Innovations in Cancer Care

A Mediaplanet Guide to Oncology After COVID-19

Innovations in Cancer Care

Dr. Bertalan Meskó The ”Medical Futurist” on the digital health technology supporting today’s hospitals The prescription digital therapy helping patients manage the emotional side effects of cancer How the future of telehealth is creating an improved patient experience

MARCH 2022 | FUTUREOFPERSONALHEALTH.COM

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The House Call of the Future is Virtual In the wake of the COVID-19 pandemic, healthcare has circled back to the house calls of the early 20th century.

I’m old enough that many TV shows throughout my childhood showed doctors making house calls. From “I Love Lucy” to Marcus Welby, M.D., the doctor came to your home and personally directed your care. Until the middle of the 20th century, this was the norm. So, what happened to the house call?

Care economics Technology, in some ways, made it impractical, but the economics of healthcare also changed. According to National Health Expenditure, the out-of-pocket share of total healthcare costs declined from almost 70 percent in 1960 to only 9 percent in 2020. To put it plainly, doctors do what is convenient for the people paying them. When patients paid the doctor directly, the doctor visited them. When insurers starting writing the checks, doctors stayed in one place and made patients come to them to increase efficiency.

At the beginning of 2022, we are again talking about care moving back to the home via telemedicine. It is primarily attributed to COVID-19, but there is an underlying trend in care economics that may accelerate the movement and give it staying power beyond the pandemic.

America is again shifting toward more self-directed healthcare spending. The growth in high-deductible health plans and the increasing use of HSAs is give spending power back to individuals, and many individuals are asking for more convenience in their care experiences.

The growth and acceptance of telemedicine, home-based diagnostic testing, and other virtual services means that the house call of the future will be virtual and quite common.

Robert Havasy, Senior Connected Health Director, HIMSS

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The Telemedical Revolution: How Technological Advancements Are Supporting Today’s Hospitals

Dr. Bertalan Meskó PhD, Director, The Medical Futurist

The newfound prevalence of telemedicine, combined with advancing technology across all aspects of healthcare, is helping to ease the burden on healthcare professionals and hospitals in 2022.

What technologies are most important for hospitals to implement in 2022 and why?

The most important thing hospitals should implement in 2022 is not a technology but a concept: patient design.

Patient design means involving patients on the highest level of decision-making in an organization. This way, patients would have a

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final say in the design of new facilities, processes, or services provided by the hospital. As digital health technologies make patients the point of care, any technology that would further support that goal could be beneficial for hospitals.

nurses to see patients through these services.

It must be a quiet, welllit room with proper equipment. Studies show that such rooms help medical professionals adjust to the increased amount of remote care visits.

What are some important steps hospitals can take to address nurse burnout and assist their nurses in 2022?

How can telemedicine support our hospitals and increase access to care?

As the pandemic is still going on, the absolute priority should be preserving the mental health of healthcare professionals, and help them try to avoid further burn-out.

Besides the traditional techniques for that, it would be crucial for hospitals to address the new norm we are building after the pandemic’s end.

One example would be a rise in telemedical visits, which requires a designated area or room for physicians and

The technical requirements for telemedicine have been around well before the pandemic hit.

But the first lockdowns led to an incredible rise in telemedical visits, proving for millions of patients and physicians that it can be a convenient way of accessing and providing medical help.

Even after the pandemic, there will be many areas, especially in underdeveloped regions, where access to a traditionally designed healthcare system will not be possible. For them, telemedical care will be the only possiblity to get the

medical help they need.

With the rise of telemedicine, it would also become possible to release the burden on hospitals. To be honest, it has been a luxury already to be able to see a physician with any kind of health problems.

With the doctor shortage we will always face, we should get used to telemedical care and understand that it represents the only sustainable option for healthcare in the long term.

What is the long-term outlook for the hospital technology industry?

Healthcare in the near future should become invisible, seamless, and as humanistic as possible. When advanced technologies can take away the repetitive components of a physician’s or nurse’s job, what’s left would be centered around empathy, compassion, and trust. This is the cultural transformation hospitals should facilitate. n

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Publisher Nina Montross Business Developer Joelle Hernandez Managing Director Jordan Hernandez Lead Designer Kayla Mendez Designer Tiffany Jackson Lead Editor Jon Adams Copy Editor Taylor Rice Content Production Manager Jordan Hernandez Cover Photo András Zoltai All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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A New Tool to Support Patients Living with Cancer Cancer and its treatment can be emotionally exhausting.

