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Something Different

March 29, 2012
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A look at Total Cancer Care, a transformative healthcare effort

For the majority of people that cover and care about healthcare, this week has been about a decision that the nine justices from the Supreme Court will eventually make on a healthcare law.  And while I’d love to add the 15 millionth opinion, thought or analysis on the impending fate of the Affordable Care Act, I’m going to focus on something that is getting far less attention but could also change healthcare definitively: the exciting role healthcare informatics is playing in the growth of personalized medicine analysis.

This topic was covered well by our Contributing Editor, David Raths, in the March issue of HCI. I encourage you to check it out because it’s an in depth look at everything going on across the spectrum.

I recently got a chance to speak with the CIO of the Tampa, Fla.-based H. Lee Moffitt Cancer Center, Mark Hulse, R.N. (also quoted in David’s piece) about the cancer-based personalized medicine research program, Total Cancer Care, which his institution is participating in. What Hulse and his cohorts at Moffit and elsewhere – a total of 18 hospitals in 10 states participate – are doing with Total Cancer Care is worth mentioning multiple times. It represents what could possibly be the future in evidence-based, personalized medicine.

Mark Hulse, R.N.

The goal of Total Cancer Care is to follow cancer patients throughout their care treatment lifetime to understand specifically what types of treatment are best for specific individuals. It’s an attempt to gain a comprehensive look at the patient: discreet clinical data, genetics, treatment outcomes, samples of blood, urine and tumor tissue from surgeries and biopsies, which are stored in a bio-repository. The information, which is collected with the patient’s consent, goes into an electronic database, supported by Oracle (Redwood Shores, Calif.)

This isn’t a simple database though. It‘s a multi-dimensional platform that can look at the data from different perspectives, whether it’s for clinicians, researchers or the patients themselves. It also pulls data from additional outside sources, such as EMRs and cancer registries. According to Hulse, Moffitt is enhancing its EMR to include more discreet data fields which can be included in Total Cancer Care.

The whole Total Cancer Care program is supported by M2Gen, a for-profit subsidiary of Moffitt, which partners with pharmaceutical company Merck, to get clinical trial treatments in practice for patients in the program. Hulse says getting patients treatment this way is usually very inclusive since the Federal Drug Administration (FDA) rarely grants approval to drug treatment options. For instance, only 21 drugs made the FDA’s cut in 2010.  

Even though Moffitt began development of it in 2003, Total Cancer Care is in its relative infancy. It first went live this past October and Hulse says the consortium is continuing to gather data from other sources. The real benefits from this program could flourish years from now if the comprehensive research can help develop treatments for future cancer patients.

In many ways, this development is similar to the population health management trend we’ve been seeing pop up all over the place in healthcare (I wrote about this trend in the same March HCI issue mentioned above). However, the bio-informatics part is unique to personalized medicine and something that will likely transform healthcare on a grand scale, albeit likely without a lot of attention. Hulse and others deserve kudos for leading the way on this quiet transformation.

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