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# Pooja Mishra Follows the Cells to Redesign Cellular Therapy Workflows
- URL: https://www.healthdatacon.io/pooja-mishra-follows-the-cells-to-redesign-cellular-therapy-workflows/
- Published: 2026-10-16T06:15:00.000Z
- Updated: 2026-10-16T06:14:59.000Z
- Description: At HealthDataCon 2026, Pooja Mishra described how following the cell journey helps teams redesign workflows, strengthen safety checks and build shared governance as cellular therapy programs grow.
- Author: Health Data Management
- Tags: Asia-Pacific

Before redesigning the digital systems supporting cellular therapy, Pooja Mishra’s team adopted a simple instruction: “follow the cells.”

That meant tracing a treatment from planning and collection through processing, manufacturing, distribution, infusion and follow-up. At each step, the team needed to understand who was responsible, what information had to travel with the cells and which checks protected the patient.

Speaking at HealthDataCon 2026, Mishra, senior manager of Technology and Digital Services at Stanford Health Care, described a transformation that began with paper workflows in 2015 and continues as therapies and clinical needs evolve. Her session, “Building What Didn’t Exist: Leadership, Digital Transformation, and Innovation in Cellular Therapy,” placed informatics alongside clinical innovation as a condition for sustainable growth.

The central lesson was practical: increasing treatment capacity requires increasing the organization’s capacity to coordinate work. More emails, spreadsheets and disconnected forms cannot reliably substitute for a shared understanding of the care pathway.

![Mishra’s slide distinguishes cell and gene therapy and outlines milestones in Stanford’s transplant and cellular therapy program.](https://storage.ghost.io/c/91/db/91db0927-dd9a-4578-9944-921da70f6885/content/images/2026/10/mishra-cellular-therapy-history.jpeg)

Program milestones as presented by Mishra. Slide credit: Pooja Mishra / HDM’s HealthDataCon 2026.

## A living treatment creates a moving workflow

Mishra began by distinguishing cell therapy, which uses living cells as treatment, from gene therapy, which changes genetic instructions or their expression. The categories can overlap. CAR T-cell therapy, for example, involves genetically modifying immune cells to recognize a target.

In the patient-derived CAR T process described by the [NCI](https://www.cancer.gov/about-cancer/treatment/research/car-t-cells?ref=healthdatacon.io), T cells are collected, engineered in a laboratory, expanded and returned to the patient by infusion. These steps connect clinical care with manufacturing in ways that a conventional medication workflow may not capture.

Mishra used the analogy of a security guard receiving identifying information before returning to patrol. For informatics teams, however, the operational challenge extends beyond explaining how the therapy works. They must preserve the relationship between a patient, a cellular product and the work performed along its journey.

Her presentation traced Stanford’s program from four patients in 1987 through successive transplant and cellular therapy milestones. Each stage, she explained, introduced additional protocols, manufacturing requirements and specialized care pathways.

The point of that history was the work required to support it. Teams repeatedly had to define data, establish operating procedures, train staff and develop the digital infrastructure needed for the next stage of care.

## Map the pathway before choosing the technology

The discovery work began with apheresis, the collection process used to obtain blood components, including cells needed for some therapies. Clinical informatics staff worked with clinical partners to document existing paper processes and gather workflow questions.

Over time, that work expanded across planning, workup, collection, preparation, distribution and infusion. Mishra described a phased approach that allowed the team to build knowledge of the workflow before implementing broader electronic capabilities.

“The goal was to really create a single source of truth,” she said. That required connecting the multidisciplinary team across the pathway, rather than simply converting an individual department’s forms into electronic documents.

The approach aligns with the Agency for Healthcare Research and Quality’s [workflow toolkit](https://digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit?ref=healthdatacon.io), which helps organizations assess how health IT changes clinical and administrative work. Understanding the current process helps reveal where a proposed system might simplify a handoff or create a new dependency.

For Mishra’s team, the guiding questions concerned the work itself: what happens next, who needs to know, and where can information become disconnected? Those questions remained relevant as the electronic record’s capabilities matured. Existing workflow knowledge provided a basis for evaluating new features instead of rebuilding the process around every software release.

