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The American Society of Clinical Oncology has unveiled its prototype for an ambitious computer network that allows physicians to search patient records and clinical evidence in real time.
The network, called CancerLinQ, promises to ultimately give oncologists access to millions of patient records, expert guidelines, and scientific literature all through a single computer interface.
The development of CancerLinQ comes as more oncologists are embracing health information technology. A recent ASCO survey shows that more than 60% of oncologists are using advanced electronic health records. Only 8% of the oncologists surveyed by ASCO said they aren’t using an EHR now and don’t plan to implement a system.
Dr. Sandra M. Swain
The prototype, which is the first major step in developing CancerLinQ, focuses on breast cancer. Through the prototype, oncologists are using their EHR systems to contribute everything from genomic data to physician notes related to their breast cancer patients. They can then search CancerLinQ’s database of about 130,000 de-identified patient records to look for trends and associations in treatment responses or patient characteristics.
The prototype also allows physicians to get individualized treatment advice based on breast cancer guidelines and to measure their performance against quality measures in ASCO’s Quality Oncology Practice Initiative (QOPI).
Once complete, the CancerLinQ system will include patients with all types of cancers.
"We’re developing a knowledge-generating computer network that will help us unlock that 97% of data that [are] currently beyond our reach," Dr. Sandra M. Swain, ASCO president, said during a demo of the CancerLinQ network on March 27.
Currently, about 3% of cancer patients participate in clinical trials, leaving the rest of the patient experience untapped for research purposes, Dr. Swain said. The development of CancerLinQ aims to bring that information directly to physicians.
For instance, if an oncologist is planning to start a patient on an aromatase inhibitor to treat a hormone-sensitive breast cancer, they might want to know how long similar patients stay on the treatment. CancerLinQ allows physicians to generate reports showing the typical treatment duration in patients with similar characteristics and to see what their outcomes were at various durations.
For individual patients and physicians, CancerLinQ will be "like having the whole medical community available for an opinion," Dr. Swain said. "It redefines what a second opinion is."
And the health care system as a whole could benefit, too. CancerLinQ has the potential to reduce fragmentation of care, decrease duplicative testing, and reduce costs, she said.
"The result will be higher-quality, higher-value care with better outcomes for patients," said Dr. Swain, who is medical director of the Washington Cancer Institute at MedStar Washington Hospital Center.
ASCO developed the prototype as a "proof of concept" that this type of "learning health system" could be developed, said Dr. Clifford A. Hudis, ASCO president-elect and an oncologist at Memorial Sloan-Kettering Cancer Center in New York. The prototype uses mostly open source software, along with some proprietary programs. But the prototype is able to import and aggregate information from a wide variety of electronic health record systems, he said.
Over the next year, ASCO officials will publish a series of white papers on their experience with the prototype. At the same time, they will continue to develop the system for an eventual rollout that will include patient data across all types of cancer. But that will be a multiyear effort, Dr. Hudis said. "This (demonstration) proves that what we want to do can be done."
Dr. W. Charles Penley, director of ASCO’s Conquer Cancer Foundation and an oncologist at a large group practice in Nashville, Tenn., has been participating in testing of the prototype. The process of linking to the prototype was fairly simple, he said. It took only about a day of work by the practice’s IT staff in to connect their EHR to the CancerLinQ system.
Lynn Etheredge, director of the Rapid Learning Project at George Washington University, Washington, and a member of the Institute of Medicine committee that proposed the concept of the "learning health care system," praised ASCO officials for their leadership in developing the CancerLinQ system and in helping to get better information into the hands of physicians.
"For the last 20 years roughly, we’ve been missing physician leadership," Mr. Etheredge said. "I want to credit ASCO with regaining leadership by physicians for what physicians and patients know needs to be the center of health policy."
CancerLinQ is supported by the Conquer Cancer Foundation, which has received funding from Susan G. Komen for the Cure, Helsinn Group, and by Genentech.