Accessing the most important information to treat the most complicated patients

“Carol” suffers from breast cancer and stage 4 lung cancer, which has spread to her brain. Like many oncology patients, Carol’s treatment requires the talents of a multidisciplinary team.

“This is the kind of patient you don’t manage on your own,” said Dr. Ernest Lo, a California-based medical oncologist who splits his time between his clinical practice and working with the Roche Information Solutions team. “It’s this entire team of people trying to work together. In theory, this sounds great, and it’s how we should approach something as complex as cancer. The problem is a lot of times it feels like everybody is looking at a different piece of the puzzle, even though they’re looking at the same patient.”

In Carol’s case, the multidisciplinary team collectively decided to radiate the brain tumor and treat the lung cancer with chemotherapy. Four days later, however, Dr. Lo received a pathology report indicating that Carol had a mutation in her lung. Fortunately, this meant the cancer could be treated with oral medication, eliminating the immediate need for radiation and chemotherapy.

Dr. Lo added that information into the EHR, flagged it and sent it to the radiation oncologist so that he would not proceed with the radiation and chemotherapy.

“I called him a day later to make sure he had gotten that information and he didn’t. I said, ‘Why not?’” Dr. Lo recalled. “He said, ‘Listen, I’ve got 70 to 80 pieces of information coming at me day to day. I don’t have time to look at and understand what is important.’”

Fragmentation of data and misalignment across the team are common frustrations when working with complex patients.

“The information that we have that’s important is not set prominently, so everybody’s looking at a different set of facts,” he said. “This leads to miscommunication and, in the worst case, medical errors.”

Disparate data becomes especially troublesome when working with a patient such as Carol, who is 75 years old, suffers from multiple conditions and has accumulated more than 15 years of information in her electronic record. In such situations, clinicians need to wade through dozens of folders and tabs in the EHR to assemble the pertinent data and create a mental roadmap of the patient’s care journey before determining the next course of action.

“Some of that data is relevant to me. Most of it is not. But because I have a fear of missing out, I end up spending a lot of time digging through all that information, trying to find out what the most important pieces are,” said Dr. Lo. “That’s infuriating and a tremendous waste of time.”

This challenge is even more frustrating for clinicians who work in organizations that require them to toggle among three or four different EHRs. In these cases, clinicians often spend as much time looking at screens as they do interacting with patients.

Making a difference

Dr. Lo, however, dreamed of a different reality.

“Imagine if we could take all that data that’s in the EHR … and organize it into one single screen … so only the most relevant information [is] there and everybody could quickly understand from the get-go what’s going on with a complex case like Carol’s,” he said.

Fortunately, Dr. Lo can now get exactly that information via a new solution developed by Roche Information Solutions, navify® Oncology Hub. The cloud-based software solution relies on interoperability standards to aggregate and organize the most pertinent information across the patient’s care journey into one easy-to-read screen. Instead of shuffling through many pages of disparate information, the most crucial elements are surfaced to the top and easily accessible at the point of care. By providing a shared, holistic view of the patient, everybody on the care team can quickly understand the patient’s unique situation and work off of a common set of facts.

Perhaps most importantly, with the most relevant information in one place, clinicians can more easily assess treatment progress over time and effectively manage patients across the care continuum.

“What makes cancer unique is not just the seriousness of disease, but the fact that it’s a continuum of care that is happening over multiple points in time. Most of what I do for a cancer patient actually involves looking backwards at what happened to them before, in order to plan for what’s going to happen next. You can imagine the amount of data I need to aggregate to make that happen. And, on top of that, I need to see how it all temporally fits together,” Dr. Lo said.

“With navify Oncology Hub, we’ve taken the most important variables for cancer care – pathology reports, imaging, treatments, biomarkers, labs, response evaluations – and put them on a multi-level timeline, so you can see the temporal correlation between each element,” he pointed out. “No need to dig through the EHR, trying to grab data that occurred months ago. No need to dig through notes, no need to go through all these histories. Now, the entire care team has a common source of facts about what’s going on with each patient’s treatment.”

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