JNCI Journal of the National Cancer Institute · 2022 · 84 citations · 55 references
ComputingHealth InformaticsOncologyClinical Decision SupportClinical InformaticsHealth Technology AssessmentDigital Health StrategyDigital Health SystemsClinical Utility AssessmentDecision Support IntegrationDigital Health InfrastructureDigital Health TransformationPathology Decision SupportPatient-clinician CommunicationPatient-clinician RelationshipResearch Data Infrastructure
Digital health has transformed many clinical fields, yet its adoption in oncology remains limited, offering opportunities for patient‑, clinician‑, and system‑focused innovations that were accelerated by COVID‑19 but also revealed integration, data, and regulatory challenges. This article reviews the current state of digital health technologies in oncology and proposes strategies to enhance their clinical utility and integration. The authors synthesize findings from a 2020 National Cancer Policy Forum workshop to outline these strategies. The resulting recommendations call on clinicians, health systems, technology innovators, and policymakers to adopt measures that enable efficient yet safe integration of digital health into cancer care.
Abstract Digital health advances have transformed many clinical areas including psychiatric and cardiovascular care. However, digital health innovation is relatively nascent in cancer care, which represents the fastest growing area of health-care spending. Opportunities for digital health innovation in oncology include patient-facing technologies that improve patient experience, safety, and patient-clinician interactions; clinician-facing technologies that improve their ability to diagnose pathology and predict adverse events; and quality of care and research infrastructure to improve clinical workflows, documentation, decision support, and clinical trial monitoring. The COVID-19 pandemic and associated shifts of care to the home and community dramatically accelerated the integration of digital health technologies into virtually every aspect of oncology care. However, the pandemic has also exposed potential flaws in the digital health ecosystem, namely in clinical integration strategies; data access, quality, and security; and regulatory oversight and reimbursement for digital health technologies. Stemming from the proceedings of a 2020 workshop convened by the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine, this article summarizes the current state of digital health technologies in medical practice and strategies to improve clinical utility and integration. These recommendations, with calls to action for clinicians, health systems, technology innovators, and policy makers, will facilitate efficient yet safe integration of digital health technologies into cancer care.
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