Feature | June 12, 2008 | Rick Dana Barlow

One Piece in a Larger Puzzle

Future OIMS expands reach outside traditional oncology arena

Outpatient oncologists and radiation therapists may be fighting cancer in more ways and with more powerful techniques and tools, but increasingly one of their major weapons is data.
Consequently, they have to amass, analyze and then synthesize volumes of data so that the resulting information populates a plan for successful treatment.

Nowadays, these information technology tools have to be interfaced or integrated with other systems outside of oncology’s traditional domain.

Outpatient Care Technology Editor Rick Dana Barlow tapped experts at three of the leading oncology technology manufacturers for their insights on how oncology IT clicks into a larger organizational puzzle.

How the next-generation oncology information management systems (OIMS) will improve workflow for oncologists without sacrificing treatment delivery effectiveness, including integration/interfacing with other systems (e.g., EMR, EHR, RIS/PACS).

Jacob Philip, director, Radiation Oncology, IMPAC Medical Systems, an Elekta company

As radiation therapy evolves, we see two dominant trends that will affect the next-generation OIMS. The first trend is the need to manage an increasingly fluid and dynamic course of therapy for each patient. Today’s technologies provide a great deal more real-time information that can be used to dynamically adjust the treatment plan for each patient. As such, change management will be an essential function of tomorrow’s OIMS. Simply put, the ability to accurately and visibly update a patients’ treatment information will be critical for the delivery of safe and effective medical care.

Secondly, not only does the next-generation OIMS need to adapt to changes in treatment plans, it must also adapt and integrate a rapid expansion of treatment delivery options. There is an explosion of new technologies emerging in the oncology arena, and the OIMS needs to integrate those solutions effectively in order to manage a comprehensive charting environment. IMPAC is leading the way toward the implementation of many of these new technologies, integrating them into the OIMS and oncology workflow in the most efficient ways possible. IMPAC is, quite literally, developing tomorrow’s systems today.

Mark Wofford, vice president, Business Management, Siemens Medical Solutions, Image Knowledge Management Division

OIMS will be quickly and forcefully driven to interoperability via standards between the different components and services of the system and enterprise. No longer will a monolithic system of all applications and functions be acceptable. Each individual task will be allowed to be optimized by any market provider, and customers will demand access to these best-in-breed applications or services.

The basis for this is the concept of ‘deconstruction of the workflow’ into components, applications and services to provide optimized solutions for all tasks in the workflow, with all components based on interoperability and standard interfaces.

Therefore, the next generation of OIMS will be a collection of
separable services and applications that can be constructed in many different configurations and can incorporate services and applications from other niche providers to build a completely integrated yet customized workflow of clinical applications optimized for each service provider. All of this will be driven by a workflow management system that can model a customer’s workflow and ensure that each clinician has readily available their list of tasks, required data, applications, services and hardware to complete their task in the most efficient and clinically effective manner.

Corey Zankowski, Ph.D., senior director, Software Systems Marketing, Varian Medical Systems

One goal of the OIMS is to make the physician as efficient as possible. To that end, OIMS vendors are all designing ‘smarter,’ more intuitive software solutions that anticipate the daily challenges faced by oncologists and that present them with all necessary information at the right level of detail so that they can easily identify the tasks they need to complete at each point of the treatment process. Oncologists will utilize a user-specific electronic dashboard with a single-screen snapshot of information about the patients they need to see and categorized tasks they need to perform that day. The patient EMR needs to display all necessary information – the patient’s chart and digital images, as well as embedded tools for clinical decision support and for evaluating tumor response – in a system that is easy to use and thoughtfully arranged.

Core elements of the oncology process should be integrated into the architecture of the OIMS. For example, the OIMS should integrate an oncology PACS so that the comprehensive system supports oncology-specific workflow. Combining two stand-alone solutions will not manage adaptive therapy as well. Tomorrow’s OIMS must be designed for collaborative work practices in the oncology clinic. Since physicians, physicists and therapists access medical images for different reasons at different points in the care process, an ideal OIMS/PACS solution will facilitate parallel routing of tasks and allow concurrent viewing and editing to enable highly dynamic, nonlinear workflows.

Data should flow seamlessly between the RIS-PACS and OIMS without user intervention, just as it does today with a [healthcare information system]. A robust interface engine using industry-standard communication protocols should continually update the patient chart with medical information generated outside the department. The future OIMS will connect all of the repositories of patient information to create a unified oncology information ecosystem that improves workflow by ensuring that oncologists have all the information they need, precisely when they need it.

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