Do we have a clear, practical plan for 2004, including milestones and deliverables

1
Do we have a clear, practical plan for 2004,
including milestones and deliverables?

• John Fox, Tony Rose and Vivek Patkar

2
Basic requirements

• Objectives for 2004 agreed
• Deliverables
• Platform
• Content
• Quality/safety strategy
• Reporting and documentation
• Milestones
• Responsibilities and ownership of deliverables
  are clear

3
Agreed project scope

• Patient journey
• Detection, work-up, treatment and follow-up
• Range of services
• Clinical, patient and communication services
• See document archive CREDO-2003-026
• One system, multiple views (patient, GP, surgeon,
  medical oncologist, clinical oncologist, nurse
  practitioner etc.)

4
Triple assessment

• First prototype already implemented (CH)
• Refined version early 2004
• Guys testing Spring 2004
• UCSF would like version early in 2004 for testing
• Addenbrookes may require different version,
  integrated with JCIS and oriented towards MDM
• VP to work with Breast Unit to establish clinical
  reqs
• CH to work with JCIS group re technical reqs

5
Cancer genetics

• Various prototypes in existence
• RAGs family history and risk assessment
• Simple Guys risk assessment
• NY testing protocol
• REACT planner
• CREDO version requires discussion with clinical
  partners, may involve several versions for
  different settings

6
GP breast care support

• ERA study carried out in Leicester by Jon Bury
  with InferMed, NHS IA (inconclusive)
• Guys version
• Baseline study in progress (VP)
• New prototype to include support for management
  in practice (both for non-referred patients and
  discharged patients)
• Addenbrookes version?
• UCSF version?

7
Clinical Evidence Interactive

• BMJ/InferMed has developed a section of CE
  dealing with Breast Cancer
• InferMed willing to share this (subject to
  agreement of BMJ Publishing)

8
Dataset definition

• Define core dataset for patient journey (SIGN?)
• Concept (e.g. tumour size, BrCa1)
• Type (e.g. integer, text)
• Repeating/non-repeating (no/yes)
• Work incrementally towards complete reference
  definition as services are developed
• Mission critical!

9
Other requests and opportunities

• Pathology services (Guys)
• Systemic therapy management and planning (Guys)
• Support for imaging thru journey (Addenbrookes)
• Multi-disciplinary meeting (Addenbrookes)
• Treatment planning (c.f. Adjuvant!) based on
  REACT (UCSF)
• Patient-centred decision support (UCSF)
• Palliative care (Guys, with Robert Dunlop?)
• Subject to manpower availability!

10
Tallis platform development

• Priority improvements to authoring, testing and
  delivery capability
• Creation and maintenance of CREDO content
  repository
• Creation of clinical infrastructure (APIs,
  interfaces etc.)
• Later talks will deal with this

11
CREDO architecture (illustrative)
Clinical UI
Special services
12
Deliverables 2004

• Fully populated, demonstration quality, web-based
  demonstrator (professional view)
• Prototype services (TA, Genetics, etc.)
• Research database and infrastructure
• Documentation and trial design
• Papers for submission
• Proposal to CRUK Development Committee

13
Milestones 2004

• Fully populated demonstrator (80 prototypes)
• Dataset definition version 1
• Service prototypes for phase 1 trials
• Triple assessment
• Cancer genetics (assessment and management)
• GP breast care support (including ERA-type
  service)
• Other service trials subject to available
  manpower
• Develop patient view
• Develop communication model

14
Presentations

• 1. Do we have a clear, practical plan for phase
  2, including milestones and deliverables? Review
  John Fox, Tony Rose and Vivek Patkar
• 2. Is the Tallis/PROforma authoring system
  adequate to build and test pilot applications
  (e.g. triple assessment, genetic risk
  assessment)? What problems need to be given
  priority for resolution during 2004? Review
  Chris Hurt, Vivek Patkar and Ali Rahmanzadeh
•  
• 3. Will the Tallis delivery software (engine, web
  server, clinical middleware etc.) have sufficient
  functionality, performance and resilience to
  permit test trials to be successfully carried out
  at Guys, Addenbrookes and UCSF during 2004? What
  issues need to be addressed on what timescales
   Review Rory Steele, Tony Rose
• 4. Can we be confident of meeting any
  infrastructure needs that will arise during 2004
  (e.g. secure patient data capture, clinical order
  entry, messaging) and anticipate being able to
  solve infrastructure needs for a clinical
  strength system during phase 3 of the project
  Review Ali Rahmanzadeh, Tony Rose, Liz Hurt
• 5. Will we be in a position during 2004 to plan a
  full CREDO trial starting 2005 (ethical
  permission, trial design, governance) and if not
  what are the major problems to be addressed?
  Review John Fox, Chris Hurt, Vivek Patkar
•  
• 6. Do we have sufficient staff to provide
  adequate manpower to support our clinical
  partners during pilot trials during 2004 (eg. for
  customising triple assessment and integrating
  Tallis into the local infrastructure)? If not,
  what are our options? Review Tony Rose and John
  Fox
•  
• 7. Other questions and issue. Review John Fox
  and Tony rose