Big Data Dashboard Could Optimize Cancer Clinical Decision Support

Researchers at the University of Missouri School of Medicine, in partnership with Roche Diagnostics, have developed a big data dashboard to optimize the process of gathering relevant information for cancer clinical decision support.

In a study published in JCO Clinical Cancer Informatics, researchers described the process for creating the NAVIFY Tumor Board, which integrates all relevant clinical data for a tumor board into a single digital dashboard accessible to everyone.

Researchers noted that multidisciplinary tumor boards are the gold standard for decision-making in cancer care. These boards are integral to cancer treatment plans, bringing together clinicians from different specialties to guide treatments and improve outcomes. However, collecting pertinent information for each case is time-intensive and requires contributions from multiple team members.

The team evaluated case preparation time during four phases: before NAVIFY Tumor Board (NTB) implementation, after manual implementation, after partial EHR integration, and after a stable EHR integration stage. The results showed that there was a 30 percent preparation time reduction across three cancer categories full integration compared to pre-implementation.

“In addition to saving time, the NAVIFY digital tumor board solution resulted in less variability in preparation time,” said Richard Hammer, MD, professor of pathology at the MU School of Medicine and vice chair of clinical affairs in the Dept. of Pathology and Anatomical Sciences. “The improvements were sustained and became more significant over time, decreasing administrative burdens of meeting preparation.”

The biggest time savings occurred in the breast tumor board, where nurse navigators reduced their preparation time by 69 percent.

“Institutions with dedicated nurses preparing for cases will likely benefit the most,” Hammer said. “This dashboard enables easy access to clinical data, which may support optimal decision-making. In addition, it reduces costs for both patients and hospitals, which is currently under analysis.”

The team is in the process of submitting data on the impact of the NAVIFY clinical decision support software on case discussion time during board meetings. Future studies will investigate its impact on the quality of case discussions.

“As the first reference site for NAVIFY Tumor Board in the US, we are already hosting other institutional leaders to help them implement this software,” Hammer said. “This is the wave of the future, where we are using digital clinical decision support software to enhance how we care for patients, while improving efficiency, standardizing the preparation of cases and making them available to clinicians at any time.”

The study was limited in that it included participants’ self-recording of preparation time, a factor that should be tested in future studies, researchers noted. Despite this limitation, the team expects that their approach could have important implications in the planning of cancer treatments.

“As the volume and complexity of data increase, there is a need for intelligent systems that can better integrate, analyze, and interpret clinical data to enable better clinical decision-making,” researchers stated.

“The results suggest that, in addition to saving time, using NTB resulted in less variability in preparation time, which can facilitate resource planning. This improvement has important ramifications for decreasing administrative burdens of meeting preparation, protecting against EMR burnout, and supporting accurate reporting for accreditation purposes.”

With all the data needed to design a comprehensive cancer care plan, the use of tools like NTB could serve as a helpful resource for clinicians of all disciplines.

“This study supports the platform’s generalizability to other cancer types and institutional settings. In addition, implementation of NTB could have positive economic impacts for cancer care providers. Most importantly, compared with other behavioral interventions, the NTB impacts and improvements were continuous and sustained over time,” the group concluded.