AI in precision oncology: Digital solutions for cancer care

• Digital solutions, like artificial intelligence, are offering healthcare systems new possibilities in cancer care
• Geisinger Health System is demonstrating how leveraging machine learning and AI in precision oncology can improve colorectal cancer screening
• Texas Oncology is tapping into digital solutions to help advance precision medicine in oncology and clinical trial recruitment in Texas, regardless of patient location

Digital technologies enable healthcare organizations to unlock new possibilities for artificial intelligence (AI) in precision oncology.¹ Despite the challenges of the rapidly evolving cancer care landscape and an avalanche of data, gaps in cancer screening, and complexities in diagnostic and treatment strategies, digital tools offer new methods to optimize and streamline clinical decision-making. Furthermore, these technologies can foster multi-disciplinary collaboration within healthcare organizations, improve clinical trial recruitment, and decrease the burden of financial pressures linked to staffing challenges.

At this year’s Healthcare Information and Management Systems Society (HIMSS) Global Health Conference & Exhibition, Dr. David Vawdrey, Lorraine Brisbin, and James Lindsey, hosted by Dr. Okan Ekinci, explored how AI in precision oncology can address screening gaps. They also discussed the innovative use of digital solutions to extend precision oncology practices to community settings, enabling more patients to benefit from personalized care.

AI in precision medicine has promised to transform the healthcare industry, providing insights into precision care while reducing manual processes and decreasing the burden on healthcare personnel.¹ Dr. Vawdrey said that artificial intelligence (AI) technology gives an “opportunity for us to work with the clinicians and others who are involved in the delivery of care to make their lives easier, to make things more efficient, and effective.”

While there have been significant advances in AI in terms of acquiring data, cleaning data, creating AI models, and building predictions, one of the significant challenges in healthcare is how the industry uses that information and those algorithms to improve interventions. Says Dr. Vawdrey, “The fundamental questions for us are: what is the outcome that we’re tryings to impact? And is there really clear evidence that the interventions that we can make are going to improve those outcomes?”

Geisinger is tapping into advanced artificial intelligence in precision medicine and machine learning technologies to improve colorectal cancer screening and transform care delivery. Using AI-based predictive models, Geisinger flagged high-risk patients who were eligible or due for colonoscopy screening. Through intervention and outreach, almost 30% of patients were able to complete the colonoscopy screening.²

“What this translates to is literally saving lives if we can catch colorectal cancer at stage one or stage two or even perform the colonoscopy,” commented Dr. Vawdrey.

Texas Oncology launched its precision medicine program to meet the needs of cancer patients across Texas, regardless of where they live.³ “We wanted to continue on our mission to bring excellent care to our cancer patients at the point of care where they live and not where there’s a large medical center,” said Ms. Brisbin. She continues, “Digital tools are really a great way for us to expand what we have and the value that we bring to the patients, but allow them to stay at home and still have a job and still see their families.”

A significant barrier in delivering precision medicine in the community setting is low clinical trial participation rates, driven by geographical barriers and a lack of awareness and resources to identify and enroll eligible participants. In the U.S., the average trial participation rate at community centers is just 3-5%, with fewer than 10% of cancer patients being offered clinical trials.“ One of our most important initiatives is getting our community oncology patients in a clinical trial in their own backyard” said Brisbin, adding that “We have about 75,000 new cancer patients. Probably a third of those are advanced metastatic. They need to be profiled, and then those patients need to be selected for trials.”

To achieve this at scale, Texas Oncology leverages their proprietary molecular database and digital solutions to identify a patient’s molecular profile, cross-referencing that information with the different clinical data from the electronic medical records (EMRs), and match the patient to potential clinical trials that they may be eligible for.^4-6

Another challenge Texas Oncology faced was fostering multidisciplinary collaboration among geographically dispersed teams. Traditional in-person tumor boards often make it difficult to coordinate schedules and organize information effectively. “If we want to look at images, we need the radiologists in the room. If we want to talk to the surgeon, we need the surgeons in the room. But getting the time on their calendar to participate, even for just half an hour, is nearly impossible for our cross-functional team,” Ms. Brisbin explained. The digital approach of a virtual tumor board not only overcomes these logistical challenges but also allows Texas Oncology to expand tumor board capabilities across the entire state, rather than limiting them to a few sites, ensuring that every patient can benefit from the collective expertise of the entire team, regardless of geographical location.

The final critical component of Texas Oncology’s precision medicine program is ensuring that the collective knowledge and expertise of its extensive medical team are shared across the network. This includes teaching best practices and integrating learnings from various cases to continually improve patient care. Digital solutions provide a platform for ongoing education and knowledge sharing, allowing Texas Oncology to cascade valuable insights and standardized practices throughout its team. Brisbin emphasized the importance of this, stating,”Now, we bring precision medicine to them, and we’re going to bring the learnings of 500-plus physicians in our practice. When we saw this patient with this type of genetic profile, we treated that patient this way or that way, and we can have that shared learning across the entire practice.”

Digital technologies are transforming precision cancer care. Healthcare leaders have the opportunity to leverage these tools to:

1. Integrate all data and systems securely and efficiently.

2. Drive operational excellence by improving lab and clinical workflows.

3. Provide medical insights that can impact patient care.

From screening to clinical trial matching, digital solutions can improve healthcare decision-making and provide comprehensive value to all stakeholders within an organization, from labs and point-of-care operations to hospitals and, ultimately, patients.