During The American Society of Breast Surgeons’ (ASBrS) annual conference, CRA co-founder and Professor of Surgery at Harvard Medical School Dr. Kevin Hughes presented on the future of breast cancer prevention. Dr. Hughes described his vision of the use of electronic health record (EHR) systems for care coordination in high-risk programs. He discussed how the EHR can help collect patient information essential to identifying the best care pathways for individual patients.
According to Dr. Hughes, the EHR has shifted from being the doctor’s adversary to their ally by providing key clinical information that enables breast images to team up with surgeons, OBs, oncologists, and other providers to care for high-risk patients. The EHR’s ability to collect a comprehensive and up-to-date electronic patient history in many different clinic types provides doctors across multiple care settings with access to the same vital information as they make medical management decisions. This allows breast care to be personalized for each patient without requiring extra work from providers.
Clinical decision support tools, such as those offered by CRA Health (recently acquired by Volpara Health), can take advantage of the information stored in EHRs. The EHR can help raise the standard of care by automatically running breast cancer risk assessments and returning results with recommendations to doctors based on local and national guidelines. These recommendations could include essential supplemental screening after a mammogram or a recommendation to receive genetic testing for the BRCA mutations, both of which can help reduce the burden of breast cancer.
In general, genetic testing is on the rise. Until recently, this kind of test was only administered to the highest risk patients and was only done by genetics professionals. Today, genetic testing is more easily facilitated by EHRs. However, Dr. Hughes says taht despite better access to genetic testing, 90% of BRCA-positive patients who have not developed breast cancer remain untested and unaware of their genetic mutation and the increased risk it brings them.
MRI exams are also being administered at a level far below what guidelines dictate — rather than the 100-150 follow-up MRIs that are recommended for every 1,000 mammograms conducted, centers are only setting up 3-4 MRI exams for every 1,000 mammograms.
As breast health focus intensifies on cancer prevention, risk assessment has begun to close the gap between those in need of genetic testing and supplemental breast screening and those offered it. The recent inclusion of breast density into the latest Tyrer-Cuzick risk model has helped to increase the number of patients receiving life-saving care that catches cancers earlier and at a more treatable stage.
To learn more about the central role EHRs can play in identifying more high-risk women for essential cancer prevention, watch Dr. Hughes’ full talk at the link below.