Who, what, when…and especially where: Why care settings matter for representative real-world datasets

A vast majority of cancer patients’ care starts with a visit to a primary care provider for a routine screening or consult for a worrisome symptom.  They may visit a local hospital or health system for testing and initial review by a specialist – but from there, the care pathway could take several different routes.

Approximately 80% of patients will remain in the community care setting for their cancer treatment.  But the other 20% will seek care at an academic medical center (AMC), whether they’re fortunate enough to live near one or have the flexibility and resources to travel to one.

Research has established that care settings have an influence on patient experiences, outcomes, and healthcare spending.  Many studies indicate that treatment at teaching hospitals and centers of excellence is associated with lower mortality, although patients that value personalized experiences, greater accessibility and flexibility may fare better in the community setting.  Additionally, many of the specialized cancer treatments such as stem cell transplants, CAR-T and BiTE therapies are only available in specialized centers. 

However, the delineation between care settings is not so cut and dry in the real world due to  the “spillover effect” of community practices and hospital being located in close proximity to an academic medical center, as well as the fact that M&A activity is rapidly shifting the traditional definition of community care, merging smaller facilities into larger community and academic networks.  

These patterns matter when developing  diverse and representative real-world data (RWD) that will be used to support the development of a new therapy or a study into the uptake, safety, and effectiveness of therapies in the post marketing setting, because new care strategies don’t always filter down consistently into the real-world practice setting.

The uneven distribution of care and resources can create challenges in our understanding of treatment utilization, adherence, and outcomes across disparate patient groups and pose continued obstacles to equity initiatives.

And from the business development viewpoint, life science companies need to know when, how, and where their therapies are being (or not being) used – and they also need to understand where the opportunities lie to expand access to cutting-edge cancer therapies.  

Unfortunately, persistent barriers in data interoperability, competing business priorities, and lack of bandwidth to engage with data companies means that diverse RWD from an appropriate mix of care settings remains hard to come by.

That’s why COTA has made it a top priority to work with both community practices, tertiary referral centers, and AMCs.

Our curated pool of more than 2 million longitudinal patient records is evenly spread across these care settings, empowering more precise insights when developing fit-for-purpose datasets to answer the next generation of research questions, including those about health equity and the impact of socioeconomic barriers on cancer care. 

We believe that every patient should be able to access the most effective treatments for their unique condition, no matter who they are, where they live, or where they seek care. Offering diverse, representative, and trustworthy RWD to the research community is an important step for improving experiences and outcomes for all cancer patients now and in the future.