Clinical Decision Support

Oncology Analytics’ Approach to Benefits Management and Clinical Decision Support

Recently, the American Society of Clinical Oncology (ASCO) has published recommended guidelines for chemotherapy utilization management companies. OA supports and adheres to these recommendations. In particular, OA has always believed in transparency in the development of a chemotherapy rating system. In order to create even greater transparency and to assist treating physicians to promptly identify the best treatments for their patients, OA has developed a proprietary “Clinical Decision Support” tool. This tool enables medical oncologists to sort all available chemotherapy options based on the parameters most important to them and their patients. Thus, if efficacy is of primary importance, followed by toxicity and cost, then medical oncologists and their patients can determine the best approach. Additional treatment (“protocol”) search filters include the risk of infection, risk of nausea and vomiting, genetic and molecular testing results, performance status, line of therapy and others.

Since its inception in 2009, Oncology Analytics (OA) has promoted high quality and cost effective chemotherapy. This is accomplished by carefully evaluating and rating all available treatments for efficacy, toxicity and cost. After a protocol is evaluated, it is placed into one of OA’s unique categories, as described in detail below.

  1. 1. Automatically processed
    • Automatically processed (Auto) protocols represent high quality, cost effective care.
    • Almost all of these protocols are supported by the National Comprehensive Cancer Network (NCCN) at category 1 (based on high-level evidence, there is uniform consensus that the intervention is appropriate) and category 2A (based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate) levels of evidence and consensus
    • In OA’s experience, about 60% of all treatment requests can be automatically processed
  2. 2. Non-automatically processed (Non-Auto without further characterization)
    • Non-automatically processed protocols represent high quality but more costly care
    • All of these protocols are supported by NCCN at category 1 and 2A
  3. 3. Non-automatically processed (NCa)
    • Non-automatically processed NCa protocols are NOT Food and Drug Administration (FDA) approved and are not supported by the NCCN at category 1 or 2A, but they are supported by Centers for Medicare & Medicaid Services (CMS) Quality Assurance and Performance Improvement (QAPI) criteria
    • OA carefully reviews all published literature. If a positive study is published in one of the 26 CMS supported journals, but it is NOT in the NCCN Guidelines or the 5 CMS supported compendia, then OA provides this unique designation.
    • In OA’s experience NCa protocols may represent the best available treatment for a patient if the patient is not eligible to receive auto or non-auto protocols as described above
  4. 4. Non-automatically processed (NC)
    • This unique designation represents protocols that are NOT supported by NCCN and are NOT supported by CMS QAPI criteria. Nonetheless, these treatments may represent the best available treatment for individual patients who have exhausted other treatments with greater scientific support.
    • OA provides references to support NC treatments
    • OA’s Distinguished Academic Advisory Board provides invaluable assistance in determining the clinical value of NC treatments

Unlike some clinical pathway systems that attempt to direct physicians to a very limited number of treatment options which they have agreed upon, OA’s Clinical Decision Support tool enables medical oncologists to choose from a multitude of evidence-based protocols and to quickly identify the treatments that best fit the patient’s clinical condition and personal preferences.

In addition, OA publishes its work, enabling all parties to review its approach to utilization management and clinical decision support, as well as the demonstrated success of its approach.