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The Growing Role of Digital Health Tools in the Care of Patients with Cancer: Current Use, Future Opportunities, and Barriers to Effective Implementation

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Abstract

Purpose of Review

This article aims to describe the ways in which digital health technologies are currently being used to improve the delivery of cancer care, highlight opportunities to expand their use, and discuss barriers to effective and equitable implementation.

Recent Findings

The utilization of digital health tools and development of novel care delivery models that leverage such tools is expanding. Recent studies have shown feasibility and increased implementation in the setting of oncologic care.

Summary

With technological advances and key policy changes, utilization of digital health tools has greatly increased over the past two decades and transformed how cancer care is delivered. As digital health tools are expanded and refined, there is potential for improved access to and quality and efficiency of cancer care. However, careful consideration should be given to key barriers of digital health tool adoption, such as infrastructural, patient-level, and health systems-level challenges, to ensure equitable access to care and improvement in health outcomes.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. USCS data visualizations. https://gis.cdc.gov/grasp/USCS/DataViz.html. Accessed 1 Jan 2024.

  2. Ronquillo Y, Meyers A, Korvek SJ. Digital health. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.

    Google Scholar 

  3. Neidich AB. The promise of health information technology. Virtual Mentor. 2011;13(3):190–2. https://doi.org/10.1001/virtualmentor.2011.13.3.oped1-1103.

    Article  PubMed  Google Scholar 

  4. Pritchett JC, Patt D, Thanarajasingam G, Schuster A, Snyder C. Patient-reported outcomes, digital health, and the quest to improve health equity. Am Soc Clin Oncol Educ Book. 2023 e390678. https://doi.org/10.1200/EDBK_390678. An ASCO Educational Book chapter authored by leaders in the field of digital health and cancer care delivery.

  5. United States Government Accountability Office. Health information technology: HHS should assess the effectiveness of its efforts to enhance patient access to and use of electronic health information. https://www.gao.gov/assets/gao-17-305.pdf. 2017.

  6. Strawley C, Richwine C. Individuals' access and use of patient portals and smartphone health apps: 2020. https://collections.nlm.nih.gov/catalog/nlm:nlmuid-9918317682006676-pdf?_gl=1*1hig3m*_ga*MTI3NjUzNTMxNy4xNjM5MDc1NTEx*_ga_7147EPK006*MTcxMzMwMDMzOS4xLjAuMTcxMzMwMDM0OC4wLjAuMA..*_ga_P1FPTH9PL4*MTcxMzMwMDMzOS4xLjAuMTcxMzMwMDM0OC4wLjAuMA. (2023).

  7. Coughlin SS, Caplan L, Young L. A Review of web portal use by oncology patients. J Cancer Treat Diagn. 2018:2. https://doi.org/10.29245/2578-2967/2018/6.1154.

  8. Almeida-Magana R, et al. E-Consent—a guide to maintain recruitment in clinical trials during the COVID-19 pandemic. Trials. 2022;23:388. This study demonstrated increased recruitment for a clinical trial through the use of electronic consent.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Welch BM, et al. Teleconsent: a novel approach to obtain informed consent for research. Contemp Clin Trials Commun. 2016;3:74–9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. De Sutter E, et al. Personalized and longitudinal electronic informed consent in clinical trials: how to move the needle? Digit Health. 2024;10:20552076231222360.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Unger JM, et al. Geographic distribution and survival outcomes for rural patients with cancer treated in clinical trials. JAMA Netw Open. 2018;1:e181235.

    Article  PubMed  PubMed Central  Google Scholar 

  12. McCullough LE, Flowers CR. Identifying and addressing disparities in survival outcomes for rural patients with cancer. JAMA Netw Open. 2018;1:e181243.

    Article  PubMed  Google Scholar 

  13. Lin CC, et al. Association between geographic access to cancer care, insurance, and receipt of chemotherapy: geographic distribution of oncologists and travel distance. J Clin Oncol. 2015;33:3177–85.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Blake KD, Moss JL, Gaysynsky A, Srinivasan S, Croyle RT. Making the case for investment in rural cancer control: an analysis of rural cancer incidence, mortality, and funding trends. Cancer Epidemiol Biomarkers Prev. 2017;26:992–7.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Daly B. et al. Digitally enabled transitional care management in oncology. JCO Oncol. Pract.2024:OP.23.00565 (2024) https://doi.org/10.1200/OP.23.00565.

