ideasIdea
Live guideline-concordance dashboards for every tumour board, generated from the record
Hospitals rarely know what fraction of their patients got the recommended treatment. Software reading the electronic record can show each team, every month, where care deviated from guidelines.
Guideline adherence varies widely between hospitals and is usually measured years later by registry studies. Structured oncology data (mCODE-style) and rule engines encoding guideline pathways make near-real-time concordance measurement possible. Each multidisciplinary team would see its own concordance by tumour type and stage, with justified deviations flagged separately from unjustified ones, and could compare against peers.
Hypothesis
Teams receiving monthly concordance feedback will increase guideline-concordant treatment by at least ten percentage points within a year, with the largest gains in centres starting below the median.
Rationale
Audit and feedback is among the best-evidenced quality interventions in medicine; the barrier in oncology has been the labour of abstraction, which structured data removes.
What would test it
A cluster-randomised trial of dashboards across 40 hospitals with registry-verified concordance and survival as endpoints.
Maturity
early clinical
Who has to act
data
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
- Knowledge reaches practice too slowly · Knowledge diffusion is slow: it takes years for a proven result to change what most patients receive, and no one can keep up with the literature.
- Data silos · Records, scans, genomes and outcomes sit in separate systems that cannot talk. Every patient's experience is lost to the next.