Clinical Decision Support in Cancer Care: Why the Patient’s Voice Matters

Mary E. Cooley, PhD, RN, FAAN, Dana-Farber Cancer Institute, speaks with the Journal of Clinical Pathways about the advantages of clinical decision support in managing patient care and how it differs from the typical standard of care. Her presentation was part of the panel titled “Treating the Individual” at the 2023 Clinical Pathways Congress + Cancer Care Business Exchange.

Transcript

Mary E. Cooley, PhD, RN, FAAN: My name is Mary Cooley. I'm a nurse scientist from Dana-Farber Cancer Institute.

Could you please discuss the importance of clinical decision support in managing patient symptoms?

Dr Cooley: Clinical decision support is essential in managing cancer symptoms. Number one, the main reason is that we have a lot of evidence-based symptom management guidelines that aren't routinely used in the clinical practice setting. A lot of these practice guidelines are all paper-based and aren't computable and individualized to the individual. The beauty of clinical decision support is it can individually tailor the recommendations at the point of care, making it very easy for clinicians to do best practices.

Why is it important to include the patient's voice in cancer care?

Dr Cooley: Patient's voice in cancer care is absolutely critical. Patients that are diagnosed with cancer experience a lot of distress initially and making it really difficult to understand information that's provided to them. A lot of times they'll go into their appointments and may not think that their symptoms are the essential thing to bring up during the appointment. Having patient reported outcomes makes it very easy for the clinician to actually see the symptoms that are most distressing to patients. This is essential because untreated symptoms are related to increased morbidity, increased cost, and mortality from cancer and its treatment.

How does patient-centered cancer symptom management differ from standard care and how does it improve patient outcomes?

Dr Cooley: Patient-centered care focuses on what's most important to the patient rather than what is important to clinicians or other people. It brings the patient's voice front and center into the conversation. It improves outcomes because we're able to treat the symptoms that are most distressing to patients that may not be brought up during the visit. Oftentimes these cause a lot of complications from treatment.

What do you think is going to change or most impact cancer care over the next year?

Dr Cooley: One of the things that’s going to affect cancer care most as a priority in the future is the use of artificial intelligence and how it's being used and integrated into clinical care. Also, integrating with EHR and being able to extract lots of data and utilize new methodologic approaches to incorporate this into clinical care and decision making.