John Sweetenham, director of the Department of Medicine at the University of Utah's Huntsman Cancer Institute, combined with clinical practice to explain the advances in electronic medical records and "big data" medical treatment in cancer treatment, is now organized as follows.
We are meeting these days to discuss cancer genomics and proteomics and the potential of “big dataâ€. We have planned further upgrades to the Electronic Medical Record (EMR) at the conference and discussed possible extensions of EMR to meet our needs in clinical care, quality metrics, and more.
Broad prospects
Let us start with the electronic medical record. Whenever I host a meeting of health care professionals or project leaders, the topic that guarantees a heated discussion is our electronic medical record. The challenges and ambiguities of using EMR, the intrusion of workflow and the creation of additional work, especially in the past year, we have converted a new electronic medical record system, which is the main source of dissatisfaction.
My colleagues understand the need for patient and clinical practice management in the 21st century electronic medical records, but the daily clinical problems caused by using EMR (such as the use of electronic medical records, chemotherapy sequences, arrangements and bills) do exist, making it difficult for us. I am glad to accept such a situation.
Electronic medical records may become more than just a record of a disease. It will become one of the most important tools in cancer clinical practice, not only because of its inherent function, but because it opens a world of big data, pathological pathway-driven therapy and real-time evidence-based clinical decision support. Window.
Big data startup projects in the field of cancer are growing rapidly. In recent weeks, ASCO has frequently exposed the CancerLinQ project. The Cancer Research Information Exchange Network (ORIEN) has recently expanded its membership from six academic medical centers to six. Like many similar initiatives, the project aims to link the clinical and demographic data of tissues and DNA to the goals of further development of precision medicine, and many other private companies, medical science research centers, and collaborative groups are developing similar projects.
All of these efforts are moving towards the ultimate goal of building a comprehensive genomic/proteomic database, and correlating with clinical efficacy data will allow us to identify specific pathways to identify targeted pathways for individuals, or even when not using small molecules Targeted therapy can provide the most effective chemotherapy regimen.
As I sit at the desk of the clinic and try to adjust the dose of chemotherapy or change the order of treatment in the medical records, it seems that there is still a long way to go to achieve the goal of precision tumors. At this point we will think that real-time, bio-based decision support exists in the far future, so that we imagine it is only a distant possibility. However, after going through the events of recent weeks, I began to believe that "Big Data" became a clinical reality that would be earlier than most of us expected.
What will the "new reality" look like?
One of the ideal cases is to take a biopsy and determine the cancer diagnosis by biopsy through genomic/proteomic analysis.
When I see patients in the clinic through electronic cases, these reports will provide me with information about clinical genome or protein genome changes, in addition to traditional diagnostic and staging data. It will give me an idea of ​​whether there are clinical trials of available drugs or drugs that target a pathway, or whether there are available chemotherapy options. These data will come from "big data."
Using this information, I can explore trial selection or treatment options from these reports at my computer desk. I will be able to determine clinical evidence for the treatment plan and test if my choice is consistent with the center.
Every time I do this, the entire system accumulates more data, collects the resulting data and expands it.
It sounded unrealizable just a few years ago. Now, I think this can be achieved in recent years.
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