Accelerating Personalized Medicine Adoption in Community Oncology:

Solving the Transformation to Compete Successfully in the 2020's and Beyond

October 23, 2020

Fredrick Ashbury, PhD, reported by Katherine Gresh, BS

ORION by VieCure

Volume 1, Issue 8

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Transforming Oncology Practice: Market Forces including the shift to

Precision Medicine

At a recent meeting sponsored by ION Solutions National Meeting, on October 17, 2020, Dr. Fred Ashbury, Chief Scientific Officer at VieCure, stated, “Market forces, including the paradigm shift to precision oncology, require an immediate and dramatic response by community oncology practices to remain competitive

in the coming decades.”  

Presently, more than 70% of cancer patients in the US are being treated or are in follow-up in community oncology practices. Dr. Ashbury described how patient volumes are expected to increase substantially in the coming years and how increasing incidence and prevalence of cancer patients will place additional burden on already strained resources in these practices. Community oncologists will be expected “to do more with substantially less”, he said, which will be amplified by workforce constraints as a direct result of retirements occurring at a rate faster than the replacement rate. In a few years, we can expect that hundreds of thousands of cancer patients may not have direct access to an oncologist compelling a different model of care delivery. We can also expect that “recruitment and retention of the new graduates will become even more competitive,” Ashbury believes,
“As such, new entrants will reasonably want to be employed by practices that demonstrate innovation and

the latest technologies.”

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On top of these concerns, oncology practitioners are witness to ane explosion of research regarding the molecular profile of cancer and its microenvironment. Tens of thousands of peer-reviewed publications report the potential of genomic-guided therapies, dozens of novel immunotherapy and targeted therapy agents, including biosimilars, have been approved for different indications and hundreds of trials are under way. This proliferation of research and FDA approvals has already resulted in a significantly enhanced arsenal of therapeutics Dr. Ashbury believes that funders and patients will “expect that oncologists and practice administrators will have sufficient knowledge of these agents to effectively treat their patients, in real-time, to mitigate cost, premature loss of life and improve quality of life.” Yet, community oncologists are unable to stay current with the literature given the demands on their time to see and treat patients.

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Reimbursement will be tied to value-based care (VBC). However, most of the common EMR platforms fail to provide decision-support for oncologists to achieve VBC while simultaneously dealing with the escalating complexity of cancer care given the myriad data points with which oncologists must wrestle. “Physicians see how complexity has added hours to each day to review cases and make decisions that affect care,” Ashbury said, “...and it will only get worse. The100s of genes of next generation sequencing platforms alone demands an artificial intelligence solution to process these discrete data against the latest available evidence at point-of-care.”

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Community Oncology Practice Impact Report

Over 1,700 community oncology practices have closed down, been acquired by hospitals, merged, or reported significant financial problems, in the last 12 years, according to a recent report of the Community Oncology Alliance. “This situation shows the dramatic impact of the different market forces on competition in this sector,” stated Ashbury, “and the expectation that closures, mergers and acquisitions will continue unless community practices act now by leveraging AI and other tools.”

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Ashbury concluded that these drivers of change precipitated the development of VieCure’s AI platform and smart EMR, “We needed the capability of turning a single oncologist into a hundred oncologists to keep up with rising patient volumes, increasing data points required for decision making, providing value-based care, and meeting obligations to treat patients  closer to home, including telemedicine consulting capability. Our solution enables a successful response to these challenges to remain competitive in business, for the coming decades.” The biggest competitors to community oncology practice are, he stated, “...the failure to change out inefficient and ineffective tools and technologies and their regional airport. Their patients will jump on planes to go to where they think they will get the best, most timely, innovative and effective treatment. The time for transformation is now.”

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Castelo-Branco L, Aspeslagh S, Koteki N, Awada A. How to assimilate the tsunami of immune checkpoints inhibitor data into clinical practice. Current Opinion in Oncology 2019;31(5):420-423.

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Community Oncology Alliance Practice Impact Report.  Available from:  https://communityoncology.org/wp-ontent/uploads/2020/04/COA_PracticeImpactReport2020_FINAL.pdf

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Curioni-Fontecedro A. A new era of oncology through artificial intelligence. ESMO Open 2017;2: e000198. doi: 10.1136/esmoopen-2017-000198.

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