Prescription digital therapies can help patients take back control.

“Anxiety and depression are considerably higher in patients with cancer compared with the general public.

In fact, more than half of the people diagnosed with cancer have clinically significant levels of distress,” says Sean Zion, Ph.D., virtual trial lead and senior manager of behavioral science at Blue Note Therapeutics. “Unfortunately, for far too many patients,these symptoms go untreated.”

Ricki Fairley, who was diagnosed with stage three triple-negative breast cancer, knows that better than most.

Her story is eye opening to the pervasiveness of cancer in all aspects of a patient’s life.

After Fairley, CEO of Touch, The Black Breast Cancer Alliance (TOUCHBBCA) and patient advisor to Blue Note Therapeutics, was diagnosed with breast cancer she underwent a double mastectomy, six rounds of chemotherapy, and six weeks of radiation — only to have her cancer return a year later. “My doctor said ‘Ricki, you have ‘two years to live,’” Fairley recalls.

“I said, I can’t really die right now.’ We need to work something out.”

Fairley says what people don’t understand about cancer is that the anxiety is constant. “You’re always thinking about it — you think about it when you wake up in the morning.

The first thing you think about is gosh, I have cancer. I could be dying. And it’s pervasive.” And the stress doesn’t end when treatment does. “The thought of recurrence is always there,” she says.

Emotional impact Stress, anxiety, and depression often manifest following a cancer diagnosis, throughout treatment, and even into survivorship. These emotional challenges can have ripple effects, impacting cancer treatment outcomes, personal relationships, and overall quality of life.

Taking control Fairley was introduced to Blue Note Therapeutics, a company dedicated to easing the burden of cancer, and their prescription digital therapy apps, by her nurse navigator. The company takes faceto-face, cancer-specific therapies and recreates that experience in a digital format

that can be used by patients “on demand” from the comfort of their home.

“Prescription digital therapeutics are software-driven therapeutic devices aimed at helping patients manage medical conditions or diseases,” Zion explains. In the case of cancer-related anxiety and depression, these digital tools can help enable patients to better manage the unique emotional challenges of cancer.

“The therapy was really, really helpful because it helped me realize that I was creating my own stress by making people dependent on me,” Fairley says.

“What I learned was that not only did I have a cancer in my body, I had a lot of cancers in my life that I had to get rid of.”

Through the digital therapy app, Fairley developed lifelong skills that helped her manage her stress and emotions — like breathing exercises she calls her “fast fix” for stress. “To have control over something when you have cancer is a great thing,” Fairley says. “Because there are not too many things you can control.” The fact that the program is available as an app on any mobile device means support and treatment are available at any time, even in the middle of the night.

Virtual trial Zion is also excited about Blue Note Therapeutics’ newly launched virtual clinical trial which can be completed 100 percent from home, with no in-person medical visits. The clinical trial is studying the impact of two digital therapy apps on the physical and mental health of patients living with cancer. “Running an in-person study involves a lot of people on the ground recruiting and enrolling patients in the hospital,” he explains.

“The products we’re studying here are digital apps that can be used at home.

This offers patients a more convenient way to participate and enables access to a patient population that may otherwise be underrepresented.”

Fairley encourages anyone living with cancer to look for tools like prescription digital therapies. “Minimize your stress as much as you can — get rid of it!” she urges. “Because anxiety does not help healing.” n Jeff Somers

Learn more by visiting: bluenotetherapeutics.com

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A Digital Transformation for a More Equitable Future in Oncology Over the past 50 years, we’ve seen a remarkable transformation in cancer treatment and patient care. However, this incredible progress is not making its way to every patient living with cancer, and deep-rooted disparities in cancer persist.

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or all patients to benefit from cancer progress, we must continue to focus on innovations that are designed to improve equity for patients in diagnosis, care, and survivorship. Innovation can bring down barriers to access and make cancer care more equitable, convenient, and efficient for patients worldwide. Over the past two years, as a result of the COVID-19 pandemic, we’ve witnessed a rapid adoption of a broad range

of digital healthcare activities and services in the U.S. healthcare system. It is my hope that telemedicine is here to stay in oncology, and that continued innovation in delivering remote care will allow patients to access specialists that they otherwise might not be able to.

