Electronic health (eHealth) applications can effectively deliver care to cancer patients and survivors, according to a researcher at Sylvester Comprehensive Cancer Center in an article published April 30 in the prestigious journal The Lancet Oncology.
“It is clear that eHealth offers the promise of advancing patient-centered care in many ways,” said Frank J. Penedo, Ph.D., director of cancer survivorship at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.
“In the past decade, there has been a growing interest in capitalizing on advances in information technology to provide quality care to cancer patients and survivors outside a hospital or clinic,” said Dr. Penedo, who is professor of psychology and medicine. “This trend has accelerated dramatically this spring as the COVID-19 pandemic has changed the landscape of clinical care here at Sylvester and around the world.”
Dr. Penedo is the first author of the Lancet Oncology article, “The Increasing Value of eHealth in the Delivery of Patient-Centered Cancer Care,” which provided an appraisal of peer-reviewed literature over the past 10 years related to cancer care delivery via mobile health, web-based portals and other telehealth and telemedicine platforms. Joshua Kronenfeld, M.D., a Sylvester post-doctoral fellow in surgical oncology and resident in general surgery, is a co-author, along with researchers at two other institutions.
“There is growing evidence to support the efficacy and acceptability of the use of eHealth for patient-reported symptom monitoring and management during and after active cancer treatment,” said Dr. Penedo, adding that eHealth has the potential to improve patient-provider communications, improve symptom management, and enhance patient engagement across the care continuum.
“When prompted, cancer patients were willing to use health information technologies to report on their symptoms and outcomes,” said Dr. Penedo. “Those results can add critical information to electronic health records, providing clinicians with immediate feedback to assist in patient care.”
Dr. Penedo said many studies show positive results of eHealth interventions designed to help cancer patients and survivors manage pain, fatigue, psychosocial distress and other symptoms. For example, one eHealth intervention designed to improve sleep for cancer survivors with insomnia was associated with a significantly higher quality of sleep.
With the onset of the COVID-19 pandemic, the eHealth delivery of support services, as an example, has increased dramatically, added Dr. Penedo, noting that Sylvester’s Cancer Support Services team now offers programs on yoga, exercise, meditation, music, eBeauty, art and other topics via a videoconferencing application.
“Today, eHealth applications support the delivery of valuable psychosocial services to patients and survivors,” he said. “Targeted interventions addressing specific concerns, such as perceived stress and symptom burden, including pain and fatigue, have shown promise in improving health-related quality of life.”
Advances in eHealth technology offer a timely opportunity to optimize research on cancer care delivery and address the multiple challenges faced by patients, their families, and care partners, added Dr. Penedo. However, he cautioned that more research is needed and that most commercially available eHealth applications for mobile devices are not based on evidence and lack documentation of their efficacy.
In addition, future eHealth research should include larger samples, randomized trial designs, long-term follow-up, and evaluation of clinical outcomes, he said. Also, most studies to date lack substantial inclusion of racial and ethnic minorities, rural and financially disenfranchised communities, and older patients. These communities may have the most to gain from eHealth services but also continue to face considerable barriers to adequately accessing eHealth programs.
“Looking ahead, we are now witnessing technological developments that will transform models of cancer care delivery,” said Dr. Penedo. “We are at a pivotal point in this transformation. Deploying eHealth services can enable better management of both patients and cancer survivors. In addition to improving patient outcomes, implementation of eHealth programs can also ultimately improve systems-level outcomes, such as a reduction in visits to emergency departments, hospital readmissions and other high-cost services.”