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Matt Hickey, Director of Clinical Strategy, - GenesisCare UK: Varian Medical Systems
- 1. GenesisCare UK: Varian Medical Systems 360 OncologyTM Cancer Care Coordination suite: Collaborative development programme Matt Hickey – Director of Clinical Strategy. GenesisCare UK
- 2. My participation in this Event does not interfere with any other obligations I have undertaken, in particular in connection with my current employment (if any) and that my institution has no objections to my participation in the Event. I acknowledge that I have no imposing duty or obligation to refer to the institution or any other health care organization, patient, or physician to any health care institution or provider supplied by GenesisCare or its affiliates or to endorse or recommend the ordering or purchasing of any product or service of GenesisCare or its affiliates. I hereby certify that I will comply with all applicable provisions of law and other rules and regulations of any and all governmental authorities in performing my obligations under my Speaker Letter Agreement, as well as GenesisCare’s own ethics codes and policies, and that I have been furnished with copies of the relevant GenesisCare codes and policies. I hereby agree that my will at all times fully cooperate with GenesisCare in meeting its obligations thereunder and that my will be bound by the ethical principles underlying such regulations. I further agree to keep strictly secret all confidential information of GenesisCare or its affiliates which I learn during the Event. I will perform all services in compliance with applicable laws and regulations and apply my best efforts to the performance of the services. I also grant GenesisCare permission to use my speech of presentation in other capacities within the Scope of Work. I also authorize and license GenesisCare to reproduce or distribute the materials used in the Scope of Work via the GenesisCare websites. GenesisCare shall maintain the appropriate attribution to Speaker. GenesisCare may modify the materials however, any modification of statements of Speaker that would fundamentally distort the meaning of Speaker’s statements are not authorized by this authorization and license. This authorisation and license shall be for the purpose of advertising, promotion of marketing of GenesisCare and its products and services, and for any other purpose that is in the spirit of the original Scope of Work. For example, the presentation or speech may be recorded, taped, captured via “LiveMeeting” and may be added to the GenesisCare website. To the extent that it has not been previously collected, GenesisCare may require collecting certain personal data from my like my name and email address. GenesisCare will do so only for the purposes required under this Letter Agreement, and always in compliance with applicable law. We will only transfer my data to GenesisCare affiliates, to the extent necessary for the fulfilment of this Letter Agreement, and specifically, to Genesis Care UK Limited, Wilson House, Waterberry Drive, Waterlooville, Hampshire , PO7 7XX and my hereby consent to such transfer to the extent that it is done solely for the purposes of this Letter Agreement and in compliance with applicable law. I also acknowledge that my are an independent contractor, subject to GenesisCare’s direction only as to specific interests where GenesisCare wants the benefit of my services and advice. Nothing in this Speaker Letter Agreement makes my an employee or agent of GenesisCare, or authorises Speaker to speak for, represent or obligate GenesisCare in any way. Disclosure
- 3. 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
- 4. 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
- 5. 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
- 6. Interoperability CANCER CARE COORDINATION: REQUIREMENTS
- 7. CANCER CARE COORDINATION: OUTPUTS
- 8. 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”
- 9. 360 OncologyTM Cancer Care Coordination suite: Clinical Portal
- 10. Streamlined referral management Interoperability with imaging & EMR systems Standardised data collection Automatic categorisation of patients (MDT or not) Referral management Integrated into governance
- 11. 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
- 12. 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
- 13. 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
- 14. 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
- 15. 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
- 16. 360 OncologyTM Cancer Care Coordination suite: Patient Engagement Portal
- 17. 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
- 18. 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)
- 19. 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
- 20. TRANSITION OF CARE Episode 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
- 21. TRANSITION OF CARE Episode 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
- 22. 360 OncologyTM Cancer Care Coordination suite: Analytics & knowledgebase
- 23. Industry standardised clinical datasets Benchmarked patient reported outcomes / satisfaction Rapid Learning & Predictive Modeling Tools Treatment Data Analytics Clinical and Operational dashboards Data-driven insights
- 24. 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
- 25. Industry standardised clinical datasets Benchmarked patient reported outcomes / satisfaction Rapid Learning & Predictive Modeling Tools Treatment Data Analytics Clinical and Operational dashboards Data-driven insights
- 26. 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
- 27. 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
- 28. 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
- 29. 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 cloud June 26: Technical testing complete - System went clinically live (pilot) Aug 12: Prostate and Breast cancer patients now being inducted 10 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 release 12 Nov: GenesisCare UK Clinical Conference – first patient experience presentation Delivery challenges and results
- 30. 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
- 31. Thank-you
Editor's Notes
- With 360 Oncology we focussed on addressing the discontinues in cancer care. We do this by bringing the information about the patient together from multiple information sources to create a 360 degree view of the patient care. We have created powerful tools to make it easier for the care team to manage their tasks and commmunciate with each other to ensure care coordination. The care coordination tools spans the entrie continuum starting with referral management, care delivery, navigation, follow up and survivorship. We are inetgrating clinical pathways into the platform so that the entire team can play from the same song sheet. Optimizing these delivery features for a disease as complicated and heterogeneous as cancer often entails complex decision making, multiple handoffs between primary and specialty care providers, and coordination among cancer care team members. (Ref: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119205/) Continuing geographic, financial and social barriers prevent patients from seeking and receiving multidisciplinary care planning and comprehensive cancer care ( Spinks et. Al 2012)
- No where else is it more critical to bring the key information and decision make than the tumor boards. Making the right treatment choice is the most critical step in cancer. Care. I truly believe that 360 Oncology Tumor board application will truly transform the way tumor boards are prepared for and conducted. It will replace the current cumbersome processes to Make it seamless to gather all the evidence data needed for the tumor board Simply tumor board workflow manage including management of the tumor boarding Imagine a few simple clicks to add patients to the tumor board including the relevant information. Intutibve and simple way to review patient cases during the tumor baord Ease of documenting the decision. Easy access to decsion support tools and clinical insights relevant to the clinical context for the patient/ I am amazed at what the team has been accomplish this application. That’s how 360 Oncology will allow you make decisions confidently.