Making strides Digital technologies have the potential to improve patient cancer. Recent research shows a digital monitoring system that allowed patients with can-

cer to report their symptoms from home led to better symptom control and physical function. When a patient’s symptoms worsened, an electronic alert was sent to care team nurses, and reports showing symptom data over time were available to oncologists during in-person or telehealth visits.

Enabling patients to digitally report their symptoms and side effects directly to their cancer care team between visits led to improved communication with the team, better symptom

management, and improved quality of life.

We’ve also seen telemedicine approaches expand to cancer research. Until recently, people participating in clinical trials had to complete many research administrative tasks in-person, deterring some from enrolling in research. It is only in the past two years — as a result of COVID-19 — that patients can provide consent and review study information remotely. Adopting digital approaches to cancer research

lessens participants’ risks, facilitates monitoring of side effects, and can potentially lower trial costs.

We’re in the midst of a digital transformation in oncology. Let us harness this moment and expand the use of innovative digital technologies with the goal of bringing high-quality, equitable cancer care to all patients. n Everett E. Vokes, MD, FASCO, President, American Society of Clinical Oncology

Digital Advances Bring New Hope for Patient Safety in Medication Reconciliation Medication reconciliation is critical to avoid adverse drug interactions and prevent patient safety incidents.

If you’ve been prescribed medicine during a healthcare encounter, chances are you’ve also been asked to verify the medicines you’re taking. The person asking is taking you through a process called medication reconciliation. This is the act of comparing the medicines listed in a person’s medical record to the medicines the person is actually taking.

Medication reconciliation

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is critical to avoid adverse drug interactions and prevent patient safety incidents. More than 40 percent of Americans aged 65 and older take five or more medications, and the risk of error rises during transitions of care when patients are moved from one healthcare setting to another, such as from a hospital to an inpatient rehabilitation facility.

If clinicians at the receiving care center are not aware of all medications a patient is taking, life-threatening complications can occur with any new prescription.

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Technology and self-reporting While healthcare technology has advanced by leaps and bounds over the past 20 years, the ability of clinicians to reconcile medications using electronic health records still needs improvement. When a person transitions between healthcare settings, and each setting uses a different software platform, then patient information may not be shared between these organizations.

In these instances, clinicians are left with incomplete lists of medications. Currently, there

is no single, comprehensive list of medications for the past year that can follow a patient from provider to provider across technology platforms.

And when the medication list is incomplete or inaccurate, patients are in jeopardy of a potential adverse drug event.

Recent digital advances offer hope for progress in this area. For example, the College of Healthcare Information Management Executives (CHIME) and others are working to improve interoperability, or data sharing, at times of transitions of care.

However, technology is one piece of the puzzle. Patient self-reporting is another, and you can help — for yourself or a family member, especially at times of transitions of care.

Please maintain a list of your medicines (prescribed and/or taken and/or discontinued) in the past year and share this list with clinicians at each care center. n Dr. Robert Latz, CIO, Trinity Rehabilitation Services; Member of Policy Steering Committee, College of Healthcare Information Management Executives (CHIME)

Innovate Oncology Operations With RTLS Patient Flow Technology Time is of the essence in cancer care. How do you ensure your patients and clinicians get the most out of their care experience?

With more than 1.8 million Americans diagnosed with cancer this year, coordinating care for a growing oncology population is no easy task.

According to the Association of Community Cancer Centers, 75 percent of cancer program leadership cited workflow inefficiencies as the most con-

cerning bottleneck to patient care delivery. In the highly emotional and time-sensitive treatment of cancer patients, an inefficient patient flow can negatively impact patients and caregivers.

Enhance patient flow Five of the top 12 cancer centers in the United States use real-time locating system (RTLS) solutions from Midmark to optimize patient flow, reduce stress on care teams, and provide extra

safety for patients and staff alike. RTLS is like GPS for the indoors — a system that displays the real-time locations of people and things on a map (or list). Badges worn by people and tags affixed to equipment communicate with a sensory network of receivers installed throughout a facility. Depending on the accuracy of the RTLS technology, the reported location can either be general (“1st Floor”) or more precise (“Infusion Chair 2”).

