By Mike Doyle, CEO, COTA, Inc.
Most of us know someone who has been diagnosed with cancer and understand first hand the tidal wave of emotions and questions that come immediately after diagnosis. One question that sticks out to providers is the seemingly simple: “How many patients have you seen who are just like me?” and perhaps even more important: “Why are you confident that I can reach the magical five year survival rate?”
Unfortunately, with systems of record like the electronic health record, neither of these questions is easy for the provider to answer. The challenge is, in today’s oncology world there is both a combination of clinical confidence based on peer-reviewed data and the artistic necessity to understand what could work based on perceived comparable patients. Oncologists do incredible work to save lives, however, there is more to be done to help support the people who are making the most important decisions at the most critical inflection points.
Meaningful data to improve cancer care
Prior to the creation of EHRs, physicians stressed that they did not have enough access to data. While data is now being stockpiled within the depths of EHRs, physicians still do not have access to everything the data has to offer. The available data in EHRs is often fragmented, disorganized, and sometimes simply incomplete, making it difficult to glean any real value from this information after it is collected.
Essentially, the EHR can be compared to a messy bureau in your bedroom. While bureaus are intended to organize your clothes — socks in one drawer, t-shirts in another, etc. — sometimes socks windup in the pants drawer. All of the valuable information and data is in the EHR, but is sometimes lost in the wrong “drawers,” making it hard for clinicians to find the important information and make sense of it to impact patient care. While physicians are doing the best they can by adding information into EHRs, technology has not caught up to allow physicians to extract insights and put that data to use.
Fortunately, with the use of outside technology, we can pull real-world data (RWD) and real-world evidence (RWE) from the EHRs. This can unlock the insights hidden within the available data and uncap the potential for improving and personalizing cancer care, while reducing overall costs.
Unlocking hidden insights
The technology available today knows how data should be arranged. It knows when something is misplaced, and knows how to make sense out of it. Through advanced algorithms and clinical input, technology can essentially sort and gather RWD from EHRs and then group together similar patients based on their own biology, disease states, and other phenotypic factors, allowing for insight into treatment plans and potential outcomes.
This information has the potential to give providers a view into how clinically similar patients responded to specific treatment paths, allowing them to better understand which treatments could result in optimal outcomes for their patients, improving overall patient care. In addition, providers are able to reduce the cost of care as they may recommend forgoing therapies that had no clinical value in similar patients but may come at a very high cost to the patient. When clinicians are given this understanding, they can then get the patient on the right drugs and treatment plan faster, ultimately helping to drive precision medicine and changing the quality of care provided.
The current evolution of cancer care
The world of pulling out RWD and RWE to gather relevant and important information to drive precision medicine and improve cancer care is not far off. This technology already exists and is being utilized today by a select number of oncologists and health systems. However, more widespread adoption of this methodology is needed if we want to arm oncologists with the right information that will empower them to impact patient care. And as we’ve learned from EHR interoperability issues, the only way to truly accomplish this is to have the industry as a whole working together. From data companies, providers, and payers, to the companies creating these powerful technologies, we must work toward the common goal of supporting oncologists to give cancer patients the best possible care.