Using technology to transform information that improves cancer care and outcomes

Yunus Munga, Business Unit Manager for Africa at Elekta – In the digital age, data are all around us.

How these data are captured, formatted and analysed determine if they are pieces of information or kernels of intelligence that give us the power to take meaningful action. The explosion of data in healthcare is creating the opportunity to gain important insights that can improve patients’ experiences and outcomes and make the delivery of healthcare more efficient and cost effective.

The incidence of cancer continues to rise, and strategic leveraging of technology and big data will be essential to addressing this global healthcare challenge. The incidence of cancer in the United States is expected to increase 35% over the next fourteen years, resulting in 2.3 million new diagnoses by 2030, and the incidence of cancer worldwide is expected to increase 54% by 2030, resulting in 22 million new diagnoses annually. The dynamic and evolving landscape of cancer care provides a model environment in which effective harnessing of big data can drive substantive improvements for patients, clinicians, care centres and payers.

Current Challenges in Cancer Care

Doing more with less is today’s top mandate for the modern cancer centre. Under constant pressure to cut costs and improve quality of care, many oncology centres face difficult decisions around treatment paradigms and resource utilization while lacking a comprehensive picture of the data that drives these decisions. With increased specialization of care, patients undergoing treatment for cancer see multiple providers, frequently in multiple facilities. This can complicate treatment and lead to missed appointments and tests, which may require cancelling or delaying subsequent care if test results aren’t available in a timely manner or the patient’s status has changed or declined. Additionally, many clinicians face increased caseloads and may struggle to coordinate care with other providers, all while trying to ensure that their patients receive optimum and timely treatment.

The convergence of genomics, precision medicine techniques and easier access to large electronic health record (EHR) data sets is also driving rapid change in the oncology arena. Clinicians have limited time to consume and analyse all the data that could help to inform treatment decisions for individual patients and, concurrently, the increasing use of multi-modality treatments is leading to an explosion of potential therapeutic options. Today’s oncologists are challenged to consistently follow treatment recommendations that are dictated by the most current clinical practice guidelines while cancer care centres are challenged to ensure standardized care across multiple facilities while improving outcomes and decreasing costs.

Care centres also face a growing need to improve the quality of care they deliver, which requires understanding whether deviations from these guidelines are due to guideline improvements or medical errors. As a result, there is an increasing demand for enhanced decision support capabilities that can transform millions of data points into patient-specific, evidence-based cancer care.

Additionally, basic access to quality oncology care can be a major challenge for patients in many emerging economies. Resource constraints resulting from a shortage of qualified clinicians, the cost of cutting-edge technologies, and the need to travel to reach care centres makes it challenging to provide all patients with optimal care. Increasing patient throughput without compromising the quality of care requires a versatile solution that can improve the workflow, safety and clinical decision making that patients and physicians in these emerging markets deserve.

Elekta’s MOSAIQ platform is a powerful solution that transforms big data into actionable intelligence

MOSAIQ®, Elekta’s industry-leading comprehensive Oncology Information System (OIS), is designed to improve patient safety and clinical workflow by housing all patient treatment-related data in a single record that is both centralized and multi-disciplinary. By capturing and feeding data into MOSAIQ® Oncology Analytics (MOA), the MOSAIQ solution produces a dynamic care plan and operational analytics that help to continually improve patient care, increase efficiency and reduce costs. MOSAIQ can help discover operational patterns and trends and makes these data actionable through MOA’s easy-to-use dashboards addressing the patient journey, machine usage and referral patterns. MOSAIQ has a high level of integration with thousands of industry data sources and healthcare systems totalling over 5,000 interfaces globally, which is important for putting global cancer insights at care providers’ fingertips. With MOSAIQ, care plans are also monitored clinically, financially and operationally to help transform how care is delivered.

MOSAIQ is leading the way in driving collaboration among care providers and clinical departments within and between institutions.

This powerful solution overcomes a key challenge to leveraging all the data sets that a care centre generates by compiling multi-disciplinary and multi-source data into a single, centralized location that is readily accessible to clinicians and administrators throughout a care centres network and multiple sites. MOSAIQ has been meeting this critical need since before big data became a big thing, enabling continuous improvement of patient care through routine assessment of care quality across a centres network and ensuring timely access to treatment by reducing wait times, eliminating bottlenecks and improving workflows.

Importantly, MOSAIQ provides efficient analysis of treatment patterns based on a variety of factors, including diagnosis, disease stage, treatment plan and prescribed versus actual treatment. These analyses readily identify trends and best practices that have the potential to improve patient outcomes. MOSAIQ also supports improved treatment efficacy and patient safety through periodic reviews of planned treatment doses, treatment plan variations, toxicity and survival. By facilitating communication between radiologists and referring physicians, MOSAIQ helps to ensure continuity of care across all a patient’s healthcare providers.

