The term Digital Health has the potential to come to symbolize compassionate support for cancer patients all along their treatment journey, the freeing of health care providers from tasks that can be automated, and more time for a richer patient-physician relationship.
We are witnessing an extraordinarily fast pace of technological innovations in healthcare, often called “Digital Health”. Digital Health has the promise to improve the lives of people suffering from many conditions, especially chronic ones. These innovations come at a time when the healthcare environment is changing dramatically and requires new technology solutions to provide optimum care and quality of life.
The United States is projected to experience rapid growth in its older population. According to the United State Census Bureau, the number of persons 65 years and older in the United States will double from the current estimate of 35 million to a projected 70 million by 2030. In 2020, this population will represent 17% of the US population and by 2030 one in every five Americans is projected to be of retirement age.
Cancer occurs at all ages, however it disproportionately affects this growing segment of the population. By 2030, an estimated 70% of all cancers will occur among adults aged ≥65 years. Therefore, the expansion of the number of persons 65 years and older is likely to increase the absolute number of older people diagnosed and treated for cancer in the United States in the next decades.
At the same time, many cancers are becoming chronic diseases due to increased survival rates. Thus, not surprisingly, oral anti-cancer medications (OAMs) are one of the fastest-growing areas of cancer treatment. They are increasingly being used as an alternative to intravenous (I.V.) treatments. They represent more than 25 percent of anti-cancer therapies in development by pharmaceutical companies. They bring convenience and ease of administration, and potential cost saving with less time spent in hospital. However, as with many chronic diseases, this shift in cancer care puts more responsibility on patients and their families. It forces them to take a more active role in managing what are often very complex treatments. Patients with OAMs are more removed from the clinical setting, and they have fewer face-to-face interactions with their healthcare providers than patients on I.V. treatments. Therefore, they tend to be much more on their own for the management of treatment-related symptoms, and medication adherence monitoring.
Simultaneously, we are facing an increasing shortage of physicians. A new report by the Association of American Medical Colleges (AAMC) foresees that by 2025 34,600 to 88,000 doctors will be lacking to meet the need of the growing and aging population. And, by 2030, the shortfall is expected to total anywhere from 40,800 to 104,900 doctors.
In this context, Digital Health could become a key solution in supporting cancer patients in their treatment journey. But, what does “Digital Health” mean?
The umbrella definition given by The United States Federal Communications Commission (FCC) speaks primarily to the technology of Digital Health. It includes many elements such as mobile health (mhealth), Wireless Health, Health 2.0, eHealth, , Digital therapeutics, Telehealth & Telemedicine, Connected Health.
Let’s examine the goals or mission of Digital Health. Based on the United States Food and Drug Administration (FDA) Digital Health page, its mission is “for providers and other stakeholders to: reduce inefficiencies, improve access, reduce costs, increase quality, and, make medicine more personalized for patients. Patients and consumers can use digital health to better manage and track their health and wellness related activities. “
This “mission statement” focuses mainly on process and cost and fails to reflect the human dimension of Digital Health. The primary goal for Digital Health with regard to cancer patients and their families should be to make sure they do not feel isolated and alone when facing their condition and treatment. Digital Health should help them feel empowered and engaged with their cancer and its treatment. It should also give them the assurance that their healthcare team will be always there when they need them. For health care providers, Digital Health should be a tool to free them from tasks that can be automated, giving them time to care for their patients, which is their true mission.
Names are not only a convenient way to distinguish one person from another, but they represent our identity. They define what we are and capture our essence. Names are a book and they tell a story, such as our life’s mission. It remains to be seen, what the story of Digital Health will be for patients and their families. Will it be a story where automation replaces the human interactions and the human touch? A story where the relationship between patients and their physician is reduced to its minimum? Or will it be a compassionate story where physicians have more knowledge about their patients’ treatment journey, more time to interact with them and to understand their values and needs? Thus, physicians are better armed to help their patients and to apply their expertise to treat them and to improve their quality of life.
