Partnering to improve outcomes for high-risk breast cancer patients
The Hamilton Health Sciences (HHS)’ Centre for Data Science and Digital Health (CREATE) is partnering with cancer genetics expert Dr. Andrea Eisen to expand the hospital’s artificial intelligence (AI) Learning Health System for Breast Cancer to include genetics information from patients.
“By including genetics, we’re opening up an incredibly powerful resource to ask critical questions about how our system is doing at delivering care, and the quality of the outcomes we’re getting.” –– Dr. Jeremy Petch
Eisen, who joined HHS last summer, is a leading expert in cancer genetics and high-risk breast cancer. She’s providing expertise from a medical perspective, while the CREATE team provides the technical knowhow. CREATE is staffed with experts in software engineering, AI and data sciences, all with a niche specialty in health care.
“We’re looking at using the Learning Health System to, for example, identify people diagnosed with breast cancer who might have benefitted from genetic testing but weren’t offered it,” says Eisen. “For instance, the criteria for qualifying for genetic testing may have been more restrictive when they were diagnosed. Or they may have felt that the timing wasn’t right because they were in the middle of treatment.”
Dr. Andrea Eisen
Eisen is the Buffett Taylor Chair in Breast Cancer Research, a position previously held by retired HHS medical oncologist and renowned breast cancer researcher Dr. Mark Levine.
CREATE-ing and expanding the Learning Health System
Several years ago, before Levine retired, he reached out to CREATE with the idea to develop an AI-driven learning health system, using records from JHCC breast cancer patients, in order to better understand this population and drive improvements in care. The system uses AI to rapidly collect, sort and interpret patients’ medical information, providing HHS doctors, leaders and researchers with data they request in real time.
The AI database currently includes diagnoses, scans, tumor pathology, demographics, social determinants of health, medications, treatments, surgeries and survivorship. Prior to this platform, it took months or even years, to search for and collect data to determine, for example, if certain patient groups faced barriers to care. Using AI, this information can be gathered and made available almost instantly.
The CREATE team is now building genetics into the system, with Eisen providing the clinical leadership as a medical oncologist and leader in cancer genetics and high-risk breast cancer. “Currently we can’t, for example, use this platform to look at the care for all HHS patients with the BRCA genes,” says Dr. Jeremy Petch, CREATE’s director.
BRCA1 and BRCA2 are the most common genes associated with hereditary breast and ovarian cancer. The risk of developing breast cancer is about 60 per cent for patients with these genes. The chances of being diagnosed with ovarian cancer is as much as 40 per cent for BRCA1 mutation carriers and up to 20 per cent for BRCA2.
By identifying people with BRCA genes early, they can take preventative measures such as surgery to avoid getting breast or ovarian cancer.
“By including genetics, we’re opening up an incredibly powerful resource to ask critical questions about how our system is doing at delivering care, and the quality of the outcomes we’re getting,” says Petch. “This means we can take a much closer look at this patient population, to help ensure they receive the care they need.”
Eisen, Levine and the CREATE team secured a grant from the Canadian Cancer Society to expand the system to include genetics information from HHS patients. It’s also expected to include data from St. Joseph’s Healthcare Hamilton, since some breast cancer patients receive care from both hospital systems. For example, a patient may receive cancer surgery at St. Joe’s and chemotherapy and radiation at HHS.
“By populating the platform with data from both hospital systems, we’ll have a more a complete, comprehensive picture of all of our patients’ breast cancer journeys,” says Petch, adding, “This will provide us a lot of very powerful insights, that will, in turn, drive improvements for breast cancer patients across our city’s health care system.”
