Improving Cancer-Related Outcomes with Connected Health

A Report to the President of the United States from the President's Cancer Panel

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Preface

The President’s Cancer Panel (the Panel) was established in 1971 by the National Cancer Act (P.L. 92-218) and is charged with monitoring the progress of the National Cancer Program—which includes all public and private activities focused on preventing, detecting, and treating cancers and on cancer survivorship—and identifying barriers to effective implementation. The Panel investigates topics of high importance to the National Cancer Program for which actionable recommendations can be made. Information is collected through focused workshops and additional research, and findings and recommendations are compiled in reports to the President of the United States.

For its 2014–2015 series of workshops, the Panel focused on connected health for cancer, with the goal of identifying ways to optimize the development and use of technologies, broadly defined, to promote cancer prevention, enhance the experience of cancer care for patients and providers, and accelerate progress in cancer research. The Panel convened three workshops to gather information from many stakeholders in this area, including patients and patient advocates as well as leaders from academia, technology, government, and healthcare.

There are many exciting and inspiring examples of how technologies can help some individuals manage and improve their own health and support delivery of high-quality, patient-centered care. These success stories illustrate the potential of connected health. However, technical, financial, policy, and cultural barriers have precluded optimal development and use of connected health technologies for cancer and other diseases. The President’s Cancer Panel concurs with the President’s Council of Advisors on Science and Technology that overcoming these barriers through improvements in health IT and investments in health data infrastructure is critical to meeting the objectives of ongoing healthcare reform in the United States.[1,2] Connected health also can help achieve the goal set by the Vice President’s Cancer Moonshot of doubling the rate of progress in cancer research and treatment over the next five years.[3]

In this report, the Panel presents objectives and action items that should be pursued to advance the use of connected health for cancer. These recommendations are consistent with calls by the Institute of Medicine[4] and the American Society of Clinical Oncology[5] to use health IT to improve the experience of cancer care for patients and providers. Several of the Panel’s recommendations align with those recently issued by the Cancer Moonshot Blue Ribbon Panel,[6] on which Panel Chair Barbara Rimer served. The Panel commends the work of the Blue Ribbon Panel—particularly in the areas of the data ecosystem, implementation science, and symptom management—and endorses its recommendations. The Panel also supports the implementation plans outlined in the recently released Cancer Moonshot Task Force report[7] and notes that there are many opportunities for connected health to help achieve the strategic goals of the Cancer Moonshot. The Panel also supports the goals set forth by the Office of the National Coordinator for Health Information Technology in the Federal Health IT Strategic Plan [8] and Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap.[9] Although not cancer-specific, the robust health information networks and processes envisioned in these reports will form a strong and essential foundation for efforts to use connected health to enhance prevention and treatment of cancers if they are thoughtfully implemented and iteratively improved. Cross-sector collaborations with those outside of healthcare—including computer and data scientists—also are essential.

The Panel urges all stakeholders—individuals, healthcare providers, researchers, patient advocacy organizations, healthcare systems, government agencies, technology developers, and others—to collaborate to ensure that technologies are developed and implemented to meet the needs of people—patients, families, and the many professionals working to support patients and reduce the burden of cancer on patients, families, and communities. The time is now. We will not achieve our highest potential to meet these needs unless we make the most of the opportunities afforded by connected health today and push the boundaries of what is possible in the future.

References

  1. President’s Council of Advisors on Science and Technology. Realizing the full potential of health information technology to improve healthcare for Americans: the path forward. Washington (DC): Executive Office of the President; 2010 Dec. Available from: https://www.whitehouse.gov/sites/default/files/microsites/ostp/pcast-health-it-report.pdf
  2. President’s Council of Advisors on Science and Technology. Better health care and lower costs: accelerating improvement through systems engineering. Washington (DC): Executive Office of the President; 2014 May. Available from: https://www.whitehouse.gov/sites/default/files/microsites/ostp/PCAST/
    pcast_systems_engineering_in_healthcare_-_may_2014.pdf
  3. The White House. Cancer Moonshot [Internet]. Washington (DC): the White House; [cited 2016 Jul 5]. Available from: https://www.whitehouse.gov/CancerMoonshot
  4. Institute of Medicine. Delivering high-quality cancer care: charting a new course for a system in crisis. Levit L, Balogh E, Nass S, Ganz P, editors. Washington (DC): The National Academies Press; 2013 Sep 10. Available from: https://www.nap.edu/18359
  5. American Society of Clinical Oncology. The state of cancer care in America, 2016: a report by the American Society of Clinical Oncology. J Oncol Pract. 2016;12(4):339-83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26979926
  6. Cancer Moonshot Blue Ribbon Panel. Cancer Moonshot Blue Ribbon Panel Report 2016. Bethesda (MD): National Cancer Institute; 2016 Oct 17. Available from: https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative/blue-ribbon-panel
  7. Cancer Moonshot Task Force. Report of the Cancer Moonshot Task Force. Washington (DC): the White House; 2016 Oct 17. Available from: https://www.whitehouse.gov/sites/default/files/docs/final-whcmtf-report-1012161.pdf
  8. Office of the National Coordinator for Health Information Technology. Federal health IT strategic plan 2015-2020. Washington (DC): ONC; 2014 Dec. Available from: http://dashboard.healthit.gov/strategic-plan/federal-health-it-strategic-plan-2015-2020.php
  9. Office of the National Coordinator for Health Information Technology. Connecting health and care for the nation: a shared nationwide interoperability roadmap. Washington (DC): ONC; 2015 Oct. Available from: https://www.healthit.gov/sites/default/files/hie-interoperability/nationwide-interoperability-roadmap-final-version-1.0.pdf