Value of Standardizing PM in the Practice

May 30, 2019

 

 

What was recently impossible for busy practices is now practically imperative.

 

How can you be sure that every oncologist in your practice is using precision medicine appropriately for every patient? It’s an important question, because if patients are under-tested, doctors could miss an important treatment option, and if patients are over-tested, it could lead to unnecessary confusion and delays in treatment—both are bad for patients and can lead to higher costs.

 

Not all doctors have the same level of knowledge in precision medicine. Even those in the same practice may use different labs, and some are hesitant to order molecular testing at all. Until recently, getting busy oncologists on the same page with precision medicine was too impractical. But not anymore.
 

 

7 reasons it is now critical to standardize precision medicine in your oncology practice:
 

 

#1: Keeps oncologists up-to-date with all available clinical evidence for precision medicine

 

Your oncologists have dedicated much of their lives to giving patients the best chance of beating cancer, but the pressures they face today are tremendous. There is simply too much information coming out too frequently from too many sources, making it difficult if not impossible for them to keep up in real time. They must also factor in thousands of data points for each patient’s treatment, ever-changing clinical information, and complex insurance and reimbursement policies, all while making life and death decisions. And, they must do this for an increasing number of patients. The cognitive burden on oncologists has never been greater.

 

Much of the information doctors use to make testing and treatment decisions is still gleaned from independent reading, attending conferences, and talking to pharma and lab reps. This leads to a wide range of knowledge from doctor to doctor, inconsistency in how information is processed and unwarranted variability in quality of care.

 

Today, there are decision-support technologies that help oncologists keep up with the changing information so they can focus more time on helping patients. Ideally, you should choose a system that is continuously updated by a team of molecular scientists and oncology specialists, so you can be sure it contains the most up-to-date published clinical literature and clinical trials for real time patient contextual access at the point of care.

 

 

#2: Ensures every patient is tested appropriately, resulting in better treatment and better outcomes

 

A majority of oncology leaders are concerned their oncologists may not always select either the most appropriate molecular tests (73%) or the most appropriate targeted therapies (63%) for their patients. Reflective of this, 84% say oncologists need precision medicine decision support. (Source)

 

Adding decision support to prior authorization reduced denials to 1% while reducing chemotherapy drug cost trends by 20%. (Source)

 

How can your oncologists know that they’ve selected the right treatment if the right tests were not performed? Oncologists must consider so much information and so many tests, it’s essential to provide decision support at the point of care.

 

You can only be certain that every patient has been appropriately pre-screened for the use of precision medicine by standardizing the process for deciding which tests to run for each patient and which labs to use, and by basing that process on clinical evidence that points to an actionable result and the patient’s insurance guidelines. By doing this, you can be confident that up and down the halls of your busy practice, every patient was treated with the highest standards of precision medicine.


 

#3: Gives Oncologists Confidence and Accuracy in Use of Precision Medicine

 

In 2017, The Academy published a survey that surprised many people. 100% of responding executives reported that it is either important or very important for oncologists to have easy and fast access to integrated clinical and molecular information at the point of care.

 

But, let’s face it. Some oncologists in your practice are simply more comfortable using precision medicine than others. They are more confident ordering molecular testing and interpreting the results. Technologies that provide precision decision support based on the most comprehensive clinical evidence available level the playing field, enabling all oncologists to use molecular testing with the same expert-level precision. No patient should miss an opportunity for the best chance to beat cancer because precision medicine isn’t considered as an option.

 

 

#4: Ensures Precision Medicine Is Used Appropriately

 

For many patients, precision medicine offers hope for the treatment of cancer, but the path from scientific discovery to evidence-based use in practice is fraught with complexity and confusion—especially when it comes to molecular testing. Labs are motivated to drive the value of their tests in more and more scenarios.

 

Payers only want to pay for evidence-based precision medicine, and they don’t want to pay for research. Doctors want better information at the point of care to give their patients the treatment most likely to result in the best outcome. However, unfortunately the market is dependent on disparate systems and divergent approaches. Everyone is trying to address the complexities of precision medicine, but too often they are doing so from competing or conflicting perspectives.

 

The effective, scalable use of precision medicine requires a coordinated, collaborative and transparent solution based on the most current published clinical evidence. Collaborative solutions facilitate the appropriate use of molecular testing, help labs get reimbursed for the value they provide, and give doctors easy ordering from their preferred labs and interpretable, actionable results, all while automatically complying with medical policies of each patient’s insurance. Many of today’s decision-support technologies use models like these to enable standardization while ensuring the appropriate use of precision medicine.


 

#5: Gives practices an edge with value-based care models that reward higher quality and managed costs

 

Which of your practice locations were most compliant with your precision medicine standards? Which doctors ordered more molecular tests based on the clinical evidence suggested and which ordered fewer? Was your practice’s overall use of precision medicine better this year over last year in?

 

If you can’t answer these questions, you’re not alone. Some practices have specific technology designed to provide this type of data, but for most, it is simply not available.  It should be. Practice Directors perform a never-ending balancing act between providing the best care to cancer patients while meeting productivity requirements and ensuring optimum reimbursement. Having the ability to track data, analyze the practice, and evaluate business operations can provide insights they need to generate more revenue while always ensuring patients receive the highest quality, most appropriate care across the practice.


 

#6: Simplifies reimbursement complexities and streamlines prior authorization

 

Molecular labs actively promote the use of their tests to oncologists who may or may not understand everything that is included in a testing panel. Many times, these panels will not be reimbursed by payers, because it is unclear how they were constructed or whether current clinical evidence supports their use.

 

In fact, in a survey, only 26% of payers reported publishing guidance on biomarker coverage, and only 19% of payers reported currently having coverage for Genomic Sequencing Panels (GSPs).

 

Standardizing gives doctors in the practice real-time information about what to order from which lab for each patient to yield an actionable result—before ordering the test. Greater transparency throughout the process can ensure that reimbursement is working in tandem with, and not in opposition to, the practice workflow process.
 

 

#7: Facilitates efficient matching of patients to clinical trials

 

Most oncologists today believe that clinical trials should be considered when evaluating treatment options, but too often clinical trials are overlooked or come into the decision too late.

 

The best time to start thinking about clinical trials is from the start. By standardizing the use of precision medicine, the practice can be alerted of clinical trials options from the moment the results come back from the lab. Everyone in the practice from doctors to research coordinators can be made aware of clinical trials candidates. Advanced systems can match patients to appropriate clinical trials based on molecular eligibility as well as clinical and geographic specificity.

 

 

 

Ready to start standardizing the use of precision medicine across your practice?
 

There are many technologies out there that address pieces of the puzzle, but Trapelo™ is the first and only single platform used by oncologists, molecular testing labs and payers to resolve the complexities of precision medicine in real time, with reimbursement assurance from the start. If you haven’t standardized the appropriate use of precision medicine in your practice, let us show you how Trapelo can help.
 

To learn more about administering and managing quality precision medicine processes across your practice, contact us today.

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