Casper – Cancer Management Software Adoption and Development

The goal of this project was to support the further development and adoption of the Casper software, developed by local company, Cievert. Casper is a web based treatment referral and patient management platform for use within oncology (cancer) departments, primarily for patients requiring radiotherapy and chemotherapy treatment. The innovation addresses the movement and transfer of clinical information between secondary care providers (hospitals) and specialist cancer centres.

Casper was developed to replace the standard paper driven process which is slow and cumbersome and relies on the referrer completing all information correctly and legibly. The opportunity for referrals to be misplaced or mislaid is significant. In addition, the process is linear so multiple staff groups cannot work on the referral in parallel.

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“I have found Casper to be very helpful. It's accessible, easy to navigate and …in a clear and logical format. It is much easier than looking through a folder with paper referrals. I got used to using it very quickly and now I use it daily as part of my planning work”
Laura Ferguson, Pre-Treatment Radiographer, (East and North Hertfordshire NHS Trust)
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Radiotherapy treatment is delivered on a regional model.  This means Clinical Oncologists (cancer specialists) regularly travel distances to other hospital Trusts to see patients at Outpatient appointments.  When a patient requires radiotherapy treatment it often results in a paper referral traveling long distances, between different provider organisations and regularly involves upwards of eight hand-overs between staff groups from the point of referral to the patient starting treatment.

There is well documented evidence linking increased waiting times for cancer treatments with poorer outcomes and so the need to expedite protocol driven, cancer treatment referrals as quickly and as safely as possible is high. The population addressed in this case study is all oncology patients requiring radiotherapy and/or chemotherapy regardless of age.

  • Casper is a web based referral and patient management system. It ensures that all information, required to expedite the patient through to starting treatment is collected accurately at the point of referral and then disseminates this information to ALL specific staff groups that require notification immediately.  The result is that each staff group/individual is alerted to the task or tasks that they need to complete in order for the patient to start treatment, in parallel, and at the same time, which significantly reduces the waiting time for patients.
  • As well as improving the speed of referrals Casper also improves clinical and corporate governance. It does this through the clinical pathways that are pre-programmed into Casper and the User settings linked to grade and education of the Referrer. This means every referral is protocol driven and governance can be automatically tailored to the individual User and treatment protocol.  The result is that more junior doctors can still safely refer patients as the system automatically contacts their Consultant for approval if and when required, without slowing the patient journey.

The AHSN NENC provided funding for additional Casper research and development to take place at Nottingham University Hospitals NHS Trust.

The commercial version of Casper is now in place at seven cancer centres across the UK (Colchester Hospital University NHS FT, NHS Tayside, Nottingham University Hospitals NHS Trust, Mount Vernon Cancer Centre (East and North Hertfordshire NHS Trust) and St Luke’s Cancer Centre, Western Health and Social Care Trust, Belfast Health and Social Care Trust).

10-15% of radiotherapy patients nationally are now benefitting from having their treatment referral managed by Casper software.

Overseas markets are now being identified for Casper and Cievert has recently launched a further product to the market with a product launch anticipated late 2016.

  • The commercial version of Casper currently benefits almost 800 patients per month and this is expected to increase to over 1,500 as all of the current clinical sites become fully operational.
  • Conservative estimates puts average waiting time reductions across all Casper cancer centres and treatment sites at one day per patient. At the rate of 800 patients per month this equates to 800 days per month and annual waiting time savings at 9,600 days per year.
  • Casper also saves time for staff, particularly freeing up clinical staff from administrative duties. This is conservatively estimated at 15 minutes per patient which translates into an estimated total staff saving of £47k per annum (across all seven Casper sites based on current referral levels of 800 patients per month).
  • Two (full time equivalent; FTE) jobs created, and one 0.6 (FTE) safeguarded over a 12 month period.
  • A survey revealed that 82% of respondents rated Casper functionality as ‘Good’ or ‘Excellent’ and 92% of respondents said Casper was easy to use.
“The impact of CASPER on prostate booking has shown an average saving of 13 days, so it really does work and is advantageous to the whole department.”
Professor Peter Hoskin, Consultant Clinical Oncologist (East and North Hertfordshire NHS Trust)