A study led by Daniel Rubin, PharmD, BCOP, from McKesson has demonstrated that optimizing clinical decision support (CDS) tools can significantly improve the documentation of critical biomarker results in cancer treatment, particularly for non-small cell lung cancer (NSCLC) and metastatic castration-resistant prostate cancer (mCRPC).
Addressing Documentation Challenges
The research team identified a concerning trend where many biomarker results were being documented as "unknown" within their CDS tool, Clear Value Plus. To address this issue, they implemented strategic modifications to the tool's prompting system, better aligning it with typical timeframes for receiving biomarker results across different cancer types.
The redesigned system includes a re-prompting feature for unknown biomarkers during subsequent therapy selections, ensuring more comprehensive documentation over time. This modification has yielded impressive results, with documented known biomarkers in NSCLC cases increasing from 69% to 78%, and mCRPC cases showing an even more dramatic improvement from 34% to 61%.
Enhanced Clinical Workflow Integration
"We wanted to see if we could tweak our decision support tool and modify how we prompt for the documentation of these biomarkers," explained Dr. Rubin. The improvements extended beyond mere documentation rates, addressing the crucial issue of physician workflow efficiency.
The enhanced tool now better accommodates the natural sequence of biomarker testing, following the typical progression from tissue analysis to next-generation sequencing and blood tests. This alignment with clinical workflows has significantly reduced "click fatigue" among healthcare providers by minimizing redundant data entry requirements.
Future Developments and Implementation
The success of this pilot program has prompted plans for broader implementation. The research team aims to extend these optimization strategies across more than 30 disease states currently supported by the tool.
"The ultimate goal is to achieve more automated documentation behind the scenes," Dr. Rubin noted. While the team envisions a future where biomarker results are automatically captured in structured, discrete formats, current technological limitations and varying data standards necessitate a focus on improving prompt curation.
Impact on Precision Medicine
This enhancement comes at a crucial time in oncology, as precision medicine increasingly relies on accurate biomarker documentation for treatment decisions. The improved CDS tool serves as a bridge between complex biomarker data and clinical decision-making, supporting healthcare providers in navigating the expanding landscape of precision oncology while maintaining efficient workflows.
The study demonstrates that thoughtful technological adaptations can significantly improve clinical documentation without adding to provider burden, ultimately supporting better patient care in the era of precision medicine.
