Taking a closer look at digital health and how to approach the task of creating the optimal digital patient experience may provide some insight for practices as they build their digital platforms.
Creating the ideal digital patient experience is the goal of many oncology practices today, but the journey to get there can be a long and winding road. There is more to developing and maintaining a well-executed digital experience for patients than just selecting technologies from the ever-increasing complex assortment now available. A much more thoughtful, long-term strategy is required for success—one that involves careful analysis of patient needs, wants, and digital literacy, coupled with a detailed plan for what the practice can realistically implement. Taking a closer look at digital health and how to approach the task of creating the optimal digital patient experience may provide some insight for practices as they build their digital platforms.
All of us have probably experienced first-rate digital interactions with financial institutions, retailers, restaurants, and other entities we commonly deal with on a daily basis. Once we experience this high level of digital communication, it creates expectations that all companies, including health care providers, will deliver these same impressive digital experiences—it raises the bar.
Unfortunately, medical facilities are somewhat behind the times, including oncology practices. Based on CMS data for Medicare patients and reimbursement policies for most payers, telehealth in oncology was rare during pre–COVID-19 days. If employed at all, it was only for second-opinion consultations and mostly for rural patients or those unable to travel to a site of specialized care or a center of excellence. It was also done in a very limited way. Typically, the primary care physician set up the visit with a specialist, and the virtual consultation took place in the physician’s office. A few payers did develop privately reimbursed programs through employers that used telehealth, but overall, telehealth was really about access in very specific circumstances
With the emergence of COVID-19, providers realized the technology existed to create an improved digital experience for patients and many moved forward with digital offerings. New Medicare regulations were also implemented, allowing providers to treat both existing and new patients virtually while being reimbursed at nearly the same rate as in-office visits.1
As a result, telehealth in oncology grew dramatically as providers embraced it as a viable channel to support care for patients unable to come to the offi ce. A recent survey found only 8% of oncologists/hematologists used telehealth before COVID-19, but that total soared to 88% by May 2020.2 Additionally, 90% reported that they planned to continue using telehealth postpandemic.2
Patients and caregivers accepted these new care delivery options. The 2021 Accenture Health and Life Sciences Experience Survey of 1800 patients revealed over 26% said their access to health care was better since the onset of the pandemic.3 Additionally, use of remote monitoring tools tripled, and 21% indicated they would be willing to participate in new digital care delivery, including clinical trials.3
Digital health and the individual digital patient experience are tightly intertwined in today’s world, representing an intersection between health care and technology. There are many definitions for digital health, as there are many different aspects to it. For instance, the FDA takes a broad view when defining digital health, including categories of health information technology, mobile health, telehealth, and personalized medicine. Another definition focuses on the connections and tools that allow providers to deliver care in a different way, ranging from remote monitoring devices to artificial intelligence–enhanced diagnostic tools. These devices enable providers to improve patient experiences and outcomes by enhancing care delivery, making it easier to care for patients while meeting them wherever they want to receive their care.
The patient experience encompasses the full range of all the touch points patients encounter during their treatment, from their interactions with practice physicians, nurses, and staff, to their encounters and communications with additional health care facilities, insurers, and others they meet during their treatment journey. All these interactions drive the patient experience, and some of it is beyond the primary provider.
Looking at the patient journey in a simplistic way, there are many steps within that journey where the patient experience could be improved through different forms of digital health technology. For instance, telemedicine could improve access, secure messaging could improve communication with the care team, and wearable devices could enhance the insight the physician and care team have when they are away from the office. Additionally, the patient’s knowledge and understanding of what is happening in their care could be improved through mobile or other forms of digital technology so they receive the information they need in a way they can understand.
As practices pivot from the analog world to one more digitally focused, there are a few key concepts to keep in mind when developing a well-executed digital patient experience, including the following:
Provide formats of digital communication that meet patients where they are. Many patients with cancer patients are not digitally native, as the disease is more prevalent in older demographics. To ensure the practice is meeting the needs of patients with limited computer skills, a straightforward digital front door should be provided, leading to user-friendly ways to securely and effi ciently transfer information between the patient and the practice. This could be through a portal or some other form of communication with administrative capabilities. Whatever platform is chosen, there should be areas where patients can securely and easily message, request or book appointments, pay bills, and see their fi nancial responsibilities. These are basic capabilities and are key to delivering a good digital experience.
Offer different levels of education. Patients have different educational needs throughout their treatment journey, and the practice should meet these needs by providing a range of educational offerings. Presenting basic information about the practice itself is a good starting point. This would include elements such as a description of the practice, locations, physician biographies, and the personnel patients may meet, including the care team, schedulers, and fi nancial counselors.
