Ottawa Hospital system culls ovarian cancer data

The Ottawa Hospital has rolled out a pilot project it hopes will help doctors improve treatment for ovarian cancer patients and even one day find a cure for the disease.

The four-month Gynecology-Oncology Services Ovarian

Cancer System is scheduled for completion at the end of August. The project is designed to help everyone involved in the care of ovarian cancer patients — from nurses and doctors to pharmacists, psychologists and social workers — input and access up-to-date patient information electronically, without having to endlessly re-enter data now in paper format.

The clinical information about each patient’s case – such as the kind of cancer, the stage it’s at, the patient’s reaction to chemotherapy or other types of treatments, the drugs she’s taking and their side-effects, for example — will also be entered into the database, where it will be available to cancer researchers to analyze.

“”The idea is to pull together all the subspecialties from medicine, nursing, pharmacy, social work and oncologists so we can come up with a comprehensive management plan for patients,”” said Dr. Tien Le, associate professor of gynecologic oncology at the University of Ottawa. “”With the paper-based system it would take a lot of work to try to get that information together, whereas if we have one centralized database access, that will facilitate our patient care and management.””

Ovarian cancer was chosen as a model, he says, because it requires input from many disciplines.

“”Right now there is a lot of work going on in ovarian cancer research in tumour profiling in terms of using genetic markers and various protein patterns to come up with an early diagnosis,”” said Le. “”The problem with ovarian cancer is that by the time it’s diagnosed usually the cancer has already spread so it’s really hard to treat and cure.””

For patients already diagnosed with the disease, he says, the database will help physicians use the most up-to-date information available about the case to decide whether to use chemotherapy or to try something else.

“”So it’s looking at the whole big picture instead of just one blood work example.””

The pilot project is built on Microsoft’s .Net architecture running over a wireless network that will be accessed on handhelds, Tablet PCs and desktops.

Ben Watson, senior product manager for Web services at Microsoft Canada Co., said the pilot is running on Windows Server 2003, the SQL 2000 operating system, the .Net framework 1.1 and Visual Studio .Net 2003 developer tools.

The challenges presented in the three-month implementation, he says, mostly involved working around the regulations restricting wireless use in hospitals.

Because they couldn’t use cellular devices due to their interference with hospital equipment, the developers had to look at an 802.11 deployment. In the meantime, they had to use data synchronization – gathering data on non-connected devices and uploading them to the database.

“”Because the infrastructures weren’t built for this sort of thing it meant some work had to be done and some sacrifices had to be made from an application deployment standpoint – deciding what is the optimum scenario to run a mobile application and what is the acceptable scenario,”” he said.

The integrators — SysteMagic Software Solutions Inc. — helped speed things along, he adds, by running the first phase of the project outside the hospital so they could start training nurses and doctors before the actual deployment.

According to Watson, it’s the first time Microsoft has engaged in such a project. And while the vendor was interested in the opportunity to help the integrator in the project switch to developing on the .Net platform, it was also interested in finding out how difficult it would be to electronically enable a health care organization in a smaller, more manageable pilot project, said Watson.

“”The visionaries in the industry would say bedside computing is the future,”” he said. “”I know there are some trials at Sick Kids and other hospitals around bedside computing, but this takes that to next level in terms of mobility.””

At the same time, though, he added, “”I know it puts another learning demand on already taxed health care professionals, so while there may be a productivity gain in the end, what does it mean in the short term to people who are trying to adopt new technologies?”” he asked. “”We would support it just based on the content alone, but above and beyond that we think the learning in this, once it’s rolled out into the other hospitals and we have a full scale application in place, will be huge for us.””


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