{"id":17241,"date":"2016-11-18T01:05:02","date_gmt":"2016-11-18T06:05:02","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-rctom\/submission\/memorial-sloan-kettering-a-digital-affair-with-cancer-care\/"},"modified":"2016-11-18T01:05:02","modified_gmt":"2016-11-18T06:05:02","slug":"memorial-sloan-kettering-a-digital-affair-with-cancer-care","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/memorial-sloan-kettering-a-digital-affair-with-cancer-care\/","title":{"rendered":"Memorial Sloan Kettering \u2013 a digital affair with cancer care"},"content":{"rendered":"<p>From precision surgery, to electronic medical records, to telemedicine, few question the impact digital innovation has had on healthcare delivery. Not only are doctors (and patients) more sophisticated than ever before, they are far more connected.<\/p>\n<p>However, these benefits come with their challenges, not the least of which is effective exchange and interpretation of clinical and patient-generated data. The volume of medical information doubles every 5 years [1], of which an estimated 80% of is unstructured and dispersed [2]. This may help explain why healthcare practitioners ignore 90% of the data that they themselves generate [2], and why the rate at which the latest research actually influences clinical practice in the broader oncology community is painstakingly slow.<\/p>\n<p>Surfing fearlessly at the crest of this digital wave is Memorial Sloan Kettering (MSK), New York\u2019s premier oncology treatment and research center. MSK treats over 130,000 patients across 400 unique cancer subtypes each year [3]. These are highly complex cases, requiring specialized, individualized treatment plans. Moreover, MSK sets the standard for digital innovations to deliver quality and efficient care. Here we\u2019ll showcase two of their more exciting initiatives.<\/p>\n<p>&nbsp;<\/p>\n<ol>\n<li><strong><u>\u201cWatson for Oncology\u201d \u2013 Clinical support tool<\/u><\/strong><\/li>\n<\/ol>\n<p>In 2011, MSK partnered with IBM to develop Watson for Oncology, a machine designed to \u201canalyze huge volumes of (medical) information and reduce it down to critical decision points [1]\u201d (Dr. Craig Thompson, MSK CEO).<\/p>\n<figure id=\"attachment_17193\" aria-describedby=\"caption-attachment-17193\" style=\"width: 640px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/IBM-watson-Memorial-sloan-kettering.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-17193\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/IBM-watson-Memorial-sloan-kettering-1024x827.jpg\" alt=\"Exhibit 1: MSK infographic on how Watson for Oncology advances personalized care\" width=\"640\" height=\"517\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/IBM-watson-Memorial-sloan-kettering-1024x827.jpg 1024w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/IBM-watson-Memorial-sloan-kettering-300x242.jpg 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/IBM-watson-Memorial-sloan-kettering-768x620.jpg 768w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/IBM-watson-Memorial-sloan-kettering-600x485.jpg 600w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/IBM-watson-Memorial-sloan-kettering.jpg 1200w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><figcaption id=\"caption-attachment-17193\" class=\"wp-caption-text\">Exhibit 1: MSK infographic on how Watson for Oncology advances personalized care<\/figcaption><\/figure>\n<p>Three months after Watson defeated <em>Jeopardy!<\/em> Grand Champions Jennings and Rutter, MSK approached IBM about using Watson\u2019s cognitive computing power to help inform clinical treatment decisions [4]. MSK had over the decades amassed thousands of patient case studies (on interventions and outcomes), the latest medical literature, and a knowledge management system designed to deliver personalized care [5]. But as MSK grows, data proliferates, and physicians are spread over a larger number of cases requiring more specialized treatment, the task of keeping up to date on the latest medical findings becomes Herculean.<\/p>\n<p>Via a tablet app, an MSK oncologist would input their patient\u2019s history, symptoms, test results, and other diagnostics, to which the program recommends a list of individualized, potential treatment plans. For each treatment option, the computer generates a degree of confidence.<\/p>\n<figure id=\"attachment_17180\" aria-describedby=\"caption-attachment-17180\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Watson-tablet-app.