  16. Basch E, et al. Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA. 2017;318:197–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Denis F, et al. Randomized trial comparing a web-mediated follow-up with routine surveillance in lung cancer patients. JNCI J Natl Cancer Inst. 2017;109:029.

    Article  Google Scholar 

  18. Mir O, et al. Digital remote monitoring plus usual care versus usual care in patients treated with oral anticancer agents: the randomized phase 3 CAPRI trial. Nat Med. 2022;28:1224–31. This study shows improved patient-centered outcomes and satisfaction with the addition of remote patient monitoring to usual cancer care.

    Article  CAS  PubMed  Google Scholar 

  19. Improving the management of symptoms during and following cancer treatment (IMPACT). https://healthcaredelivery.cancer.gov/impact/. Accessed 1 Jan 2024.

  20. Cronin C, Barrett F, Dias S, Wong S, Pearson L, Hazard-Jenkins H, Bian J, Dizon D, Osarogiagbon R, Schrag D, Hassett MJ. Electronic patient-reported outcomes in oncology: Lessons from six cancer centers. NEJM Catalyst. 2024;5(2). https://doi.org/10.1056/CAT.23.0331.

  21. Herrin J, Finney Rutten LJ, Ruddy KJ, Kroenke K, Cheville AL. Pragmatic cluster randomized trial to evaluate effectiveness and implementation of EHR-facilitated collaborative symptom control in cancer (E2C2): addendum. Trials. 2023;24:21.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Basch E, Wilfong L, Schrag D. Adding patient-reported outcomes to medicare’s oncology value-based payment model. JAMA. 2020;323:213–4.

    Article  PubMed  Google Scholar 

  23. Basch E, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016;34:557–65.

    Article  CAS  PubMed  Google Scholar 

  24. Basch E, et al. Effect of electronic symptom monitoring on patient-reported outcomes among patients with metastatic cancer: a randomized clinical trial. JAMA. 2022;327:2413–22. This randomized control trial demonstrated improved physical function and health-related quality of life for patients reporting ePROs weekly versus those who did not.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Velikova G, et al. Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol. 2004;22:714–24.

    Article  PubMed  Google Scholar 

  26. McLachlan S-A, et al. Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol. 2001;19:4117–25.

    Article  CAS  PubMed  Google Scholar 

  27. Schrag D, Hershman DL, Basch E. Oncology practice during the COVID-19 pandemic. JAMA. 2020;323:2005–6.

    Article  CAS  PubMed  Google Scholar 

  28. Pritchett J, et al. Patient- and provider-level factors associated with telehealth utilization across a multisite, multiregional cancer practice. J Clin Oncol. 2022;40:1512–1512.

    Article  Google Scholar 

  29. Zon RT, et al. Telehealth in oncology: ASCO standards and practice recommendations. JCO Oncol Pract. 2021;17:546–64. An Expert Panel establishes standards and recommendations for implementing telehealth in cancer clinics.

    Article  PubMed  Google Scholar 

  30. Kircher SM, et al. Telemedicine in oncology and reimbursement policy during COVID-19 and beyond. J Natl Compr Canc Netw. 2020;19:11–7.

    Article  Google Scholar 

  31. Boucher AA, et al. Adult hematology/oncology patient perspectives on telemedicine highlight areas of focus for future hybrid care models. Telemed J E-Health Off J Am Telemed Assoc. 2023;29:708–16.

    Google Scholar 

  32. Bramati PS, Amaram-Davila JS, Reddy AS, Bruera E. Reduction of missed palliative care appointments after the implementation of telemedicine. J Pain Symptom Manage. 2022;63:e777–9.

    Article  PubMed  Google Scholar 

  33. Alkilany R, Tarabichi Y, Hong R. Telemedicine visits during COVID-19 improved clinic show rates. ACR Open Rheumatol. 2022;4:136–41.

    Article  PubMed  Google Scholar 

  34. JC Pritchett, JC Paludo, BJ Borah, TC Haddad. Remote Patient Monitoring to Transform Management of Febrile Neutropenia in Cancer Patients. NEJM Catalyst. 2024;5(4). https://doi.org/10.1056/CAT.23.0365. This study describes the safety, feasibility, and acceptability of a novel remote patient monitoring program for the mangement of cancer patients with febrile neutropenia.

