ePROs Play a Key Role in Personalized Therapy

Michael Kolodziej, MD, Advisor, Canopy, discusses at the 2022 Oncology Clinical Pathways Congress how electronic patient-reported outcomes and electronic engagement with patients can aid improve outcomes.

Transcript

My name is Mike Kolodziej. I'm a physician, medical oncologist. I've had many jobs in my career, including practicing oncology for over 25 years; being a medical director at Aetna, where I was in charge of the oncology programs; working briefly at FlatIron, and then being a consultant for the last four years. My role here today at the meeting is to discuss use of electronic patient engagement to improve patient outcomes. I'm currently serving as an advisor for Canopy.

How can technology such as ePROs improve clinical pathways?

When I was invited to speak and discuss the session with the meeting planners, the desire was to try to bring a discussion technology, and how it impacted health care, and specifically how it might impact clinical pathways. I was pleased to find that we had an excellent presentation on artificial intelligence. We had an excellent presentation on CancerLinQ, and the use of the data that's in the electronic medical record. And my presentation was focused, essentially, on how electronic patient-reported outcomes and electronic engagement of patients could add to our knowledge base, improve the care of patients, keep them out of the hospital, keep them out of the ER, keep them on treatment longer, and then add to our knowledge base, and help us learn about the best way to treat our patients, the best way to personalize care beyond, for example, knowing what their mutation analysis might be, which is one part of personalized therapy, but not the only part, to be sure.

The presentation really focused on why this might make sense. That is the published evidence that electronic patient engagement could improve outcomes. And focused on some of the experience that we've had at Canopy, including experience in outpatient engagement, initial patient reporting, and the consequences of it for their care. And then, two health outcomes: one, ER and inpatient utilization, and the other, time on therapy. All this information has previously been presented at the ASCO meetings, and some of it is actually now published ahead of print in the Journal of Oncology Practice online. At any rate, we reviewed the story and what the preliminary results are.

What are the challenges in implementing ePROs?

I think we didn't spend a lot of time talking about the challenges that practices might face in terms of adopting this kind of technology, what it might mean to a practice if they choose to move forward. The other thing we didn't talk about was how this type of technology fits into the ongoing decision of alternative payment models, and more specifically the enhancing oncology model. Now, as many of the people watching this know, the enhancing oncology model does require participants in the model by the third year of the program to implement an ePRO system. And although we don't yet have a lot of details exactly what they expect this to look like, that really was something that caught a lot of people by surprise. But I will tell you, from having spoken to the folks at CMMI, they are convinced that this is going to make a big difference in terms of both the patient care experience, as well as the patient health outcomes.

I would say that we're very early on in the implementation of this type of technology. I think there's some hesitancy and concern on the part of many oncology practices. We did address this briefly in the Q&A. It's a tough time in community oncology. There's a lot of uncertainty. The EOM was a little bit of a surprise, and I think for a lot of practices isn't exactly what they wanted.

And so, I think practices are at a point where before they decide to adopt a new technology, they have to be convinced that's either going to make things more efficient, really improve the patient experience, or have financial benefits to the practice. And proving those things to an individual practice, it's challenging right now. But I'll say this, COVID stunk. It was horrible. But one thing we learned about COVID is that patients like to engage their care team electronically, and they like to be close to their care team. And this is a technology that will build on all that initial experience with telehealth, remote patient management. It just is such a natural, general way to get closer to our patients and improve their experience, and I think every oncologist wants to do that. Every single oncologist wants to do that.