GenesisCare UK: Varian Medical Systems360 OncologyTM Cancer Care Coordination suite:Collaborative development programmeMatt Hickey – Director of Clinical Strategy. GenesisCare UK
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Disclosure
A lack of control on patient outcomes post treatment• Global survivorship league tables paint a grim picture – not the whole story! • After-effects are ‘post-treatment’ - Lack of ‘holistic’ surveillance - reactive care not proactive
Poor harnessing of the collective knowledge of our clinicians• Best practice not being applied consistently
Disproportionate funding• Chemo = 2% of cures, RT = 16% (40% combined therapy) • Lack of public & private outcomes visibility
Commissioner mandates• Demand for transparency• New quality mandates
Cancer funds are under threat• Cost of cancer treatment increasing (£7.6bn = -£17.6bn) - True cost of cancer unknown• True benefits of innovation unknown (DFS v PFS v OS v HQoL)
SOME CANCER SERVICE CHALLENGES
COMPLEXITY OF INTEGRATING THE CARE CONTINUUM
SURVIVORSHIP
SCREENING CHEMOTHERAPY
Explosion of data in disparate data sources
Is the correct pathway being followed?
Need to see patient’s imaging and treatment history in one place
Inefficient care team collaboration
DIAGNOSIS RADIATIONSURGERY FOLLOW-UP
RECURRENCE
Loss of control of outcomes post treatment
Late, incorrect diagnosis
GenesisCare UK Aim
“In line with our visions and values, our goal is to ensure each patient receives a personalised, evidence-based care plan that
achieves the best possible outcomes, during and beyond
treatment”
CANCER CARE COORDINATION
Interoperability
CANCER CARE COORDINATION: REQUIREMENTS
CANCER CARE COORDINATION: OUTPUTS
GenesisCare UK Aim
“In line with our visions and values, our goal is to ensure each patient receives a personalised, evidence-
based care plan that achieves the best possible outcomes, during and beyond treatment”
360 OncologyTM Cancer Care Coordination suite:Clinical Portal
Streamlined referral management
Interoperability with imaging & EMR systems
Standardised data collection
Automatic categorisation of patients (MDT or not)
Referral management
Integrated into governance
Simplify Tumor Board Workflow
Manage Tumor Board Meetings
Access Clinical Insights
Seamless Workflow Integration
Collaborative decision making: Tumor Boards (MDTs) (presence and virtual)
Ensure evidence-based best-practice
Full in-clinic and external MDT engagement
Patient support design
PROMs & PREMs publishing, surveillance and management
Access Clinical Insights
Seamless Workflow Integration
Supportive care and survivorship planning and management
Full in-clinic and external MDT engagement
Patient support design
PROMs & PREMs publishing, surveillance and management
Access Clinical Insights
Seamless Workflow Integration
Supportive care and survivorship planning and management
Dynamic patient-specific insights at the point of care
Context-sensitive (PROMs/ PREMs, personalised)
Predictive & rapid learning consequence of treatment modeling
Treatment Data Analytics
Clinical and Operational dashboards
Data-driven insights
Dynamic patient-specific insights at the point of care
Context-sensitive (PROMs/ PREMs, personalised)
Predictive & rapid , consequence of treatment modeling
Treatment Data Analytics
Clinical and Operational dashboards
Data-driven insights
360 OncologyTM Cancer Care Coordination suite:Patient Engagement Portal
Integrate patient values, needs, preferences
Patient Reported Outcomes & Patient Satisfaction
2-way web-based survivorship planning & support
2-way mobile-based survivorship support
Patient participation in treatment decisions
Meaningful patient engagement: Patient engagement portal
Integrate patient values, needs, preferences
Patient Reported Outcomes & Patient Satisfaction
Survivorship
Patient support via mobile platform
Patient participation in treatment decisions
Meaningful patient engagement: Patient engagement portal
PROM; Hybrid of c35 PROMs Qs
highlighting key symptoms present
in patient presentations for
support
PREM; Hybrid of NHS, GMC,
GenesisCare Australia
(multi-stakeholder benchmarking)
Integrate patient values, needs, preferences
Patient Reported Outcomes & Patient Satisfaction
Survivorship
Patient support via mobile platform
Patient participation in treatment decisions
Meaningful patient engagement: Patient engagement portal
