Advancing digital innovation to improve equity and reduce financial toxicity in cancer treatment.

Abstract

e18644 Background: The global burden of cancer is set to increase by more than 60% (to 29.4 million cases) by 2040 . Certain subgroups of patients experience avoidable disparities in access to specialized cancer treatment and discrepancies in clinical outcomes following treatment. The risk of financial toxicity following a cancer diagnosis is also not equally distributed . These disparities in cancer disease burden, treatment, and the risk of financial toxicity have the potential to be disintermediated by digital innovation. Methods: The Digital Medicine Society and Moffitt Cancer Center are co-hosting a pre-competitive collaboration to define the value of digital innovation in cancer treatment, address methodological and implementation gaps, and develop best practices for equitable adoption of digital health technologies at scale in precision oncology. We undertook a landscape review to identify and prioritize causes of disparities and financial toxicity and to benchmark the clinical, engineering, and implementation science dimensions relevant to enhanced digital innovation in cancer treatment. We convened and synthesized information from an expert roundtable which focused on challenges preventing the effective implementation of digital solutions as well as the infrastructure, payment, policy, and regulatory changes needed to promote equity and address financial toxicity with digital health tools. Results: We outline the value of digital innovation in cancer treatment and present consensus-based recommendations from workgroup convening about how digital health tools can be implemented to: Reduce costs associated with advanced cancer treatment and ameliorate disparities in cancer burden by equitably supporting early detection and cancer prevention   Advance precision oncology, minimize the costs of delays in accessing the right care and ensure that the best outcomes are available to all cancer patients  Reduce disparities in access by extending the best specialist expertise and clinical trial opportunities to all cancer patients . Conclusions: Innovative digital approaches have yet to be applied at scale to minimize the burden of financial toxicity to patients with cancer and to reduce healthcare access and outcomes disparities. The delivery of high-quality precision cancer care for all patients depends on our collective ability to increase access to specialized care, harness flows of existing patient data and the power of decentralized clinical trials, and reduce the impact of social determinants of health on patient outcomes. There is substantial opportunity to leverage the results of this landscape review and convening to 1) build impact models that articulate the value of implementing fit-for-purpose digital solutions to promote equity and reduce financial toxicity, and 2) develop implementation toolkits for the equitable and effective deployment of those solutions.