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How Cota Is Making Oncology More Precise


Traditional guidelines and ICD-10 codes get it wrong, according to the cutting-edge company's chief medical officer.

Andrew Norden, MD, explains the Cota Nodal Address in an interview with Healthcare Analytics News™ at the HealthXL Global Gathering in Pittsburgh, Pennsylvania.

When Andrew Norden, MD, hears the term “precision medicine,” he sometimes bristles. Ironic? A bit, considering the company he helps lead, Cota, is quickly emerging as a top player in the healthcare data and analytics space, meaning its work fuels precision medicine. “Now we have a lot more data sources,” Norden, Cota's chief medical officer, adds. “But I don’t think it’s a new phenomenon.”

Cota’s work simply seems like the logical next step for medicine, he says. The New York City-based start-up has brought together some of the brightest minds in healthcare, aiming to use these high-tech tools to combat cancer by crushing inefficiencies and improving outcomes. The team has forged partnerships with institutions like Hackensack Meridian Health in New Jersey, Memorial Sloan Kettering Cancer Center, and Baptist Health South Florida. Healthcare Analytics News™ caught up with Norden this week to learn more about his views on precision medicine and cancer care and how these blue-chip partnerships are progressing.

As precision medicine continues to prove effective, it will likely become something of a norm. In fact, soon enough, doctors might be committing malpractice if they were to treat cancer without considering phenotypes, pathologies, and genetics, Norden suggests.

But those tools are only as precise as the data behind them. A barrier to using good data is the healthcare industry’s reliance on ICD codes, which have more to do with administration and billing than treatment, Norden notes. The codes lack the specificity needed to categorize and compare patients with complex diseases like cancer, making it far more difficult to conduct meaningful analytics, he says.

Norden discusses his company's collaboration with Hackensack Meridian Health during an interview

at the HealthXL Global Gathering in Pittsburgh, Pennsylvania.

Traditional treatment guidelines can also be problematic. Most were developed before the deluge of data flooded medicine, and they are often obtuse, Norden says. Although such standards may produce consistent outcomes, there’s often enormous variability in cost and side effects, he says.

Cota’s answer: the Cota Nodal Address (CNA), a proprietary tag that Norden calls a “turbo-charged ICD code” that allows for more personalized treatments to be created. “Knowing that the patient has breast cancer in 1 particular part of the breast may be of interest to the surgeon or radiologist, but it tells you very little about the therapy and outcomes that we can expect,” he says. The CNA gives a more specific look at patients, by sorting through a series of 6 codes: cancer type, neoplasm, invasive ductal, phenotype, advancement therapy, and number of progressions.

Hackensack Meridian Health in New Jersey has already linked with the company to develop prospective bundled payment plans for 6 or 12 months of cancer care.

“Because of the richness of the data that we provide and the use of the CNA to organize that data, both organizations know what costs to expect,” he tells Healthcare Analytics News™. The collaboration provides a “granular ability to ensure that the optimal therapies are chosen to achieve the best possible outcomes and to minimize toxicities all while controlling costs,” he adds.

And even though Cota is a self-described “cancer company,” Norden says he thinks the concept behind the CNA could be used to typify other diseases and patients. Where the company is headed, it seems, is toward the future, and quickly.

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