UCSF Breast Care Center: Improving healthcare research with a digital engagement platform

About Athena Breast Health Network

The Athena Breast Health Network is a collaboration of breast cancer experts, health care providers, researchers, and patient advocates at five University of California Medical Centers (UCD, UCI, UCLA, UCSD, UCSF) and the Sanford Health System, a rural health care system in the Midwest region of the United States. Athena was established in 2009 and has assessed breast cancer risk as part of the standard of care for over 150,000 women. Athena is conducting the WISDOM Study, a pragmatic clinical trial comparing personalized breast cancer screening to standard annual screening in 100,000 women.

Industries: Healthcare
Location: United States

About Life Image

Life Image is a medical information network connecting healthcare networks, providers, and patients to clinical information including imaging records.

Athena Breast Health Network at the University of California selected Mammosphere on Google Cloud Platform for its breakthrough WISDOM Study to determine the optimal frequency and methods of breast cancer screening.

Google Cloud Results

  • Testing a personalized approach to breast cancer screening using novel risk assessment tools
  • Provides a more secure and efficient way to store and share mammogram data
  • Improves study recruitment and retention with more convenient, rewarding experiences
  • Helps improve women's healthcare by giving patients access to their own records

18K+ women have joined the WISDOM Study

At the Athena Breast Health Network, a collaboration across the University of California, doctors and researchers are applying recent scientific advances to breast cancer screening, as well as breast cancer treatment, by transforming patient care for the 12.4 percent of U.S. women who will develop invasive breast cancer during their lifetime.

Dr. Laura Esserman, Director of the UCSF Breast Care Center and founder of the Athena Breast Health Network, is conducting a five-year study called WISDOM that will test two different approaches to breast cancer screening: the current U.S. standard of annual mammography versus a personalized, risk-based approach. The goal is to determine whether personalized screening that incorporates individual risk assessments is just as safe and effective as the standard one-size-fits-all approach. The study will measure number of cancers detected, number of follow-up screenings and biopsies, and whether women accept and prefer this new approach to screening. The study will also help determine whether some patients at higher risk would benefit from more frequent screening, or fewer mammograms if at lower risk, thereby reducing unnecessary biopsies and lowering overall healthcare costs, and lessening anxiety from false positive results.

"We decided to use Google Cloud Platform to host Mammosphere because it's highly secure, cost effective, and offers a variety of managed services and APIs. It's fast and easy to deploy new applications and analytics services on GCP, and Google is always willing to work with us on new ideas."

Janak Joshi, Chief Technology Officer, Life Image

Participants in the interventional group are screened for specific genetic mutations that increase risk of breast cancer, as well as other risk factors. Those considered at high risk for developing breast cancer would have more frequent screening schedules.

Dr. Esserman compares personalized screening to a Transportation Security Administration Pre-Check that allows a passenger to pass through airport security faster at every airport visit after one quick in-person appointment for a background check and fingerprinting.

"Everyone who has Pre-Check loves it, because you can tailor the amount of screening you do based on the risk you pose," she says. "It's a good concept to apply in cancer screening."

But the potential ramifications of the study go far beyond convenience for patients. By better understanding which women are at risk for certain types of breast cancer, Dr. Esserman and her colleagues hope to improve breast cancer screening and enable better clinical outcomes for thousands of patients. They also seek to empower women by allowing them to track and share their own breast health history. Approximately one out of four U.S. women does not have access to prior mammograms at the time of their exam. False positive and recall rates, or the percentage of screening studies for which follow-up was recommended by the radiologist, are 260 percent higher for those patients.

Shortly after the WISDOM Study began, the Athena team realized that it needed a more secure and convenient platform to provide access to mammograms and other breast health information.

"The WISDOM Study is almost entirely virtual as far as enrollment and consent, yet we still depended on faxes to get the mammogram information from healthcare providers," says Allison Stover Fiscalini, MPH, Director of Athena Breast Health Network. "We also didn't have an easy way to return results to our participants to impact how they interact with medical providers in the future."

