Update on CancerLinQ: A Rapid Health-Care Learning System


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The vision for CancerLinQ has always been that it is firmly positioned as part of the quality portfolio of ASCO. Most important, it will improve provider performance by delivering guidance on the best evidence at the point of care.

Robert S. Miller, MD

On March 26, 2013, ASCO announced that it had completed a prototype of CancerLinQ™, the Society’s groundbreaking health information–technology initiative to achieve higher quality, higher value cancer care with better outcomes for patients. At this year’s 2016 ASCO Quality Care Symposium, Robert S. Miller, MD, Vice President, Quality and Guidelines and Medical Director, CancerLinQ, gave an update on CancerLinQ. Please see the video below for Dr. Miller's discussion about CancerLinQ.

Need for Computer Speed and Large Data Sets

“For the past 15 months I’ve been privileged to be involved in the development and implementation of CancerLinQ, which is ASCO’s big-data health information–technology platform. Although about 1.7 million Americans are diagnosed with cancer each year, only 3% of adult patients enroll in clinical trials in which their data are systematically captured in a way that can later be retrieved,” said Dr. Miller. “The vast majority of patient data are locked away in unconnected files and servers in electronic health records that don’t communicate very well. As a result, these valuable learning records are lost and don’t contribute to the greater knowledge.”

He continued: “The other phenomenon that we are all aware of is the increase in data required for medical decision-making relative to human cognitive capacity. When I was in medical school in the 1980s, medicine was practiced largely on clinical symptoms, which only required up to ten facts per decision. But in the modern era of genomics and proteomics we need computer speed and large data sets to process the information needed in clinical decision-making.”

Dr. Miller noted that our greater knowledge of the molecular drivers of the hundreds of different cancers creates an imperative for a knowledge-generating computer network that will collect and analyze cancer care data from millions of patient visits, together with expert guidelines and other evidence, to generate real-time, personalized guidance and quality feedback for physicians.

“The Institute of Medicine has defined a health information technology–based learning health system like CancerLinQ as critical to the future of the of the nation’s health-care system,” said Dr. Miller, explaining that a learning health system is a centralized computer where research and practice inform each other. Moreover, discovery is not only limited to the 3% of cancer patients in clinical trials, but in the everyday care experiences in clinics, which are currently locked in disconnected servers across the country.

The concept of a technology-enabled rapid health-care–learning system was the underpinning of an Institute of Medicine report on how we will use real-time knowledge to improve outcomes, engage patients and family members, create a new culture of care, and form a continuous cycle of quality improvement in cancer care. “So, this was a challenge attacked by the ASCO board of directors in 2011, when they first articulated the principles of a learning health system. And they asked one important question: Could we bring electronic data that are collected each day from caregivers around the country into one rapid learning health system?”

Project Launch

According to Dr. Miller, ASCO saw the promise of a consolidated learning health system, and the CancerLinQ project was launched. In 2012, a prototype demonstrated the feasibility of such a system to provide lessons about the technologic and logistical challenges involved in full-scale implementation. The prototype included “de-identified” data from 100,000 patients with breast cancer who were treated at leading cancer care institutions around the United States. The full system is being rolled out in 2015 and 2016.

“The vision for CancerLinQ has always been that it is firmly positioned as part of the quality portfolio of ASCO. Most important, it will improve provider performance by delivering guidance on the best evidence at the point of care,” noted Dr. Miller.

He explained that CancerLinQ will incorporate ASCO’s clinical practice guidelines as well as more than 200 Quality Oncology Practice Initiative® quality measures are considered the gold standards for assessing the quality of care. “Secondarily, the big data aggregation that is enabled by CancerLinQ will produce insight for exploration and hypothesis generation at a scale not seen by the limitations of the health electronic record. Another feature is that CancerLinQ will be able to accept data from different systems to enable interoperability across many sources,” said Dr. Miller.

Technology Partnership

In early 2015, ASCO and the global business software company SAP engaged in a strategic technology partnership to develop the CancerLinQ platform. Dr. Miller said that the partnership would enable wide deployment of CancerLinQ. The partnership will synergize its areas of expertise and provide:

ASCO:

  • Overall development of CancerLinQ
  • Control over the data and services and products that stem from
    CancerLinQ
  • Oncology subject matter expertise

SAP:

  • Access to SAP global health-care technology platform
  • Customized tools unique to CancerLinQ needs
  • Engineering, development, and other technical support

More Than One Million Records by the End of 2016

“CancerLinQ is a web-based portal that allows access to the various CancerLinQ applications, such as the data-exploration tools and quality-performance indicators and a whole series of customized analytical reports,” said Dr. Miller.

Dr. Miller then highlighted CancerLinQ’s product features, including quickly accessible patient clinical data, insights that allow oncologists to uncover trends that can improve quality care, a patient’s clinical event history in a longitudinal view—all of which is HIPAA (Health Insurance Portability and Accountability Act) compliant.

“We currently have more than two dozen vanguard practices that have signed HIPAA business associate agreements with ASCO, representing more than 600 oncologists across multiple sites, aggregating more than 250,000 patient records into the CancerLinQ system. Within the next month or so, we’ll be bringing on two large multisite health systems. We are on our way to way more than 1 million records by the end of this year,” said Dr. Miller.

Dr. Miller stressed that CancerLinQ is being created by oncologists for the oncology community to improve the quality of patient care. “CancerLinQ is built on an incredibly fast technology that reacts in real-time clinical care. Most important, CancerLinQ is guided by ASCO’s mission to support all physicians in every community and setting,” concluded Dr. Miller. ■

Disclosure: Dr. Miller reported no potential conflicts of interest.



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