Sydney Adventist Hospital uses AI to Increase Cancer Multidisciplinary Meetings Efficiency

Sydney, NSW, (June 12, 2020) – Sydney Adventist Hospital (The San) is now using Artificial Intelligence to automatically populate their cancer Multidisciplinary Team meeting system with pathology information using Natural Language Processing from local company Health Language Analytics (HLA).

The San uses HLA’s CliniSearch application to identify relevant data from a pathology HL7 feed provided by Douglass Hanly Moir (DHM) for the San’s cancer patients. The pathology information is used to automatically pre-populate the correct data fields in preparation for the various cancer Multidisciplinary Team (MDT) meetings run at the San.

Associate Professor Gavin Marx, Director of the Integrated Cancer Centre at the San, sees this as a real advantage for the clinical team and patient care processes. “Pathology is a key component of cancer MDT meetings and there is a significant amount of data generated from each pathology report”, he emphasised. “To have the ability to automatically extract and use this data in a structured format in the context of other available information for clinical decision-making at the meeting saves us a significant amount of time and effort, and enables us to use the data for research purposes”, he explained.

To give a sense of the clinical staff time saved in preparation for an MDT meeting and increased data availability at the meeting at the San, there are sixteen different pathology templates currently included in the extraction service as a joint effort by the San, DHM and HLA. The sixteen reports contain a total of 616 data fields, all of which are identified, extracted from the reports and then coded to SNOMED CT using natural language processing before being fed into the MDT system for presentation at a patient discussion. This is now fully automated, uses no critical staff time and prevents manual transcription errors.

The following table presents the current data extraction volumes:

Tumour StreamTemplateNo. of Fields
BreastBreast Carcinoma61
Breast Carcinoma Post-Neoadjuvant Therapy67
Biomarkers15
LungLung Carcinoma41
UrologyProstate Biopsy23
Radical Prostatectomy54
Prostate TURP18
Bladder Cystectomy32
Renal Pelvis & Ureter34
Renal Cell Nephrectomy40
Renal Cell Partial Nephrectomy33
Testis27
Gynae-OncologyCervical Carcinoma42
Hysterectomy45
Ovaries, Fallopian Tubes, or Peritoneum39
Vulval Carcinoma45
TOTALs16616

Professor Warick Delprado, Director of Histopathology at DHM, highlighted the value of this collaboration, “This is a valuable initiative, allowing us to work in partnership on a project that has mutual benefits for the San and all patients, as well as enhancing the efficiency of our pathologists to continue to deliver high quality service for the Multi-Disciplinary teams”.

The San’s CliniSearch application runs on the Horizon technology platform from HLA and currently has over two million reports indexed for a wide range of clinical concepts. All the pathology reports’ free text sections have been coded to SNOMED CT. By automatically indexing, unpacking and coding the pathology reports from DHM, HLA’s AI is able to fill in the pathology data fields in the newly implemented Multidisciplinary Team meeting system, so that each patient discussion is as fully informed as possible.  With the MDT meetings being moved online due to COVID-19, this ensures that all relevant pathology information is available to all participants remotely, and a high level of patient care is still available.

Professor Jon Patrick, CEO and co-founder of HLA said, “we are pleased to work with the San and DHM by adding AI-based natural language processing to their MDT data workflows. This has reduced admin time and improved accuracy while giving far greater depth to the pathology information available at each MDT meeting”.

ICIMS roll-out to MDT streams continues

Meanwhile, the Sydney Adventist Hospital’s Integrated Cancer Centre had quickly responded to the COVID-19 crisis by moving its MDT meetings onto a remote footing. The Integrated Cancer Information Management System (ICIMS) commenced implementation in June 2019, thanks to a generous donation by the San Foundation. Since then, the San has brought the Lung and Breast tumour streams online, and more recently, the Urology and Gynaecological Oncology modules went live and were launched remotely due to the COVID-19 crisis.

The remote set-up enables cancer case-viewing and treatment-planning on a centralised patient cancer record during the online meetings with Surgeons, Medical Oncologists, Radiation Oncologist, Pathologists, Radiologists, Nurses and Allied Health Services, who may be working from premises all across Sydney.

“The transition to online MDT registrations for our prostate patients has been seamless and very important especially during the COVID crisis. Having the ability to see the surgical and pathological data automatically available in the system has been vital to our MDT discussions” emphasised prominent urologist Professor Henry Woo.

Another immediate benefit of ICIMS is that pathologists and radiologists involved in the MDT now get access to the patient lists and required reviews in real-time. Previously a batch process the day before the meeting often left them needing to work late into the night to compile the required data in time for the meeting. In addition, the data are now automatically populated in ICIMS as soon as a pathology report for a San patient is authorised by the pathologist. These abilities also significantly reduce the workload on the MDT meeting coordinator while increasing data richness and accuracy at the meeting.

