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A team of Wisconsin brain experts and University of Wisconsin-Milwaukee app developers have created a new tool that is designed to improve care and reduce hospital stays for brain cancer patients.

NIMBLE – Network for the Integrated Management of Brain Metastasis: Linking Experts – is a mobile app that streamlines communication between specialist doctors treating patients whose cancer has metastasized to the brain.

A total of 20% to 40% of all cancer patients will be diagnosed with brain metastasis, which is cancer that spreads from another part of the body to the brain, said Dr. Joseph Bovi, radiation oncologist with Froedtert & the Medical College of Wisconsin Clinical Cancer Network.

A tumor board, consisting of oncologists and other specialists, meets weekly to discuss an effective plan of care for their patients at Froedtert & MCW. However, oftentimes specialists have to assemble patient care plans outside of that tumor board meeting, especially in patients who are acutely ill, Bovi said.

NIMBLE provides oncologists and specialists with a medium to have a high-level conversation about a patient’s condition through a secure and encrypted message board. With NIMBLE, specialists can compare their observations, share MRI scans and other notes with members from each discipline to develop an appropriate plan of action for a patient with brain metastases, Bovi said.

“Any time that we can get a plan of action in place for a patient faster, the end result is they get the critical care they need sooner than they would have otherwise,” Bovi said. “With brain metastases, that time may be critical.”

NIMBLE was created by Bovi, Dr. Christopher Schultz, MCW professor and chairman of the Department of Radiation Oncology, as well as students with App Brewery, UWM’s mobile innovation lab program.

Beyond the message board, NIMBLE has an educational component that provides specialists with best practices for brain metastasis management. A complex algorithm, based on metastasis characteristics, leads specialists down a path towards a treatment plan, which is backed by evidence-based articles.

“So, you click on that, and this drives you out to the actual data and manuscript that supports that decision for that patient to help our clinicians know, ‘Here’s the data to support the decision that you made,’” Bovi said.

However, Bovi and his team recognize that each case of brain metastases is different, and the message board allows specialists to discuss those nuances, Bovi said.

“It’s a phenomenal tool because brain metastasis management is incredibly complex,” Bovi said. “And we just put a tool in their hand with that medical decision-making.”

During the pilot of the app, Bovi and his team discovered a 40% reduction in hospital stay for patients with brain metastases. However, he believes NIMBLE will lead to benefits in other disciplines as well as cost savings and efficiencies in other areas of the hospital.

“Anything we can do to make beds available for those who need them is critical right now,” Bovi said. “And if we’re able to manage these patients, of which we see about 150 a year, you have that number of patients multiplied by those numbers of days – think about the bed time that is saved on the back side by allowing us to communicate in this more efficient way.”

The app is scheduled to go live March 31.

NIMBLE is one example of more than 20 apps that App Brewery has designed for the Froedtert & MCW health network. App Brewery lead project manager Dustin Hahn and his students meet with doctors to discuss app features, and in the case of NIMBLE, challenges, such as patient record protection.

“I needed to make Dustin an expert in this whole process in order for him and his team to visualize and create ultimately what we have now with the NIMBLE app,” Bovi said. “That partnership and the level of communication and understanding that it takes is just critical.”

NIMBLE
Milwaukee
Innovation: Mobile app that streamlines communication among specialist doctors
Developers: UWM’s App Brewery, Dr. Joseph Bovi and Dr. Christopher Schultz
Launch Date: March 2020
froedtert.com
uwm.edu/appbrewery