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Cancer Trends: Big Data = Big Solutions

Q&A with Dr. Debra Patt, Medical Oncologist, Texas Oncology–Austin Central

How is Texas Oncology utilizing big data for cancer care?
Texas Oncology is at the forefront of using big data in many ways, including genetic risk assessment, therapeutic discovery, improving health services with a focus on patient-centered care, and a relentless attention to value-based care. From 33 cancers and more than 11,000 patients, we understand the genes that play a role in cancer evolution. We’ve used that information with some of our partners to offer leading-edge clinical trials to our patients.

How is Texas Oncology propelling the big data trend forward?
One of the biggest ways that Texas Oncology uses cancer data is to contribute to health services through the Oncology Care Model (OCM). We have information on patient illnesses, Medicare data on other services they’ve used, and their total cost of care. This enables us to innovate in our care delivery model at every step. For example, we:

  • Hire patient navigators
  • Make sure patients discharged from the hospital have the right services they need to help prevent readmission
  • Characterize the patient story to increase patient-reported outcomes with a focus on patient satisfaction

Those innovations help us deliver better patient care and then measure that as a population. We’ve enrolled more than 19,000 Medicare beneficiaries on a pilot project in Texas. We analyze patient outcomes, hospitalizations, and ER visits to help us identify where we should change care delivery to improve outcomes. We take individual information, learn from populations, and then apply that back to individual care.

Texas Oncology is at the forefront of using big data in many ways, including genetic risk assessment, therapeutic discovery, improving health services with a focus on patient-centered care, and a relentless attention to value-based care." Debra Patt, M.D., MPH, MBA, Medical Oncologist
Texas Oncology–Austin Central

How does cancer data improve treatment planning?
Cancer data are critical to treatment planning. Oncology is a highly evidence-based specialty. We don’t like to move forward with treatments without justification, because it’s both costly and toxic. For more than a decade, we have participated in evidence-based pathways, using cancer data to improve outcomes. Pathways are nudges to doctors to facilitate evidence-based decision making. They are not binding, so doctors always have the ability to choose what they think is in the best interest of their patient.

As our genomic and precision medicine capabilities grow, those decisions likely will become more complex. I'm not just going to make decisions about patients with stage II breast cancer, but I'll make decisions about patients with stage II breast cancer with certain molecular profiling that gives me insights into their likely benefit from therapeutic treatment options.

What is the future of big data in cancer in both the near and long term?
The big data revolution in cancer is just beginning. Our early studies have been on things like survivorship and treatment effects. Health services is probably the first place where we will see big data’s greatest value. These include things like patient navigation, patient-reported outcomes, patient satisfaction scoring, identifying high-risk patients and giving them the appropriate treatment, and supporting patients who are either at high risk or have been hospitalized. These are going to be early five to 10-year wins that will improve patient care tremendously.

Secondary wins in the 10-20-year timeframe will be around therapeutic intervention and discovery, taking the patient’s life needs story and learning from each individual patient. As we receive more information on precision medicine and somatic mutations that drive cancer, we’ll take those to the population level and bring them back to the individual patient and say much more specifically who is likely to benefit from which treatment. We are excited about how big data will help us innovate, and we are really looking forward to better outcomes in cancer as a result.