Bolstering Patient Care with Decision Support Tools

In preparation for the ACCC 46th Annual Meeting & Cancer Center Business Summit (AMCCBS) in Washington, D.C. on March 4-6, we are talking with several featured speakers about the topics they plan to address at the summit. Debra Patt, MD, MPH, MBA—a breast cancer specialist in Austin, Texas, whose research focuses on imaging informatics for breast cancer, clinical decision support systems, predictive analytics, and quality improvement—will speak about applied informatics in oncology.

ACCCBuzz: What message do you hope to send in your address at AMCCBS?

Dr. Patt: The time for data science to help improve healthcare is here. We are not yet at the tipping point, but we can get there faster if we work together. Addressing this issue with cancer centers in local communities gives me the opportunity to share information about how to navigate predictive analytics more seamlessly.

ACCCBuzz: What are the most beneficial applications of decision support and predictive analytics at your cancer center?

Dr. Patt: At Texas Oncology, we have a clinical decision support system through our electronic health record (EHR). When I write for a therapy for a patient, all of that patient’s data, their tumor characteristics, are collected in one place, and a clinical decision support tool pops up and gives me treatment options to choose from. This can reduce error by pre-populating the chemo treatment based on a patient’s weight, creatinine levels, and other variables, and pairing the chosen therapy with the right supportive care drugs. When I started in this field, we wrote for chemotherapy treatments with a pen and paper, and you know a doctor’s handwriting is not known for being the most legible. That method was much more prone to human error and could lead to suboptimal outcomes.

ACCCBuzz: How do decision support tools and predictive analytics impact patients at the point of care?

Dr. Patt: I have my EHR open at the point of care. When I write for chemo, I receive pop-up options concordant with clinical guidelines that I can order while I am with the patient. This information also populates our health literacy tool, which explains the risks and benefits of therapies to patients, improving their health literacy and helping them make informed treatment choices at the point of care. I no longer have to write for therapies at the end of day; I’ve already done it when I was physically with my patients. Our studies have demonstrated that this method improves patient adherence to guidelines and contributes to cost reductions.

ACCCBuzz: What is the future potential of telemedicine in local cancer care?

Dr. Patt: I continue to be excited about telemedicine in cancer care centers. It has been slow going, largely because of reimbursement, but I can envision a time when patients can get supervision from subspecialists and not have to travel for consultations. It can be done; telemedicine can make supportive care and subspecialty care more accessible to patients. This would especially help community practices far from urban areas.

On a practical level, telemedicine can save patients time, money, and inconvenience. For example, if I refer patients for proton therapy, they have to travel for both a consultation and for treatment. With telemedicine, they could receive the consultation remotely. If they are not a candidate for this therapy, they would be saved a potentially lengthy trip. If they are an appropriate candidate for proton therapy, they would only have to travel once, for treatment. Telemedicine reduces the burden of travel for patients who need subspecialty services.

Telemedicine can also make supportive care services more accessible. Our practice has just started using a telemedicine platform to bring a social worker to our centers remotely. Already the social worker is helping our patients with advanced care planning and other issues.

Debra Patt, MD, MPH, MBA, is a practicing oncologist and breast cancer specialist in Austin, Texas. An executive vice president of Texas Oncology, Dr. Patt’s research focuses on imaging informatics for breast cancer, clinical decision support systems, predictive analytics to reduce risk in patients with advanced cancer, and quality improvement. She is the editor-in-chief of the Journal of Clinical Oncology-Clinical Cancer Informatics. She is an active leader in breast cancer research, serves on the US Oncology Research Breast Cancer Committee, and chairs the breast cancer subsection of the Pathways Task Force for The US Oncology Network. She has expertise in healthcare policy and has testified before Congress to protect access to care for Medicare beneficiaries.