The Best Way to Track and Improve Cancer Patient Outcomes
In a recent report, the Institute of Medicine (IOM) declared that the cancer care delivery system is in crisis—amplified by the complexity of cancer care and historical limitations in clinical quality improvement tools and healthcare analytics.
Who Hasn’t Been Impacted by Cancer?
I’m a registered nurse, daughter, wife,mother and friend. Cancer, like all of you, has touched my family in a multitude of ways- some with happy endings- and some with questions around what the outcome might have been if diagnosis or treatment had occurred sooner, or if different treatment protocols would have been used. Professionally, one of the biggest challenges I faced as an emergency department (ED) nurse was access to cancer patient data including items such as care plans and medication regiments.
As a result of an aging population, the IOM predicts a 30 percent increase in cancer survivors by 2022 and a 45 percent increase in cancer incidence by 2030. Parallel to this increase in incidence is a trend toward increasing costs. In 2010, $125 billion was spent on cancer care compared to $72 billion in 2004. In fact, the cost of cancer is expected to reach $173 billion by 2020—a 39 percent increase in just seven years.
My job focuses everyday on improving the quality of care delivered to patients while being a steward of our U.S. healthcare expenditures. Healthcare analytics provides the tools necessary to capture data around key variables such as time from diagnosis to treatment, sequence of treatment and outcomes associated with different types of treatment. Healthcare analytics also enables sharing of the data with all members of the healthcare team. The ultimate goals are delivering evidence-based medicine to improve outcomes, identifying variance in treatment and reducing waste.
Improved Cancer Patient Outcomes with Preferred Protocols
One of the benefits of a hospital enterprise data warehouse (EDW) and business intelligence tools is the ability to track the usage and effectiveness of various treatment protocols. Most healthcare systems have preferred protocol templates. However, the data often times reveals that physicians’ customization can result in several hundred different templates being used.
A hospital EDW enables healthcare organizations to track which protocols are being used by which clinician and can track the incidence of ED or urgent inpatient admissions after receiving a specific treatment protocol—a useful indication of the protocol’s relative effectiveness.
However, without staging documentation in discrete EMR fields, the outcomes data has limited value.
The Power of Data to Change Physician Behavior
Physicians want to give the best care possible and send their patient home healthy. Most electronic medical record (EMR) systems permit the capture of cancer staging data. However, many physicians do not enter the data. This large medical center used a hospital EDW and healthcare analytics to increase one cancer cohort’s staging documentation—breast cancer—from 4 to 40 percent.
With the promise of increased data availability and outcomes-driven motivation to change documentation practices, physicians are more convinced to input staging data in the EMR.
Sample Visualization of Staging Module Utilization
Cancer Clinical Improvement Programs
A hospital EDW and healthcare analytics can be used for a variety of cancer clinical improvement programs, including:
- Shortening the time from initial patient contact to scheduled first treatment for new cancer patients
- Reducing treatment variation (based on analysis of cost and outcomes metrics)
- Collecting detailed chemotherapy treatment plans for such tasks as cost analysis and establishment of first treatment standards.
What business intelligence tools are you using for improving cancer patient outcomes? What have you found most useful?
Read about analytics success stories in healthcare .