Nurses Leslie Kronberger, Susan Dowman, Judy King and Katie Hudson worked with oncology patients before joining Philadelphia-based health information technology company eviti, Inc., where they and other nurses are helping create one of the most comprehensive online evidence-based medical oncology libraries.
Evitis evidence-based medical library contains information on more than than 2,000 cancer treatment regimens and more than 10,000 clinical trials. It is at the heart of eviti Advisor, an online decision-support tool for the treatment of oncology patients.
Kronberger, Dowman, King and Hudson have played instrumental roles in building and maintaining the online library, along with nurses Ali Barrows, RN, OCN, and Robin Walker, RN. The nurses come from different areas of the country and work remotely, but Kronberger and Dowman live in New Jersey near Philadelphia.
Kronberger, RN, OCN, has been a nurse for 22 years and worked in radiation oncology before coming to eviti, then known as ITA Partners, in 2008. She started as an oncology case manager but has been a knowledge-base manager for almost five years.
Loving the clinical area the way I did, I was a little torn, and I was a little skeptical when I was planning to interview because I thought, I hope theyre as a true as they seem to be, Kronberger said. I was so impressed, [I thought], Where do I sign?
Reviewing cancer researchJudy King, RN
Kronberger and her fellow knowledge-base managers review scientific articles that are evidence-based for cancer treatment. They then build chemotherapy or radiation regimens around those articles for the EBML. Each regimen is carefully reviewed by other nurses and Chief Medical Officer William Flood, MD, before it is included in the EBML.
Dowman, BSN, RN, OCN, was a nurse for about 20 years, including 14 years exclusively treating cancer patients, before coming to work for the company seven years ago. She said the EBML gives doctors and nurses access to the latest information on clinical trials and treatments, which didnt exist when she dealt with patients.
You are able to look at a library of cancer treatments by putting in the pathology and staging, she said. You are seeing immediately what’s available and appropriate.
King, RN, who worked as a study coordinator for oncology trials before coming to eviti three years ago and has 42 years of nursing experience, said each regimen must be endorsed by at least one and preferrably two or more of the consensus groups used by eviti, including the National Comprehensive Cancer Network.
This is an independent company, King said. In other words, theyre unbiased. Theyre not supported by drug companies. Were not obligated to put any regimen in there, no matter what. We only put in what is evidence-based.
Like King, Hudson, BSN, RN, OCN, worked in clinical trials before coming to eviti in 2008 as an oncology case manager. Hudson said not only has the EBML grown over the years, but also it has become more user-friendly. Its the kind of tool she could have only dreamed of when she was working with patients.
When she was an oncology nurse, she performed her daily tasks such as giving chemo treatments or administering medicine, but often did not fully understand the research or rationale that went into those decisions.
Any nurse in a doctors office will tell you theyre too busy to look at all this stuff, said Hudson, a nurse for 22 years. This gave me a whole new way of looking at everything. You can look at the paper yourself, but right in front of you [with eviti Advisor] you see the outcomes and toxicities. You can compare regimens side by side.
The online tool also shows estimated costs of regimens as well as possible side effects of drugs, which allows oncology physicians and nurses to better prepare their patients for what they might be facing from both a financial and a health standpoint.
Once a regimen has been added to library, it still can be revised or deactivated based on ongoing review of trials presented in peer-reviewed literature, major oncology meetings throughout the year and updates to guidelines produced by national government agencies, oncology organizations and national consensus groups.
While the work may not be as hands on as patient care, the nurses realize they are creating a valuable tool.
If the person is not getting the right treatment, the patient is going to suffer, Kronberger said. After that, family members anyone close to that person are going to suffer. The provider is going to suffer. If the payer starts to question why theyre doing something thats incorrect, theyre not going to get paid. The whole focus of eviti is like this win-win-win [situation] for everybody.
Tom Clegg is a freelance writer.