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Interview with Pamela Swackhamer from Hematology Oncology Associates of Central New York

December 6, 2021


Please note that we’ve since rebranded the Genomic Profiling Integration to the Molecular Profiling Integration.

Joining us today From the Community, we’re speaking with Pamela Swackhamer, the EMR coordinator at Hematology Oncology Associates of Central New York.

Flatiron: Hi Pamela, thank you so much for speaking with us today! To kick things off, can you tell us about how you first came into community oncology, and how long you have been a practice administrator at your practice?

Pamela: Sure thing. I started with Hematology Oncology Associates (HOA) of Central New York in the Health Information Management department in 2005 and moved into their electronic medical record department in 2015. For the past four years I have been the EMR Coordinator at my practice.

Flatiron: What are some tips that have helped you succeed in your role? We know how busy practice administrators are and would love to hear about how you prioritize the decisions you have to make on a daily basis.

Pamela: It takes a lot of hard work and dedication for the practice to succeed as a whole. I personally focus on what I can do that will help make the staff’s workflows easier and more efficient.

Some projects are short term, and others take a long term approach, depending on the impact on the teams. I depend on the experts in each department to help talk out and work through any EMR-related workflows and upgrades. You cannot do this alone, it takes a village to make the company succeed! I am blessed because some of the most intelligent leaders work right here at HOA and are so willing to help and answer questions when needed.

You cannot do this alone, it takes a village to make the company succeed.

Flatiron: I definitely agree, it absolutely takes a village to make a company succeed. Your practice decided to be one of the early adopters of the new Genomic Profiling Integration with Foundation Medicine...what has your experience with that been like? In building this feature, we aimed to help clinicians streamline the test ordering process and improve turnaround time, but I would love to hear about your perspective on this feature as a practice admin.

Pamela: As a beta partner, we received early access and had the opportunity to provide feedback on the feature and workflow. The Genomic Profiling Integration between OncoEMR® and Foundation Medicine has been great, and it has tremendously streamlined the test ordering and reporting process. Seeing in the Treatment Plan when the order is in process, and having the results coming directly into the documents and physician inbox solves many of the previous process issues we had, like manually adding the information into Foundation Medicine’s portal, monitoring the order progress and uploading the results into OncoEMR.

Flatiron: What are you doing at your practice to ensure that all patients who should be tested are getting tested?

Pamela: Several years ago, HOA implemented next generation sequencing (NGS) panel testing, rather than a single-gene test, for all newly diagnosed non-small cell lung cancer (NSCLC) patients. This led to almost all of those eligible patients having a complete genomic profile of actionable mutations. Furthermore, it created a searchable database of results that could be queried — which we do! — when new agents are approved. From that initial NGS testing process of NSCLC patients, we have seen tremendous growth in our utilization of genomic testing in other types of cancers. This is the result of new targeted therapies, disease agnostic therapies, new indications or the need for a more complete genomic test compared to the limitations of small panel or single gene testing. Also important, the genomic testing results help guide our decision when not to use certain therapies.

Flatiron: Across our network of practices on OncoEMR®, we’ve seen the frequency of genomic testing increase over time, likely due to taking a more personalized approach to cancer treatment through precision medicine. What is your vision for precision medicine at HOA and how are you currently putting precision medicine in action?

Pamela: We are at the point in oncology that almost every solid tumor patient should have genomic testing done. We are entering a time when precision medicine is starting to make sense in that we treat the patient’s cancer based on their genomic profile and not with the use of only traditional chemotherapy agents. We are only limited in our ability to provide that from the payers, although many, including the Centers for Medicaid & Medicare Services, understand the importance of testing and have broad coverage policies in place.

We are at the point in oncology that almost every solid tumor patient should have genomic testing done.

Flatiron: Are there any upcoming features on Flatiron’s product roadmap that you’re especially looking forward to having at your practice? With regards to precision medicine specifically, over the next year you can expect us to continue to add additional molecular profiling testing vendors to our platform while making test results more actionable by incorporating them into critical clinical workflows, such as clinical trials matching.

Pamela: We look forward to the increased integration of genomic test information into the EMR. We would like to get discrete genomic data to match and input automatically into the appropriate diagnosis data fields will have a tremendous time savings and reduce errors from manual entry. Having that discrete data will make the accuracy of matching regimens with Flatiron Assist that much better.

In regards to trial matching, that is what has been needed all along. Most of today’s trials have a genomic component and to have that discrete genomic data populate into the EMR will only make trial-matching better. Too much time is wasted in the clinical trial review process having to verify a patient’s genomic status when that information could be automatically and accurately mapped and matched.

Most of today’s trials have a genomic component and to have that discrete genomic data populate into the EMR will only make trial-matching better.

Flatiron: Pamela, thank you so much for taking the time to speak with us today!