Tracey Walker

Oncologists recognize the potential of artificial intelligence (AI) in improving the quality of care and patient outcomes according to new research.

, a research-based report series analyzing the views of more than 180 U.S. oncologists, from Cardinal Health Specialty Solutions, found that overall, participating oncologists are optimistic AI will improve both patient care and practice operations.

When asked about the future impact of AI on the oncology industry, 53% of participating oncologists said they are “excited.” More than half of oncologists said they anticipate AI will help enhance the quality of care (53%), improve clinical outcomes (57%), and drive operational efficiencies (58%) in three or more years. Nearly half (47%) also expect it to lower the cost of care.

“The potential of AI-based tools to improve care and lower healthcare costs is significant,” says Bruce Feinberg, DO, vice president and chief medical officer for Cardinal Health Specialty Solutions.

As evidence of this, public and private investment in healthcare AI is expected to reach $6.6 billion by 2021, according to Forbes.

“Healthcare systems will play a key role in the early adoption and use of this technology,” Feinberg says. “Our research may help healthcare executives better understand the expectations and concerns oncologists have about these tools, and identify potential barriers that will need to be addressed as new technology is introduced into practice.”

One in three oncologists (36%) said AI will have a significant impact on oncology care over the next few years.
	When asked to identify the most valuable benefit that AI could provide to their practice, 37% said automating administrative tasks to allow oncologists to focus more on patients and 27% said identifying best treatment paths to help them choose the right drug the first time.
	Oncologists also cited the potential to predict patients most at risk of complications and the ability to enhance the accuracy of diagnostics as key opportunities for AI to improve oncology care.
	Top concerns about using AI in practice included the need for clinical trial data to show effectiveness (29%), the potential for bias in algorithms (27%), and oncologists’ own lack of familiarity with the technology (27%).
	“The potential breakthroughs in oncology treatment make this the most exciting time in history to provide care to cancer patients,” Feinberg says. “At the same time, oncologists face unprecedented challenges including growing patient volumes, rising costs, increasing regulatory pressures, increasing industry consolidation, and changing reimbursement models. Emerging tools such as AI have the potential to help ease some of these burdens for oncologists-but, if not understood and used effectively, they could also add to the complexity.”

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Optimism for AI in Cancer Care

The expected spending and growth in the oncology market is growing, according to a new report.

Oncology is the largest therapy area in biopharmaceuticals characterized by a large number of recently launched therapies, significant clinical benefits, the largest pipeline of any therapy area and significant potential breakthroughs in new mechanisms in the next few years, according to IQVIA Institute’s “

Global Oncology Trends 2019: Therapeutics, Clinical Development and Health System Implication

The report found that in 2018, a record number of 15 new active substance oncology treatments with 17 indications, including one tissue-agnostic therapy, launched in the U.S. Those 2018 debuts bring the total number of new oncology therapeutics launched since 2013 to 57 covering 89 approved indications for 23 different tumor types.

Consumer Reports Says Imported Drugs Are “Risky”

However, despite extensive pipeline activity, oncology remains the most challenging area for research and development, facing significant risk of failure and long, costly development, according to the report.

Other unique findings from the report include:

31% of the new drug launches treat non-solid tumors (leukemias/lymphomas/multiple myeloma)

Overall pipeline up 63% in the past five years with over 100 next-generation biotherapeutics (including cell, gene, and nucleotide therapies), examples already launched include CAR T therapies

Clinical trials remain risky but the overall numbers are high and large numbers of launches are expected through 2023

Biomarkers are a key success factor for future drugs and a wide range of them are already in use across a range of tumors, but a range of barriers persist that delay or limit patient access to medicines.

Spending reached nearly $150 billion globally in 2018 and is projected to exceed $200 billion by 2023 growing at 9% to 12%.

New oncology drugs launched in 2018 took a median of 10.5 years from the time of first patent filing to regulatory approval and launch, an acceleration of more than four years from the 2017 level


	“The future looks robust with a large and varied pipeline, a focus on biomarkers and overcoming logistical and technological hurdles to identifying and managing patients, and extremely promising mechanisms in development promising improved patient response and survival across a range of tumors with large populations and small,” says Michael Kleinrock, research director, IQVIA Institute.

The 2018 oncology drug market had a record number of new treatments and continued a trend of growth.

