Oncology as a speciality is fundamentally multidisciplinary in nature, necessitating an integration of past successes, innovations in care, and becoming even more patient-centred. In Queensland Health, the prescribing and recording of cancer systemic therapies is an all-digital affair, which is a trait that some other jurisdictions cannot claim. However, as healthcare is the last major sector of contemporary society to undergo significant disruption in the digital era, many opportunities and challenges have arisen. Some specialties have grasped the opportunity to innovate and modernise, integrating new ICT systems, devices, and equipment that synchronise and facilitate integrated care. Other specialties, including oncology, have yet to fully realise the potential that digitisation provides.
A well-functioning ICT platform to assist the delivery of chemotherapy is not the silver-bullet solution. Instead, it should be viewed as an enabler or foundation on which good processes and systems can evolve. In the Australian context, cancer services have wonderful resources including the COSA guidelines for the safe prescribing, dispensing and administration of systemic cancer therapy; however there is no imperative, other than aligning with best-practice, for services to fully embrace and implement guidelines in their context. The delivery of systemic therapies currently has no overarching standards and governance framework, which leads to variations in service capability, and subsequently, fragmentation of care. The recent publicity around systemic therapy dosing has placed a beaming spotlight on the medical oncology and haematology specialities, and the public are hungry for assurances in safety and quality in healthcare
Good standards, governance, and ICT solutions in the cancer context are symbiotic, and need a focus beyond the individual. A systems-lens approach of the Australian systemic therapy landscape reveals a expanding specialty struggling to keep pace with the increasing cancer burden, whilst simultaneously failing to innovate their practice style and clinical focus. Excellently developed standards, governance and ICT are paramount to enable cancer specialist disciplines the ability to capitalise on continual improvement opportunities, perform and contribute to world-class research, and implement truly patient-centred care, in the framework of sustainable reporting and monitoring structures for their respective health system. All three elements of this ‘holy trinity’ are essential to success. Without just one, the field of oncology risks falling behind other specialties as the progression of the digital age occurs.
‘… value is not restricted to the clinical benefits as has been the case historically, but going forward will include the value to patients (both in clinical outcomes and more patient-related outcome measures (PROMs)), payers and the wider society.’ KPMG study
http://www.cec.health.nsw.gov.au/patient-safety-programs/medication-safety/high-risk-medicines/A-PINCH
https://www.safetyandquality.gov.au/publications/nsqhs-standards-hospital-accreditation-workbook-october-2012/