Sledge George W, Miller Robert S, Hauser Robert
From Stanford University, Stanford, CA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; American Society of Clinical Oncology, Alexandria, VA.
Am Soc Clin Oncol Educ Book. 2013:430-4. doi: 10.14694/EdBook_AM.2013.33.430.
Patients, health care providers, and payers all have a similar interest in a health care system that is both efficient and intelligent. The attributes of such a system are widely recognized: we want a system that provides widespread access to consistently high-quality, science-based medical care; we want that system to be efficient, avoiding unnecessary waste, while delivering the right treatments to the right patients in a timely fashion; we want a system that allows us to both learn from our experience and generate new knowledge that will inform future treatment options; and we want a system that is compassionate and caring. What we want from a health care system often runs up against real-life obstacles and challenges: a fragmented delivery system, varying levels (or lack of) insurance, a growing burden of regulation and paperwork, and an increasingly complex understanding of tumor biology and the therapeutic approaches derived from this biology. New challenges are on the horizon-emerging genomic and imaging technology, with their enormous cognitive and data burdens, and a looming demographic challenge, where inadequate personnel resources face an aging population and an explosion of new treatments. Not all problems have technologic solutions, but many of the issues described above have potential solutions related to information technology. ASCO's CancerLinQ, described in this article, is an evolving attempt by the Society to improve the quality and efficiency of cancer care, while supporting education and research in the cancer field.
患者、医疗服务提供者和支付方都对高效且智能的医疗保健系统有着相似的兴趣。这样一个系统的属性已得到广泛认可:我们希望有一个能广泛提供始终高质量、基于科学的医疗服务的系统;我们希望该系统高效,避免不必要的浪费,同时及时为合适的患者提供正确的治疗;我们希望有一个能让我们从经验中学习并产生新知识以指导未来治疗选择的系统;我们还希望有一个富有同情心和关怀的系统。我们对医疗保健系统的期望常常遭遇现实生活中的障碍和挑战:一个分散的医疗服务体系、不同水平(或缺乏)的保险、日益加重的监管和文书工作负担,以及对肿瘤生物学和基于此生物学的治疗方法的理解日益复杂。新的挑战即将出现——新兴的基因组和成像技术,伴随着巨大的认知和数据负担,以及迫在眉睫的人口结构挑战,即人力资源不足要面对人口老龄化和新治疗方法的激增。并非所有问题都有技术解决方案,但上述许多问题都有与信息技术相关的潜在解决方案。本文所描述的美国临床肿瘤学会(ASCO)的CancerLinQ,是该协会不断发展的一次尝试,旨在提高癌症护理的质量和效率,同时支持癌症领域的教育和研究。