MOSAIQ increases productivity, allowing care centres to treat more patients more efficiently

MOSAIQ improves resource utilization and eliminates inefficiencies, resulting in simplified workflows for all providers/departments involved in delivering care to patients and reducing long wait times to access care. The system automatically identifies new start appointments, which helps to plan use of staff and machines, as these appointments typically take more time than do appointments for ongoing care. It also identifies incomplete appointments to ensure that patients are receiving complete care and to facilitate identification of the factors that lead to cancellations, enabling process changes that ensure continuity of care.

MOSAIQ’s ability to identify trends that impact time from referral to first consult and from first consult to initiation of treatment planning also supports continuity of care, optimizes the use of personnel resources and minimizes the number of times the patient must come in for clinic visits. It also provides real-time insight into patient populations, community demographics and referral patterns, ensuring that care centres effectively meet the needs of patients and physicians and expand their ability to reach patients who may benefit from their services.

MOSAIQ also identifies which machines are being used most often to make informed decisions about decommissioning older devices and investing in new equipment. It also ensures that data security, integrity and utilization meet internal and external quality and regulatory standards, which is an ongoing concern in an increasingly digital age.

Reducing cost without compromising the quality of care

MOSAIQ helps care centres reduce the cost of delivering high-quality cancer care, addressing a key challenge in today’s healthcare economic environment. Its easy-to-read dashboards provide a complete picture of practice, departmental or institutional performance and operations across an entire care network. Insights gained from MOSAIQ facilitate planning and cost analysis, ensuring cost-effective use of personnel and equipment and helping centres provide the best care to the right patients at the right time. MOSAIQ is an important tool for helping cancer centres to operate as efficiently and effectively as possible, increasing the proportion of expenditures devoted to care delivery and minimizing unnecessary expenses. It also enables rapid identification of potential fraud, waste or abuse, which is essential for controlling costs and meeting increasingly stringent regulatory and reimbursement requirements.

MOSAIQ’s benefits are also a powerful solution for addressing the needs of care centres in emerging markets, for which effective resource utilization is not only important to the bottom line, but also essential for ensuring that as many patients as possible receive effective care.

MOSAIQ + IBM Watson for Oncology: enabling the next generation of OIS

Elekta is collaborating with IBM Watson Health to integrate Watson for Oncology into MOSAIQ. The collaboration will combine Elekta’s demonstrated success and innovative capacity in advancing the care and management of cancer patients with IBM’s unparalleled expertise in the development and application of artificial intelligence and machine learning.

Integration of MOSAIQ with Watson for Oncology is expected to refine development of individualized care plans that are evidence-based, results-driven and patient-focused.

Watson for Oncology was developed with Memorial Sloan-Kettering Cancer Centre (MSKCC), a globally recognized leader in oncology care, and is a cognitive technology for enhanced decision-making support from evidenced-based National Comprehensive Cancer Network (NCCN) guidelines. The system analyses 40 million documents from more than 300 journals and 250 textbooks that MSKCC has curated in just 15 seconds and is designed to facilitate decision making among tumour boards and other multi-disciplinary care teams.

Integration of Watson for Oncology into MOSAIQ will incorporate hundreds of attributes from the patient’s EHR, including physicians’ notes and laboratory data into the analysis using IBM’s Natural Language Processing technology. Clinicians will receive confidence-ranked treatment options and supporting evidence directly through MOSAIQ, facilitating treatment decisions and the addition of the selected treatment plan into the patient’s EHR. Importantly, MOSAIQ with Watson for Oncology will provide every cancer care provider with access to MSKCC’s curated library and insights whether they are cross-town or on the other side of the world. This helps to ensure that providers are up to date on the most effective regimens for each individual patient, even in resource-constrained healthcare environments.

Big data doesn’t have to give you a big headache

Centralizing data sets from multiple sources and functional groups is essential to creating a data ecosystem that can be analysed comprehensively and inform clinical and operational decision-making.  Robust algorithms can transform patient, financial and operational data into actionable intelligence that helps care centres provide the best care most efficiently. However, the value of any big data technology is tied to how it can be customized to meet the needs of individual end users with respect to both data collection and data outputs. The integration of MOSAIQ and Watson for Oncology is an example of how big data can be used to transform care for individual patients. Data sets are getting larger, and it’s up to technology innovators, such as Elekta and our partners, to cut them down to size and put them in the palm of the provider’s hand.

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