In a discussion hosted by HealthXL, we joined other leaders from healthcare and life sciences to talk about digital therapeutics in oncology. We discussed the growing interest in using digital tools to empower cancer patients to monitor and report their symptoms as they emerge. In turn, these tools put that information in the hands of healthcare providers so that they can respond as appropriate.
While the evidence is slowly building, there have been pilot and proof of concept studies that show empowering patients with symptom-monitoring tools during chemotherapy can improve their quality of life and overall survival rate. For example, a randomized control study that Memorial Sloan Kettering ran for many years provided patients with a web-based platform to report their cancer symptoms. Nurses could respond to the patient-reported information by calling the patients at home, managing side effects and addressing other chemotherapy-related challenges. The result was increased overall survival, likely stemming from the fact that the patients who received this in-the-moment help were able to tolerate their chemotherapy better.
Creating an evidence-based, patient-centered connected platform that is relatively easy for a cancer center to implement is no small challenge, but some startups are working on just that. Kaiku Health, a Finnish digital health company, has been working with cancer centers across Europe, offering an app that allows patients to monitor their symptoms and automatically use that data to provide intelligent symptom tracking and management support for providers in a way that fits into existing care management routines. The benefits of a platform like this one are manifold for patients, providers and the entire ecosystem. As numerous, more-complex combination therapies enter the market, platforms such as Kaiku offer a source of real-world data giving insights into the experience and side effects for patients who are on these combinations. These are insights that could not come from clinical trials.
While everyone who participated in the HealthXL conversation agreed that digital health solutions could help address some of the overlooked issues patients face during cancer treatment—challenges with nutrition, intense fatigue and depression, to name a few—implementing these solutions is not easy. Solution providers need to ensure platform solutions are not limited to just one cancer type but can benefit a broad range of patients, even those with cancers seen only rarely. Platforms need to be simple to use for all involved and easily integrated into a cancer center’s information technology systems and workflow.
Even when a digital health solution addresses the needs of all parties, it falls to the oncologist and the healthcare team to support, champion and promote the platform application to patients. It’s not enough to make healthcare practitioners aware of a helpful solution. Incentives should be built in to ensure that patients and practitioners adopt these digital health solutions. Broader and richer reimbursement for medical nutrition and other supportive cancer services may be offered in the future, but payers are moving slowly. Cancer centers are unlikely to broadly adopt platform solutions if they are seen as cost centers.
Given that the need is now but available reimbursement mechanisms are uneven at best, there are a few possible approaches. First, solution providers should be looking toward those areas within cancer care that are currently reimbursed, such as occupational therapy and speech therapy. These are relevant to cancer patients’ quality of life. A support platform can find ways to tap into these reimbursed service centers to build revenue before new reimbursement codes become available.
Second, in the absence of new revenue sources from payers, pharmaceutical companies should support platforms as therapy companions. Life sciences leaders can invest in pilot oncology solutions that deliver robust real-world evidence that grows in value to the provider community. Pilots can build the needed evidence showing that connected multimodal services lead to quality of life improvements, a reduction in healthcare costs and a reduction in patients falling off of treatment.
When that data is robust, then digital health-enabled services in oncology may find broad support in academic and community cancer centers. Pharmaceutical company partners will see them not as optional but of essential value to the cancer community.