Using real-world data can improve the quality care delivery, lower costs, inform policy decisions to help accelerate and improve clinical research.
During a June webinar hosted by Becker's Hospital Review and sponsored by Flatiron Health, medical oncologist and hematologist Ivy Altomare, MD, medical director of Flatiron Health, discussed the importance of using real-world data in oncology.
Four insights:
1. Real-world data has tremendous value. "We're experiencing an explosion in demand for high-quality evidence, due to not only the unmet needs of cancer patients, but also the acceleration in development of new science and new therapeutics," Dr. Altomare said. There are abundant sources of data, including EHRs, claims and billing systems, product and disease registries and patient-generated data through mobile devices and other sources.
2. Practical use cases for RWD apply to health systems, policy, drug research and development, and direct patient care.
- Health systems use cases include using RWD for quality metrics, clinical pathways and risk stratification. An example is how the chief quality officer at Yale's Smilow Cancer Hospital in New Haven, Conn., used real-time data to discover that practitioners were administering intravenous chemotherapy within 30 days of death more than the national benchmark. "Just reporting the results raised awareness among practitioners," Dr. Altomare said. Over time, Yale matched and then outperformed the national benchmark.
Other health system examples include leveraging clinical pathways to drive down the cost of care, changing the standard of care in cancer treatment and using risk stratification to manage population health.
- Health policy use cases include using RWD to show the rapid adoption of telemedicine during the pandemic, highlighting telemedicine's scalability and addressing potential concerns and questions among payers.
- In R&D, drug companies can use RWD to overcome challenges in enrolling enough patients into clinical trials. Trial enablement tools can be embedded into EHRs to send real-time alerts to match patients with appropriate trials. Today, only about 8 percent of adult cancer patients enroll in a clinical trial, even though more than half say they would enroll if they had the opportunity. Real-time data and alerts provide that opportunity.
- Direct patient care is impacted by RWD. A recently published study examined patients with lung cancer. Using RWD for thousands of patients, the study found that patients receiving only immunotherapy lived as long as patients receiving both immunotherapy and chemotherapy. Based on these results, many patients could be spared the toxicity of chemotherapy, improving their lives and lowering costs.
3. Implementing a process for collecting and learning from RWD requires a platform. First, EHR raw data must be cleaned to ensure accuracy, assessed for missing data and harmonized into a common data language. Then, this data can be linked with other data sources to improve the usefulness of the data. To generate usable data, a platform is needed, whether homegrown or commercially acquired.
4. Leveraging data to improve processes is a continuous loop. Process improvement is cyclical. First, organizations must have the tools to access the data and insights needed. Next, that data is used to grow the practice and improve workflows, which transforms the practice for a value-based future. "As you get more familiar with data capture and analysis, you can do more and more projects over time," Dr. Altomare said.
"I hope I made the case for how important real-world data is to improve the life of every cancer patient and how it can potentially be used to support a value-based future," Dr. Altomare summarized.
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