Debra A. Patt, MD, PhD, MBA, FASCO, Editor-in-chief of the Journal of Clinical Oncology - Clinical Cancer Informatics Medical oncologist at Texas Oncology, and US Oncology Research Breast Cancer Committee member

Cancer: Clinical Decision Support System Improved Compliance with Evidence-Based Treatment Interview with:
Debra A. Patt, MD, PhD, MBA, FASCO
Editor-in-chief of the Journal of Clinical Oncology – Clinical Cancer Informatics
Medical oncologist at Texas Oncology, and
US Oncology Research Breast Cancer Committee member What is the background for this study?

Response: Cancer care is increasing in complexity with differentiation of cancer subtypes, new treatments, and treatment sequences and combinations.  Complying with evidence based therapy has become an increasing challenge.  We see that compliance with guideline based care across the country is highly variable.

Our study evaluated an electronic health record based Clinical Decision Support System to facilitate compliance with evidence based guidelines–or pathways–to deliver care to adult patients with cancer. What are the main findings? 

Response: In evaluating almost 30,000 patients across 9 statewide practices we found that

    • The Clinical decision support system DOES significantly improve compliance with evidence based treatment
    • Assessable data and understanding of variance reporting also improved substantially
    • Clinical Decision Support Systems are a way to influence clinician behavior at the point of care and drive high quality cancer care What should readers take away from your report?

    • In complex systems like cancer care, clinical decision support is a clinical informatics tool that can improve the quality of care.  Given the tremendous variability across the country in compliance with evidence based guidelines, it is a tremendous enhancement in cancer care quality.
    • The system we use, clear value plus, is actually a value based guideline pathway that incorporates the best, least toxic, highest value treatment choices so it is also a way to steward healthcare spending. What recommendations do you have for future research as a result of this work? 

    • Clinical decision support systems can grow and become more useful and patients and providers will benefit. Clinical decision support and other clinical informatics solutions introduce efficiency and can enhance the quality of patient care and the patient experience.
    • We now link our clinical decision support system to educational information to patients so when their doctor discusses new treatments they have a tailored document that summarizes the discussion. Growing these systems to enhance healthcare quality and enhance the patient experience improves patient care. 

Any disclosures?

This research was conducted within The US Oncology Network, and I am a Vice President of Texas Oncology and a Medical Director of Analytics for McKesson. 


DOI: 10.1200/JCO.2020.38.15_suppl.2045 Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020) 2045-2045.
Published online May 25, 2020.


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Last Updated on May 30, 2020 by Marie Benz MD FAAD