Design a better patient experience Cancer centers that implement Midmark RTLS’s patient flow optimization can tell instantly how long each patient has been waiting, what stages of care they’ve completed, who’s already seen them, and who may need to see them next.

This information keeps patient visits progressing smoothly and helps to reduce patient and staff frustration. Midmark RTLS provides chair-level locating with minimal hardware, allowing

cancer centers to monitor infusion length, staff interaction, and chair utilization.

Increase capacity Midmark’s patient flow optimization solution improves workflow efficiency and communication at top cancer centers as well as community cancer centers. One leading cancer center in Boston optimized workflows with Midmark RTLS and increased capacity by 10 percent without adding physical space. With better efficiency and communication comes the ability to impact more patients’ lives and provide the highest standard of care. Details on how Midmark RTLS has improved patient flow and satisfaction can be found at midmark.com/oncology. n Jeanne Kraimer, Product Marketing Manager, Midmark RTLS

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Recent events have showcased the potential that data can have in shaping the future of healthcare.

There is a collective understanding across healthcare leaders that our industry is in the throes of constant disruption, a drive to become more efficient, and an urgency to be more responsive. Core to these efforts of supporting change is a fundamental need to understand and utilize data in comprehensive, and informed, ways. And there is a lot of data to be used.

Forbes reported in 2021 that a “single patient generated nearly 80 MB of data each year” and that “by 2024, the compound annual growth rate of data for healthcare will reach 36 percent.” Historically, we’ve naturally collected and used critical data in caring for patients; however, these data have traditionally been siloed, transactional, and retrospective. This is changing, and there are now many examples of partnerships that are leveraging data to inform focused care delivery, new insights, more patient-focused outcomes, and usage across silos.

A team effort The past two years have provided the best use case for using reliable data to inform action, caution, planning, and response.

The COVID-19 pandemic showcased a host of examples whereby data was leveraged to inform hot spots and trends related to COVID-19 surges, hospitalizations, deaths, and capacity constraints at hospitals. It’s likely that this extent of reporting will become incorporated into daily life in the years and decades to come and will usher in a new way of informing the care we provide.

Data in healthcare is being used to advance care delivery, address current challenges, and provide caregivers more relevant and useful insights to help with their day-to-day work. The time for transformative data has arrived, and it will dramatically shape healthcare in the coming years.

Christopher M. Cornue, President & Founder, sláinte global partners (sgp), Expert, International Society for Quality in Healthcare (ISQua)

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How the COVID-19 Pandemic Changed Cancer Care for Good

PHOTO: COURTESY OF SCCA

Has the Time for Transformative Data Usage Finally Arrived?

When the COVID-19 pandemic began, a need to receive medical care remotely spiked among many patient populations, and the cancer population was no exception.

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hat’s where telehealth came in handy. “Oncology has embraced telehealth. I think we’ve found a niche where it really is helpful,” says Dr. Jennie R. Crews, medical director at the Seattle Cancer Care Alliance (SCCA) Affiliate Network.

While telehealth is no replacement for in-person cancer screenings, those who are already diagnosed with cancer and receiving treatment can conduct their follow-up appointments and even obtain supportive care services online. Telehealth has also allowed immunocompromised cancer patients to avoid long-distance travel and instead receive healthcare safely from home.

“That’s particularly impactful to vulnerable populations and patients who are hourly employ-

ees, where it’s really hard to leave work because any time spent away is going to significantly impact their take-home pay,” explains Crews.

The new normal At the SCCA, demand for virtual medical care peaked in March and April of 2020, when the pandemic first hit the United States.

The SCCA saw about 35 percent of its patients via telehealth. Virtual visits decreased to about 20 percent of all appointments at the end of 2020 and beginning of 2021, and then increased back to about 27 percent, Crews says.

Crews notes that this percentage has held steady during the surge in COVID cases due to the highly contagious Omicron variant. All in all, the SCCA has conducted nearly 58,000 telehealth visits since March 2020.

SCCA has surveyed its patients on their satisfaction with in-person and virtual visits and found that those who receive in-person care are only 0.2 percent more satisfied than those who receive telehealth. “They’re neck and neck in terms of patient satisfaction.”

Crews says she doesn’t think in-person care is going away; rather, telehealth will simply enhance in-person cancer care.

