CancerLinQ Technology in the Oncology Community

Data collection presents its share of challenges. But there are opportunities to improve cancer data interoperability that will ultimately prove beneficial.

Robert S. Miller, MD, FACP, FASCO, FAMIA, Chief Medical Science Officer, CancerLinQ, American Society of Clinical Oncology, presented “Oncology Practices and Technology: The Way Forward” on the final day of the 2022 Oncology Clinical Pathways Congress.

Technology continues to advance and evolve, and we need to embrace it, Dr Miller said.

The ASCO CancerLinQ is a health-technology platform developed in 2014, Dr Miller explained. It is an extension of ASCO programs such as the Quality Oncology Practice Initiative (QOPI) to collect and analyze real-world cancer care data from multiple health care IT systems, then deliver that data back to physicians and researchers. The first CancerLinQ practice went live in 2016, and it just recently passed 7 million patients in the database from about 110 cancer centers and oncology practices around the country.

CancerLinQ offers automated data abstraction (eliminating manual abstraction), management of quality with actionable insights, and identification of data gaps in order to address them.

“When I was in community practice in the pre-CancerLinQ days and we did QOPI, it was all manual and it was me and my nurse practitioner coming in on Saturday mornings to go through dozens of charts and enter them manually into the system,” Dr Miller said. “That isn’t sustainable, it’s expensive, and the challenge you have with manual data abstraction is that it’s not proactive. Tools like CancerLinQ and others enable a more prospective view of cancer care quality, allowing you to close data gaps.”

SmartLinQ also integrates with ASCO’s Patient-Centered Cancer Care Certification (APC4) pilot program. APC4 was implemented using the oncology medical home (OMH) standards, which were developed based on input from a multidisciplinary expert panel and a systemic review of evidence. Patient-centered cancer care includes patient engagement, availability and access to care, evidence-based medicine, equitable and team-based care, quality improvement, chemotherapy safety, and goals of care and end-of-life discussions.

The goals for APC4 are to demonstrate successful review of practices’ quality of cancer care; confirm the OMH standards add value to the practice, patients, and payers; and develop consistent expectations for cancer care in all payment models.

The first nine practices were certified in July 2022, with more on the way.

“This is still in the pilot phase but it is a practical way of how some of these tools are being used,” Dr Miller said.

Dr Miller discussed how CancerLinQ has been providing research communities access to real-world oncology data, which has been generating real-world insights to its users, like government agencies, clinicians, health care companies, researchers, nonprofits, and medical societies.

“One opportunity to use retrospective data like this is to inform pathway development, to see what’s going on in the real world,” Dr Miller said. “That’s the value of real-world data. It reflects not just the 3% to 5% of patients that are in clinical trials, but all care that’s rendered.”

The future of CancerLinQ is focused on the development of three product lines. SmartLinQ will serve as a one-stop shop for oncologists and care teams to help them improve quality of care, support decision-making, and reduce administrative burdens. TrialLinQ collects clinical trial and prospective data to support real-world disease registries and cancer clinic trials. CancerLinQ Discovery will provide the oncology research community with real-world data from more than 7 million patients.

Dr Miller then circled back to his introductory statement that it’s critical to get the data right. There are enormous challenges related to cancer data in the EHR.

“Most of the important aspects of the cancer patient journey are not captured consistently in structured data in the electronic health record,” he said.

A potential solution ASCO has been working on to solve this issue has been the Minimal Common Oncology Data Elements, or mCODE. A data standard, mCODE is a set of terminologies agreed upon by a working group to improve cancer data interoperability, which could lead to improved care and better opportunities for research.

“The vision is really simple and it’s aspirational, but it’s important to reflect that we’ve actually come a long way since mCODE was first started,” Dr Miller said. “The goal really is to be able to collect cancer patient data once and to reuse that for multiple-use cases.”