BIO20-026: A Digital Solution to Enable Improved Implementation and Usability of NCCN Guidelines®

Background: NCCN Guidelines® are the most commonly accepted guidelines in the US and globally (Downloaded in 180+ countries in 2018). They document evidence-based, consensus-driven management to support decision-making along cancer prevention, diagnosis, treatment, and supportive services. Since their inception, however, the number, scope, length and detail has increased significantly. The increased complexity and regular updates have created challenges for clinicians to be up to date. Solutions are needed to improve usability. Methods: Semi-structured interviews with clinicians (regular users of the guidelines) were used to identify key needs for clinical users. Expert representatives from the NCCN provided further input. A set of key product requirements were established and used to develop the NAVIFY® Guidelines application. An initial usability evaluation was performed following the principles of time-driven activity-based costing approach (TDABC) to compare current approach (defined by an experienced community-based oncologist) versus using NAVIFY® Guidelines application. Results: The NAVIFY® Guidelines application provides a tree and step view of the current guidelines. It has been designed to facilitate navigation, real-time capture of clinical decisions, incl. reasons for deviation from guidelines. The output can be recorded in the application, sent to an EMR, or saved as pdf files, which could facilitate communication with patients and payers. In the existing scenario of NCCN Guidelines® utilization, proposed by an experienced community-based oncologist, the legacy approach required 9+ key steps, the involvement of 2+ users (oncologist, administrator), 2+ switches between users, and an estimated 24 hours of time-to-communication-ready. Conversely, using the NAVIFY® Guidelines application, it required 3 key steps, 1 user, no switches between users, and no requirements to print & scan. Conclusions: The NAVIFY® Guidelines application has been developed to enable clinicians to apply the latest recommendation, improve the documentation of decisions and ultimately to facilitate better communication between specialists and with patients. Preliminary research has shown that NAVIFY® Guidelines application reduced steps, switches between users, and time to communication-ready. These benefits could reduce accumulated risk, support patient safety, and increase operational efficiency. Evidence generation efforts are ongoing.

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Corresponding Author: Chaohui Guo, PhD
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