Clinical Integration of Digital Solutions in Health Care: An Overview of the Current Landscape of Digital Technologies in Cancer Care

Abstract

Digital health constitutes a merger of both software and hardware technology with health care delivery and management, and encompasses a number of domains, from wearable devices to artificial intelligence, each associated with widely disparate interaction and data collection models. In this review, we focus on the landscape of the current integration of digital health technology in cancer care by subdividing digital health technologies into the following sections: connected devices, digital patient information collection, telehealth, and digital assistants. In these sections, we give an overview of the potential clinical impact of such technologies as they pertain to key domains, including patient education, patient outcomes, quality of life, and health care value. We performed a search of PubMed ( www.ncbi.nlm.nih.gov/pubmed ) and www.ClinicalTrials.gov for numerous terms related to digital health technologies, including digital health, connected devices, smart devices, wearables, activity trackers, connected sensors, remote monitoring, electronic surveys, electronic patient-reported outcomes, telehealth, telemedicine, artificial intelligence, chatbot, and digital assistants. The terms health care and cancer were appended to the previously mentioned terms to filter results for cancer-specific applications. From these results, studies were included that exemplified use of the various domains of digital health technologies in oncologic care. Digital health encompasses the integration of a vast array of technologies with health care, each associated with varied methods of data collection and information flow. Integration of these technologies into clinical practice has seen applications throughout the spectrum of care, including cancer screening, on-treatment patient management, acute post-treatment follow-up, and survivorship. Implementation of these systems may serve to reduce costs and workflow inefficiencies, as well as to improve overall health care value, patient outcomes, and quality of life.

Mobile Apps for Helping Patient-Users: Is It Still Far-Fetched?

“…Additionally, digital health constitutes a combination of both software and hardware technology with health care delivery and management, and encompasses a number of domains, from wearable devices to AI, utilizing varied methods of data collection and information flow, including monitoring of chronic conditions, such as respiratory, weight management, metabolic, and cardiovascular diseases [31], training of medical professionals [32][33][34] and core uses, such as apps in medical laboratories [35,36]. Another fine example is on cancer care, from its screening and management strategies to survivorship [37] and in personalized medicine, supporting fitness, health education, symptom tracking, and collaborative disease management care coordination [38][39][40], as well as, apps targeting from aging population [41,42] to children [43].…”

“…Undoubtfully, careful interpretation of the dynamics and potential of such combination (ANN and app) is required and this should be in a harmonic balance with clinical judgment and decision-making. Also, further expansion of the system by incorporating data from research collaborations to include cases with an adverse outcome or other more complex pathological states of disease, could prove beneficial for the research community or at routine clinical implementation [8,37].…”

Addressing the needs of cancer survivors during the COVID-19 pandemic

“…As discussed above, this disruption may increase anxiety for cancer survivors, and though there is no current evidence for negative long-term consequences (such as delayed diagnoses, worsened health outcomes), these should be considered. Though challenging, it is imperative that clinicians continue to offer ongoing contact with these patients, review their symptoms, and provide reassurance as needed through virtual health platforms, including the existing mobile applications that are currently available [21]. There may also be an opportunity to expand remote monitoring of patient-reported outcomes [22][23][24] and pave the way for survivors to become more engaged and activated [25].…”

Quantifying the use of connected digital products in clinical research

“…A few recently published papers have used online literature sources (e.g., Pubmed, Embase, and Medline) to track how frequently medical researchers are incorporating mobile and remote monitoring technologies into their clinical studies [2][3][4] . One study also used ClinicalTrials.gov to document how internet-connected technology is being studied in cancer-specific applications 5 . Other researchfocused organizations have made efforts to track clinical research involving the use of a particular brand of wearable product (https:// www.fitabase.com/).…”