Advanced Oncology Certified Nurse Practitioner Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
BACKGROUND Precision medicine continues to be an area of focus and growth in oncology. With the ever-expanding world of biomarker testing and variant assessment, oncology nurses and advanced practice providers (APPs) are in need of educational resources and clinical decision support tools (CDS) to help provide current and evidence-based care to oncology patients. The Oncology Nursing Society (ONS) Biomarker Database was developed by oncology nurses, the majority of which were APPs, who are members of ONS and considered experts in their specialty areas. This CDS is specifically developed for oncology nurses and providers.
METHODS A baseline survey of 700 ONS members conducted in early 2020 showed 45% did not feel confident talking to their patients or the healthcare team about genomics. This led to strategic planning and the identification of a gap in nursing practice that a biomarker point-of-care tool could fill. The Biomarker Database development started in April 2021. Subject matter experts were recruited through a volunteer application via the ONS Communities platform. Group discussions among experts and focus groups affirmed content to be included about each biomarker and cancer type based on current evidence. Once content was written, it went through a double peer review by additional experts and content consensus was reached by the panel.
RESULTS The database was developed in response to a clear need for a comprehensive and evidence-based precision oncology CDS tool for oncology nurses and APPs. Each biomarker entry in the database includes information on the mechanism driving cancer growth, required testing, specific targeted therapies, available clinical trials, and implications for patient care. Data can be viewed by searching individual biomarkers, and then sorted by cancer type, or by searching a specific cancer type and viewing all biomarkers associated with that disease. The Biomarker Database was launched on June 8, 2022. Since launch the site has seen an overwhelming positive response from oncology nurses with over 2,000 unique users accessing the database between June 1, 2022 – July 13, 2022, as well as over 10,000 views. As the tool is rolled out, end-users will be surveyed to measure usability, satisfaction, relevance to practice, and reported practice outcomes, to further focus and adjust the CDS.
SUMMARY The Biomarker Database is a user friendly, content filled, first-of-its-kind CDS developed for oncology nurses and APPs. It currently includes 5 cancer types and over 100 biomarkers. The CDS tool content will be maintained and updated quarterly to stay up to date with new advances and evidence. By the end of the first quarter of 2023, the database is planned to contain approximately 25 disease sites associated with 250 biomarkers.
RECOMMENDATIONS We recommend oncology nurses and APPs use the Biomarker Database for personal education and growth, when educating patients on biomarker testing results, when discussing appropriate treatments and referrals based on biomarkers, etc. To access the ONS biomarker database: https://biomarkers.ons.org/.