Oncology Market Remains Robust, Says Report

Precision medicine or “targeted therapy” is said to be the pathway to improved cancer treatment.In fact, UC San Francisco recently opened a $275-million cancer center which is set to provide adult patients with immunotherapy, genetic counseling, molecular profiling of tumors, fully integrated clinical trials, and advanced imaging.Â Â The Bakar Precision Cancer Medicine Building, part of the university's Helen Diller Family Comprehensive Cancer Center, focuses on a range of cancer services including medical care provided by surgical, medical, and radiation oncologists who work with an expanded care team to support the whole patient and their family with specialized psychosocial support, cancer specific nutrition expertise, hereditary cancer care, and wellness programs such as exercise counseling.Related: Precision Medicine Cutting-Edge Developments: What Health Execs Should KnowJeremy Schafer, PharmD, MBA, senior vice president, director, Access Experience, Precision for Value, views precision medicine as a potential game-changer. Here, Schafer offers four ways that he believes precision medicine will change cancer treatment:

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How targeted therapy could be the pathway to improved cancer treatment.

4 Ways Precision Medicine Impacts Cancer Treatment

A pharmacist-driven intervention program can reduce readmissions, according to a study published in the American Journal of Health-System Pharmacy.

Rates of 30-day readmissions were substantially lower with pharmacist involvement and collaboration with other healthcare team members during patient transitions from the hospital to home, according to the study.

Deborah Hauser, RPh, MHA, network director of pharmacy, outpatient pharmacy, Einstein Medical Center, and her colleagues conducted a quality-improvement cohort study of 1,059 admissions of 667 patients at an inner-city hospital. Einstein is the largest independent academic medical center in the Philadelphia area.

The study compared rates of unplanned readmissions within 30 days of discharge in the full- and partial-intervention groups and in patients who received standard discharge care.

Among patients who received the full intervention, 30 of 305 admissions (9.8%) resulted in unplanned readmissions within 30 days, compared with a readmission rate of 20.4% (110 of 538 patients) among patients who received standard discharge care.

The findings demonstrate the role and value of pharmacists in reducing hospital readmissions using a standard intervention that includes medication reconciliation, patient-centered education, resolution of access-to-care issues, and follow-up counseling and communication with healthcare providers, says Hauser.

“When a pharmacist is deployed with a structured intervention as a part of the multidisciplinary discharge process, readmissions can be reduced,” she says. “This study was conducted as a quality improvement program to improve hospital readmissions.”

Patients in the intervention groups received some or all components of Einstein’s multifaceted “Medication REACH” intervention, which includes:

Reconciliation of the patients’ medication lists making sure they are accurate and complete at discharge. At this step, the pharmacist contacts the prescriber to optimize therapy and clarify any medications for safety and accuracy.

Patient-centered education by the pharmacist.

Access, where the pharmacist works closely to ensure the patient has access to medications through insurance and assists with prior authorizations or therapy changes to formulary products. “Many patients were able to gain access through our discharge pharmacy, so medications are readily available at discharge,” Hauser says.

Counseling, with post-discharge follow-up phone calls, which can be done by a delegate or pharmacy personnel. “In our study, we teamed with the Philadelphia Corporation for Aging and had a bridge coordinator who did visits to homes and calls,” Hauser says. “The pharmacist is then deployed if further clarifications about medications are needed. Post-discharge counseling can reinforce medication adherence, verifying that patients are not experiencing any side effects and making sure the patient sees a primary care physician for follow up.”

Healthy patient at home. “If the prior steps are fully implemented, we strive for a healthy patient at home, and not being readmitted,” Hauser says.

Pharmacists are best suited to review and optimize patient therapies to improve patient care outcomes, Hauser says. “Pharmacists play very close attention to medication details to ensure an optimal discharge for the patient as it pertains to medication therapy management beyond the hospital as part of a larger population health strategy.”

Pharmacists are often underutilized in hospitals, according to Hauser. “There is tremendous opportunity to improve the discharge process and continue to build on the use of pharmacists to improve medication therapy management beyond the hospital as part of a larger population health strategy.”

Einstein Medical Center is developing a role for pharmacists in an accountable care organization as a follow-up expansion to its current program.

Tracey Walker is content manager of Drug Topics’ sister publication, Managed Healthcare Executive

Study validates benefits of pharmacists on healthcare teams.