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Virtual tumor board platforms: a game changer for cancer case review

January 2019—If Suneal Jannapurredy, MD, had been able to read the patient’s outside radiology report prior to breast tumor board, he would have re-examined the gross specimen to determine whether, as the other providers were now telling him, there was a second area of focus he hadn’t included in his presentation.

Dr. Jannapurredy

“We all tend to assume we know what everybody is thinking,” says Dr. Jannapurredy, a staff pathologist at Emory Decatur Hospital, formerly DeKalb Medical Cancer Center, Atlanta. But, he notes, if he is not informed of an additional area of concern, he may not learn about it until tumor board.

Scenarios like this one are leading institutions across the country to adopt virtual tumor board software platforms—solutions that enable pre-conference data sharing, virtual conferencing, and other forms of collaboration across the cancer care team.

A number of virtual tumor board platforms are on the market or on the horizon, including OncoLens (by the company of the same name) and Roche Diagnostics’ Navify tumor board, both of which were launched in late 2017, as well as Avanade’s tumor board solution, in production since October 2017.

OncoLens had its genesis in DeKalb’s cancer committee, says Lijo Simpson, MD, a medical oncologist at Emory Decatur who worked with a technology team in Atlanta to build the product. The team’s efforts were fruitful. Since implementing the platform, he says, the small community cancer center has doubled the number of cases it can assess in a year. “And OncoLens is now used in a variety of institutions, ranging from small community to large academic cancer centers,” he adds.

Dr. Simpson

The platform, which includes browser- and mobile-based versions, provides each member of the cancer care team with a dashboard that updates in real time when a new case is created, allowing providers to review cases immediately or at their convenience, explains Dr. Simpson, now chief medical officer at OncoLens. The product also furnishes practitioners with user-friendly presentation templates and the ability to upload patient reports directly from an EHR system or smartphone.

Uploading images of glass slides directly from his iPhone to the platform, instead of using a microscope camera, halves the time Dr. Jannapurredy spends preparing images for tumor board presentations. “Even my colleagues can’t tell the difference,” he says. “The images you get from smartphones are just as good, if not better, than the ones I used to take with my camera setup.”

Including ancillary data has also become easier with OncoLens, Dr. Jannapurredy says. For example, he used to find it tedious to summarize a FISH report on a PowerPoint slide. Now he can take a picture of a report with his phone and use the OncoLens iPhone app to upload it directly to the platform.

OncoLens has been a game changer in terms of meeting logistics as well, he says. Before using the product, “we’d be switching between my PowerPoint and radiology’s PowerPoint and the conference presenter’s PowerPoint just for patient histories. OncoLens organizes everything.” Tumor board participants typically open OncoLens on a projector screen and present directly from the platform during tumor board meetings, he adds.
The platform can be integrated with any of the major EHR and lab information systems, as well as homegrown EHR systems, Dr. Simpson says. It ingests only cancer-specific information, so providers are not deluged with irrelevant data.

As the largest university health care system in Missouri, University of Missouri Health Care, or MU, is equipped to review all cancer cases in tumor board. Still, when Roche Diagnostics approached MU pathologist Richard Hammer, MD, about piloting Navify, “of course the answer was yes,” he says. The tumor board preparation process at MU entails pathology residents spending up to six hours a week preparing for one conference—no small potatoes considering MU runs approximately 10 tumor boards weekly.

Dr. Hammer

Dr. Hammer, who is also co-principal investigator of a clinical trial looking at the effectiveness of the software, hopes Navify will decrease preparation times in the four tumor boards where it’s been implemented. Standardization is key, he says, explaining that each meeting at MU is run slightly differently and “the [Navify] software provides an opportunity for standardization.”

Navify “automates the [data] ingestion process” to create a streamlined method for putting a tumor board story together, explains Ketan Paranjape, vice president of diagnostic information solutions at Roche. On the front end, users might find the experience similar to Pinterest. Providers “pin” patient information—everything from patient history to molecular results to radiology and surgical pathology reports—all of which is automatically formatted into a standardized Power­Point presentation after providers choose a function called generate tumor board presentation.

“The beauty of Navify is it pulls the essential data we need to discuss and make clinical decisions,” adds Dr. Hammer, noting that MU recently completed the initial phase of the integration process with Navify, which included patient demographics and pathology reports. The hospital plans to eventually integrate the product with radiology.

Roche has successfully integrated Navify with Cerner at MU and with a homegrown EHR system at Hospital Del Mar, in Barcelona, Spain, both Navify beta sites.

When Roche first conceived of Navify, Paranjape says, “our focus was on oncologists.” During the research period, however, the company quickly realized “nine out of 10 times the person leading tumor board is a pathologist.”

Taking a slightly different approach to improving tumor boards is Avanade, which is not a software vendor, explains Thomas Hoglund, the company’s digital workplace executive. Avanade worked with a large hospital system, currently under a nondisclosure agreement, to implement a virtual tumor board solution employing the Microsoft Office 365 suite, which allows end users to access Office programs from any device with an Internet connection. Over a yearlong period, providers at this hospital system were able to increase the number of tumor board cases seen fourfold, Hoglund says.

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