Author: phall2

Currently Recruiting: Research Manager in Cancer Informatics

The Edinburgh Cancer Research Centre is seeking a Research Manager with skills in academic project management, research governance, data analytics and communications, to work within the Edinburgh Cancer Informatics Program.

We seek a dynamic individual with an academic background and an enthusiasm for new technology, opportunities in data science. Familiarity with Health Research and an interest in Health Policy is highly desirable. Experience in the charitable sector, government or industry would also be valued, as would an ability to work with the media, write for the web and promote academic networking.

The Edinburgh Cancer Information Programme is a collaboration between the NHS and University, that is liberating the use of clinical and genomic data for clinical and scientific research into cancer prevention, treatment and better outcomes for patients. Our team brings together data scientists with clinical researchers and industry to improve cancer care. The development and application of new methods in analytics such as artificial intelligence and big-data processing is central to our mission. The successful applicant will be expected to work closely with other academic groups within the IGMM and the Usher Institute as part of the University’s strategic prioritisation of data-driven research.

Initial projects will include work with The Health Foundation and the Edinburgh Palliative and Supportive Care Research Group on a project that is using qualitative and quantitative approaches to understand the clinical pathway and unmet needs of patients with poor prognosis cancer. There will be work on reporting the changing patterns of care related to Cancer Services’ COVID-19 response and recovery. There will be a theme looking at the use of data to measure the impact of new cancer medicines on patients.

Whilst the main purpose of this position is to work within the Cancer Informatics Team, in a management and leadership role, to manage a portfolio of applied research projects, develop the programme and disseminate findings; there will also be the opportunity for the candidate with the right skills to work hands-on with data analysis and produce academic papers.

For further information please contact Dr Peter Hall (p.s.hall@ed.ac.uk)

More information and application

South East Scotland Cancer Database launch

The South and East Scotland Cancer Database (SESCD) launched on its new SQL Server platform in November 2019. As a significant step forward from our old Microsoft Access database, the new database, hosted by NHS Lothian eHealth, now provides a capable basis for wide ranging uses of cancer data, from simple clinical audit to advanced predictive modelling projects.

You can read about the database and view it’s data dictionary on our wiki pages.

HealthyR

HealthyR: R for Healthcare Data Analysis is an amazing 2.5 day quick start course run by Surgical Informatics. This introduces healthcare researchers with no experience of using the industry-standard R computer coding language for data science. It takes an innovative approach, is delivered on bespoke servers, and uses code specially designed for education.

Treatment sequencing in metastatic breast cancer

Edinburgh Cancer Centre Oncology Specialty Registrar Ashley Horne @AshHorne1983 used data visualisation to demonstrate the power of Scottish prescribing data for complex treatment sequencing in metastatic breast cancer at the 2019 European Society of Medical Oncology annual conference.  Full poster:   ESMO_2019_Optimized

Integrating PROMs using a smartphone support app for patients with breast cancer

Patients helping to drive innovation in NHS Scotland

A guest blog, originally posted by the Cancer Innovation Challenge, from Dr Anne Bruinvels, Founder of Px HealthCarePx HealthCare received Phase 2 funding from the Cancer Innovation Challenge to develop their tool OWise in Scotland, in partnership with NHS Lothian, in the New approaches to record and integrate cancer PROMs and PREMs funding competition.

During one of the user workshops that we organised in collaboration with Maggie’s Centres, Sarah said, ”It has been quite a revelation. Using OWise I found out that my breast cancer is Stage 2. This helps me to much better understand what my situation is and deal with it.”

Sarah also highlighted other benefits of OWise breast cancer, the mobile patient app and website supporting patients during treatment, such as the symptom and side effect tracking function and the personalised list of suggested questions to help her prepare for doctor’s visits. She liked the fact that OWise gave her much more control over her situation.

When the Cancer Innovation Challenge (CIC) was launched back in March 2017, we knew that OWise and its existing “How Do I Feel Right Now?” function would be a perfect fit for the initiative’s objective to incorporate electronic Patient Reported Outcome (PRO) data into NHS Scotland’s electronic patient records. Our company Px HealthCare (Px stands for Patient Experience) had focused its energy on developing a patient-centred app and website to help people who had been diagnosed with breast cancer.

The Px team consists of: Anne, a pharmacist by training and David who is a clinical occupational physician specialised in oncology, and some great support staff and excellent software developers. As we continuously involve patients and their carers in the co-design of our products we believed that OWise would be very well suited for the Cancer Innovation Challenge. This would allow a patient-driven approach to have OWise users share their real time PRO data with their NHS Scotland hospital or health board.

Nudging patients to seek medical help

It immediately became clear that extensive collaboration with patients and carers (OWise users) was required. We needed to understand how patients envisioned their side effect and symptom tracking (PRO) data to be used by NHS Scotland. For example, how OWise could aid them in understanding when they needed help during chemotherapy and how their data could be used by their NHS health board to improve their treatment. With the amazing support from Maggie’s Centres we were able to hold five user workshops during the first phase of the Cancer Innovation Challenge. This gave us great insight into the “stoical” nature of the Scots and how smart alerts could nudge patients to call the Cancer Treatment Helpline when their side effects exacerbated rather than have complications aggravate resulting in avoidable hospitalisations.

