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Managing the Complexities of Cancer Care With Information Technology

Wilfong, Lalan MD

doi: 10.1097/01.COT.0000524563.59346.41
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Information technology (IT) plays a significant role today in the delivery of high-quality, patient-centered cancer care. As the complexity of cancer care continually increases with new drugs and protocols, IT helps providers keep up with the ever-evolving changes. By putting current information at providers' fingertips, IT arms them with information to choose the best treatment option for patients. It also allows providers to utilize valuable information hidden in the huge volumes of data captured during the day-to-day care of patients, enabling operational efficiencies that support care improvements. Our ultimate goal is to always get the right treatment to the right patient at the right time. Advanced technology is helping providers achieve this goal.

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Technologies That Improve Care

There are many different technologies that contribute to improving cancer care, helping providers overcome the multitude of challenges caused by today's complex environment:

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Clinical Decision Support Tools

Clinical decision support (CDS) tools are among the biggest technological advances in recent years that can help improve quality of care. Using patient information, these tools help identify the appropriate therapeutic options. For example, treatment options for lung cancer expand seemingly daily. If the provider does not treat lung cancer frequently, he or she may forget to check for genetic alterations that guide therapeutic decisions. CDS tools prompt the provider to test for specific genetic alterations and then list the appropriate therapy, which can improve survival compared to standard treatment. They can also alert the provider to certain issues that may have gone unnoticed over time, such as slow weight loss or declining performance status.

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Electronic Health Records

Electronic health records (EHRs) also play a critical role in improving care by having all of the patient's records in one place and easily accessible by all members of the care team. Providers have all the information needed at their fingertips to make sound care decisions based on facts. Providers can quickly access and compare reports, enabling them to track changes in the patient's condition. Alerts can also be used to remind providers to check issues that might need to be addressed. Having a regimen library helps providers with dosing and supportive care algorithms.

Mobile EHR capabilities also greatly improve care, allowing quick and easy access to real-time patient records anytime anywhere. With a mobile EHR, providers working away from the office can see exactly what therapies patients are getting and where they are in their cycle, all of which play a critical role in after-hours care. Providers can also send notes to the care team instructing them how to follow-up with patients, enhancing care coordination and enabling the entire team to participate in quality care.

The EHR also improves access to educational information for both providers and patients. Educational material can be quickly retrieved and linked to patient portals so patients can view appropriate disease-specific information any time. Providers can also access nationally-recognized resources through the EHR for current standard guidelines and therapies, rather than relying on potentially outdated reference books. Cancer information has exploded in the past decade, so it is critical for providers to have convenient access to the latest material to ensure they are giving the appropriate treatment.

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Patient Portals

Patients can access their labs, scans, medical notes, and other records at their convenience through patient portals, improving the patient experience. This is a great advantage for patients who travel, as they always have access to their medical history. Some portals have the ability to collect patient reported outcomes (PROs), electronic surveys submitted by patients that report their health status. A recent study demonstrated improved quality of life and survival rates for patients submitting PROs in real time, triggering alerts to clinicians.

Today's tech savvy patients also want the ability to perform basic tasks online, such as sending reports to the clinic from other providers or scheduling appointments. Some patients communicate better electronically than they do verbally, so the portal also helps improve care and communication by enabling electronic messaging between the clinic and the patient.

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Data Analytics Tools

Data analytics tools improve care in a variety of ways. Using EHR data, quality measures and compliance with clinical guidelines can be monitored, allowing administrators to identify and work with providers needing improvement. Analytics also improve access to clinical trials. When a trial opens, patients who may be eligible to participate can easily be identified and physicians are informed which of their patients may qualify.

In the near future, analytics will mine big data to identify unreported problems that are occurring, enabling providers to act on them to improve care. For instance, many new drugs that target uncommon mutations are studied in small populations. Side effects may be occurring that are not recognized in the trial due to its small size, however, when treatment begins across the country, analytics may uncover these issues.

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Drug Management Technologies

Pharmacy technologies can improve care by helping to ensure the right drug is appropriately administered to patients. Because the number of drugs has dramatically increased, these tools have become invaluable by putting information about proper drug concentrations and administration protocols at the fingertips of pharmacists and infusion nurses, helping to prevent errors.

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Interoperability Is Improving

Interoperable technologies that facilitate care coordination are improving, but more progress is needed to enable a seamless flow of information from one care setting to another. As health care becomes more dependent on technology, it is critical to solve these issues to ensure all of the patient's providers have the information they need to deliver excellent coordinated care.

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Transforming Cancer Care

Technology will never replace the human touch or the care team's compassionate guidance as they expertly manage the patient's cancer journey, but it can enhance the ability to provide high-quality care. With the explosion of knowledge in cancer care, providers struggle to keep up with important new developments that can improve patient outcomes, quality of life, and operational efficiencies that support better care. Technology harnesses this vital information and makes it easily accessible, improving the provider's ability to deliver the right care to the right patient at the right time.

LALAN WILFONG, MD, is Medical Director of Quality Programs for Texas Oncology, an affiliate of The US Oncology Network.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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