Medullan recently participated in a discussion hosted by HealthXL, which brought together leaders from across the healthcare and the life sciences to talk about digital therapeutics in oncology. There is growing interest in using digital tools to empower cancer patients to monitor and report their symptoms as they emerge. In turn, they facilitate providers with that information so that they can respond as appropriate.
The evidence is slowly building, but there have been pilot and proof of concept studies that show that empowering patients with symptom monitoring tools during chemo can improve quality of life and overall survival. For example, a randomized control study run at Sloan Kettering over many years provided patients with a web-based platform to report their cancer symptoms. Nurses could respond to the patient-reported information by calling them at home, managing side effects, and addressing other chemo-related challenges. The result was increased overall survival, probably stemming from the fact that the patients who received this in-the-moment help were able to tolerate their chemo 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 start-ups 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 simply 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 providing such a platform are manifold for patients, providers, and the entire ecosystem. With ever more complex and numerous combination therapies, platforms such as Kaiku offer a source of real-world data giving into the experience and side-effects of patients on these combinations 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 but can benefit a broad range of patients, even those with cancers seen only rarely. Platforms need to be simple to use by all involved and adopted and easily integrated into a cancer center’s information technology and workflow. Even when those mandataries are addressed, it falls to the oncologist and the team to support, champion, and promote the platform application to patients. It’s not enough to make healthcare practitioners aware of a helpful solution; there need to be incentives built-in to ensure they are really used. Broader and richer reimbursement for medical nutrition and other supportive cancer services may hopefully 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 towards those areas within cancer care currently reimbursed, such as occupational therapy and speech therapy. These are relevant to cancer patients’ quality of life, and 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 fall to 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 those data are seen as 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.