Dr. Adam Dicker
“There is enough going on here that these topics can be their own sustaining sessions,” said Adam Dicker, MD, PhD, of Thomas Jefferson University Hospital and Sidney Kimmel Cancer Center, who is chair of the session “mHealth: Mobile Technologies to Virtually Bring the Patient Into Oncology Practice,” to be held on June 3.*
“There is this big tent that goes by a number of different names, including ‘digital health,’ ‘digital medicine,’ or ‘mHealth.’ Under this big tent, you have telehealth, health IT, electronic medical records (EMR), the internet of things, social media, wearables, big data, and clinical decision support,” Dr. Dicker said.
Although many medical specialties have embraced digital health, the oncology field is just starting to introduce telehealth and other types of technology into practice and to study their impact, especially in the context of the Value Framework, where ASCO has been leading the discussion, Dr. Dicker said. His presentation will focus on telehealth, which generally involves video conferencing between the health care provider and patient.
Dr. Dicker will discuss how digital health is actively addressing three key health care challenges. These include managing the chronic disease aspect of oncology, increasing access to health care, and assisting aging populations of patients with cancer with the unique challenges faced by their demographic.
During the session, Dr. Dicker will discuss types of patients who are most likely to benefit from telehealth. He will also provide examples of its applications and its potential benefit of allowing doctors to follow up with patients between visits and to more closely monitor toxicity associated with cancer treatment.
“It is a totally different type of interaction when you video conference and you are in the moment with a patient as opposed to a phone call,” Dr. Dicker said.
He will also discuss criteria for using telehealth, such as integrating telehealth into the EMR, establishing an infrastructure with HIPAA-compliant software, and ensuring patients have adequate Wi-Fi bandwidth and are comfortable with the interaction.
The mHealth session will also address mobile phone apps that aim to improve patient care, such as by collecting patient-reported outcomes. An app called Strength Through Insight, which Dr. Dicker and his colleagues at Thomas Jefferson University developed, asks patients with prostate cancer to fill out surveys on their mobile devices about their cancer symptoms and treatment.
“We have some good examples of using apps combined with wearables, such as remote activity trackers, Fitbit, and Garmin, to obtain more frequent patient-reported outcomes and other things going on in that space,” Dr. Dicker said. “The hypothesis is this can reduce emergency room visits and hospitalizations, trigger early intervention to reduce IV hydration, and have other demonstrable clinical benefits.”
The session will include presentations of approaches and preliminary data from ongoing studies of these apps. The session will additionally provide an overview of some of the hundreds of mobile apps that aim to improve treatment adherence and their various features, including flexible medication scheduling and password protection.
However, these apps have not been well studied to determine whether they are effective at improving adherence specifically in the cancer-treatment realm, such as with patient-administered oral cancer medications or hormonal therapy. Instead, there have been extrapolations based on studies of diabetes treatment adherence, even though the factors that affect adherence to cancer treatments, such as toxicity, could be very different from those of diabetes drugs.
Social Media for Doctors
Dr. Merry Jennifer Markham
During the Education Session “Social Media 101: A Primer for Professionals” on June 2, presenters will explain how doctors, nurses, and other health care professionals can use social media for professional development and networking, as well as to engage with patients and share information, such as about clinical trials. The session is intended both to introduce novice users to the benefits of social media, particularly Twitter, and to offer tips on best practices for experienced users.
Although many physicians are engaged in social media, at least for personal use, “there are many who have reservations about using social media because of issues like privacy, or because it’s a time suck, distracting from patient care and productivity. Those are valid concerns. The reality is that if you give it a try, you might actually find that it has more benefit than risk,” Session Chair Merry Jennifer Markham, MD, FACP, of the University of Florida, said.
In her session, Dr. Markham will discuss how health care professionals can use Twitter to participate in online journal clubs or to share the latest research findings from academic literature or from presentations at meetings, such as the ASCO Annual Meeting.
“It’s a way for physicians and other health care professionals to communicate and network with people all around the world in a way that was previously not really possible,” she said.
At the same time, it is important to be aware of risks, such as the fact that “whatever you put out there on social media, such as a tweet, is permanently there. Even if you delete it, it’s never really gone,” Dr. Markham said. She will point out resources for the safe and ethical use of social media, such as the ASCO Ten Tips for Use of Social Media for Oncologists, available on ASCO.org, which lists the need for the user to identify themself and protect patient privacy.
One of the highlights of the session will be a discussion of the use of social media to engage patients in clinical research that they might not have found out about from their oncologist or by searching clinicaltrials.gov. An example is the Metastatic Breast Cancer Project led by the Broad Institute of MIT and Harvard.1 It is a crowd-sourced study that launched in 2015 that patients with metastatic breast cancer can participate in by filling out online consent forms and sharing clinical samples. Researchers have been promoting the project through patient groups on Facebook and Twitter.
Social Media for Patients
Digital health technology can play an important role in helping patients and consumers in the entire gamut of health care, from prevention to treatment and survivorship issues. The June 4 Education Session “Using Social Media and Mobile Technology for Cancer Prevention and Treatment” will provide an overview of how these individuals are using technology, including social media, websites, and apps for smartphones and wearable devices, as well as the limitations and risks.
Dr. Judith Prochaska
Dr. Prochaska will discuss her ongoing research of a Twitter-based smoking-cessation intervention called Tweet2Quit that involves peer-to-peer support groups.2 In an initial randomized controlled trial, the group that participated in Tweet2Quit, in conjunction with receiving nicotine patches and educational material, had two-times higher quit rates than the control group that only received nicotine patches and educational material. Follow-up research is exploring whether participation in a women’s-only support group increases abstinence among female participants, who have lower quit rates overall than male participants.
Other types of technology are geared toward treatment and survivorship, rather than prevention. For example, PatientsLikeMe is a website that patients can use to communicate with each other about treatment options and side effects.
The session will also highlight potential concerns with the use of various digital health technology, including the lack of data security. In the case of wearable devices, which individuals are using both for peer-to-peer support and to monitor their own behaviors, GPS data can be collected that may not be secure and could be sold for advertising purposes.
Across the board, digital health technology is growing in popularity among consumers. Even though many tools incorporate key principles of behavioral change, such as social support and motivation enhancement, it is important for health care professionals to be aware and discuss with patients that many of them also have not been evaluated in clinical studies to determine whether they are effective, Dr. Prochaska said.
*Program information updated as of March 6. For session time and location information, please refer to the ASCO iPlanner on the Attendee Resource Center.