The benefits of using of multi-disciplinary teams (MDTs) for the delivery of clinical care to cancer patients has been well-established. But the realisation of the benefits is being hampered by the inability to assess and visualise clinically relevant data in ways that aid MDTs to improve clinical decision making and the delivery of care.
A project supported by Sydney Health Partners is making important progress towards this by overcoming some technical and organisational barriers to bringing together data from disparate sources and visualising the information in a consumable format.
Working at Western Sydney Local Health District, University of Sydney Professor Tim Shaw and his group, Research in Implementation Science and eHealth (RISe) have created a clinical analytics dashboard for the use of MDTs treating lung cancer and breast cancer patients. By daily combining data extractions from two different hospital electronic medical records (eMRs), the dashboard allows MDTs to consider real-time information including surgical, radiation, and medical oncology data in a single graphical snapshot.
“This project is about analysing routinely collected data and presenting it in a useful way to the MDTs,” said Candice Donnelly, Senior Research Officer, RISe. By presenting the data in an actionable format it allows the teams to more readily monitor their delivery of evidence-based care and engage in quality improvement.”
Clinically relevant sets of Quality Indicators (QIs) have been identified through a multi-site prioritisation process, online survey and consultation with the project’s breast and lung cancer working groups.
“In contrast to the traditional approach to quality indicators - which are developed at a Federal or State level - we wanted to develop QIs that clinicians care about and enable them reflect on practice behaviour, thereby changing the way care that is delivered to the patient.”
To achieve this, a number of technical and organisational challenges have had to be met. Not every eMR, for example, has a reporting server, meaning new systems for regular extraction from different data sources have needed to be developed.
Candice Donnelly says that despite the hurdles, working closely with information technology and business analytics teams have made the outcomes worthwhile and sustainable.
“The dashboard allows MDTs to compare their quality measures with similar teams at two different hospitals within WSLHD,” she said.
“The ability to compare clinical analytics between MDTs at other NSW hospitals provides those teams with relevant local benchmarks in addition to national and international standards.”
The clinical analytics dashboard has been enthusiastically welcomed by clinicians involved in the working groups. Associate Professor Elizabeth Elder from the Westmead Breast Cancer Institute (BCI) said the process had prompted her to reflect on clinical practice.
“Knowing what you are doing, not just what you think you are doing, is the key to your whole practice,” she said. “Having the data available and visualised on a screen – and being able to respond to that – creates a positive feedback loop.”
BCI Associate Professor Nirmala Pathmanathan says the project has brought together different databases in a way that is meaningful and useful.
“We generate huge amounts of data every day but it’s a matter of using that data and formatting it in a way that allows us to change the way we do things and improve practice,” she said. “So for me it’s a really important project.”