We welcomed Dr. Andrew Feifer for a presentation about Ned, an app designed specifically for prostate cancer patients, as well as a discussion about the incorporation of data driven smart technology in the survivorship of cancer patients. The webinar was followed by an interactive question & answer session. Ned was conceptualized and co-founded by our webinar presenter: Dr. Andrew Feifer, a Urologic Surgical Oncologist at Trillium Health Centre in Toronto. Dr. Feifer evisioned a tool that would empower prostate cancer survivors by putting their health into their own hands and giving them more options to manage their own care.

1. Innovating in
Prostate Cancer
Survivorship Care
Dr. Andrew Feifer

2. Innovation: A Crucial Measure of Change in
Medicine
• What are the desirable features and necessities
of innovation?
• What major innovation has occurred in prostate
cancer?
• How do we evaluate and embrace innovation?
• What examples can we follow and not follow?

3. Desirable features in a definition of
“surgical innovation”
3
1. Able to be applied easily and consistently in practice
2. Appropriately sensitive to actual uses of the term
3. Comprehensive enough to identify the full range of surgical innovations
4. Able to distinguish:
• innovation from variation
• innovation from introduction
5. Prospective and focused on features relevant to safety and evaluation
» Hutchison et al 2015 Annals of Surgery

4. Surgeons’ definition of surgical
innovation
4
• Interviews with practising surgeons identified the following features that
they associated with innovation
1. “Newness”
2. Provides a Degree of change to what we are already doing”
3. Degree of risk
4. Impact on patient care
5. Formal processes
• Rogers et al 2014 Annals of Surgery

6. Innovation distinguishes
between a leader and a
follower – Steve Jobs
(2001)
People think focus means saying yes to the
thing you've got to focus on. But that's not
what it means at all. It means saying no to
the hundred other good ideas that there
are. You have to pick carefully. I'm actually
as proud of the things we haven't done as
the things I have done. Innovation is saying
no to 1,000 things
Innovation distinguishes
between a leader and a
follower – Steve Jobs
(2001)
ple think focus means saying yes to the
g you've got to focus on. But that's not
t it means at all. It means saying no to
hundred other good ideas that there

7. How do we Innovate in
Survivoship?

8. The vision for technologies
Precision eHealth

9. PROSTATE CANCER
SURVIVORSHIP TOOL

10. Ned Timeline
PMH
Launch
Trillium
Launch
Partnership
with
Scale
Ned
Winner
of
Patient & Clinician
Interviews
Product Defined &
Product Development
Cancer Care Ontario
Strategic
Conversations
First consumer app
to access provincial
data assets
OLIS & SPARK
Partnership

11. • Is this normal? Is my body healing or healthy?
• How long will this last?
• I feel like a burden on my family
• Are we really in the clear?
• I guess some issues can’t be helped
The Patient Experience

12. Ned brings together:
• Patient reported
outcomes
(reported through Ned on
a monthly bases)
• Lab results
(directly from OLIS)
Ned shares this information
with both patients and their
clinicians.
Giving patients and clinicians
access to the same
information in one location
provides a cohesive picture
of the patient’s well-being
and enables shared
strategies for improved
quality of life.

13. Patient Interface

14. Clinician Interface

15. Patient
logs into
Ned
account
Reports
sym ptom s
m onthly
(EPIC-26, FACT-
P)
Stored and
can view
trends over
tim e
Patient views his
PSA result
Stored and
can view
trends over
tim e
Reviews patient
sym ptom s (EPIC-
26, FACT-P)
Views patient
PSA results
Releases New
PSA results
Updates
treatm ent plans
as necessary
Views PSA
Kinetics
User
Workflow

16. PATIENT
Report PROs (EPIC-26, FACT-P)
View PROs & View PSA results
View relevant prostate cancer
inform ation via RSS feed
Add personal notes
View relevant events
View Care Team inform ation
CAREGIVER*
Report patient PROs
View PROs & View PSA results
View Care Team inform ation
*level of access is determ ined
by patient
CLINICIAN
View PRO alerts (over tim e)
View PSA alerts (over tim e)
View all patient PSA results
Release PSA results to patient
through Ned
CLINICIAN’S ADMIN
ASSISTANT*
Add/rem ove patients to Ned
*access granted by clinician
ORGANIZATION
ADMINISTRATOR
Modify user account inform ation
SYSTEM
ADMINISTRATOR
Modify user account inform ation
Create new users
Audit
User Types & their Functions

17. Deployments
Ned @ Princess Margaret GU Clinic
Ned @ Peel Region Cancer Centre
Ned @ Urologist Private Clinic
Oct 2017
June 2018
Summer 2018

18. Current Future
Patient Reported
Outcomes
Provider
Interface
Patient
Self-Enrollment
Lab
Results
Bluetooth Captured
Patient Parameters
Product Roadmap

19. What
The Ned App is a prostate cancer survivorship tool, once this app is downloaded, it
works to support the patient by providing a three-way communication from patient,
physician and caregiver, helping to quickly and clearly articulate and to receive, timely
patient data (i.e.. PSA, PROs).
Why
The Ned App fills a void in the prostate cancer patient journey, in that it enables a
real-time communication link between physician, patient and potentially, their
caregiver. This link will help to reduce waiting and anxiety, all while having a
significant impact on patient’s quality of life. The app will work to encourage the
patient to engage in their journey and work intercept critical changes along the
continuum (i.e.. PSADT, QOL decreases, changes in symptoms).
How
The Ned App captures the patients PSA and PROs (i.e. EPIC-26, FACT-P) information
into the Ned Server (OAUTH 2.0 & FHIR compliant). Presently, Ned utilizes the OLIS
(Ontario Laboratories Information System) health information to seamlessly and
accurately create an real-time patient profile and communication linkage between
patient, physician and caregiver.
Progress
Determine potential incorporation within Integrated Care Model to support disease
progression and enable physician to patient dialogue

20. Canadian Cancer Survivor Network
Contact Info
1750 Courtwood Crescent, Suite 210
Ottawa, ON K2C 2B5
Telephone / Téléphone : 613-898-1871
E-mail: jmanthorne@survivornet.ca or info@survivornet.ca
Website: www.survivornet.ca
Twitter: @survivornetca
Facebook: www.facebook.com/CanadianSurvivorNet
Instagram: @survivornet_ca
Pinterest: http://pinterest.com/survivornetwork/