The Challenge: Modernizing a Legacy System
For decades, the ONKOS database has been a cornerstone of the ROH’s oncology research and clinical services, serving as one of the most valuable registries for sarcomas and rare bone cancers. Originally developed in the 1970s, ONKOS has supported clinical care, academic research, and service evaluations. However, several challenges have emerged:
- An outdated data model that risks duplication and overwriting.
- A reliance on manual data entry, which is resource-intensive.
- Limited adaptability to evolving research needs.
- The upcoming transition to a new Electronic Patient Record (EPR) system, raising uncertainties about ONKOS’s future role.
Matthew Revell, Executive Medical Director and Consultant Orthopaedic Surgeon at ROH, outlined the importance of addressing these challenges:
“Our ONKOS system drives the Oncology Department’s international reputation for research in the field of musculoskeletal sarcomas. [...] The ask was to see if we could design the potential successor to our system and to come at the problem from the basis of integrating existing data systems, adding what we could in terms of value for clinicians. The solution demonstrated after our innovation sprint was a showcase of Ledidi's rapid understanding, not only of our systems, but also the meaning of our clinical data; ability to place in context. The added layer was a surprise too – a deep understanding of the clinician-researchers need to manage ad hoc and short-term data collection for individual studies. Neatly integrated into a unified solution.”
With these factors in mind, Ledidi set out to develop a proof of concept for ONKOS 2.0—a modernized oncology database capable of:
- Enabling real-time reporting on oncology service outcomes and activity metrics.
- Enhancing research capabilities by improving data structure and accessibility.
- Reducing manual data entry while preserving data accuracy and completeness.
The Solution: Reimagining ONKOS
The innovation sprint spanned just two months, during which Ledidi collaborated closely with ROH clinicians, data managers, and leadership teams to scope the project and secure necessary information governance approvals. The team also reviewed published research papers to identify the most pressing oncology research questions.
Key components of Ledidi’s proposed solution included:
Restructuring the Data Model
ONKOS was reorganized from a procedure-level structure to a patient-centered model. Surgical procedures and outcomes were grouped into Series, facilitating better tracking of longitudinal patient data and trend analysis over time.
Streamlining Data Capture and Entry
New structured data capture forms were introduced to standardize patient-level data recording, ensuring consistency, accuracy, and ease of use for both clinicians and administrators.
Note: The patient information shown is fictional
Real-Time Analysis and Dashboards
Ledidi configured customised data visualization dashboards tailored to ROH’s needs, providing insights on:
1. Diagnosis prevalence and treatment patterns.
2. Patient demographics and clinical characteristics.
3. Outcome analysis, including infection rates, readmissions, recurrence, reoperations, and survival trends.
4. Real-time subgroup analysis, enabling clinicians to filter by diagnosis types and other variables for more detailed insights.
A Model for Successful Collaboration
The project culminated in a Demo Day at ROH, where five innovation teams showcased their solutions. This initiative underscored the value of collaboration across multiple stakeholders, including clinical leadership, research teams, data managers, information governance, and finance. The West Midlands Health and Wellbeing Innovation Network played a pivotal role in facilitating the process.
Reflecting on the project, Matthew Revell shared:
“It has been a delight working with the Ledidi team exploring future options for our Oncology Database (ONKOS) and support for Research and Development. The product is clear in its offer – it feels to me like intelligent BI with a light statistical capability. Ideal for clinicians looking at case series for presentations and the first steps to publications. What you don’t know, until you work with Ledidi, is how positive, proactive and efficient they are in their application. I have no hesitation at all in recommending this company to work with, based on our experiences to date.”
This West Midlands Health and Wellbeing Innovation Network (WMHWIN) initiative was supported by the West Midlands Health Technology Innovation Accelerator (WMHTIA).