A GROUNDBREAKING software innovation project to help those in general practice risk assess for familial breast cancer has reported strong progress in its initial deployment phase and has useful tips to share, an evaluation has showed.
The initial evaluation report provides a thorough overview of literature, current tools and findings, and shows 100% approval among parties receiving the tool.
The software project, based in the East Midlands, UK, helps general practitioners with decision support to improve identification and referral of women in specialist and primary care.
GPs are able to use the tool to identify those at population risk who do not need a secondary care review, and those who need to be referred in to specialist care.
The project, a link between the East Midlands Academic Health Science Network (EMAHSN), FaHRAS, the University of Nottingham and local Clinical Commissioning Groups (CCGs), is seeking to improve referral referral pathways for cancer and promote early detection in those who are at increased genetic risk that are without symptoms, particularly in areas of unmet need. This is expected to provide increased robustness to the pathway with complimentary cost benefits.
One practice manager is reported as saying: “It is a great step in the direction of collating family history”, while another user says that it “Helps primary care to navigate complex…algorithms”.
The initial literature review uncovered that 95% of GPs surveyed were either a little or not at all confident to calculate the associated risk of breast cancer. In addition, an estimated 20-50% of patients referred from primary care did not meet criteria indicating that secondary care review was necessary, as perceived for breast cancer risk.
The literature does note that while no one model appear to be able to totally distinguish between those who do and do not have gene mutations and those who will or will not develop breast cancer, objective means of risk classification is essential to inform clinical management desicions.
The report also looks at staff and patient feedback, barriers experienced and key drivers.
“A key part of the evaluation was packaging up our lessons learnt and building them in to future improvements. It is also hoped we can help others successfully implement innovations in the healthcare setting through these shared learnings” said Eric Robertson FaHRAS sales manager.
Feedback was gathered between May 2017 and December 2018, across 13 GP practices as part of the project feedback cycle. This was important to promote effective deployment of the innovation and encourage proactivity.
The FaHRAS software developer reported: “Integration of the tool into GP medical systems would be highly advantageous but this would also rely on family history being taken in a proactive, [routine]way.”
A section on top tips is aimed at spreading understanding and knowhow when operating in an innovative setting. Importantly it identifies clarity is needed early on when assessing the case for need of a system, patient views must be reflected in the product and how an understanding of the underpinning data and it’s availability is essential to crafting a successful innovation.
The team is currently working hard to spread the technology throughout the NHS and package improvements to the pathway in a sustainable, forward thinking way.
Notes / Contact points
FaHRAS, a University of Nottingham Spinout company based in the East Midlands, hopes to improve service and reduce costs to the NHS with cancer pathway decision support tools.
East Midlands Academic Health Science Network (EMAHSN)