OWise patient and clinician interface

Providing clinicians with actionable insights

We were incredibly pleased to partner with NHS Lothian (NHSL), where our Clinical Lead Dr Peter Hall (a breast oncologist and researcher focused on using PRO data to improve clinical outcomes) and the extensive breast team have been very welcoming and open to discuss the use of OWise. Together, we worked towards improving the patient experience and by finding practical solutions for patients to share real time OWise PRO data making a direct impact on the treatment and outcomes of patients.

The NHSL eHealth team proved very effective at finding innovative solutions to enable patients to share their OWise PRO data with their NHS health board of choice and making it visible within the TrakCare electronic patient record (EPR). In depth workgroups with NHSL clinicians highlighted a need to create new ways of visualising OWise data for clinicians. As a result, we developed monthly overviews of patients’ toxicity and side effect profiles which informs clinicians at once of a patient’s response to treatment and highlights any issues using colour coding of the UKONS (United Kingdom Oncology Nursing Society) grading system.

Extending Reach and Impact

As of July 2018, this extended version of OWise has been made available to NHSL patients. The breast cancer nursing team, charge nurses, prescribers and oncologists are now actively introducing OWise to patients. The medical team appreciates that having the patient reported outcome data directly visible in TrakCare is really helpful; it allows them to have better informed conversations with patients and even helps them with the scheduling of chemotherapy appointments.

Julie, a breast cancer patient, commented: “As a breast cancer patient, the OWise App is an invaluable tool to give peace of mind to the patient, that during stressful treatment periods, monitoring is thorough and continuous. It is easy to use with clear guidance. It could also be useful in improving patient reported outcomes.”

Following NHSL we are now exploring the introduction in other NHS Scotland health boards wanting to make a similar impact on the lives and outcomes of people with breast cancer. Due to demand of patients and clinicians we have started the development of OWise for all cancer types and patients, which we aim to trial in 2019.

OWise breast cancer can be downloaded for free. For more information, please visit www.owise.uk or www.pxhealthcare.com. If you have any questions please contact Anne on anne [at] pxhealthcare.com

What is Cancer Informatics?

Information technology plays a key role in fighting cancer through a growing field called cancer informatics.

Cancer informatics is where information science, computer science and health care intersect. It’s about acquiring, storing and using information about cancer most thoroughly and efficiently.

Its tools include computers, clinical guidelines, and information and communication systems. It uses information about patient physical, psychological and social characteristics (‘phenotype’) and their molecular characteristics (‘genotype’). These characteristics are studied in relation to how patients interact with the health system and how patients are affected (‘outcomes’).

A key feature is the synthesizing of data about cancer in ways such as analyzing captured data, gathering evidence from clinical trials, applying information into clinical practice, evaluating outcomes of changes in clinical practice, and generating new hypotheses for investigation.

The Edinburgh Cancer Informatics Programme is striving to use methods in cancer informatics to implement a “rapid-learning system for cancer care.” The “rapid-learning’ comes from the healthcare system being able to keep itself constantly informed on how it is affecting the patients it cares for.

Cancer Informatics is a broad field, getting deeper and more complex as medical research and information technology progress. The field is all about collaboration, not just among physicians and researchers but between doctors and health IT professionals and patients and the public.

There are current trends within Cancer Informatics emphasizing the use of machine learning, artificial intelligence, statistical algorithms, advanced imaging techniques, data visualization, and high-throughput technologies. The discipline leverages methodological improvements in systems biology, genomics, proteomics, metabolomics, and molecular biochemistry into the fields of cancer detection, treatment, classification, risk-prediction, prevention, outcome, and modeling.

Cancer PROMs pilot project with My Clinical Outcomes

SCAN, the South East Scotland Cancer Network, has been awarded funding from the Cancer Innovation Challenge to trial an implementation of a regional platform for PROMs and PREMs in cancer care in South East Scotland. SCAN will be working with CIC Phase 2‘s My Clinical Outcomes.

The project kick off meeting took place on 5 August 2019 and we are looking forward to hearing more from the 6 month trial in due course.

In the meantime, find out more about the project below.

Implementing a regional platform for PROMs and PREMs in cancer care in South East Scotland

There is good evidence that the care of cancer patients can be improved by asking them to report on their health using validated questionnaires. Patient reported outcome measures (PROMs) are questionnaires patients complete on their health and quality of life. Patient reported experience measures (PREMs) measure allow patients to feedback on the service they receive. The information collected from PROMs can help to monitor patient progress, help professionals and patients discuss health issues with each other and help to improve the quality of health services.

The South East Scotland Cancer Network (SCAN) and the Edinburgh Cancer Centre (ECC) are working with the digital technology company My Clinical Outcomes (MCO) to implement the use of PROMs in routine care. Initial pilots are likely to take place in specific groups of patients:

  1. After surgery for early bladder cancer
  2. After radiotherapy for lung cancer
  3. Following a diagnosis of ‘cancer of unknown primary’
  4. During treatment for breast cancer
  5. After surgery for cancer which has spread to the liver
  6. After radiotherapy for pelvic cancer

Information that patients record using PROMs will be available to the clinical teams to assist in treatment or to advise patients on how to manage their condition. The SCAN Health Boards will also be able to use PROMs to assess how patients are affected by their cancer and by the services that are provided to care for them.

The SCAN Cancer PROMs pilot aims to align with other similar initiatives in Scotland to provide a comprehensive PROMs service to enable national comparisons of the outcome from treatment. The ultimate goal is joined-up patient-centred care for all cancer patients that is fit for purpose in the new digital healthcare era.