2020 was the year we were forced to go digital. Time to look at the possibilities of a digital healthcare landscape.
Digital care or eHealth, as it often is referred to, is rapidly growing and offers many benefits such as encouraging self-management, facilitating communication between health care givers and patients and providing a solution for barriers like time, financial cost or other practical manners like the distance to a health care facility. Too often, time-constraint and pressure on health care workers in oncological treatment means that not all aspects of care are addressed equally. EHealth can be a solution, not as a substitute of face-to-face health care but rather with a supportive role.
Despite those benefits, there are also some concerns. First of all, access to and the know-how of this digital world is not a given for everyone. Secondly, not all health information on the internet or health-apps that you can find in your app store are designed by health care professionals. There are no restrictions on who can develop a health app. Yet efforts are made to ensure quality control and privacy of the collected data. For example, when requesting an approval for a health app to the app store, there are strict requirements and the app undergoes a thorough review.[1] However what this thorough review exactly entails and who executes it, is not really clear. Another effort has been the development of guidelines.[2] But the question remains if these efforts are enough?
We can consider different types of eHealth. The form can differ such as a website, an e-mail newsletter, a mobile app, … maybe even some informative Instagram posts. The content of technology itself can focus either on collecting clinical data or on offering and/or supporting a treatment. Some general examples: Fibricheck[3] is an app that analyzes your heart rhythm and alarm you if medical aid is needed. Additionally it offers your doctor with plenty of data to facilitate treatment. Another example is MedApp [4], a handy tool which reminds you to take your medication.[4]
Within oncological care, there are some more specific apps for the patient or the health care professional.
chemoWave, gives you the possibility to enter information on side-effects that you may experience during your treatment. This is useful information for your doctor or nurse. [5]
OWise is an app that guides you through cancer treatment. It tracks your symptoms, it provides reliable information and keeps all your appointments and notes gathered in one place. Owise has a specific app for breast cancer and for prostate cancer.[6]
Cancer exercise, an exercise app based on guidelines of the American college of sports medicine (ACSM) for cancer survivors.[7]
Lymvol, an app tailored to lymphedema professionals to aid in measurement and calculating the limb volume.[8]
Lymphatrack is another app for measuring lymphedema, but aimed at the patient.[9]
Calm is a meditation app, research has shown that meditation can provide relief for side-effects during treatment and after-treatment.[10, 11] Calm is an accessible way to start with meditation.[12]
Research has already shown the benefits of digital interventions for cancer patients and survivors on symptoms such as pain, psychological distress, fatigue [13, 14] and the positive effect on improving quality of life[14] and self-efficacy[15]. However not a lot of information is available on user experience and satisfaction of these health apps. Further research should identify preferences or barriers of the patient as well as the health care providers, to optimize further design.
Although the industry is growing, a lot of digital cancer care programs are not commercially available and are only accessible within a clinical or research setting. The cost of developing and commercializing can be blamed for hindering the availability. To incorporate the commercial side and the health care aspect will prove to be a difficult balancing act.
In conclusion, because of its many benefits, the positive effects shown by research and the rise in digital technology, eHealth is here to stay.
Sophie Van Dijck
1. https://developer.apple.com/app-store/review/guidelines/#health-and-health-research.
2. Parker, L., et al., A health app developer’s guide to law and policy: a multi-sector policy analysis. BMC Medical Informatics and Decision Making, 2017. 17(1).
7. https://www.annaschwartzphd.com/cancer-exercise-app/.
8. http://www.lymph.org.uk/what-is-lymphoedema/what-is-mld/limbvolumecalculator/.
9. https://www.lympha-press.com/lymphatrack-app/.
10. Suh, H.-W., et al., The mindfulness-based stress reduction program for improving sleep quality in cancer survivors: A systematic review and meta-analysis. Complementary Therapies in Medicine, 2021. 57: p. 102667.
11. Ngamkham, S., J. Holden, and E. Smith, A Systematic Review: Mindfulness Intervention for Cancer-Related Pain. Asia-Pacific Journal of Oncology Nursing, 2019. 6(2): p. 161-169.
13. Hernandez Silva, E., S. Lawler, and D. Langbecker, The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review. Journal of Cancer Survivorship, 2019. 13(1): p. 97-107.
14. Escriva Boulley, G., et al., Digital health interventions to help living with cancer: A systematic review of participants' engagement and psychosocial effects. Psycho-Oncology, 2018. 27(12): p. 2677-2686.
15. Xu, A., Y. Wang, and X. Wu, Effectiveness of e‐health based self‐management to improve cancer‐related fatigue, self‐efficacy and quality of life in cancer patients: Systematic review and meta‐analysis. Journal of Advanced Nursing, 2019. 75(12): p. 3434-3447.