Jonathan C. Trent, MD, PhD
Director, Sarcoma Program
Associate Director, Clinical Research Sylvester Comprehensive Cancer Center
University of Miami Health System Miami, Fl
This scenario is familiar to oncologists at cancer centers around the world: A patient with advanced cancer requires a precision medicine test, such as next-generation sequencing (NGS), for optimal management. The physician fills out a paper form, which is then faxed to a vendor. After receiving the fax and routing it to the right individual, requesting tissue, obtaining tissue, and performing NGS, the vendor faxes or e-mails the results to the doctor’s office. The fax or the printed e-mail is often scanned into the patient’s electronic medical record (EMR) or placed in the paper record.
Needless to say, this approach is slow, inefficient, and archaic. The EMR folder is already overflowing with other data that are often not organized in an easily searchable format. At times, tracking down the NGS results is a test of endurance. This entire process is laden with manual exchanges and time-consuming printing and scanning that substantially delay care for patients with cancer, who clearly do not have time to waste.
To better manage this challenge, Sylvester Comprehensive Cancer Center, part of the University of Miami Health System, initiated a partnership with Syapse, a company that specializes in precision oncology solutions. With Syapse, we have been able to streamline the precision medicine process and organize the data to improve care for our patients with cancer.
The most obvious benefit from this partnership with Syapse is easy access to critical precision medicine data. Syapse has created a secure electronic portal between vendors and our EMR that is compliant with the Health Insurance Portability and Accountability Act. Our updated version of the precision medicine workflow is not only more efficient, it improves turnaround time for test results.
Physicians and patients decide to pursue NGS. The physician enters the patient’s chart in the EMR and not only chooses specific tests but also selects the vendor to perform testing from user-friendly dropdown menus. The system automatically notifies our pathology laboratory to obtain the patient’s archival tumor samples and provides the tissue to the testing vendor in a timely fashion.
After the testing is complete, the vendor sends the results through an electronic portal directly to the patient’s chart in the EMR. An automated, electronic notification is sent to the physician or designee when the test results are available. When the patient returns, the provider can open the patient’s record and easily find the new testing data, which are searchable and annotated by vendor and test type.
This approach eliminates a number of barriers that often unacceptably delay patient care. By placing all the test data in the patient’s EMR, physicians no longer need to access multiple vendor sites, with multiple passwords. Also, removing the manual handling associated with faxes and e-mails enhances speed and reduces human error.
The Big Payoffs
Rapid access to precision medicine data is necessary for optimal patient care and drives important opportunities that could potentially advance our understanding of cancer.
This new, digital process supports a wide range of clinical investigations. Discrete precision medicine results enhance data mining so that we can identify patients within the EMR whose tumors harbor specific mutations. This allows for seamless collection and analysis of clinical outcomes and fosters the development of biomarkers that allow continuous improvement in patient care.
The Syapse platform ensures our ability to rapidly and easily study patients who have received precision medicine tests. Early results from these types of investigations have been quite positive.