The impact of digital health technology on oncology care

Mar 23, 2017 - reading time 5 mins

By Andrea Chipman

Andrea Chipman has been working as a freelance journalist since 2004 and is based in Nottingham, England. She writes about healthcare, business and science policy for a range of publications including the Economist Intelligence Unit, for which she has written a number of healthcare reports, including “Reducing the burden: the economic and social costs of lung cancer in Italy,” “Tackling Hepatitis C: Moving Towards an Integrated Policy Approach” and “The Future of Healthcare in Africa”. Andrea has also written for the Wall Street Journal and Nature Magazine, and previously spent eight years as a staff reporter for Dow Jones Newswires, working in New York, Moscow and London. She was educated at Columbia University and Oxford University.

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Oncology treatment is among the largest contributor to health expenses. As expenditure continues to increase, better use of connected care could help drive down the costs.

Doctor and patient in consultation with digital tablet

To achieve the potential savings, healthcare systems will need to reform health delivery systems and use the new data produced by connected care devices to identify the patients most likely to benefit from new oncology treatments.

The Philips 2016 Future Health Index report found that among healthcare professionals whose patients have used devices or applications to manage their health and share data with their physicians, 59% agreed that their patients were more motivated to adhere to treatment plans. An additional third of those surveyed believed patients would manage their health more effectively if they used technology to keep track of health indicators.

The potential impact of using better health management and improved data to alleviate financial pressures on health systems is sizeable. A study by the U.S. National Cancer Institute (NCI) found that medical expenditures for cancer were projected to reach at least $158 billion in 2020, an increase of 27% over 2010. If costs of new diagnostic tools, treatments and follow-ups continued to climb, the study found, medical expenditures could rise as high as $207 billion.¹

Similar projections have been made in the UK, where a study by private health insurance provider Bupa estimated the number of new cancer cases would rise to 383,000 a year by 2021 from 318,000 in 2010, at a cost of £15.3 billion, up from £9.4 billion.²For patients, the prospects for lowering costs are no less significant. Research by CLIC Sargent, a cancer charity that helps families of young cancer patients, found that parents spent an average of £600 extra a month during their child’s active treatment, and three in five parents accumulated some form of debt as a result of their child’s illness.

Using connected care to improve outcomes

The number of ways in which connected care technology can be used to improve patient awareness and monitoring is well-documented.

The U.S. President’s Cancer Panel, in a recent report to President Obama, defines connected care as technologies that can be used to “promote cancer prevention, enhance the experience of cancer care for patients and care teams, and accelerate progress in cancer research.”

Some of the basic elements of connectivity are already available in many developed economies, including electronic health records (EHRs), internet access and smart phones. In the case of oncology care, the biological complexity of cancer and the necessity of using multispecialty care teams to treat it, makes the use of technology especially important for more efficient collection and communication of information. It is also important for connecting patients, especially those with rare forms of cancer, and helping to support them.

The most recent data available indicates that 84% of Americans now have internet access, 68% have smart phones, and the clear majority of hospitals have at least basic EHRs, which were required under the HITECH Act of 2009, according to a recent article from the U.S. National Cancer Institute.³

The NCI report highlights five priorities for advancing connected health:

ensuring that health IT systems and applications are interoperable
enabling individuals to manage their health and participate in their care
making sure federal programs and health IT tools support the cancer workforce
expanding internet access for healthcare providers, individuals and organisations;
facilitating data sharing and integration to help improve care, surveillance, and the progression of research.

As part of this process, the report recommends the creation of tools and services to help individuals identify cancer-related clinical trials appropriate to them and to flag perceived errors in their medical records, as well as IT tools to “help support the oncology workforce as it delivers care.”⁴

Indeed, the Future Health Index Report quoted a Japanese physician as saying that connected care devices will make it easier to collect health data from patients receiving home care in remote regions, which will help to improve the quality of care.⁵

Connected care adapting healthcare delivery

While more connected care has the potential to improve patient awareness and autonomy, there is no guarantee that it can, by itself, reverse skyrocketing costs. Indeed, for it to have a significant impact on expenditures, connected care technology will have to be combined with improved adaptation of delivery pathways for oncology care and, in some cases, with initial outlays on training of healthcare personnel to help patients better manage their own care.

Directing as much treatment as possible to outpatient care clearly has a potential to reduce costs and patient comfort. The Bupa report found that just over a quarter of expenditure for cancer care was spent on hospital inpatient costs not including surgery.

One example of a potential remedy is found in a 2011 Bupa report, which recommended that enabling patients to receive chemotherapy at home could exempt hospitals from the value-added tax (VAT) that is charged on chemotherapy drugs.⁶

EHRs and the data they provide can help encourage the use of evidence-based medicine and help oncologists to develop pay-for-performance opportunities.⁷Yet, as the President’s Cancer Panel report points out, interoperability of records is a pressing challenge for health systems, particularly in the US. Meanwhile, a number of experts have suggested that health systems in emerging economies – where connected care technology has been largely based on mobile devices rather than on so called “legacy” IT systems, and where concerns about privacy issues have been lower than in the developed world – could potentially leap-frog other parts of the world in expanding the use of such technology for cancer patients.

Connected care technology has the potential to help with both cost containment and the improvement of outcomes in oncology care, but practitioners will need to make sure that health systems are adapted to cope with it and use it to its full advantage.

¹ A.B. Mariotto, K.R. Yabroff, et al., “Cancer Care Costs in the United States: Projections 2010-2020”, Journal of the National Cancer Institute, January 19, 2011

² “Cancer diagnosis and treatment: a 2021 projection,” Bupa.

³ B. K. Rimer, “Connected Health: An Important Tool for Making Progress against Cancer,” National Cancer Institute, November 16, 2016.

⁴ “Improving Cancer-Related Outcomes with Connected Health: A Report to the President of the United States from the President’s Cancer Panel,” November 2016, page 15.

⁵ Future Health Index Report 2016, Page 21.

⁶ “Cancer survival rates ‘threatened by rising cost’,” NHS Choices, 12 December 2011

⁷ M. A. Kolodziej, “Does Evidence-Based Medicine really Reduce Costs?”, http://www.cancernetwork.com/practice-policy/does-evidence-based-medicine-really-reduce-costs