CIC Cancer Project
Patients First: Continuous Improvement in Care – Cancer (CIC Cancer) Project
(as at November 2021)
The Continuous Improvement in Care – Cancer (CIC Cancer) Project aimed to establish if value-based health care (VBHC) can become part of routine cancer care in WA, improving both the experience and outcomes of care for those affected by cancer, and providing a rich databank for ongoing research into improving cancer services and outcomes. The project is well on the way to achieving these aims.
Over the past 12 months, the CIC Cancer project has continued to progress activities across several major thematic areas.
ITC system development and integration
- Data capture via internationally utilised patient-reported outcome and patient-reported experience measures (PROMs and PREMs), and costing collections in the WA environment.
- Enhancements to the bespoke information systems for collection of patient-reported measures and clinical data to minimise duplication of data entry and enhance data security through secure linkage connections.
- Development of data analytics and outcome visualisation dashboards.
- Identification of new opportunities for data capture e.g., testing the utility of a unique ovarian cancer dataset in external trials and implementation of breast cancer data collection in an additional site.
Research outcomes for cancer services research and quality improvement
- Exploring value and adherence to optimal care pathways for patients with breast, colorectal, and lung cancer.
Change management & implementation
- Building awareness and understanding amongst the health workforce, from the Director General of WA Health to the clinical workforce and administration, and to students.
- Leveraging from the core project to seed new aspects of VBHC into cancer care within WA e.g., proof-of-concept projects for health economics and a model for bundled healthcare in breast cancer.
- Working with Clinical Senate to make VBHC a focus for WA Health
Selling the vision
- Successfully hosting Australia’s first conference on VBHC
- Actively collaborating with national and international bodies to enhance knowledge of VBHC implementation and awareness of CIC Cancer work.
Data collection is in place at five hospital sites involving four cancer types, using a customised informatics platform now installed at SJoG (Midland and Subiaco hospitals) and WA Health (RPH, FSH & KEMH). The robustness of the system in repelling external ‘hacking’ attempts has been tested by both WA Health’s Health Support Service (HSS) and by external review and was found to be a highly secure platform with only minor updates required to align with HSS policy requirements. To date, PROMs have been collected from almost 500 patients with PREMs being collected from a further 404 patients in collaboration with All.Can, part of a sub-project to understand the impact of COVID-19 on care provision, or student projects. Surveys are also currently underway to capture PREMS for people diagnosed with cancer in 2019 and identify the information needs of consumers but results will not be known until early-mid 2022.
Delays with installation of the CIC Cancer informatics platform have been encountered given the significant transformation of WA Health IT infrastructure under the HealthNext program, which commenced in 2019 and continues today, with the phased transition of all clinical and corporate applications from a physical datacentre to a cloud-based platform. This was exacerbated with a slowing of the migration of systems at the height of the COVID-19 pandemic in early 2020 in the interest of patient safety during this uncertain period. Due to the delays in installing the system, the expected level of PROM data capture has not been fully achieved.