November 16, 2016 by Barbara K. Rimer, Dr.P.H.
In the year 2000, when I was director of NCI’s Division of Cancer Control and Population Sciences, only about half of U.S. adults had Internet access. The first iPhone was still 7 years in the future. Few health systems used electronic health records (EHRs) for patient care, and the notion of patients communicating with their health providers and accessing their health records via their own computers was science fiction for most people.
There were—and still are, to a lesser extent—large disparities by age and race in access to and use of the Internet, and at NCI, we were already focused on overcoming this “digital divide.” WiFi was not ubiquitous, and I remember many offsite meetings where we had to go outside to get a wireless signal.
Today, that all seems like a world away: According to the most recent data available, 84% of Americans now have Internet access, 68% have smartphones, and a vast majority of hospitals have at least basic EHRs (a mandate of the HITECH Act of 2009). And nearly 70% of people now turn to the Internet first when they need health or medical information.
Technology and connectivity have dramatically altered the health landscape in ways we could not have imagined even several years ago. They have transformed many of our lives, helping us to monitor workouts and diets, track medications, and interact with friends and families. They also have transformed the way we collect and access health information, communicate about our health, and use data to support decision making. Many people with cancer, for example, now use web-based resources like their Facebook pages or special customizable websites to keep their close friends and family up to date on their health.
The dynamic use of technology to facilitate the efficient and effective collection, flow, and use of health information, or connected health, is essential to accelerating progress against cancer. Progress includes improving everything that happens to individuals from prevention through treatment, survivorship, and, still too often, end of life.
This week, the President’s Cancer Panel (PCP) released our latest report, Improving Cancer-Related Outcomes with Connected Health, to President Obama. The report focuses on the development and use of technologies to promote cancer prevention, enhance the experience of cancer care for patients and care teams, and accelerate progress in cancer research.
The PCP is charged with monitoring the National Cancer Program—which includes all public and private activities focused on preventing, detecting, and treating cancers and on cancer survivorship—and reporting to the President of the United States the barriers to progress. It’s a huge responsibility and one to which I and my fellow panel members, renowned physician–scientist Owen Witte, M.D., of the University of California, Los Angeles, and distinguished actor, author, and philanthropist Hill Harper, J.D., are deeply committed.
Cancer—with its complex biology, multispecialty care teams, transitions between treatment phases, and profound impact on the lives of patients and families—is an area of health care likely to benefit especially from improved coordination, communication, information access, and health behavior change facilitated by connected health. The capacity to share and integrate data also has the potential to expedite scientific discovery and support collaboration among researchers, enabling identification and development of strategies to more effectively prevent and treat cancers.
Throughout the series of meetings that informed this report, we heard about many exciting examples of technology that are helping individuals manage and improve their own health; supporting the delivery of high-quality, patient-centered care; and accelerating research, many of which we highlight in the report.
Our new report also outlines five priority objectives and associated action items to advance the use of connected health and address challenges to implementation:
- Enable interoperability to ensure that health IT systems and applications can communicate, share data, and use information
- Enable individuals to manage their health and actively participate in their care
- Ensure that federal programs and health IT tools support the cancer workforce
- Expand Internet access for health care providers, individuals, and organizations
- Facilitate data sharing and integration to improve care, enhance surveillance, and advance research
As we concluded in the report, connected health is not about technology or people, but is rather about technology and people. Connected health serves to forge helping relationships with patients around the world, break down barriers, and enable those with cancer, particularly those with rare cancers, and their caregivers to find support from people like them.
Since President Obama announced the Cancer Moonshot earlier this year and placed Vice President Biden at the helm of these activities, the call to accelerate progress against cancer has never been louder.
As a member of the Blue Ribbon Panel (BRP) to help identify NCI’s research priorities as part of the Cancer Moonshot, I appreciate the many synergies between the BRP’s recommendations and the PCP’s conclusions on connected health. For example, both highlight the importance of overcoming technological barriers to data and information exchange and the urgent need to engage patients and members of the public as partners in their care and in providing input on research priorities.
Vice President Biden was right when he said that progress against cancer can be accelerated if collaboration becomes the norm. I encourage everybody who has been touched by cancer, is interested in prevention, or is committed to ensuring Internet access for all who desire it, to read the PCP’s report on connected health. In it, we show how connected health is an integral part of this collaboration and can facilitate the information exchange and partnerships needed to make important advances in cancer prevention, care, and research that will benefit every person in this country and beyond.