In the face of a novel disease like COVID-19, established approaches to gathering, studying and applying medical data can be dangerously slow.
In this episode of the “Real World Talk with COTA” podcast, we spoke to Dr. Andrew Pecora, COTA’s founder and Executive Chairman, about the impact of COVID-19 on cancer patients and how COTA’s data analysis has helped federal agencies respond to the pandemic.
Healthcare spending is increasing every year in the US, thanks to more new therapies and higher than average lifespans. But the system that money is flowing into is inefficient.
“Work done by former COTA board member Donald Berwick, MD and others showed that we may have been wasting $1 out of every $3 in the application of healthcare,” Dr. Pecora says.
Dr. Pecora has long been an innovator when it comes to biological problems, especially in oncology.
When he joined a team examining the growing cost of care, he realized a piece of the puzzle was missing: RWD.
Explaining COTA’s new take on data, he gives the example of car services like Uber and Lyft.
The value of ride-sharing services lies in their ability to serve each rider exactly what they need, when and where they need it, at the touch of a button, while also providing specific real-time information and at a fixed price.
“We have nothing even close to that in healthcare, and that's your life,” Dr. Pecora says.
In 2011, COTA began developing the COTA Nodal Address (CNA) to gather, organize, and make sense of EHR data, including treatments and outcomes. The CNA creates a “digital code” for each patient’s cancer journey, so that it’s easy to group your patients and see unwarranted variation in treatment plans, outcomes, and costs.
“If we're going to change healthcare at scale, we have to have a practical solution at the point of care that can be utilized by physicians, healthcare administrators and payers,” Dr. Pecora says.
Many people going through cancer treatment are immunosuppressed, making them more vulnerable to catching the virus in the first place and more likely to have worse outcomes.
Another problem is that many people with cancer are now so scared of contracting COVID-19 that they’re delaying doctor visits for diagnosis and treatment.
As oncologists know, the longer a tumor goes undetected, the further it can progress, and the harder it becomes to treat.
“In my own practice, I have seen several people presenting with way more advanced cancer than they otherwise would have had this COVID-19 problem not existed,” Dr. Pecora says.
The COVID-19 pandemic is also causing problems for oncology practices.
With patients staying away from clinics, revenues have dropped significantly. This affects those clinics’ abilities to help their patients.
“Running an oncology practice is very expensive,” Dr. Pecora says. “The overhead is extensive, the cost of drugs is high. Having readily available, well-trained, dedicated people is very difficult.”
For example, early in the pandemic, when the Northeast was the epicenter in the US, the number of new patients seeking treatment at cancer centers dropped by about 75 percent.
“Cancer programs were trying to support their infrastructure costs with only 25 percent of the patient volume we’d otherwise expect,” Dr. Pecora says.
And speaking of dedicated staff, convincing people to keep showing up to work to treat potentially COVID-19-positive patients has also become a challenge.
“They really are heroes,” he says. “They're risking their lives: They're face-to-face with patients with COVID-19 that need chemotherapy.”
The pandemic is affecting individual cancer patients in a terrible way, but it could also have a long-term impact on the way oncologists are able to provide treatments.
Faced with a novel virus, researchers need quick answers about what they’re dealing with and how to treat it.
While academic and government institutions slowly plow through traditional methods, COTA’s data analysis puts it in a unique position to provide immediate insights.
“We realized that with COTA's ability to abstract massive quantities of data in a very short period of time, we might be able to find some answers to these questions,” Dr. Pecora says.
Thanks to the hard work of many people on the front lines collecting the data, COTA was able to leverage its advanced analytics capabilities to provide their findings to FDA and the CDC faster than peer-reviewed methods.
The results were so useful that COTA was invited to join the COVID-19 Evidence Accelerator established by the Reagan-Udall Foundation for FDA and Friends of Cancer Research.
“We were able to show things far in advance that allowed FDA, CDC and other government agencies to think about setting policy,” Dr. Pecora says.
It’s COTA’s ability to provide a fast, data-driven response to this and future public health crises in real-time that Dr. Pecora believes will make it an essential tool in healthcare one day.
Of course, it will take a while for the various cogs in the healthcare machine to get used to a new way of doing things.
“It’s a tipping-point strategy,” he says. “You've got to fix the pieces one at a time.”