ASCO Past-President Anticipates a New Position With an Ongoing Goal of Advancing the Field of Oncology

A Conversation With Peter Paul Yu, MD, FACP, FASCO

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Peter Paul Yu, MD, FACP, FASCO

Peter Paul Yu, MD, FACP, FASCO

After an extensive national search, Hartford HealthCare has appointed ASCO Past-President Peter Paul Yu, MD, FACP, FASCO, as the first Physician-in-Chief of the Hartford HealthCare Cancer Institute. As Physician-in-Chief, Dr. Yu will be responsible for working closely and collaboratively with physicians and nurses who practice within the Hartford HealthCare Cancer Institute to ensure a single, elevated standard of world-class care for patients with various types and stages of cancer as part of the Memorial Sloan Kettering (MSK) Cancer Alliance. Dr. Yu will be jointly appointed at Memorial Sloan Kettering as Head of Health Informatics for the MSK Cancer Alliance. The ASCO Post recently spoke with Dr. Yu about his new position and other activities.

ASCO Reflections

Can you give us a wrap-up of your 2014–2015 ASCO presidency—with its theme of Illumination and Innovation: Transforming Data Into Learning—in terms of your expectations and how you feel the Society is positioned moving forward.

I thought of that theme by considering how we transform data in the oncology world into knowledge that ultimately enhances patient care. There are a variety of ways to think about the nature of cancer data, but more recently I have reflected on the pressing need to integrate two fundamental forms of such data.

One type of data is derived from the cancer patient’s care: the clinical details such as risk factors and diagnosis of cancer, the staging and development of a treatment plan, the treatment experience, and the resulting outcomes. Clinical data are captured in a variety of locations such as electronic health records, laboratories, and cancer registries. The second type of data derives from research laboratories that explore the molecular basis of cancer using systems biology and computational biology approaches as we explore the cancer genome and panomics in general.

One of the grand challenges facing oncology is the need to integrate these two data worlds. But that will only happen when organizations and institutions make a commitment to work together and share their data.

And that is the central mission of ASCO’s CancerLinQ program, which is designed to bring clinical data across the entire spectrum of care and store it in a centralized fashion so we can all access and learn from it. There are a few similar projects out there, such as ORIEN and GENIE, so I believe we are on the right path. Because of its dynamic structure and size, ASCO is well positioned to contribute to this evolution of integrating cancer data in support of rapid-learning health systems.

New Role

Congratulations on your new position as Physician-in-Chief of the Hartford HealthCare Cancer Institute. Please shed light on the Institute, and describe your position and your goals.

First, I’m very excited about my career transition to Hartford HealthCare Cancer Institute, an institution that truly represents the entire spectrum of health-care delivery in the United States. Hartford HealthCare comprises five hospitals, with foundation medical groups and large independent multispecialty groups as well as smaller oncology practices in the system.

It also represents a full range of care from the inner city and disadvantaged populations to suburban communities. So Hartford HealthCare has everything you would want to work with in developing a national model for a cancer care delivery system. And the administration is committed to making this institution a nationally recognized center in cancer care and research.

We’re also excited that the Hartford HealthCare Cancer Institute is the first charter member of the Memorial Sloan Kettering Cancer Alliance, and we will work collaboratively to assess the resources and capabilities of each of the system’s five acute care hospitals, identifying specific areas of focus.

One benefit of the Alliance is that it provided Hartford HealthCare with a nationally recognized academic partner to elevate us to a higher standard of clinical care and research. Moreover, the expanding Alliance re-engineers research and health-care delivery in the age of precision medicine, when research demands access to an expanded population base and where data integration and quality improvement are essential for implementation of precision medicine into clinical care.

It’s a transformative initiative to improve the quality of care and outcomes for cancer patients in community health-care settings.

Transformative Step

Given your expertise in big data and projects like CancerLinQ, do you feel we are nearing a place in which we are able to adroitly use these data sets in real-time clinical practice?

We are certainly making rapid progress with CancerLinQ, as we achieve clarity about the challenges we face in using big data and respond with solutions. We’ve invested a lot of sweat equity to reach our current level of sophistication. That said, we are in the early promising stages of culling valuable data from these massive banks of information and being able to deliver high-quality decision support in real time to clinical practices. As Bill Gates said, people overestimate what can be achieved in 1 year and underestimate what can be achieved in 10 years. I am confident that we will get there much sooner.

Trying to find ways to better use information technology to help us deliver better care became a large part of my work during my ASCO presidency. What has attracted me to Hartford HealthCare and Memorial Sloan Kettering Cancer Center is that same desire to create a new model for cancer research and delivery.
— Peter Paul Yu, MD, FACP, FASCO

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To get there, it will require the cooperation of oncologists not only to agree to take the time and effort to collaborate on this initiative, but also to be willing to change how they view their daily practice habits. It’s nothing short of a transformative step in oncology care, and it will be a stepwise process over the next several years.

The Interoperability Problem

Despite all the optimism about interoperability, our cancer care system is still fragmented, and electronic health records do not have the ability to “talk to each other.” What are your thoughts on this issue?

A quote from Dr. Paul Batalden fits here: “Every system is perfectly designed to get the results it gets.” Interoperability once again reverts back to the central issue of cooperation among various stakeholders and a commitment to share data. And it is a commitment that—for a busy oncologist—becomes a culture change. From team science to value-based medicine, we are dependent on each other’s contributions to obtain successful outcomes.

This week ASCO hosted its third Interoperability Summit, bringing together oncologists, nurses, vendors, federal agencies, and informaticists to learn about efforts to increase interoperability for precision medicine, value based medicine, patient-centered care, and survivorship. The technical issues regarding universally adopted standards for data capture and transmission are truly a big hairy problem, but the consensus is one that will be solved. The societal issues around building trust and engagement are even larger.

The goals of sharing and learning from clinical data are to help us deliver better, more accessible, and cost-effective care for our patients. The oncology community agrees on that; now we have to pull together and agree on collecting and sharing our data. 

Looking Ahead

Please share some last thoughts about your career moving forward.

I initially got involved with ASCO because I felt the organization provided a place where you could roll up your sleeves and take steps that moved the field of oncology forward. During that period, I began to realize the full potential that technology offers the cancer community. Trying to find ways to better use information technology to help us deliver better care became a large part of my work during my ASCO presidency.

What has attracted me to Hartford HealthCare and Memorial Sloan Kettering Cancer Center is that same desire to create a new model for cancer research and delivery. In today’s world, oncologists will need to re-invent themselves several times in their professional career as they respond to a rapidly changing world. For myself, ASCO has given me the means to explore and realize substantial personal growth and professional satisfaction for which I am indebted. ■

Disclosure: Dr. Yu reported no potential conflicts of interest.