"Mammosphere is a great adjunct for the WISDOM Study because we're giving women something back: the ability to request and manage their breast health records. Women are joining the study to help generate new information about breast health and they get a bonus of easy access to their records. We can assure them their data is highly secure because of the Google Cloud and Life Image partnership."

Allison Stover Fiscalini, MPH, Director, Athena Breast Health Network

Improving recruitment and retention

Already a customer of Life Image for medical image exchange, the Athena team heard about Mammosphere, a patient engagement platform that stores breast health information and mammograms in a highly secure, online location. Mammosphere is powered by Life Image and runs its frontend app on Google Cloud Platform (GCP), using App Engine to scale easily on a fully managed, serverless application platform.

"We decided to use Google Cloud Platform to host Mammosphere because it's highly secure, cost effective, and offers a variety of managed services and APIs," says Janak Joshi, Chief Technology Officer at Life Image. "It's fast and easy to deploy new applications and analytics services on GCP, and Google is always willing to work with us on new ideas."

Using Mammosphere is optional for WISDOM participants, but interest has been high. Women simply select their mammography facility from a dropdown list and then request which records they want, over which time period, and where they want those records to be sent. The WISDOM Study is one of the recipients they can choose. Because women no longer have to go through the process of requesting records by phone or mail, it's more convenient for them to participate in the study, which will help the WISDOM Study reach its goal of 100,000 participants.

"Mammosphere is a great adjunct for the WISDOM Study because we're giving women something back: the ability to request and manage their breast health records," says Allison. "Women are joining the study to help generate new information about breast health and they get a bonus of easy access to their records. We can assure them their data is highly secure because of the Google Cloud and Life Image partnership."

"We are using Mammosphere because it enables us to efficiently acquire the information we need to perform the WISDOM Study and further, it enables us to explore the elements of the breast image that drive risk. Mammosphere leverages leading Google Cloud technology and the growing network offered by Life Image, which will only help us integrate advances in imaging technology and artificial intelligence. We hope we can enable significant improvements in breast cancer screening and prevention for generations to come."

Dr. Laura Esserman, MD, MBA, University of California San Francisco Breast Care Center

Groundbreaking analytics opportunities

Recognizing the power of Google Cloud APIs and managed services, Life Image is developing new features for Mammosphere that will help UCSF and other customers analyze breast imaging data within and across studies. For example, it plans to use Cloud Healthcare API to connect providers' data to advanced Google Cloud capabilities, including scalable big data analytics with BigQuery.

"This is just the beginning of our strategy to enhance Mammosphere with Google Cloud Platform," says Janak. "We're excited to interact with care networks using standards and modalities such as Fast Healthcare Interoperability Resources, HL7v2, and DICOM, and bring mammogram image data into BigQuery for analysis."

Driving better patient outcomes

As the WISDOM study progresses, researchers hope to gain valuable insights that will help determine the safest and most effective breast cancer screening processes for women.

"We are using Mammosphere because it enables us to efficiently acquire the information we need to perform the WISDOM Study and further, it enables us to explore the elements of the breast image that drive risk. Mammosphere leverages leading Google Cloud technology and the growing network offered by Life Image, which will only help us integrate advances in imaging technology and artificial intelligence," says Dr. Esserman. "We hope we can enable significant improvements in breast cancer screening and prevention for generations to come."

About Athena Breast Health Network

The Athena Breast Health Network is a collaboration of breast cancer experts, health care providers, researchers, and patient advocates at five University of California Medical Centers (UCD, UCI, UCLA, UCSD, UCSF) and the Sanford Health System, a rural health care system in the Midwest region of the United States. Athena was established in 2009 and has assessed breast cancer risk as part of the standard of care for over 150,000 women. Athena is conducting the WISDOM Study, a pragmatic clinical trial comparing personalized breast cancer screening to standard annual screening in 100,000 women.

Industries: Healthcare
Location: United States

About Life Image

Life Image is a medical information network connecting healthcare networks, providers, and patients to clinical information including imaging records.