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Debating the changing role of digital in cancer care

Health Tech World sat in on Careology’s ‘The Changing Role of Digital in Cancer Care’ webinar recently, which featured a lot of interesting discussion around healthcare technologies now and in the future.

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After making introductions Sophie Hossack, head of growth at Careology, kicked off the webinar by asking Dr Majid Kazmi, chief of cancer services at Guy’s and St Thomas’ Trust, to explain his experiences with the digitalisation of cancer care.

Dr Kazmi: “My first involvement in this space was really around implementation of a cancer information solution and when I took that project, like most big IT projects it was two years behind schedule and massively over budget.

“But we managed to turn that around and we were able to see really quite quickly the benefits to patients about just simply having electronic records.

“We saw improvements in terms of patient safety. Chemotherapy prescribing errors and all of those things reduced.

“Then what I was able to do was to take that chemotherapy prescribing component of our electronic solution and roll it out across six hospital sites in the southeast London sector, which allowed, for the first time, connectivity between the different hospitals.”

James Clark, senior business development manager at McKesson UK, agrees with Kazmi’s points on ePrescriptions, going on to describe his own experiences in cancer care.

“The way the technology that we’ve seen, in the last ten years to when electronic prescribing started, is that it was all geared towards patient safety and clinical governance efficiencies.

“COVID certainly bought a fast track around a lot of the growth of these elements is around remote nursing and remote nurse training.

“Patients are a lot more empowered now to use technology and even though we’re dealing with an ageing population, a lot of these people have smartphones, computers and emails.

“I do think that it has shifted slightly to actually looking at how we empower patients and offer more choice.”

Christine Husbands, managing director of RedArc, continues this by detailing how her firm embraced this digital change.

“The last few years, there’s been a lot popping up for mental health and physical fitness, but not very much for physical ill health.

“I think that the pandemic has accelerated the use of technology in many areas and I think it’s going to be a matter of time before we see healthcare become more virtual.

“So that’s going to give much more efficient use of the consultant’s time, the hospital staff’s time, the resources and the patient’s time.”

Speaking about this acceleration of technology because pandemic Rachel Murphy, CEO of Difrent, said she has seen a similar process with her work.

“When I first came into the NHS, there was already a real willingness to start to adopt and move towards patient facing services. But whilst there was a desire, the experience and capability probably wasn’t there.

“I think there has been a huge wave of acceptance of digital in the last 12 months.”

A cancer diagnosis can completely disempower even the most active patients according to Dr Kazmi. He says that current healthcare systems have not properly grabbed the concept of fully supporting a patient.

“Giving patients volumes of information, all about their diagnosis and hoping that they can go away and read all of it, understand it and digest it just doesn’t work.

“You’re then talking about a paradigm shift in cancer care. We’ve moved it to become a much more recognisable condition, that is treatable for the majority of patients.

Looking to the future James Clark feels giving patients this information alongside a choice will play a major part in how cancer care is shaped.

“There’s no doubt there’s going to be more cancer diagnosis over the next 12 to 18 months, but it’s not like there’s all of a sudden a lot more treatment capacity.

“So patients are potentially going to have to become more empowered. What we have seen is, certainly from the NHS side, more patients taking on administration of their own medication.

“That’s a big thing in terms of patient experience and in terms of patient empowerment, because then the patient is fully engaged within that process.”

This empowerment is something Sophie Hossack wants to see even after recovery, noting how a patient’s network is often lost after this.

However Dr Kazmi explains how this will directly benefit those in the healthcare sector.

“Initially there’s a fear amongst clinicians saying you’re going to get the patient coming in with 20 pages downloaded off Google to question you and every decision you’re making.

“But I think once you get past that, you realise that empowered patients in the longer term are easier for you to look after and manage collaboratively.

“Decisions you have to make with patients about what the best options are for them can only be made if patients are really engaged. I think the days of patients being very passive on the whole are passing now.”

James Clark continued this discussion on patient empowerment.

“I think what I’ve always thought is that patient empowerment is great, but then patients need the tools with which they are empowered and I think digitalisation is key to this.”

Data can massively improve this, with Christine Husbands highlighting some innovative ways that patients can record their symptoms.

She spoke about the possibility of creating digital journals for cancer patients where they can record how they feel in real time to give clinicians quick access to this, thus allowing for a faster diagnosis.

However companies should be wary about taking every process online according to Rachel Murphy, as she said that simply putting a broken process online will not fix it.

“The other bit for me with change management, on a small or large scale, it’s only ever about people. So the tech bit is the really easy bit, but I think it’s an afterthought.

“But I guess it goes back to what the outcome is that people are aiming for in the first place, getting people bought into that direction of travel and calling out what the benefits are for them as individuals.”

Sophie Hossack then moved on to talk about the implementation of Careology in the NHS, which is a digital service that brings patients, clinicians and support networks together to assist the whole cancer care process.

Speaking about these three ‘stakeholders’ in this, James Clark said it is vital they are all on board when it comes to the adaptation of these new technologies.

“They all need to feel as though they have a say in how the process works, I think that is important.

“So it is taking the nurses, the patients and the clinicians on that journey in terms of actually how you are going to get to the end of this and then how the adoption of this will actually improve the care that a patient receives from a clinicians perspective.”

This is all part of the change management process that happens across the NHS, as Dr Kazmi drew upon his own examples to show it is something that shouldn’t be underestimated.

“When we did a cancer information solution, there were a number of my clinicians who weren’t interested, who said this is just adding another layer to everything else they have to do.

“But ultimately, once it was implemented and it was working people couldn’t believe how we’d ever work without it. 

“So if the technology makes life easier for the clinician then it is going to get adopted. Even the initial naysayers will finally end up using it because everyone is just so busy.”

Looking to the future, Sophie Hossack began questioning what is next for cancer care technology, asking the speakers what approach to technology should be implemented in the next ten years, with Rachel Murphy going first.

She mentioned the interesting new approaches that could change all parts of healthcare, drawing on examples of how plant-based medicines and psychedelics are being looked at as effective treatments for mental health issues which could benefit the cancer patient.

James Clark said although an ageing population may be seen as a burden when it comes to healthcare, the fact that these people have grown up around technology can massively assist how these are implemented.

This is something we are already seeing now according to Dr Kazmi, who closed with an eye-opening view of how cancer care could soon be delivered.

“What is staggering is the pace of change,” he said. “It’s not just in medicine but in science and other areas, the development cycles are rapidly accelerating.

“Things that we could never have imagined a decade ago are now real and I see that in my area, in cancer medicine.

“I can see a future where we have a dispersed model of care. Hospitals as they currently exist will probably no longer be the case in the future, much more cancer medicine will be delivered in the community, closer to patients homes.

“Looking at how you monitor those patients, how you look after them or how you make the right decisions for them and support them, that technology is already out there, it’s just how we coordinate it and bring it in.”

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