Development of a BRIDG-Harmonized Multipurpose Information ... · Development of a BRIDG-Harmonized Multipurpose Information System for an Academic Cancer Center February 23, 2017

Development of a BRIDG-Harmonized Multipurpose Information System for an

Academic Cancer Center

February 23, 2017

Thomas R. Klumpp, MD, FACPProfessor of Medical Oncology

SAS Certified Professional (Version 8)Thomas Jefferson University

Philadelphia

Research Information Systems

EMR Systems

Administrative Information

Systems

Specimen Repositories

Scheduling Systems

Quality Management Information Systems

Billing Systems

Tumor Registries

Laboratory Information

Systems

Radiology Information Systems

Protocol Management

Systems

Background: Typical Academic Cancer Center

Document Management

Quality-Assured Data

Repository

Patient CareReal-Time

Clinical Decision Support

Research Planning, Execution, and

Analysis

Quality Management

Fox Chase-Temple BMT Information System

BMT online Information

System (BMTIS)

Administrative Decision Support

Data Required for Accreditation and Certification for Blue-Cross, Aetna, Cigna, URN, CIBMTR,

NMDP, BMT Info Net, BMT-CTN, Care Science, FACT, Cancer

Registry, etc.

Teaching

Marketing and Recruiting

Personnel and FundingName Role FundingMouneer Odeh Project Administrator IS&TNick DeGregorio Project Coordinator Rad Onc, IS&TTom Klumpp, MD Medical Director Med Onc, IS&T, SKCCMichael Li, PhD Statistician IS&TEric Chen, PhD Bioinformaticist IS&TDania Beadle, MS Bioinformaticist Med OncLaurie Harris Relational Data Modeler IS&TJoe Neff Applications Developer IS&TEd Bruner Applications Developer Med Onc, SKCCPhil Mahre Epic Team IS&TCatherine Smith Bioinformatics Student Drexel UniversityLisa Wen Bioinformatics Student Drexel University

Work Plan: Iterative Approach, Starting with BMT

Iteration 1 Iteration 2 Iteration 3 Iteration 4Solution Delivered

• Quality assured relational database tracking 36 “Inner Core” data elements

• Online data entry application for primary data manager

• Data extracts to support real-time analyses at BMT team meetings

• Tracking ~100 data elements in robust, quality assured database

• Online data entry for BMT coordinator

• Online access to interactive insights for all team members

• Bidirectional interface of BMT application database and OJDT.

• Tracking ~500 data elements in comprehensive, quality assured database

• Online data entry for additional BMT staff

• Automated protocol activation transmission

• Eliminate ~ 10 duplicative data repositories

• Tracking full set of quality-assured CIBMTR TED-Level data elements (~1,000elements)

• Online data entry for all BMT data specialists

• Eliminate ~20 duplicative data repositories in total

• Integration into Epic including bidirectional data flow

Patient Benefit • Improved outcomes due to use of quality-assured data to guide clinical decision-making.

• Streamlined intake procedure • Streamlined follow-up procedure

• Decreased readmissions• Faster insurance approvals

(shorter waits for BMTs)Clinical Excellence

• Incorporate high-quality data into real-time clinical decision-making, including real-time actuarial analyses of EFS, OS, TRM, RFS, within subsets of patients

• Increased accuracy of physicians' predictions of patient outcomes

• Improvements in outcomes metrics

• High-stringency clinical quality management analyses

• Protocol adherence/deviation statistics

Program Administration

• Accurate real-time tracking of volume and outcomes data for the program as a whole or within key subsets of patients

• Partial electronic submission to CIBMTR

• Tracking referral patterns,length-of-stay, readmissions, etc.

• Electronic submissions to ASBMT, BMT Infonet

• More complete electronic submissions to CIBMTR

• Full electronic submission to CIBMTR on TED-level patients

• Electronic submissions to insurance companies

High-Impact Science

• Reduced duplication of data entry by research staff

• More rapid completion of research analyses

• BMT coordinator’s duplicative data input is reduced dramatically

• Accurate tabulation of pts eligible for research protocols

• Automated notification to Research Coordinators re: protocol-eligible patients

• Support for translational research

• Dramatic reduction of duplication of effort by research data staff

• Support for basic research

Program of Global Distinction

• CIBMTR and NCI have already expressed interest in this project

• Improved support for status as NCI-designated Comprehensive Cancer Center

• Increased ability to attract and retain research talent

• Substantial support for status as NCI-designated Comprehensive Cancer Center

Forward-Thinking Education

• Inclusion of accurate research-quality data in teaching

• Online, ad hoc analytics for qualified faculty

• Online, ad hoc analytics for qualified students

• Bedside access to BMT database & analytics while rounding

Retrospective Data Grab

- CIBMTR/DBTC File- SPSS File (Lori)- BMT Consecutive list- BMT ProgInfo file- “BMT Database”

Staging FileQuality-Assured

Core Data Repository

Reporting File

Prospective Data Capturing

- Demographics window- Transplant window- Follow-Up Window

First Iteration Software Overview

CIBMTR/FormsNet Database

FormsNet Windows

sAS

SQL

ROR/Data QA

FN3

AGNIS

SQL

Training and Reference Documentation

IDA/SQL

ROR/Data Entry

Biomedical Research Integrated Domain Group ModelNCI, FDA, CDISC, HL7, ISO (BRIDG)

Retrospective Data Grab

- CIBMTR/DBTC File- SPSS File (Lori)- BMT Consecutive list- BMT ProgInfo file- “BMT Database”

Staging FileQuality-Assured

Core Data Repository

Reporting File

Prospective Data Capturing

- Demographics window- Transplant window- Follow-Up Window

Retrospective Data Gathering

CIBMTR/FormsNet Database

FormsNet Windows

sAS

SQL

ROR/Data QA

FN3

AGNIS

SQL

Training and Reference Documentation

IDA/SQL

ROR/Data Entry

POSTGRESTRANSPLANT TEMP5

POSTGRESPATIENT

TRANSPLANTTEMP4 TEMP7 TEMP9 TEMPD

COMBINED POSTGRES

POSTGRES PATIENT

BASETEMP8

POSTGRES CLINICAL

PRESENTATION

TEMP9

TEMPC

TEMPB

POSTGRES CLINICAL

PRESENTATION

POSTGRES DIAGNOSIS

TEMPB

TEMPA

TEMP10

TEMP11TEMP3TEMP1BMT

CONSECUTIVE LIST

TEMP13 TEMP15

J9

BMT PROGRAMINFO

LISTTEMP2 TEMP12

SPSS FILE

TEMP14

CIBMTR DBTC

SAS PROGRAM TO DETECT AND CORRERCT ERRORSAND INCONSISTENCIES IN THE PRIMARY KEY VARIABLES

1

2

4K

7

7

9

10

9

86

3

3 5

5

4H

4B

4C

4C

4D

4E

4E

4F

4G

4H

4A 4I

4I

4J

Postgres Data Values

Program Info List Data

Values

CIBMTR Data Values

SPSS Data Values

Consecutive ListData Values

CIDS Reference

Values

CIDS Reference

Values

CIDS Reference

Values

CIDS Reference

Values

CIDS Reference

Values

ConsensusValues (J10)

SAS PROGRAM TO DETECT AND CORRERCT ERRORS IN NON-PRIMARY KEY VARIABLES IN THE EXISTING BMT DATA REPOSITORIES

J9

Questions?