The ICIMS solution presents the same functionality to each user whether they are working in a combined conference room or logging in remotely. This means that no user retraining is needed and each patient receives the full benefit of the multidisciplinary team no matter where each team member is located.

iCIMS (Innovative Clinical Information Management Systems)has been recently granted a patent for its LATTICE technology platform by the United States Patent and Trade Mark Office.

See PULSE+IT article here.

iCIMS Technology Awarded Patent by the United States Patent and Trademark Office

iCIMS is pleased to announce that it has been granted a US patent for the technology underlying its award-winning software platform LATTICE.

This comes on the heels of iCIMS being announced as the inaugural winner of the Medical Software Industry Association (MSIA) Best Innovation by a Member Company 2019. See article here.

iCIMS won the award for its implementation of a LATTICE powered solution for the Sydney Adventist Hospital’s Cancer Centre of Excellence that enabled automation of the various multidisciplinary team meetings that form part of the core offering in the San’s fight against cancer.

The power of the LATTICE technology was demonstrated with a seamless move to remote team collaboration due to the CoVid-19 crisis. Ali Besiso, iCIMS’ Managing Director was pleased with the result, “For one of our major clients to be able to bring a new tumour stream online, and do it remotely, during this crisis shows the power of our infrastructure and its unique way of very quickly building and deploying clinical systems, a uniqueness that has been acknowledged by the recent granting of a Patent for our technology by the United States Patent and Trade Mark Office.”

Melbourne Health Breast Cancer Services moves to Phase II/HL7

Melbourne Health Breast Cancer Service Phase II/HL7

The Melbourne Health Breast Cancer Service RUTH II system has moved to Phase II of the implementation with the successful addition of the HL7 module.  The module enables integration to the hospitals’ Patient Administration Systems (PAS).

A key advantage of the extra functionality is the ability to process HL7 A40 merge messages to update each patient’s medical record number to the new Parkville Precinct Unique Record Number (PURN) shared across all three hospitals (including the Peter MacCallum Cancer Centre where the joint weekly Multi-Disciplinary Team Meetings take place).

The integration, coupled with iCIMS’ workflow engine, reduces cognitive load, lowers ‘click fatigue’ and increases accuracy by pre-filling form entries from the PAS and from patient clinical details held within RUTH II. This functionality reduces the time taken by staff to enter data and prepare for Multidisciplinary Team Meetings. Figures from usage data indicate that the RUTH II system has saved over 20% of interns’ data entry time.  Time that is now available to work directly with patients.

Melbourne Health Breast Cancer goes live with RUTH II from iCIMS

Melbourne Health – Breast Cancer Service

Melbourne Health has upgraded its Clinical & Research information management system used by the shared Breast Cancer service of The Royal Melbourne and The Royal Women’s Hospitals. The new system, installed by Innovative Clinical Information Management Systems (iCIMS) is also designed to allow easy access from other institutions within the Parkville precinct.

The iCIMS system (RUTH II) is a full Clinical Information System (CIS) which enables the two hospitals to track the patient journey, manage the Multidisciplinary Team Meetings and transparently share patient information.

iCIMS RUTH II for Royal Melbourne Hospital

iCIMS used its advanced technology to enable a concept it calls Immediate Adaptability to very quickly prototype a system tailored specifically to the needs, workflows and outcomes required by the two hospitals.

One facet of Immediate Adaptability that sets iCIMS developed systems apart is the speed of user-driven system design changes. This speed, in turn, allows iCIMS to deploy a unique installation model; once the initial handover is completed, the client has three months to request system design changes without additional cost.  The result is a highly tailored, fit for purpose solution that has overwhelmingly high user buy-in from senior clinicians, nurses, data administration and ancillary services.

Professor Bruce Mann –   Director of Breast Tumour Stream, Victorian Comprehensive Cancer Centre (VCCC) has seen the effects of iCIMS’ Immediate Adaptability within his team; the MDM team has been very impressed that changes suggested during the MDM one week had been implemented and operational the following week.

As an example of the immediacy of changes, with the RUTH II system, there were 98 design changes requested by the clinical users as a result of them using the system in a live environment in the first three months. Of those changes, 93 have been delivered already with an average turnaround time of 3 days without any system downtime.

As well as the core functionality, the system has additional modules that produce:

  • End of treatment summaries and outcomes
  • A survivorship component
  • Breast audit data exports

RUTH II has been designed to be fully expandable into other tumour streams and other sites within the Parkville precinct and is already remotely accessible from the Peter MacCallum Cancer Centre (PMCC).