach to clinical workflow and information management.
New clinical workflow and decision support tools standardise, streamline and simplify this process, giving the care team more time to focus on each patient’s case and the appropriate recommendations instead of meeting logistics. A study shows that tools improve workflow efficiency with shorter preparation time particularly for oncologists. The tools also allow the board to meet virtually rather than requiring that everyone be in the same room; clinicians can participate and view relevant patient data remotely which further enhances collaboration. In addition, integrated decision support apps help identify and present in real time relevant information such as publications or clinical trial options based on patient-specific attributes like age, gender and biomarkers.
Using clinical decision support tools significantly improves the way the tumour boards work, Dr. Hammer observes. “It provides a single, coherent solution with all the data in one place,” he says. “This facilitates our discussions and leads us to make the best decision regarding therapy for the patient.”
The benefits of improved clinical workflow, decision support and data quality give teams more time to focus on patients and improve quality of care through more confident decision making. Time efficiencies can translate into more timely answers for patients and more patients being included 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.4
Hope through certainty
“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.
- Landhuis, E. Scientific Literature: Information Overload. Nature. 2016 July 21;7612:457-58.
- 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
- 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/
- 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