For Patrick Anderson, the opportunity to work with an organization that’s doing groundbreaking work with immunotherapy to transform the way cancer is detected and treated was a dream come true. But along with the ability to build decision support capabilities with genomics to determine precise pathways comes quite a daunting problem: harnessing and managing unfathomable amounts of data. It’s enough to turn a dream into a nightmare.
Fortunately, Anderson doesn’t see it that way. In fact, when he came to City of Hope about a year ago, he knew the challenges he’d face as CIO, which included upgrading the entire infrastructure. And while it’s an ongoing task, it’s one he and his team have embraced. Recently, we spoke with Anderson about the “permanent optimization strategy” in place at City of Hope, how he’s using reinforcement to connect IT staff with patients and families, as well as clinicians, and how his past experience helped him build the ultimate toolkit.
- City of Hope’s “tremendous” growth
- Leveraging CAR T-cell therapy to “attack cancer cells”
- Challenges of being a research organization – “We’ve had to upgrade everything.”
- Data center modernization
- “We need to have highly available systems with excellent capacity.”
- Creating a new IT strategy
- Combining decision support with genomics to drive precision care
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED
It requires that whole body of science and care and research to deliver a really effective immunotherapy program. That’s what we’re most proud of here at City of Hope. Our research is the foundation for our success.
I have to build enough capacity for the infrastructure and for the applications to meet this overwhelming demand for our services. It’s been quite interesting as we’ve had to figure out how to prioritize and literally upgrade our entire portfolio of systems.
The organization is growing. We’re hiring. We’re expanding our research. We’re expanding our care. We’re opening up new clinics constantly, and so we need to be able to have highly available systems with excellent capacity. That’s really what I’ve been driving since I’ve been here.
We really want to build this decision support capability with genomics to drive this precision care for each and every one of our patients.
Gamble: Hi Patrick, thanks so much for joining us today. Can you give an overview of City of Hope?
Anderson: City of Hope has been around for over a hundred years. Back in the 1970s, they conducted research that led to the creation of synthetic human insulin. That really put the City of Hope on the map. Since then, they’ve been pioneers in cancer research and cancer care. As cancer has become more prevalent, City of Hope has been growing tremendously.
About three or four years ago, we had one single campus here just east of Los Angeles. Now we have 30 locations and we are building a new state-of-the-art campus in Orange County, California. Now, although we’re geographically in Southern California, we’re serving patients from all around the world in various ways, leveraging various telemedicine technologies as well as second opinions and so forth.
People are lining up to come here because of our advanced therapies and our advanced research, along with the hundreds of clinical trials we have. That’s why we expanded to all those locations in the last several years — we couldn’t handle the demand. In fact, we’re rebuilding our entire campus here in Duarte, which is a small town east of Los Angeles, and building another hospital and research and large clinics in Orange County because the demand is just tremendous.
Recently, we were named the highest ranked cancer center in the Western United States by US News & World Report. That’s amazing, because there’s some tough competition in the west coast with Stanford, University of California San Francisco, and University of California Los Angeles. They all have a great cancer centers. But we were also one of the founding members of National Comprehensive Cancer Network.
The challenge we have is with access. It’s really tough because we are above capacity. So we’re building a hotel. We’re building a new patient tower, a new medical office building, and a new clinic, all on this campus. We’re also building parking structures. Our campus plan is just on fire, and then you have the campus in Orange County. As you can tell, we are really making a huge investment to meet this demand. That’s what’s so exciting.
Gamble: Right. You mentioned receiving a high-ranking from U.S. News, which I’m sure was very exciting. What do you think has set your organization apart in such a competitive market?
Anderson: A few things. Number one, I think it’s our science and it’s our compassionate care. Our research organization is very large. We’re running over 500 clinical trials. Our scientists, our physicians, and our manufacturing facilities are all here on our campus. We’re doing a lot of work with immunotherapy. Basically, we harvest immune cells out of patients, take them to our factory, and program the actual cells from these patients to attack the specific proteins in cancer cells. We then take the cells we’ve reprogrammed and we infuse them back into the patient, and the patient’s immune system actually attacks the cancer. It’s called immunotherapy; you need very specific facilities to manufacture these cells.
Gamble: That’s really interesting. And it’s happening close by?