“The oncology industry has adopted telehealth in an amazing way,” Crews says. “Prior to the pandemic, telehealth had not been widely used in oncology compared to some other fields like psychiatry, primary care, and genetic counseling. We were forced to adapt and make that change because of the needs of our patients.” n Melinda Carter

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Improving the Patient Experience

by Overcoming the Digital Divide The emergence of telehealth during the global pandemic could make healthcare more accessible, safer — and more effective.

Telehealth — receiving medical care and treatment virtually, without an in-person visit — surged during the COVID-19 pandemic. Many patients discovered telehealth offered distinct advantages over in-person visits. In fact, a recent study conducted by Cleveland Clinic reported that patients were just as satisfied with virtual visits as they were with in-person healthcare.

Now that the pandemic appears to be ebbing, providers face a new challenge. “People are revisiting what was a stopgap solution and asking, how can we adapt this for the future?” says Krish Ramakrishnan, chief of innovation and products at BlueJeans by Verizon, a video collaboration and events company that has developed a next-generation telehealth platform.

Benefits of telehealth The rise of telehealth during the pandemic underscored its benefits. One important aspect of telehealth is improved patient access, both to those living in remote areas as well as to traditionally underserved or marginalized patients wherever they live.

“Telehealth is a great equalizer,” says David R. Penberthy, M.D., MBA, president of the

Association of Community Cancer Centers. “Especially for patients with cancer who live in remote or rural locations and now have access to remotely-located specialists, like dietitians, and services, such as genetic counseling, via virtual appointments.”

Removing the need to travel not only removes logistical challenges and the expense of travel, it also results in improved care. “Think about a brick and mortar visit,” suggests Ramakrishnan. “It takes a lot of planning, it takes a lot of effort. What’s more convenient than something that’s done at your own home? You’re more relaxed, your blood pressure is not elevated. In a lot of scenarios, the initial screening is better with telehealth.”

The low cost and convenience of telehealth also results in more proactive healthcare, because patients don’t need to overcome the traditional obstacles associated

with seeing a healthcare professional, such as waiting on hold for long periods to schedule a visit. Especially when you consider the elderly and those with advanced stages of varying diseases, a visit to a doctor’s office can be an all-day, physically and psychologically-draining experience.

Telehealth, coupled with personal and in-home patient monitoring devices, gives providers increased, continual access to patient data, allowing providers to build a 360-degree view of the patient more easily.

Telehealth services, like BlueJeans Telehealth, also helps keep those with underlying health risks safer, while still giving them access to healthcare providers. “Telehealth has become vitally important to facilitating care,” notes Dr. Penberthy. “While the rest of the world gets vaccinated and the threat of COVID-19 wanes, immuno-compromised

patients, like those with cancer, remain at great risk. Virtual visits, wearables that allow remote patient monitoring, and technology that allows patients with cancer to receive care from the safety of their homes is a game-changer.”

Revolutionizing healthcare A major obstacle to telehealth adoption and development was removed during the pandemic when federal and state governments introduced payer parity, and Medicare introduced billing codes for telehealth sessions. Suddenly telehealth visits were reimbursed at the same rate as in-person visits—and many jurisdictions are making the change permanent.

Ramakrishnan believes telehealth solutions, such as the one BlueJeans has developed, offer the opportunity to revolutionize healthcare in many ways. “That’s the needle-mover, in my opinion,” he says. “Over the long haul,

healthcare will no longer be geographically dependent.

You may be living in New York City, while your specialist may be in Connecticut. Why can’t you have a telehealth solution?

Telehealth has the potential to provide world-class medicine to everybody, everywhere in the world.” Looking toward the future, as telehealth becomes a universally accepted form of healthcare, homes will become their own personal medical clinic, with consumers increasingly using internet-connected remote patient monitoring devices that automatically collect and send data to their healthcare providers.

When vital signs indicate anomalies, providers will be able to automatically conduct a telehealth visit to virtually examine the patient.

BlueJeans intends to be part of this revolution. “When we started in this area,” notes Ramakrishnan, “we asked ourselves, how can we make this so seamless that people would have a world-class experience?

Our telehealth motto is ‘Better than being there.’ That’s our North Star.” n Jeff Somers

For more information about BlueJeans’ telehealth platform bluejeans.com/ products/telehealth

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