Implementation and Clinical Adoption of Precision Oncology Workflows Across a Healthcare Network

Area of Science:

• Oncology
• Molecular Diagnostics
• Healthcare Networks

Background:

• Precision oncology leverages molecular diagnostics to enhance patient care.
• Modern healthcare networks aim to standardize high-quality care across sites.
• A clinical pilot was conducted to standardize precision oncology workflows.

Purpose of the Study:

• To standardize precision oncology workflows through the development and implementation of disease-specific molecular order sets.
• To assess the impact of standardized workflows on molecular test ordering and clinical outcomes.
• To evaluate provider adoption and adherence to standardized molecular testing protocols.

Main Methods:

• Developed 12 disease center-specific molecular order sets over approximately 9 months.
• Tracked the timeline, composition, and effort of consensus meetings for test selection.
• Assessed order set adoption over two years, comparing pre- and post-implementation periods for gastrointestinal and hepatopancreatobiliary malignancies.

Main Results:

• Order set development took ~9 months; average tests per indication remained stable (2.9 to 2.8).
• Post-implementation, significant increases were observed in GI patient test requests (17%), compliance (9%), and abnormal results (6%).
• High provider compliance (99%) was achieved, with minimal use of non-recommended tests impacting targeted therapies.

Conclusions:

• Establishing standardized precision oncology workflows requires significant effort but is achievable.
• Standardized molecular testing order sets improve adoption, compliance, and utilization of molecular diagnostics.
• Optimizing patient care through precision oncology necessitates effective communication tools for molecular testing.