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-17180\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Watson-tablet-app-300x200.jpg\" alt=\"Exhibit 2: Dr. Mark Kris (MSK) and Manoj Saxena (IBM) looking onto 2013 version of Watson for Oncology app\" width=\"300\" height=\"200\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Watson-tablet-app-300x200.jpg 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Watson-tablet-app-768x513.jpg 768w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Watson-tablet-app.jpg 1024w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Watson-tablet-app-600x401.jpg 600w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-17180\" class=\"wp-caption-text\">Exhibit 2: Dr. Mark Kris (MSK) and Manoj Saxena (IBM) looking onto 2013 version of Watson for Oncology app<\/figcaption><\/figure>\n<p>For those suspicious of artificial intelligence, rest easy. Watson does not replace the physician. It lacks the empathy and critical judgment for which doctors are held responsible. MSK instead uses Watson as a means to share expert knowledge and enhance decision making, leaving the final decision on treatment to the physician.<\/p>\n<p>By facilitating information flow throughout the MSK network, physicians have access at all touch points, whether in the hub inpatient facility or at one of the 21 outpatient clinics. Patient satisfaction is expected to increase as physicians now have more time to interact with their patients in lieu of tedious paperwork. And as the Watson brain learns and expands its knowledge base with further clinician input, its potential to create value for cancer patients expands beyond breast and lung cases to other cancer types like colon and bladder.<\/p>\n<p>&nbsp;<\/p>\n<ol start=\"2\">\n<li><strong><u>\u201cVersus\u201d \u2013 Real-time location monitoring<\/u><\/strong><\/li>\n<\/ol>\n<p><u><\/u>One other manifestation of the Internet of Things at MSK is the \u201cVersus\u201d software, a real-time location system (RTLS) currently being piloted at a few of the hospital\u2019s outpatient clinics [6]. The primary purpose of the software is to monitor the patient\u2019s movement through every stage of care, from admission, to procedure, to discharge.<\/p>\n<p>Patients and their visitors receive a small electronic badge upon arrival that integrates location data with MSK\u2019s OR management software, which feeds into the EMR. This greatly improves accuracy and reliability of EMR data, and frees up time for the clinician to spend with the patient.<\/p>\n<figure id=\"attachment_17213\" aria-describedby=\"caption-attachment-17213\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/RTLS-badge.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-17213\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/RTLS-badge-300x200.jpg\" alt=\"Exhibit 3: RTLS electronic badge\" width=\"300\" height=\"200\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/RTLS-badge-300x200.jpg 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/RTLS-badge-768x512.jpg 768w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/RTLS-badge-1024x683.jpg 1024w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/RTLS-badge-600x400.jpg 600w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/RTLS-badge.jpg 1200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-17213\" class=\"wp-caption-text\">Exhibit 3: RTLS electronic badge<\/figcaption><\/figure>\n<p>\u201cGlance-and-Go\u201d electronic whiteboards throughout the facilities allow clinicians to see instantly each patient\u2019s surgery schedule and wait time alongside OR and bed availability [7, 8]. Not only can patients move freely while remaining accessible to their clinician, clinicians are able to mitigate long wait times, prioritize care, allocate resources (like beds and staff) accordingly, and track their patients\u2019 recovery (through metrics like post-surgical ambulation). The net benefit is an enhanced patient experience and, ultimately, superior outcomes.<\/p>\n<figure id=\"attachment_17221\" aria-describedby=\"caption-attachment-17221\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Glance-and-go-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-17221\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Glance-and-go-1-300x89.jpg\" alt=\"Exhibit 4: Glance-and-Go chart (simplified example)\" width=\"300\" height=\"89\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Glance-and-go-1-300x89.jpg 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Glance-and-go-1.jpg 478w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-17221\" class=\"wp-caption-text\">Exhibit 4: Glance-and-Go chart (simplified example)<\/figcaption><\/figure>\n<p>***<\/p>\n<p>Each of these solutions strives to improve MSK\u2019s quality of care, streamline workflow, and optimize patient satisfaction.<\/p>\n<p>The issues that arise with each align to the challenges of big data in healthcare overall. The first is data-system interoperability. That is, how do we ensure the proliferation of data is actually exchanged, interpreted, and actioned upon. By extension, does the cost of harnessing this data justify its collection? The other primary risk is one of privacy. Has the race to innovate ignored patient consent? After all, isn\u2019t having one\u2019s movement in a hospital tracked constantly plain creepy?