The most recent ASCO annual census, completed by 80% of its members, showed that 68% have robust EHRs with oncology functionality to support data gathering and exporting. “The next battle to win,” he said, is “to get consistent data to get quality data,” given the variables: a variety of vendors, lack of standardization, different software versions, and how EHRs are actually used.

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CancerLinQ benefits to members will include, for example, reports that benchmark their practices. One such report might show a drug or a test costs more within one practice than another, information that “is an important quality-improvement strategy.” ASCO may also publish de-identified data based on requests from researchers. All requests will be reviewed from the standpoint of whether they are scientifically meritorious, ethical, and have institutional review board approval.

Other opportunities include collaborating with external agencies. “We’ve spoken to the FDA and they are very interested in this. Postmarketing is a big black hole for them.” Once a drug is approved and goes into widespread use, patients receiving the drug are “quite a bit different than in the clinical trial.” In fact, “most would not have met the requirements for the clinical trial” due to comorbidity, degree of renal insufficiency, or the need to be on concomitant agents, Dr. Yu added.

Pharmaceutical companies are also interested in how their drugs are being used; for example, are side effects higher in certain populations?

Dr. Yu said that after the responses to the RFP are reviewed, ASCO will reassess how much it can afford and therefore, how fast the project can go. The goal is to test the first model in a number of practices by the end of 2014, and to launch in a limited number of practices as development continues, with data available in 2015.

He explained that he was not at liberty to reveal the cost of CancerLinQ, in part because many parameters remain unknown; as of November, ASCO had raised $7.8 million. “We hope eventually that this project will be self-sustaining,” he said, including from development of revenue-generating commercial products. “We do not expect members to pay for this, but have to consider all options.”

CancerLinQ emanated from a workshop held by the National Cancer Policy Forum of the Institute of Medicine in 2009 and is based on the research of Lynn Etheredge, PhD, who created the phrase, “rapid-learning system.” Writing in the Journal of Clinical Oncology in 2010, Dr. Etheredge, director of the Rapid Learning Project at George Washington University, Washington, DC, and colleagues envisioned “a cancer-focused rapid-learning system that makes practical use of rapidly growing electronic health data repositories, such as electronic medical record systems, disease registries and databases, to hone in on what works best for individual [patients with cancer],” according to the Robert Wood Johnson Foundation, which has supported Dr. Etheredge.

Dr. Yu wrote in an item posted on ASCO Connection, “for CancerLinQ to succeed, the entire oncology ecosystem will need to contribute data, including…pathway developers and payers. We will need to re-think and accept new concepts such as patient-centered outcomes. There is no point in building CancerLinQ to ossify what we are already doing.”

For more information about ASCO CancerLinQ™, visit http://www.asco.org/quality-guidelines/cancerlinq.