TRANSITION OF CAREEpisode of Care Summary: Referring Physicians, Local Care Team, Dieticians, Social Workers, …
Full charting capability
Automated summary (Txt, RTOG, PROMs etc)
Survivorship plan
Toxicity profile, co-morbidity risk, monitoring plan
Patient participation in treatment decisions
Taking cumbersome manual forms
with incomplete information
TRANSITION OF CAREEpisode of Care Summary: Referring Physicians, Local Care Team, Dieticians, Social Workers, …
Full charting capability
Automated summary (Txt, RTOG, PROMs etc)
Survivorship plan
Toxicity profile, co-morbidity risk, monitoring plan
Patient participation in treatment decisions
Automated, categorised and
proactive, forms
360 OncologyTM Cancer Care Coordination suite:Analytics & knowledgebase
Industry standardised clinical datasets
Benchmarked patient reported outcomes / satisfaction
Rapid Learning & Predictive Modeling Tools
Treatment Data Analytics
Clinical and Operational dashboards
Data-driven insights
Industry standardised clinical datasets
Benchmarked patient reported outcomes / satisfaction
Rapid Learning & Predictive Modeling Tools
Consequence of treatment analytics
Clinical and Operational dashboards
Data-driven insights
Industry standardised clinical datasets
Benchmarked patient reported outcomes / satisfaction
Rapid Learning & Predictive Modeling Tools
Treatment Data Analytics
Clinical and Operational dashboards
Data-driven insights
Industry standardised clinical datasets
Benchmarked patient reported outcomes / satisfaction
Rapid Learning, Predictive Modeling & correlation tools
Treatment Data Analytics
Clinical and Operational dashboards
Data-driven insights – Dynamic knowledgebase
Activated Patients• Shared decision making with clinicians. • Supported transition into post-treatment life. • Optimised personal experiences directly informing therapeutic rationale - brand improvement
and return to source (GenesisCare)
Empowered Clinicians• Dynamic decision aids to identify emerging risks and trends (+/-)• Timely access to quality, integrated information. • Improved shared decision making with patients for optimal treatment and long term planning
– clinicians preferentially refer
Informed Commissioners• Transparent quality information for targeted cost-effective commissioning decision making
from preferred providers • Primary care providers are more empowered to provide preventive care and refer to source
GCUK Cancer Care Coordination: Benefits
Activated communities and society• Lower costs of morbidity. • Improved workplace productivity• Activated patients and empowered carers - socio-economic/ socio-political benefit
Validated research & development• Informed R&D funding• Better post-market release surveillance• Patient experience reflected in public: private investment decisions
GCUK Cancer Care Coordination: Benefits
CHALLENGES
• GenesisCare OIS: Elekta Mosaiq• Third-party Patient Insights, Decision Support and late-effects predictive modelling suite• UK installation – US support• Technical teams with difference skills (gaps)• Limited IT & technical skills & resources in UK
RESULTS (12mths, Sept 2015-16)Feb 9: System locally installed (4 sites, Ox, MK, Maidstone, Southampton)Mar 12: Mosaiq mapped – IT infrastructure, hosting and cloudJune 26: Technical testing complete - System went clinically live (pilot)Aug 12: Prostate and Breast cancer patients now being inducted10 Sept: Clinical feature acceptance clinicians now being finalised (11 Dec 2016)16 Oct: GenesisCare Clinical Collaborative, Brisbane – first RT clinical support officer experience 24 Oct ASTRO, Boston. Varian commercial release12 Nov: GenesisCare UK Clinical Conference – first patient experience presentation
Delivery challenges and results
Varian Core project team:• Sukhveer Singh (Sponsor): Vice President, Varian• Roman Wicha (Project Lead)• Shridhar Parvatikar (Technical Lead)• Gunther Lenz (Director, OCS Technology Office)• Steve Laws (Project Coordinator)• Saurabha Bhatia (Snr Product Manager)• Julien Chergui: (Insightive Lead)
GenesisCare team• Eleanor Love (Project lead)• Thomas Pinn (International CIO)• Delos Wilbur (UK IT) • Gary Bee & Dave Wastall (UK) technical support• Fraser Hughes (Australia) (Technical support)• GenesisCare UK Staff, Clinicians & PATIENTS
Acknowledgements
Innovation Collaboration
for a
Quality Outcome
Thank-you
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