<\/p>\n<p>Whatever the case, as healthcare becomes increasingly democratized, the patient plays a central role in digital-enabled care innovation.<\/p>\n<p>(Word Count: 792)<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>[1] \u201cIBM Watson helps fight cancer with evidence-based diagnosis and treatment suggestions\u201d. <em>Anon. <\/em>\u00a0<a href=\"http:\/\/www-935.ibm.com\/services\/multimedia\/MSK_Case_Study_IMC14794.pdf\">http:\/\/www-935.ibm.com\/services\/multimedia\/MSK_Case_Study_IMC14794.pdf<\/a> . Jan 2013. Web. Accessed Nov 16.<\/p>\n<p>[2] \u201cSmart use of big data: the key to the future\u201d. <em>Anon. <\/em><a href=\"https:\/\/www.healthcare.siemens.com\/magazine\/mso-big-data-and-healthcare-2.html\">https:\/\/www.healthcare.siemens.com\/magazine\/mso-big-data-and-healthcare-2.html<\/a> . Aug 12, 2015. Web. Accessed Nov 16.<\/p>\n<p>[3] \u201cFact and figures\u201d. <em>Anon. <\/em>\u00a0<a href=\"https:\/\/www.mskcc.org\/pressroom\/facts-figures\">https:\/\/www.mskcc.org\/pressroom\/facts-figures<\/a> . <em>nd. <\/em>Web. Accessed Nov 16<\/p>\n<p>[4] \u201cLearning machines: Watson could bring cancer expertise to the masses\u201d. <em>David Kerr. <\/em><a href=\"http:\/\/www.huffingtonpost.com\/david-kerr\/learning-machines-watson-_b_1388429.html\">http:\/\/www.huffingtonpost.com\/david-kerr\/learning-machines-watson-_b_1388429.html<\/a> . Mar 29 2012. Web. Accessed Nov 16<\/p>\n<p>[5] \u201cWhat\u2019s your strategy for managing knowledge?\u201d. <em>Morten T. Hansen, Nitin Nohria, Thomas Tierney.<\/em> <a href=\"https:\/\/hbr.org\/1999\/03\/whats-your-strategy-for-managing-knowledge\">https:\/\/hbr.org\/1999\/03\/whats-your-strategy-for-managing-knowledge<\/a> . March 1999. Web. Accessed Nov 16<\/p>\n<p>[6] \u201cVersus Advantages\u2122 Improves Patient Experience at Memorial Sloan Kettering Cancer Clinics\u201d. <em>Versus. <\/em><a href=\"http:\/\/www.versustech.com\/rtls-news\/press-releases\/versus-advantages-improves-patient-experience-at-memorial-sloan-kettering-cancer-clinics\/\">http:\/\/www.versustech.com\/rtls-news\/press-releases\/versus-advantages-improves-patient-experience-at-memorial-sloan-kettering-cancer-clinics\/<\/a> . March 11, 2015. Web. Accessed Nov 16.<\/p>\n<p>[7] \u201cMemorial Sloan Kettering\u2019s Josie Robertson Surgery Center Innovates New Uses for RTLS\u201d. <em>Anon. <\/em><a href=\"http:\/\/www.prweb.com\/releases\/hospital\/patientflow\/prweb13256104.htm\">http:\/\/www.prweb.com\/releases\/hospital\/patientflow\/prweb13256104.htm<\/a> . March 10, 2016. Web. Accessed Nov 2016<\/p>\n<p>[8] \u201cMemorial Sloan Kettering facility uses RTLS to monitor patient recovery\u201d. <em>Claire Swedberg. <\/em><a href=\"http:\/\/www.rfidjournal.com\/articles\/view?14250\/\">http:\/\/www.rfidjournal.com\/articles\/view?14250\/<\/a><em> . <\/em>March 29, 2016. Web. Accessed Nov 2016<\/p>\n<p>&nbsp;<\/p>\n<p>Exhibit 1: <a href=\"https:\/\/www.mskcc.org\/blog\/msk-trains-ibm-watson-help-doctors-make-better-treatment-choices\">https:\/\/www.mskcc.org\/blog\/msk-trains-ibm-watson-help-doctors-make-better-treatment-choices<\/a><\/p>\n<p>Exhibit 2: <a href=\"http:\/\/fortune.com\/ibm-watson-health-business-strategy\/\">http:\/\/fortune.com\/ibm-watson-health-business-strategy\/<\/a><\/p>\n<p>Exhibit 3: <a href=\"https:\/\/www.mskcc.org\/blog\/five-innovations-helping-msk-transform-outpatient-surgery-2016\">https:\/\/www.mskcc.org\/blog\/five-innovations-helping-msk-transform-outpatient-surgery-2016<\/a><\/p>\n<p>Exhibit 4: <a href=\"http:\/\/www.versustech.com\/rtls-news\/press-releases\/memorial-sloan-ketterings-josie-robertson-surgery-center-innovates-new-uses-rtls\/\">http:\/\/www.versustech.com\/rtls-news\/press-releases\/memorial-sloan-ketterings-josie-robertson-surgery-center-innovates-new-uses-rtls\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Physicians (and patients) are more sophisticated and connected than ever before. But how can hospitals effectively harness this wealth of health data to deliver better care?<\/p>\n","protected":false},"author":2074,"featured_media":17242,"comment_status":"open","ping_status":"closed","template":"","categories":[],"class_list":["post-17241","hck-submission","type-hck-submission","status-publish","has-post-thumbnail","hentry"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-rctom\/assignment\/digitization-challenge-2016\/","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Memorial Sloan Kettering \u2013 a digital affair with cancer care - Technology and Operations Management<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/memorial-sloan-kettering-a-digital-affair-with-cancer-care\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Memorial Sloan Kettering \u2013 a digital affair with cancer care - Technology and Operations Management\" \/>\n<meta property=\"og:description\" content=\"Physicians (and patients) are more sophisticated and connected than ever before. 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