- No where else is it more critical to bring the key information and decision make than the tumor boards. Making the right treatment choice is the most critical step in cancer. Care. I truly believe that 360 Oncology Tumor board application will truly transform the way tumor boards are prepared for and conducted. It will replace the current cumbersome processes to Make it seamless to gather all the evidence data needed for the tumor board Simply tumor board workflow manage including management of the tumor boarding Imagine a few simple clicks to add patients to the tumor board including the relevant information. Intutibve and simple way to review patient cases during the tumor baord Ease of documenting the decision. Easy access to decsion support tools and clinical insights relevant to the clinical context for the patient/ I am amazed at what the team has been accomplish this application. That’s how 360 Oncology will allow you make decisions confidently.
- No where else is it more critical to bring the key information and decision make than the tumor boards. Making the right treatment choice is the most critical step in cancer. Care. I truly believe that 360 Oncology Tumor board application will truly transform the way tumor boards are prepared for and conducted. It will replace the current cumbersome processes to Make it seamless to gather all the evidence data needed for the tumor board Simply tumor board workflow manage including management of the tumor boarding Imagine a few simple clicks to add patients to the tumor board including the relevant information. Intutibve and simple way to review patient cases during the tumor baord Ease of documenting the decision. Easy access to decsion support tools and clinical insights relevant to the clinical context for the patient/ I am amazed at what the team has been accomplish this application. That’s how 360 Oncology will allow you make decisions confidently.
- Last but not least, 360 oncology is designed to provide data driven insights at every step of the way. The beauty of integrating workflow and analtycis is that 360 Onclogu brings the insights to you where they are needed and in the context they are needed. We also enabling access to an array of context sensitive and predictive decision support tools. The analytics capabilities of 360 degree include clinical as well as operational tools The costs of direct medical care for cancer are estimated to account for 5 percent of national health care spending (Sullivan et al.,2011) One large insurer, United Health care estimated that 11 percent of its costs are for cancer care (IOM,2013) Cancer care costs are highest in the months following a cancer diagnosis and at the end of life (Yabroff et al.,2011)
- Last but not least, 360 oncology is designed to provide data driven insights at every step of the way. The beauty of integrating workflow and analtycis is that 360 Onclogu brings the insights to you where they are needed and in the context they are needed. We also enabling access to an array of context sensitive and predictive decision support tools. The analytics capabilities of 360 degree include clinical as well as operational tools The costs of direct medical care for cancer are estimated to account for 5 percent of national health care spending (Sullivan et al.,2011) One large insurer, United Health care estimated that 11 percent of its costs are for cancer care (IOM,2013) Cancer care costs are highest in the months following a cancer diagnosis and at the end of life (Yabroff et al.,2011)
- Research indicates that when patients are involved in their own care, they are more satisfied with the care they receive and often experience better health outcomes (Alston et al., 2012;CFAH,2010;Hibbard and Greene 2013) Decision aids are one mechanism that can help improve patient’s understanding of their prognosis, their treatment options and the benefits and harms of treatment (Leigh et al.,2011) Studies have found that clinicians ask for patient preferences in medical decisions only about half the time (Lee et al., 2012; Zikmund-Fisher et al., 2010). Limitation of the current evidence base is that it frequently does not capture information about the impact of a treatment regimen on quality of life, functional and cognitive status, symptoms and overall patient experience with the disease (IOM 2013) Reminder systems triggered from data in patients’ EHRs can lead to patients’ improved adherence to treatment protocols and screening recommendations (Din et al., 2005; Nease et al., 2008; Sequist et al., 2009; Shea et al., 1996). In a study where patients were invited to read their clinicians’ notes, patients accessed their EHRs regularly and reported that this was a positive experience; the clinicians reported this had a minimal impact on their workflow (Delbanco et al. 2012).