Anderson: It’s all there. We control it all. This immunotherapy, which is also called CAR T-cell therapy, is how we attack several cancers, including lymphoma, leukemia and brain tumors. It’s absolutely amazing. The science has been around for a couple of decades, but to perfect it has required a lot of science, a lot of research, and a lot of clinical trials, as well as the manufacturing facilities. It requires that whole body of science and care and research to deliver a really effective immunotherapy program. That’s what we’re most proud of here at City of Hope. Our research is the foundation for our success.
Gamble: That is very exciting, and hopefully is something we’ll start to see more of as researchers learn more about it. I imagine it’s really exciting to be part of an organization that’s a trailblazer.
Anderson: It’s really exciting. But it comes with challenges; because we have such a high demand — and we have to be able to meet that demand — and so we’ve had to upgrade everything. We migrated to Epic about a year and a half ago, and we literally had to our entire infrastructure. We had to upgrade all of our applications systems, because we’re growing so rapidly with all of these off-site clinics, and then the rebuilding of our entire campus.
From an IT perspective, I have to work on the science side and the precision medicine side. But I also have to build enough capacity for the infrastructure and for the applications to meet this overwhelming demand for our services. It’s been quite interesting as we’ve had to figure out how to prioritize and literally upgrade our entire portfolio of systems. So it’s pretty exciting.
Gamble: Definitely. Now, you’ve been with the organization for about a year, correct?
Gamble: What was your mindset going in, especially in terms of what needed to happen from an infrastructure standpoint?
Anderson: As we’re rebuilding the campus and growing our offsite locations to meet the demand, it really required a complete infrastructure upgrade. We had to start off with a data network modernization, and that means going into a hundred buildings and upgrading the data network so that we could support wireless and support all of the applications that depend on wireless.
Obviously, we had to connect all the buildings together. We had to do a data network modernization. Then we migrated all voice data and video to unified communications to bring all of those capabilities together. On the applications side, because of the growth, we’ve have to upgrade our ERP, and we’ve had to go in and optimize our EMR. We have five SWAT teams who are going in and optimizing clinical workflow.
We’re doing a complete rebuild of revenue cycle so we can we can optimize everything from registration and scheduling, all the way through to charge capture, billing, and everything in between. We’re literally upgrading our entire infrastructure. We’re upgrading our application portfolio as we work to create more capacity within the organization, because the organization is growing. We’re hiring. We’re expanding our research. We’re expanding our care into many locations. We’re opening up new clinics constantly, and so we need to be able to have highly available systems with excellent capacity. That’s really what I’ve been driving since I’ve been here.
Gamble: That’s a lot. It sounds like you’re talking about a 10-year span, not just one year.
Anderson: It’s interesting. When I got there, there wasn’t really a strategy for that. I had to bring an IT strategy to leadership. They accepted it, and they provided me the funding to upgrade everything we needed to meet this demand. I have to tell you, it’s been very exciting.
Gamble: It seems like it’s really a change in philosophy for the organization to bring someone in, have an assessment done, and providing the funding to be able to take things to the next level. That’s a big shift.
Anderson: It is. What’s interesting is simultaneously, the organization also has a considerable list of strategies. This is a very dynamic organization. We’re continuing to drive science and precision medicine to all new heights. We have a very sophisticated genetics lab in Phoenix called Translational Genomics Research Institute (TGen).
Our strategy is to do the full human DNA genome for every one of our patients so that we can we can actually do precision medicine against every individual and make sure they have the absolute best outcome. We’ve put a small leadership team together to drive this forward, and it’s two-fold. We want to be able to do early detection and prevention of cancer, while also leveraging the research out there so that if you have a cancer patient and you do the DNA sequencing or the full DNA genome, you can go in and determine if that patient is susceptible to the different types of cancer. Not just that, but you know exactly what type of cancer it is, and through the research and the databases, you can provide the absolute precision pathway and care for that patient.
We really want to build this decision support capability with genomics to drive this precision care for each and every one of our patients. At the same time, we’re leveraging our lab in Phoenix and our science and research here in California to drive this new precision medicine capability for City of Hope.
Gamble: It’s really fascinating when you’re talking about being able to use that sequencing to determine if there is susceptibility to certain cancers, but you’re talking about so much data.
Anderson: Right. Meeting that expertise working with the data is a real challenge. The full genome is like five terabytes of data for a patient, which is just massive. You really need to be able to develop expertise in working with that data and combining it with decision support tools so that we can develop the precision medicine program of the future. That’s really what we’re working on here as we continue to do all of our research, and take care of the increasing demand of patients.