Digital Cancer Care and the Vision for Transforming the Quality of Care.

Abstract

National efforts are underway to build a digital health system that can deliver existing knowledge real-time to increase evidence-based clinical decision-making and provide continuous learning models to reduce clinical errors. Electronic medical records and health information exchanges are increasing access to medical records for patients, professionals, and health systems. A next step will be to develop decision-support models with high-quality data from the clinical record. Patient findings that contribute to creating a diagnosis and a therapeutic plan-as well as all relevant outcomes measuring success or failure of such plans-need to be readily available as data to inform models. Registrars have been turning clinical narratives into high-quality standardized and structured data to monitor cancer trends for decades. Despite great success, it would be costly to scale this human-dependent process to include abstraction of all clinical and laboratory findings in real-time. Efforts to structure data after the fact using natural language processing have yielded mixed results. This article posits that cancer registrar professionals might play a new role in advising and assisting in the creation of novel approaches to abstracting high-quality clinical data. This would include building and auditing more standardized and structured clinical records, such as synoptic reports. Furthermore, in the absence of a single, comprehensive national patient registry, cancer registries are probably most qualified to take on the challenge of collecting, storing, and reporting all the additional clinical and biologic cancer data needed to build models that inform individual care and improve the overall quality of care. Improving the quality of patient care is the imperative behind national digital health care efforts. High-quality comprehensive cancer data will be a cornerstone to the success of this effort in oncology. Cancer registries and cancer registrar professionals have a lot to offer in the efforts to close the quality gaps in oncology care.