- Research indicates that when patients are involved in their own care, they are more satisfied with the care they receive and often experience better health outcomes (Alston et al., 2012;CFAH,2010;Hibbard and Greene 2013) Decision aids are one mechanism that can help improve patient’s understanding of their prognosis, their treatment options and the benefits and harms of treatment (Leigh et al.,2011) Studies have found that clinicians ask for patient preferences in medical decisions only about half the time (Lee et al., 2012; Zikmund-Fisher et al., 2010). Limitation of the current evidence base is that it frequently does not capture information about the impact of a treatment regimen on quality of life, functional and cognitive status, symptoms and overall patient experience with the disease (IOM 2013) Reminder systems triggered from data in patients’ EHRs can lead to patients’ improved adherence to treatment protocols and screening recommendations (Din et al., 2005; Nease et al., 2008; Sequist et al., 2009; Shea et al., 1996). In a study where patients were invited to read their clinicians’ notes, patients accessed their EHRs regularly and reported that this was a positive experience; the clinicians reported this had a minimal impact on their workflow (Delbanco et al. 2012).
- Research indicates that when patients are involved in their own care, they are more satisfied with the care they receive and often experience better health outcomes (Alston et al., 2012;CFAH,2010;Hibbard and Greene 2013) Decision aids are one mechanism that can help improve patient’s understanding of their prognosis, their treatment options and the benefits and harms of treatment (Leigh et al.,2011) Studies have found that clinicians ask for patient preferences in medical decisions only about half the time (Lee et al., 2012; Zikmund-Fisher et al., 2010). Limitation of the current evidence base is that it frequently does not capture information about the impact of a treatment regimen on quality of life, functional and cognitive status, symptoms and overall patient experience with the disease (IOM 2013) Reminder systems triggered from data in patients’ EHRs can lead to patients’ improved adherence to treatment protocols and screening recommendations (Din et al., 2005; Nease et al., 2008; Sequist et al., 2009; Shea et al., 1996). In a study where patients were invited to read their clinicians’ notes, patients accessed their EHRs regularly and reported that this was a positive experience; the clinicians reported this had a minimal impact on their workflow (Delbanco et al. 2012).
- Last but not least, 360 oncology is designed to provide data driven insights at every step of the way. The beauty of integrating workflow and analtycis is that 360 Onclogu brings the insights to you where they are needed and in the context they are needed. We also enabling access to an array of context sensitive and predictive decision support tools. The analytics capabilities of 360 degree include clinical as well as operational tools The costs of direct medical care for cancer are estimated to account for 5 percent of national health care spending (Sullivan et al.,2011) One large insurer, United Health care estimated that 11 percent of its costs are for cancer care (IOM,2013) Cancer care costs are highest in the months following a cancer diagnosis and at the end of life (Yabroff et al.,2011)
- Last but not least, 360 oncology is designed to provide data driven insights at every step of the way. The beauty of integrating workflow and analtycis is that 360 Onclogu brings the insights to you where they are needed and in the context they are needed. We also enabling access to an array of context sensitive and predictive decision support tools. The analytics capabilities of 360 degree include clinical as well as operational tools The costs of direct medical care for cancer are estimated to account for 5 percent of national health care spending (Sullivan et al.,2011) One large insurer, United Health care estimated that 11 percent of its costs are for cancer care (IOM,2013) Cancer care costs are highest in the months following a cancer diagnosis and at the end of life (Yabroff et al.,2011)
- Last but not least, 360 oncology is designed to provide data driven insights at every step of the way. The beauty of integrating workflow and analtycis is that 360 Onclogu brings the insights to you where they are needed and in the context they are needed. We also enabling access to an array of context sensitive and predictive decision support tools. The analytics capabilities of 360 degree include clinical as well as operational tools The costs of direct medical care for cancer are estimated to account for 5 percent of national health care spending (Sullivan et al.,2011) One large insurer, United Health care estimated that 11 percent of its costs are for cancer care (IOM,2013) Cancer care costs are highest in the months following a cancer diagnosis and at the end of life (Yabroff et al.,2011)
- Last but not least, 360 oncology is designed to provide data driven insights at every step of the way. The beauty of integrating workflow and analtycis is that 360 Onclogu brings the insights to you where they are needed and in the context they are needed. We also enabling access to an array of context sensitive and predictive decision support tools. The analytics capabilities of 360 degree include clinical as well as operational tools The costs of direct medical care for cancer are estimated to account for 5 percent of national health care spending (Sullivan et al.,2011) One large insurer, United Health care estimated that 11 percent of its costs are for cancer care (IOM,2013) Cancer care costs are highest in the months following a cancer diagnosis and at the end of life (Yabroff et al.,2011)