VIPCare: Virtual Predictive Care workflow with integrated surveillance for optimal care protocol selection and management in at-risk prostate cancer patients

VIPCare：虚拟预测护理工作流程，具有综合监测功能，可为高危前列腺癌患者提供最佳护理方案选择和管理

• 批准号: 10758350
• 负责人: Sharon Hensley Alford
• 金额: $ 40.65万
• 依托单位: VIZLITICS INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10758350
• 关键词: Acute; Address; Aftercare; Algorithms; Biochemical; Businesses; Cancer Center; Cancer Patient; Caring; Case Management; Classification; Clinic; Clinical Decision Support Systems; Collaborations; Communities; Computer Models; Consult; Cost Savings; Data; Electronics; Ensure; Explosion; Future; Guidelines; Health Insurance Portability and Accountability Act; Health Services Accessibility; Health system; Ingestion; Knowledge; Malignant Neoplasms; Malignant neoplasm of prostate; Manuals; Marketing; Medical; Medical Records; Modeling; Monitor; New York; Nurse Practitioners; Oncologist; Oncology; Operative Surgical Procedures; PSA screening; Patient Education; Patient Preferences; Patient-Focused Outcomes; Patients; Performance; Persons; Phase; Physicians; Population; Preparation; Probability; Process; Production; Protocols documentation; Provider; Publishing; Recommendation; Recurrence; Reporting; Research; Resource Allocation; Resources; Retrieval; Retrospective cohort; Running; Sampling; Skin Cancer; Survival Rate; Symptoms; Test Result; Testing; Time; Training; Triage; Urology; Visit; Visual; Visualization; Woman; active method; cancer care; cancer diagnosis; cancer type; care providers; clinical decision support; clinical decision-making; cloud based; cohort; commercialization; dashboard; design; follow-up; improved; individual patient; insight; men; novel; patient health information; patient population; performance tests; pilot test; prostate cancer risk; screening; software as a service; tool; usability; virtual

Abstract Prostate cancer is the leading cancer diagnosis in men (not including skin cancer) and has high survival rates (98% at 5 years), resulting in an estimated 3.2M US men currently living with prostate cancer. However, data shows follow up among prostate cancer patients remains a significant challenge. A recent study at Dana- Farber/Brigham and Women’s Cancer Center (DF/BCC) demonstrated its novel Virtual Prostate Cancer Clinic (VPCC) increased access to care for new patients by 1110% and expanded revenue by 174% in four years. Leveraging knowledge gained by the VPCC’s preliminary studies and to address this challenge in the market, Vizlitics will develop a Software-as-a-Service product on top of its existing Cancer Insights (CI) platform in collaboration with its research partners at DF/BCC to serve US cancer centers and community oncologists. Known as VIPCare, this new CDSS will automatically monitor, track, and optimally classify prostate cancer cases for triage by applying advanced algorithms to curated medical data. The cloud-based platform will ingest and curate cancer patient medical records, including unstructured notes and apply Markov Decision Process (MDP) modeling of patient longitudinal data onto published surveillance guidelines. VIPCare will automatically retrieve new medical record data to keep models current with the latest tests and encounters and then compute a classification probability for a patient being in each care protocol (active surveillance, active treatment, or post- treatment surveillance) and the probability of moving from one care protocol to another. In addition, the model will provide a recommendation for whether the patient should be followed by an electronic, virtual or in-person visit with an APP or physician. This approach will: 1) improve follow-up of surveillance patients by scaling an already validated approach, 2) leverage MDP to reduce the need for manual data entry, medical record review and hands-on patient management, and 3) improve allocation of clinic resources. Phase I Specific Aims are to: 1. Develop a MDP model by incorporating prostate cancer guidelines on longitudinal patient data. Using retrospective patient data, the team will apply the MDP model to compute probabilities for current and future care based on latest tests and medical record data. 2. An optimization algorithm will use the probability scores created in Aim 1, patient preferences, and provider constraints to compute the triage recommendation for each patient. The dashboard will give the overview status of each patient individually and the entire patient population globally. 3. In lab usability testing will be run as well as accuracy testing of the classification and optimization algorithms. At the end of Phase I, the company will have demonstrated feasibility of VIPCare, achieving acceptable user testing and computation model accuracy ≥80%. Phase II will be a real-time test pilot of VIPCare at a prostate cancer clinic with additional technical enhancements in preparation for commercialization. Significant market opportunities exist for a tool like VIPCare that can offer demonstrated cost savings, increased practice efficiency and improved patient outcomes.

抽象的 前列腺癌是男性中最主要的癌症诊断（不包括皮肤癌），并且具有很高的生存率 （5 年时为 98%），据估计目前有 320 万美国男性患有前列腺癌。 丹纳最近的一项研究表明，前列腺癌患者的随访仍然是一个重大挑战。 法伯/布莱根妇女癌症中心 (DF/BCC) 展示了其新颖的虚拟前列腺癌诊所 (VPCC) 在四年内将新患者的护理机会增加了 1110%，收入增加了 174%。 利用 VPCC 初步研究获得的知识来应对市场中的这一挑战， Vizlitics 将在其现有的 Cancer Insights (CI) 平台之上开发软件即服务产品 与 DF/BCC 的研究合作伙伴合作，为美国癌症中心和社区肿瘤学家提供服务。 这个新的 CDSS 被称为 VIPCare，将自动监测、跟踪和优化分类前列腺癌病例 基于云的平台将通过应用先进的算法来收集和分类医疗数据。 整理癌症患者的医疗记录，包括非结构化笔记并应用马尔可夫决策过程 (MDP) 根据已发布的监测指南对患者纵向数据进行建模将自动检索。 新的医疗记录数据使模型与最新的测试和遭遇保持同步，然后计算 患者在每个护理方案中的分类概率（主动监测、主动治疗或术后治疗） 治疗监测）以及从一种护理方案转向另一种护理方案的概率。 将提供关于患者是否应该接受电子、虚拟或面对面随访的建议 与 APP 或医生进行会面 这种方法将： 1) 通过扩大监测范围来改善对监测患者的随访。 已经验证的方法，2) 利用 MDP 减少手动数据输入、医疗记录审查的需要 和实践患者管理，以及 3) 改善诊所资源的分配 第一阶段的具体目标是： 1. 通过将前列腺癌指南纳入纵向患者数据来开发 MDP 模型。 回顾性患者数据，团队将应用 MDP 模型来计算当前和未来护理的概率 2. 优化算法将使用创建的概率分数 在目标 1 中，患者偏好和提供者限制来计算每位患者的分诊建议。 仪表板将提供每个患者个人以及全球整个患者群体的概览状态。 3. 在实验室中进行可用性测试以及分类和优化算法的准确测试。 第一阶段结束时，公司将展示 VIPCare 的可行性，获得用户认可 测试和计算模型精度≥80% 第二阶段将在前列腺进行 VIPCare 的实时测试。 癌症诊所进行了额外的技术改进，为重大市场做好准备。 像 VIPCare 这样的工具存在机会，可以证明可以节省成本，提高实践效率 并改善患者的治疗效果。