This project aimed to identify whether it was possible to map the journey of lung cancer patients from private rooms and public regional cancer service against the Optimal Care Pathways (OCPs) using electronic and paper based systems. This provides information about what changes need to be made to data input and reports to enable the routine use of these pathways for monitoring and improving patient care.
The study population was a random sample of 75 people who, during 2015, were newly diagnosed with lung cancer in the LMR and known to the host site through multi-disciplinary team meeting presentation. Patient characteristics were obtained from paper and electronic records in the treating health services including the private rooms of the referring clinicians. The service system and the data systems available were mapped to identify the best source of data for each OCP step.
It was possible to capture between 85 and 100% of the required data points to map the Optimal Care Pathways using the methodology. Significant effort was required to review eight structured and unstructured databases as well as paper based records. There were some areas where OCP language could be interpreted in different ways. For example whether palliative care is considered a first treatment for patients who are palliative on diagnosis. The data points related to multiple services were the hardest to capture. In particular the GP referral dates for private patients.
Careful mapping of the service system for a patient cohort is required to facilitate accurate monitoring of OCPs. This is possible using the region's legacy systems when resources and partnerships are in place. The team is working hard to ensure business requirements for any new electronic medical records include routine capture and reporting OCP of pathway points including public and private data points.