Helping Improve Patient Care Through the NAVIFY™ Decision Support Portfolio
Oncology care is undergoing a major transformation. Thanks to therapeutic successes, cancer is slowly becoming a chronic disease, albeit a highly complex one. Multidisciplinary teams of oncologists, surgeons, radiologists, pathologists and molecular biologists decide on combination therapies or multimodal treatment strategies that are tailored to individual patients and individual tumours. These therapeutic strategies need to be adjusted continuously along the patient journey, especially given that oncology research has shown that tumours consist of the proliferation of malignant cell that behave differently in different stages of the disease.
Decision support for clinicians in complex environments
The complexity of oncology means that every individual therapeutic decision is highly dependent on data from various sources, be it the electronic medical record, the picture archiving system, the pathology or laboratory system, “omics”-platforms of all kinds or various international research databases. For clinicians, this complexity is becoming increasingly difficult to handle, said Professor Okan Ekinci, Chief Medical Officer of Roche Diagnostics Information Solutions (DIS). “Clinicians are asking us to enable them to better utilise data in order to make the right therapeutic decision at the right moment.”
As a company that has the combined strengths of pharmaceuticals and diagnostics under one roof, with considerable knowledge in the field of oncology, Roche has expanded into the field of digital decision support, developing strong partnerships with companies like Accenture and the imaging specialist GE Healthcare, among others, to bring the vision to life. “Our strategic goal is to combine all this knowledge that we have to provide tailored decision support tools to the benefit of our customers and patients,” explained Raj Harapanahalli, Head of Software Center of Excellence at Roche DIS.
First use case tumour board
During the session ‘Personalised healthcare: Leveraging data to improve patient care through clinical decision support’ at the HIMSS Europe 18 conference in Sitges, Spain, the new digital decision support portfolio of products was introduced under the NAVIFY™ brand name. The first product, The NAVIFY™ Tumor Board solution is a workflow tool for interdisciplinary tumour boards and is now available in the following selected European markets: Sweden, Germany, the UK, the Netherlands, Spain and Switzerland, as well as in the US. According to Prof Ekinci, this is only the first step: “In the longer run, we are planning to go beyond oncology. With GE Healthcare, we are planning to explore other complex disease areas.”
Decision support software for tumour boards was chosen as the first use case, because of the need for faster, more accurate and more targeted decision making tools which are particularly crucial in this area: “For tumour boards today, it takes typically two to three hours to prepare each case,” said Clemens Janus, Head of Customer Success EMEA at Roche DIS. Given how time consuming the process currently is, and the fact that many patient cases must be revisited several times along their patient journey, Janus sees huge potential for an integrated technology platform that streamlines these processes.
Interoperability and security are a major focus
Among the big challenges that Roche has addressed in building its decision support platform is, of course, interoperability. “This is the number one concern of our customers,” Prof Ekinci told Insights. “Clinicians don’t want to have yet another IT tool that is separate from the 25 they already have in place,” he said. That’s why Roche’s platform is a cloud-based, vendor-agnostic Software as a Service and works with whatever systems are available in a given care organisation.
Interoperability is one of the areas in which close co-operation with Accenture is key. Roche leverages Accenture’s expertise for the integration of the customer’s data with the platform. Even though the platform uses open international standards like HL7, FHIR, and DICOM wherever possible, Harapanahalli admits that interoperability can be tough: “Success strongly depends on the individual institution. We work closely with the customer’s IT departments and tailor the integration to our platform based on their specific IT landscape.”
Interoperability is not the only challenge that NAVIFY™ Tumor Board addresses. Privacy and security have also been a major focus in the software development process. Roche has a proven track record of operating in highly regulated environments within pharmaceuticals and diagnostics. The NAVIFY™ Tumor Board solution is built on a secure cloud platform, in alignment with HIPAA and GDPR regulations, and is certified against HITRUST and ISO 27001. Additionally, in Q4 2017 Roche was one of nine companies selected for the FDA pilot program of Digital Health Software Pre-Certification, a collaboration of FDA with tech industry leaders to help shape the regulatory landscape for digital healthcare.
The primary beneficiary is the patient
Prof Ekinci pointed out that it is ultimately the patient who benefits most from a streamlined, highly personalised decision-making process that incorporates the most up-to-date data available: “Since we strive for the best possible therapeutic decision for the individual patient, simply applying guidelines is not enough anymore.” By incorporating new data domains such as molecular testing and patient reported information (PRIs), more personalised clinical decisions are possible. Enhancing The NAVIFY™ Tumor Board solution, clinical decision support apps that are currently being developed enable clinicians access to best-matching therapy and clinical trial options for a patient, as well as the relevant guidelines and latest scientific publications available.
“First experiences are positive. It shows that with our system, the workflow enhancements help clinicians to standardise and streamline their tumour board processes. This is a tangible benefit. We also believe that the increase in efficiency will ultimately help drive down costs of care,” Prof Ekinci concluded.