TORONTO – A cancer surgeon at North York General Hospital has led the development of a new, digital platform – called MyJourney Health – that supports breast cancer patients, clinicians and healthcare administrators with an all-in-one app that facilitates their access to data.
On the patient side, the app automatically pulls data from their records in different systems to create a longitudinal chart that summarizes their breast cancer journey. Available on desktop and on smartphones, it can be used by the patient, for example, during encounters with clinicians in the community or with new specialists.
The benefit is that it provides an accurate summary for decision-making. “It saves a lot of time for everyone, and it means that clinicians don’t have to log in and out of different systems to get the information they need,” said Dr. Fahima Osman, the surgeon who led the development of MyJourney Health. “It puts the whole experience into a short story.”
Patients, too, have a detailed summary of their own experience at hand – on their smartphones, if they wish. They can use the data to understand their condition, to help with self-care, and to explain their issues to everyone from family members to specialists they may meet.
In doing so, the system automatically accesses numerous patient record systems – such as the Oracle/Cerner EHR at North York General and the Mosaic cancer care system at nearby Sunnybrook Health Sciences, where many of NYGH’s patients go for radiation treatment. It can also access other hospital information systems, such as Epic and MEDITECH.
“It’s vendor agnostic, and it’s not an electronic patient record,” said Dr. Osman. “It’s middleware that accesses all of these systems, with the patient’s permission.”
MyJourney accesses scheduling systems and loads appointments into the app in real-time – soon after an appointment is made, it shows up in the patient’s app and in her calendar. “That saves time, because patients are often calling by phone to find out the date of their next chemo or radiation appointments,” said Dr. Osman.
It’s helpful for nurses and physicians, too, who can use the system to track when their patients have appointments. It also tells them when the patient has completed a specific test or treatment.
“That’s important, because often a patient can’t be scheduled for surgery until she has had certain tests or chemo or radiation,” said Dr. Osman. “Clinicians spend a lot of time phoning around for this information. Now, it’s automatically sent to MyJourney.”
She observed that cancer nurses at North York General Hospital each treat about 100 patients each month. Tracking their appointments by phone is a heavy burden; with MyJourney, the system will do the tracking for them.
MyJourney also automatically collects statistical data that must be sent to Cancer Care Ontario on a regular basis.
At most hospitals, this is a heavily manual task, with figures ultimately tracked in Excel spreadsheets by nurses and clerks. MyJourney is doing the work for them, reducing the need for clerks and enabling nurses to focus more on patient care.
For its part, NYGH’s breast cancer program is accredited under the National Accreditation Program for Breast Centers (NAPBC), a quality program administered by the American College of Surgeons. Indeed, it is the first and only Canadian hospital to have earned this designation.
To maintain its status as an accredited breast cancer centre, it has to report regularly to the NAPBC. This data, too, is now being collected automatically by MyJourney.
Dr. Osman noted that with the system aggregating so much data, it will soon be used to make predictions by applying smart algorithms. “It will be able to look at various types of diagnostic data and tell us which cancer patients are likely to have complications in the future,” she said.
Clinicians can use these insights to more closely monitor the patients and to offer specific tests to detect problems when they are more easily treatable.
MyJourney contains a wealth of educational information for breast cancer patients. It also contains checklists, advising them about what they need to do or bring to hospital when they’re having chemo, radiation or other appointments. The information is customized for each patient – for example, whether she has triple negative breast cancer; it will educate her about what this means for her treatment and post-operative care. It provides practical information, too, such as where the patient can get a wig in her neighborhood, or where to find a nanny for childcare.
Some advanced features are in the works and will likely be rolled out in the fall. They include a component called the Multidisciplinary Cancer Conference Tool. It acts like an online tumour board and provides a secure space where specialists can discuss cases and decide on the best course of action for the patient.
MyJourney Health has been in development for 8 years and went live at North York General Hospital breast center in September 2022. The team is planning a bigger rollout at NYGH this summer. As well, Dr. Osman said the goal is to offer the system to other hospitals. Patients will be able to use the app for free, while hospitals will pay a licensing fee.
