Software delayed for years now changing the face of Nova Scotia cancer care

For more than six years, pathologist Dr. Laurette Geldenhuys and a team of around two dozen other pathologists in Nova Scotia have been meticulously entering information about people's cancer specimens into a software database.

The data fields for the "electronic synoptic reports" feature drop-down options to enter things like the type of cancer, how far it has spread, and how slowly or quickly it is likely to progress. This information helps surgeons and oncologists decide on the best treatment for each patient.

Depending on the complexity of the case, it can take anywhere from 30 minutes to two hours to complete this work, said Geldenhuys.

Thanks to some long-delayed software troubleshooting, Nova Scotia Health can finally use this data to get better insight into cancer rates, prevalence and severity across the province.

"It can tell decision-makers how best to spend health-care dollars to improve cancer outcomes," said Geldenhuys.

What synoptic reporting can do

For example, if Nova Scotia had higher rates for certain cancers compared to other provinces, setting up screening programs could be an option, she said.

As well, the data could be used to determine whether certain cancer treatments are more effective than other types, said Geldenhuys.

"This data can be potentially very powerful," she said.

Geldenhuys has been pushing for the necessary changes to allow the software to offer full functionality.

Being able to extract data from the software to draw these broader conclusions is a process that should have been completed in late 2019, but was delayed because of the COVID-19 pandemic, said Matthew Murphy, the chief data officer for Nova Scotia Health.

While the pandemic didn't officially arrive in Nova Scotia until March 2020, the health authority's information technology professionals were busy planning for it in late 2019.

Software struggles

Murphy said there's always some troubleshooting involved with the installation of new software.

He said the team responsible for entering data regarding COVID-19 testing and reporting is also the same team that was responsible for troubleshooting the problems with the synoptic reporting.

"It consistently got pushed to the side in favour of the COVID response," said Murphy.

Murphy also said making the necessary software changes wasn't a matter of picking up where the team left off. Rather, they'd have to go back several steps each time they resumed working.

He said accessing this data speeds up the timeline by which it can get insight about things like cancer rates, prevalence and severity in the province.

Previously, it would have to wait a year or two to get that kind of information from the Canadian Institute for Health Information.

Now that the data can be extracted, Murphy said the data entered for the past few years wasn't all for naught as it can now be extracted to provide a big-picture perspective.

"The ability to use this information to better support cancer care in Nova Scotia is uplifting," said Murphy.

"You want to be able to leverage your data assets to improve the health of Nova Scotians, improve screening, surveillance, and I think this gives us a really great opportunity."

Reporting needs to be expanded, says pathologist

While Geldenhuys is pleased the software is finally up and running, she'd like to see the synoptic reporting done for more than colorectal, breast, lung, prostate and endometrium cancers.

"Those were the five biggest ones that we wanted to start with, but the others are not available yet," said Geldenhuys.

Synoptic reporting is also done for thyroid cancer in the central zone.

In a statement, Nova Scotia Health said the synoptic reporting covers the majority of cancers.

"We will be considering how best to expand this approach as part of our overall digital transformation strategy," it said.

Geldenhuys would also like to see a governing body created to oversee electronic synoptic reporting in the province. She said they're in place in provinces such as B.C., Ontario and Alberta.

She said the bodies provide useful data and ensure templates are updated as new ways of reporting cancer information are developed.

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