Education can also be presented about the types of care available from the practice such as medical and radiation oncology, surgical and social services, and information about research activities. Linking this information through a portal allows the patient to go back into different areas of the portal to easily access other capabilities.
A deeper, more personalized education can also be provided for patients who are already in the system who may have specifi c educational needs. Surveys have indicated patients want improved communications with their care team and access to helpful information. This need can be met by directing patients to sources that are appropriate for their specific diagnoses or therapies. Ideally, this information can be specified by the care team offering assistance to patients seeking a better understanding of their condition.
Provide guidance for holistic emotional support. Practices need to offer support to the patient, or at least provide guidance about where assistance can be found, as patients want access to mentorship and support groups. Proprietary research done by Accenture for McKesson verifi es this, fi nding that 7 of 10 patients believe having peer support would be valuable, whether from a support group or 1-on-1 mentorship, and 9 of 10 want emotional support recommended by their provider or through their provider. This was a key gap for patients, particularly after active treatment. Although many small practices may not be able to offer these needed services, they can direct patients to helpful resources within their region or various digital support groups.
Although implementing best practices sounds like it should be straightforward, doing so has been diffi cult due to a lack of clarity about patient needs. Recent surveys have provided some insight, but ideally, as practices move forward to build their digital offerings, they should utilize internal surveys to ascertain what their own patients need and want. Those needs may be very different in an academic setting vs a community-based practice, so practices should do their own research and not rely on others.
Next, practices should thoughtfully look at what they can realistically implement. They cannot begin by employing a complex research platform if the basics are not in place. If practices cannot communicate easily and answer those communications in multiple formats, they should not attempt more complicated tasks.
Developing a comprehensive road map to deliver on first needs while working toward more complex capabilities is another best practice. After evaluating what the practice can deliver vs patient needs, a detailed strategy should be developed with goals, timelines, costs, and assigned responsibilities to move the project forward.
Finally, a group or committee should be designated to put the time and energy into ensuring decisions are carefully thought out and not made in a reactive response. Practices need to step back and think about digital health and new technologies in the same way as they view a new treatment or therapy. Oncologists are very careful about new drug regimens and they expect them to be tested and reviewed. They should think about their digital capabilities in the same way. There are many exciting new technologies, but it is imperative to examine these tools with a critical eye. Practices should be thoughtful about the patients who will use the technology and whether it will help build a solid foundation to keep pace with the rapidly changing technology landscape.
Although COVID-19 pushed digital health forward by leaps and bounds, many obstacles still inhibit patients from having the optimal digital experience, including the following:
There are also obstacles that block practices from efficiently moving forward to implement the necessary technologies. The fi nancial investment can be prohibitive, especially for small practices. Interoperability challenges exist across technologies, and privacy and security remain a concern.
Despite the challenges, there is good news. Because of COVID-19, much has been learned about digital health, and many investments have been made. Numerous applications and technologies have already been adopted, which should drive down prices and put these technologies within the reach of more practices. Additionally, there are many initiatives to expand broadband access to rural communities and socially disadvantaged populations.
There is no doubt a digital path is in our future, and digital technologies will increasingly support how patients are cared for and how practices deliver the best possible patient experience. The question is not whether health care will go there, but rather how it will get there. Careful consideration is needed to ensure we are not swept away by exciting new technologies coming to the forefront, as their capabilities may not yet be optimized. Physicians need and want guidance selecting these technologies to ensure they are appropriate for the patient population being served and that they have been properly vetted by credible external organizations.
Adoption and change will require commitment and focus. Practices will need to dedicate resources, make investments, and set realistic goals they can work toward to evolve digital care and create the optimal digital patient experience.
1. Lee TH, Mohta NS, Prewitt E, et al. NEJM Catalyst Innovations in Care Delivery - a new journal leading the transformation of health care delivery. N Engl J Med. 2020;382(1):80-81. doi:10.1056/NEJMe1914982
2. COVID-19 impact on oncology. Healthcare Research & Analytics. Accessed April 13, 2022. https://bit.ly/3FrCBAU
3. Digital adoption in healthcare: reaction or revolution? 2021 Accenture Health and Life Sciences Experience Survey–US fi ndings. Accessed April 19, 2022. https://accntu.re/3ynNkei
4. Vogels EA. Digital divide persists even as Americans with lower incomes make gains in tech adoption. Pew Research Center. June 22, 2021. Accessed May 3, 2022. https://pewrsr.ch/3MZ9yat 5. Vogels EA. Some digital divides persist between rural, urban and suburban America. Pew Research Center. August 19, 2021. Accessed May 3, 2022. https://pewrsr.ch/3P3RGNn