On June 2, 2022 Navigating Cancer in collaboration with Texas Oncology reported that executes large-scale patient engagement study revealing high digital health solution engagement while demonstrating the opportunity to increase support for diverse patient populations (Press release, Navigating Cancer, JUN 2, 2022, View Source [SID1234615422]).

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Scientific and technological advancements have helped enhance cancer care and access to care. Indeed, an important silver lining in the pandemic has been the acceleration of adoption of virtual care and related digital health technologies. But these innovations have also helped highlight gaps and inequities that challenge healthcare providers and other stakeholders. Aligned with the 2022 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting theme, Advancing Equitable Cancer Care Through Innovation, Navigating Cancer in collaboration with Texas Oncology, will present key research evaluating the benefits and need for digital health solutions (DHS) across all patient populations.

These abstracts are a continuation of research Navigating Cancer and Texas Oncology presented in 2021 that addresses digital health equity, and specifically, the crucial question: Are we making digital health solutions accessible and supportive to all patient populations?

Communities that experience gaps in care are often underrepresented at the point of product, service, and program design, creating inefficiencies for healthcare professionals (communication and care barriers) and accessibility obstacles (language, internet/device access, insurance, etc.) for patients.

The goal of this study was to gather data to develop insights into these key access-related challenges, including the significant barriers facing rural, elderly, and Spanish-speaking communities interacting with digital health solutions and care teams, as well as other insights from implementing DHS across a large, geographically dispersed community-based practice.

Findings presented during the Podium Presentation, Evaluating mass implementation of digital health solutions to improve quality and reduce disparities in a large multisite community oncology practice (Abstract #1575) and the follow-up study (poster presentation), Analyzing patient engagement with digital health tools to facilitate equity across a large statewide community oncology practice (Abstract #1575), offer insights into these key challenges.

"Working harder than we ever have to serve patients in the last two years, I’m so excited to see how digital health tools are improving the patient journey,"

– Debra Patt, MD, Ph.D., MBA, Texas Oncology

Findings from the research highlight the benefits of DHS in improving the patient journey, while demonstrating the additional value derived from Navigating Cancer’s broad ability to improve clinical outcomes and capture longitudinal data that provides engagement insights.

"It is gratifying to see a highly successful implementation of patient-centered digital care enhancements in a large and leading oncology practice in the US which provides an exemplar for other practices towards the future," said Ethan Basch, MD, MSc, University of North Carolina.

Outcomes
Sociodemographic data coupled with digital engagement insights from Texas Oncology’s large, diverse patient population reveal an important disparity among segments of the patient population related to the so-called "digital divide." In this context, access and ability to use internet technology, language barriers and other sociodemographic determinants underlie health disparity and equity challenges.

In our two highlighted abstracts, researchers were equipped with data from Texas Oncology’s 220 sites of service with total sample size populations spanning both 100,888 and 283,000 unique cancer patients, respectively.

Evaluating mass implementation of digital health solutions to improve quality and reduce disparities in a large multisite community oncology practice (Abstract #1507):
In this oral presentation (details below), Navigating Cancer highlights insights from a longitudinal (3-year) observational study of DHS implementation across a multi-site community practice covering over 280,000 cancer patients. In this study, the researchers observed high engagement across the digital health solution, including rates of 83%, 68%, and 57% for the patient portal, remote monitoring, and digital education, respectively. Additionally, there was positive engagement among groups typically vulnerable to equitable digital engagement, including the older age demographic and patients living in rural settings. While there was active engagement among non-English language patients, the authors note that opportunities exist to improve engagement among racial/ethnic minorities and individuals without English-language preference.
Analyzing patient engagement with digital health tools to facilitate equity across a large statewide community oncology practice (Abstract #1575):
In this poster presentation (details below), researchers at Navigating Cancer and Texas Oncology focused on understanding differences in digital activity rates based on various sociodemographic factors across tools within the DHS. The authors observed high overall rates of digital activity, including a 64% read rate for digital education, 55% compliance rate with ePRO remote monitoring, and an average of 1 portal/login per week. Additionally, despite variable engagement across age, rural status, and language preference, patients within these groups continue to utilize the DHS. Specifically, despite language barriers, the engaged population were interested in consuming patient education on the DHS. This was demonstrated by the fact that among patients that had read at least one education article, the overall read rate was 96%. The authors concluded that additional tool optimization for patient-specific barriers should be addressed in the future.
Navigating Cancer will continue, alongside our advisors, to support equitable care innovation through research and dialogue to better understand and listen to patient voices that may go unheard. Research being presented this year demonstrates the need to close gaps in care related to language barriers through translation of patient education information, and more availability of translated materials at the point of product, service, and program design.

Navigating Cancer is committed to pushing forward a technology roadmap that addresses digital health equity. "In addition to highlighting digital health divides in oncology, the accepted abstracts also demonstrate the power of collaboration between clinicians and technology vendors in bridging the gaps in transformative and innovative cancer care delivery, " said Amila Patel, PharmD, BCOP.