## Make safety visible across every handoff

Cellular therapy creates information requirements that can be obscured when teams rely on isolated documentation. Mishra identified risks involving donor checks, laboratory information, treatment-specific warnings, dual sign-offs and incomplete chain-of-custody visibility.

These were workflow and design concerns described in her presentation, not evidence that every listed risk resulted in patient harm. Her emphasis was on ensuring that essential checks remain visible and actionable throughout a complex sequence of work.

The FDA’s January 2024 [CAR-T guidance](https://www.fda.gov/media/156896/download?ref=healthdatacon.io) addresses manufacturing controls, labeling and clinical considerations for these products. Its recommendations reinforce the need to manage product identity and handling carefully; they do not prescribe a particular EHR product or module.

Mishra described how documentation built around traditional blood and marrow transplant workflows could fail to support newer immune effector cell pathways. When an initiating episode or required field was absent, downstream documentation could be affected. Local workarounds helped individual teams continue, but also added fragmentation.

The response involved shared patient itineraries, centralized status information and visible tasks for different staff groups. These changes aimed to make responsibilities clearer while reducing reliance on separate paper, email and telephone coordination.

The [FACT resources](https://www.factglobal.org/resource-center/immune-effector-cell-resource-center/?ref=healthdatacon.io) for immune effector cell programs similarly frame quality as a program-level undertaking. Digital documentation is one component of that work, alongside clinical expertise, controlled processes and organizational accountability.

## Connect systems and help staff adopt them

One concrete milestone involved integrating electronic health record information into the unrelated-donor search process. Mishra reported that a March 2023 implementation reduced manual entry time for donor search coordinators by 50%.

[NMDP’s announcement](https://www.nmdp.org/what-we-do/news/press-releases/winners-of-2023-nmdp-awards?ref=healthdatacon.io) independently confirms that Stanford’s technology, donor search and HLA laboratory teams received its 2023 Simplify Award for a pilot that automated patient data entry using electronic health record data. The announcement does not provide the time-reduction figure, which remains a result reported in Mishra’s presentation.

For Mishra, the significance was the coordinated redesign behind the interface. Clinical experts, operations staff, technology teams and an external partner worked on the same consequential process. Removing duplicate entry addressed a specific burden for the people doing the work.

Adoption required a separate investment. Asked about the biggest staff hurdles, Mishra pointed to anxiety about how new workflows would change the working day. Her team used side-by-side demonstrations, comparing the paper process with its electronic equivalent and timing the work.

Training and user acceptance testing helped staff examine the proposed changes before relying on them. End users then became advocates: experienced nurses could show incoming colleagues a shared electronic workflow instead of a collection of paper forms. That practical endorsement mattered more than assuming a new tool would explain its own value.

## Govern growth across specialties and resources

As cellular therapy research extends beyond oncology, governance must accommodate new pathways while preserving common safeguards. Stanford Children’s, for example, describes a [lupus trial](https://www.stanfordchildrens.org/en/topic/default?id=lupus-85-P00058&ref=healthdatacon.io) evaluating CAR T-cell therapy. Such research should not be confused with routine approval for every condition discussed in the presentation.

Mishra called for shared ownership across IT, pharmacy, nursing, legal, research, compliance, operations and specialty leadership. In the discussion, she acknowledged that the organization had not yet found a complete governance solution. The starting point was agreement on common principles, including how chain of custody would be documented across groups.

She described earning support by showing how consistent workflows helped clinical teams. Some skeptical physicians became more receptive when they saw benefits for their support staff. Standardization depended on relationships and demonstrated usefulness as well as formal decisions.

Asked what smaller organizations could do, Mishra returned to the same design principle. Following the cells reveals opportunities regardless of the platform or resources available. Digitizing two high-friction steps may still reduce meaningful handoffs and reporting work, even when a complete transformation is not immediately feasible.

Her closing advice was to involve informatics early and treat each new specialty as a program requiring workflow discovery, safety analysis, education and governance. Clinical innovation will keep changing the journey. The people, processes and information supporting that journey must be prepared to change with it.