Digitising Cancer Care: The need for a national solution
A national digital solution for cancer care will help identify health inequalities and improve patient outcomes.
The article in Nursing Times, ‘Digitising Cancer Care: using electronic patient-reported outcomes measures’, was extremely positive. Digitising cancer care can lead to dramatic improvements and benefits for both patients and healthcare teams(1).
The NHS long-term plan to reduce face to face outpatient appointments by a third due to the projected increase in patient numbers and challenges makes sense. The use of digital tools to collect Patient Reported Outcomes Measures (PROMs) outside of clinical appointments to support and empower patients to become more involved in their care (self-driven care), is cost effective, service efficient and has shown to improve quality of life and outcomes.
More and more hospitals are creating bespoke platforms to collect PROMs. However, ironically as they make improvement, we need to be aware of a risk of widening inequalities of cancer care once again, as these centres of excellence create their own individual platforms that meet local service needs and service functionality but that don’t work for other hospitals. It is well recognised that during the cancer pathway a patients care can be transferred between several different organisations; to ensure truly personalised care it is vital that PROMs data is tracked throughout. That’s not to say that we’d advocate the other end of the spectrum either. The nationally imposed government ‘connected for health’ one size fits all solution, which was tried back in 2005 wasted £20bn of tax-payers money with a one size that didn’t work for anybody.
In the new world of self-driven personalised care, patient involvement can no longer simply be given lip-service. Pointing to ‘public patient involvement’ is also no longer sufficient. Patient centricity needs to be part of ePROM platform DNA. Patients need a greater say in what PROMs data needs collecting, how often, what it gets used for and who can see it.
Collecting data just before an appointment for example, will focus on specifics for an intervention – not general quality of life. Also, it does not accurately track long-term health over a period: offering only a temporary snapshot, when we need to measure health against patients day-to-day when away from clinical interventions, as much as during. Self-care is also compromised if we collect data that the patient can’t ‘own’. They need to be able to see themselves, what changes they are experiencing. If a solution does not permit them to view their personal data – they can’t be empowered to monitor themselves.
Patients are waking up to the fact that hospitals can’t solve the problem of inequalities. Hospitals are the ones that keep widening them, in a competitive trust-based system. Knowing this, healthcare leaders have been saying for the past 10 years that the way to fix healthcare is to move away from clinically lead systems based around what hospitals do, to a more patient centric model – based on the patient outcome achieved.
A hospital’s emphasis will always be on fixing their delivery inefficiencies first. A patient centric system is different. It’s all about achieving better outcomes and better care irrespective of hospital. It needs to provide the feedback both to support patient self-care but also to provide understanding for what works for patients and allow patient to see how healthcare meets the needs of its population.
So, there is a need for a simpler, universal ePROM solution that supports cancer care delivery nationally. It needs to be community based using ongoing and consistent data collection, to develop a national picture, that can help identify health inequalities across the country in real-time in order that we can address it.
If that’s not a better way to deliver self-driven, patient centric care, what is?
Article author: DaSH Global / Your Health Companion
Article source: (1) Nursing Times, October 2023