VIPCare: Virtual Predictive Care workflow with EHR integrated surveillance for optimalfollow-up care management for Cancer Patients

Abstract For the first time, over 2 million new US cancer cases are expected to be diagnosed in 2024. But the oncology workforce is not keeping pace with the increase. The American Society of Clinical Oncology estimates that the gap between provider availability and patient needs will increase to 40% by 2025. Beyond the provider shortage, the struggle to provide oncology care is further exacerbated by the complexity of coordinating care across multiple disciplines. Care coordination is notoriously fragmented in the US resulting in redundant services, decreased patient satisfaction, and worse health outcomes. The total annual cost of fragmented care in the US is estimated to be between $27B - $78B. The stress on health systems means that providers focus on active care (diagnosis, active treatment, and metastatic care) with little to no effort left for follow-up care (post-treatment surveillance, long-term survivorship). There is a significant need to track and monitor patients in follow-up care for a) treatment effects, b) recurrence, and c) second primary cancers. However, tracking follow-up care patients is currently done as a manual time-consuming process that costs health systems millions in overhead and results in poor patient outcomes. Vizlitics successfully developed VIPCare for prostate cancer in their completed Phase I grant. Prostate cancer is the leading cancer diagnosis in men (not including skin cancer) and has high survival rates (98% at 5 years), resulting in an estimated 3.2M US men currently living with prostate cancer. In addition, prostate cancer follow-up care also includes active surveillance, which is the monitoring of patients diagnosed with low-risk prostate cancer for whom postponing treatment is an option. VIPCare ingests prostate cancer patient data and classifies the patient’s current care state using a current care state assignment algorithm. A user interface (UI) allows providers to quickly review a summary of the patient’s prostate cancer diagnostic details, treatment history, and PSA results. The tool also includes guideline-based recommendations for follow-up generated by the follow-up recommendation engine. This Phase II proposal includes EHR integration (Aim 1), clinical validation (Aim 2) and scalability verification (Aim 3) of VIPCare which will be completed at geographically and administratively separate institutions, Dana-Farber/Brigham Cancer Center (Boston), Northwestern University’s Lurie Cancer Center (Chicago) and University of Illinois Cancer Center. Phase II aims are to: 1) Complete EHR integration and testing of VIPCare with the institution’s EHR instance of Epic to enable comprehensive functionality; 2) Clinical validation and testing of the EHR-integrated VIPCare for clinical utility and usability for prostate cancer; and 3) Enhancement of the VIPCare current care state assignment and follow-up recommendation models for application to solid cancers including head and neck, breast, lung, gastrointestinal and genitourinary and endometrial cancer including associated UI updates and testing. At the completion of the proposed Phase II activities, it is expected that VIPCare will be ready for real-time, in-clinic testing at multiple cancer institutions across all cancer types.