  35. Care utilization and satisfaction among patients with cancer with neutropenic fever managed by a remote patient monitoring (RPM) program. | JCO Oncology Practice. https://doi.org/10.1200/OP.2023.19.11_suppl.572.

  36. Paludo J, et al. Pilot Implementation of remote patient monitoring program for outpatient management of CAR-T cell therapy. Blood. 2021;138:568.

    Article  Google Scholar 

  37. Bansal R, Paludo J, Corraes A, Spychalla M, Haugen K, Khurana A, Hampel PJ, Durani U, Dingli D, Hayman SR, Kapoor P, Wang Y, Binder M, Kenderian SS, Kourelis T, Kumar SK, Warsame RM, Bennani NN, Gertz MA, Johnston PB, Ansell SM, Lin Y. Outpatient management of CAR-T and teclistamab for patients with lymphoma and multiple myeloma. Blood. 2023;142(Supplement 1):253. https://doi.org/10.1182/blood-2023-187186.

    Article  Google Scholar 

  38. Offodile AC, et al. Integration of remote symptom and biometric monitoring into the care of adult patients with cancer receiving chemotherapy—a decentralized feasibility pilot study. JCO Oncol Pract. 2023;19:e811–21.

    Article  PubMed  Google Scholar 

  39. Pritchett JC, et al. Association of a Remote Patient Monitoring (RPM) program with reduced hospitalizations in cancer patients with COVID-19. JCO Oncol Pract. 2021;17:e1293–302.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Mooney K, et al. Oncology hospital at home in rural communities: the Huntsman at Home rural experience. J Clin Oncol. 2022;40:1535–1535.

    Article  Google Scholar 

  41. Paulson MR, et al. Implementation of a virtual and in-person hybrid hospital-at-home model in two geographically separate regions utilizing a single command center: a descriptive cohort study. BMC Health Serv Res. 2023;23:139.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Nipp RD, et al. Supportive oncology care at home interventions: protocols for clinical trials to shift the paradigm of care for patients with cancer. BMC Cancer. 2022;22:383.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Laughlin AI, Begley M, Delaney T, Zinck L, Schuchter LM, Doyle J, Mehta S, Bekelman JE, Scott CA. Accelerating the Delivery of Cancer Care at Home During the Covid-19 Pandemic. NEJM Catalyst Innovations in Care Delivery 2020;1(4). https://doi.org/10.1056/CAT.20.0258.

  44. Nundy S, Cooper LA, Mate KS. The quintuple aim for health care improvement: a new imperative to advance health equity. JAMA. 2022;327:521–2.

    Article  PubMed  Google Scholar 

  45. Pritchett JC, Haddad TC. Avoiding the “faux equalizer.” Mayo Clin Proc. 2021;96:2963–5.

    Article  PubMed  Google Scholar 

  46. Tejeda HA, et al. Representation of African-Americans, Hispanics, and Whites in National Cancer Institute Cancer Treatment Trials. JNCI J Natl Cancer Inst. 1996;88:812–6.

    Article  CAS  PubMed  Google Scholar 

  47. Murthy VH, Krumholz HM, Gross CP. Participation in cancer clinical trialsrace-, sex-, and age-based disparities. JAMA. 2004;291:2720–6.

    Article  CAS  PubMed  Google Scholar 

  48. Duma N, et al. Representation of minorities and women in oncology clinical trials: review of the past 14 years. J Oncol Pract. 2018;14:e1–10.

    Article  PubMed  Google Scholar 

  49. Huang Y, Upadhyay U, Dhar E, Kuo L-J, Syed-Abdul S. A Scoping review to assess adherence to and clinical outcomes of wearable devices in the cancer population. Cancers. 2022;14:4437.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Thanarajasingam G, et al. Integrating 4 methods to evaluate physical function in patients with cancer (In4M): protocol for a prospective cohort study. BMJ Open. 2024;14:e074030.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Roberts ET, Mehrotra A. Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine. Jama Intern Med. 2020;180:1386–9. This article highlights disparities in digital access: those with lower income, less education, older patients, and racial and ethnic minorities had less digital access.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Wood BR, et al. Advancing digital health equity: a policy paper of the Infectious Diseases Society of America and the HIV Medicine Association. Clin Infect Dis. 2021;72:913–9.

