Upload
ann-george
View
219
Download
1
Tags:
Embed Size (px)
Citation preview
Treatment Summary
University of California San FranciscoCenter of Excellence for Breast Cancer Care
PI: Laura J Esserman MD MBA; Edward Mahoney; Elly Cohen PhD; Susil Rayamajhi MS
A Collaborative Tool for Generating a Care Plan and
Treatment Summary
This work is licensed under a Creative Commons Attribution 3.0 Unported License.© 2007 Laura J Esserman
Improving Quality of CareUCSF Roadmap Strategy
Z
Patient Entered Data
Intake, Sx, Follow-up
MD Pt Collaborative
SpaceCare Plans
MD/ EMR Entered Data
Pathology Treatment Data
Central Data
Repository
Personal Health Record(Treatment Summary)
Clinical Trial Matching
caMATCH/BCT.org
Decision Aids
Portals
Research
Aggregated Data for QI
Treatment Summary:The Need
• Patients need to know their treatment options when they are diagnosed with cancer• Need to visualize treatment strategies and time lines• Need to be able to share potential care plans with
• Family• Other physicians
• Patients need a record of their care plan and where they are on the treatment continuum• Indicate when complications affect time line
• Everyone needs structured treatment summary data• Patients, providers, researchers, policymakers, registries,
payers• Enter once (correctly), use many times• Patients should have access to clinical trials, decision
support even if MD does not provide it
Treatment Summary:Design - form follows function
• Functional tool for use at the point of care
• Provide a space for patient/physician collaboration
• Provide context for the many physicians and caregivers that are involved with treatment
• Generate a care plan collaboratively
• As the care plan is carried out, the critical data (treatment summary) is generated as a by-product of care
• Maximizes interactivity with other useful applications, decision support, and outcomes of care
Treatment Summary: Step 1MD/Patient create care plan during consultation
Care Plan/ Calendar
Situation
1. Example for 36 yr old with Stage 3b Her-2 positive, ER + breast CA
2. Example for 65 yr old with Stage 2a Her-2 negative ER + breast CA
Surgery XRT Chemo Biologics HormonalChoices
2006 Jan April July Sept
Chemo XRT
Biologics
Surgery
+Hormonal
Hormonal
2006 Jan April July Sept
Surgery XRT Hormonal
Treatment Summary: Step 2MD updates Care Plan with patient at each visit
Surgery XRTChemo Follow-up
2006 Jan Feb July Sept 2006-2010
Chemo
Care Plan/Calendar
Situation: Stage 2a breast cancer ER/PR/Her-2 negative, recurrence 4yrs post Rx
Treatment Summary:Embedded within Longitudinal Patient
History
Treatment Summary:Component of UCSF Roadmap• Scope
• Comprehensive patient data available at the point of care• Facilitate patient/care provider collaboration• Real-time collaboration supporting effective decision support• Accessible via static devices and mobile technology
(Smartphones, etc.)
• Scalable solution• Open source• Enterprise architecture• Interoperability with new and existing healthcare solutions
• Support for healthcare and technical standards• Continuity of care record (CCR/CCD)• HL7 standards• Templates and archetypes• Unified medical language system (UMLS)• Java 5, Ajax and business process execution language, etc.
Treatment Summary:Underlying Architecture
Document Store
Index
Service Layer
Presentation Layer
Data M
apping
1. Data Input and Export
2. Document Storage3. Document Indexing
4. Invoking Rules, Workflow and Normalization
Input or View
Input or Export
• Common Framework
• Common application design and development
• Semantically interoperable archetypes
• Leverage collaborative development
• Establish interoperable applications
Consumer Other Providers
Pharmacy
Clinician
Monitoring
Clinical Trials
Disease Information
Wellness
Email and Calendaring
Other Providers
Pharmacy
Consumer Diagnostics
Clinical Trials
Protocols
Medical Search
Email and Calendaring Drug
Alerts
Eligibility
Clinician
Treatment Summary:Exported to PHR/EMR and Available for Sharing
Common Consumer and Clinician RequirementsSingle point of access to information collated from multiple sourcesIntegration with existing healthcare applicationsConsumer privacy and confidentiallyEnhanced user experienceAlerts and reminders
Diagnostics