    Article  PubMed  Google Scholar 

  53. Khera N, et al. Payment and coverage parity for virtual care and in-person care: how do we get there? Telemed Rep. 2023;4:100–8.

    PubMed  PubMed Central  Google Scholar 

  54. Bressman E, et al. Expiration of state licensure waivers and out-of-state telemedicine relationships. JAMA Netw Open. 2023;6:e2343697.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Gordon NP, Hornbrook MC. Differences in access to and preferences for using patient portals and other ehealth technologies based on race, ethnicity, and age: a database and survey study of seniors in a large health plan. J Med Internet Res. 2016;18:e5105.

    Article  Google Scholar 

  56. Lam K, Lu AD, Shi Y, Covinsky KE. Assessing telemedicine unreadiness among older adults in the United States during the COVID-19 pandemic. JAMA Intern Med. 2020;180:1389–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. White-Williams C, Liu X, Shang D, Santiago J. Use of telehealth among racial and ethnic minority groups in the United States before and during the COVID-19 pandemic. Public Health Rep. 2023;138:149–56.

    Article  PubMed  Google Scholar 

  58. Weber E, Miller SJ, Astha V, Janevic T, Benn E. Characteristics of telehealth users in NYC for COVID-related care during the coronavirus pandemic. J Am Med Inform Assoc. 2020;27:1949–54.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Qian AS, et al. Disparities in telemedicine during COVID-19. Cancer Med. 2022;11:1192–201.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Chu JN, Kaplan C, Lee JS, Livaudais-Toman J, Karliner L. Increasing telehealth access to care for older adults during the COVID-19 pandemic at an academic medical center: Video Visits for Elders Project (VVEP). Jt Comm J Qual Patient Saf. 2022;48:173–9.

    PubMed  Google Scholar 

  61. Jacobbi, V. Telehealth’s lasting impact on cancer care delivery. Discovery’s Edge. https://discoverysedge.mayo.edu/2023/11/17/telehealths-lasting-impact-on-cancer-care-delivery/. Accessed 1 Jan 2024. 2023.

  62. Laccetti AL, et al. Increase in cancer center staff effort related to electronic patient portal use. J Oncol Pract. 2016;12:e981–90.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Dyrbye LN et, al. Relationships between EHR-based audit log data and physician burnout and clinical practice process measures. Mayo Clin Proc. 2023;98:398–409.

    Article  PubMed  Google Scholar 

  64. Jha AK, Iliff AR, Chaoui AA, et al. A Crisis in health care: a call to action on physician burnout. Waltham, MA: Massachusetts Medical Society, Massachusetts Health and Hospital Association, Harvard T.H. Chan School of Public Health, and Harvard Global Health Institute; 2019.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Robert Haemmerle & Jonas Paludo

  2. Division of Hematology, Mayo Clinic, Rochester, MN, USA

    Jonas Paludo & Joshua C. Pritchett

  3. Department of Oncology, Mayo Clinic, Rochester, MN, USA

    Tufia C. Haddad & Joshua C. Pritchett

  4. Center for Digital Health, Mayo Clinic, Rochester, USA

    Tufia C. Haddad

  5. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    Joshua C. Pritchett

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  1. Robert Haemmerle
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  4. Joshua C. Pritchett
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Contributions

RH and JPr wrote the main manuscript text. All authors reviewed the manuscript.

Corresponding author

Correspondence to Joshua C. Pritchett.

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Competing interests

The authors declare no competing interests.

Conflict of Interest

Robert Haemmerle, Joshua Pritchett, and Jonas C. Paludo have nothing to disclose. Tufia Haddad has received research grant funding from Takeda Oncology (Institutional) and served on an advisory board for Puma Biotechnology (no personal compensation); both are unrelated to this work.

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Haemmerle, R., Paludo, J., Haddad, T.C. et al. The Growing Role of Digital Health Tools in the Care of Patients with Cancer: Current Use, Future Opportunities, and Barriers to Effective Implementation. Curr Oncol Rep (2024). https://doi.org/10.1007/s11912-024-01534-5

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