Digital disease management in solid tumor oncology

Executive summary

Cancer care has experienced dramatic advances in the last decade that will benefit millions of people and their families worldwide. About 40% of Americans will be diagnosed with cancer at some point during their lifetimes, and cancer is among the leading causes of death worldwide. Solid tumors account for about 90% of cancers in adults.¹

Biopharma is innovating in oncology at a rapid pace. The FDA has recently overseen some 800 cell and gene therapy applications. And 20% of global pharma sales are in oncology. Due to advances in early detection and breakthroughs in cancer therapies—including personalized and precision medicine, immuno-oncology and others—cancer patients are living longer than ever.²

But these advances also introduce challenges that could limit their true potential. For example, medical imaging and minimally invasive biomarkers hold promise for improving cancer detection, treatment and monitoring. But it can be a challenge to interpret the vast amounts of data to fully realize those potential advances.

Forward-thinking biopharma leaders recognize the opportunity that lies in digital disease management. In a recent survey from BrightInsight and HealthXL, 61% of respondents said that disease management is the most promising use case for Software as a Medical Device (SaMD). And across SaMD, oncology was the second-most active therapeutic area, making up 16.5% of SaMD activity. While it’s clear that biopharma companies are playing in the oncology digital space, there is ample opportunity for solutions that specifically address some of the biggest challenges in treating solid tumor cancers.

A 2020 meta-analysis found that digital health solutions that collected electronic Patient Reported Outcomes (ePRO) and enabled remote monitoring showed "benefits to patients regarding symptom reporting and management, reduction in symptom distress, decrease in unplanned hospitalizations and related costs, and improved quality of life and survival."³

Regulated digital solutions can enhance patient care and drive therapy value in a multitude of ways: impacting physician prescribing patterns, improving patient access, increasing adherence or persistence and optimizing dose delivery, among others.

White paper Sa MD most active therapeutic areas v24

Digital enables more engaging patient experiences by increasing therapy compliance, improving disease and medical tracking and, as importantly, building connections among patients and with healthcare providers. The data collected with digital can be used to deliver more personalized therapies, increase reimbursement and potentially increase revenues through extended patent life."

– Brad Gescheider, former Global Head, Digital Innovation and Patient Services, Immunology at Sanofi

1  Tawfik EA, Aldrak NA, Albrahim SH, et al. Immunotherapy in hematological malignancies: recent advances and open questions. Immunotherapy. Sept. 9, 2021.
2  Pulte D,Jansen L, Brenner H. Changes in long term survival after diagnosis with common hematologic malignancies in the early 21st century. Blood Cancer Journal. May 2020.
3  Aapro M, Bossi P, Dasari A, et al. Digital health for optimal supportive care in oncology: benefits, limits, and future perspectives. Support Care Cancer. Oct. 2020.

Challenges in oncology

Part of the challenge in designing digital disease management solutions lies in the complexity of disease management itself. Here are some of the key hurdles faced by providers and patients during solid tumor treatment:

For providers

Data overload: There’s a wealth of both patient-level and population-level data available to clinicians, yet there’s no single source of truth. Advances in technology produce volumes of additional data from radiographic images, genomics, pathology, electronic health records and even social networks, but it can be a challenge to synthesize it into meaningful clinical recommendations. Much time is spent navigating multiple systems, data sources and brand-specific tools, all with different logins and interfaces. Then, layer in clinical trial data and the (often very manual) collection and analysis of post-treatment data points of an individual patient, and it’s easy to see how providers are spending so much time in front of their computers instead of their patients.
Siloed care providers: Treating a cancer patient is a team effort, with multiple clinicians and other providers working together. And managing comorbidities and risks is crucial for optimizing patient outcomes. Yet, EHR limitations make it hard for oncologists to collaborate—much less gather invaluable insights from their expert peers and clinicians in other fields. Without secure opportunities to share best practices, it’s difficult to learn about and prescribe innovative treatments.
A myriad of treatments: The global cancer therapies market was estimated at $161.3B in 2022, and is projected to grow to more than $209B by 2026.⁴ With so much investment in this area, there are already a wide range of treatments (and treatment combinations) available—with new treatments arriving all the time. There’s also the promise of immuno-oncology. While this is a hopeful sign for patients with cancer, it represents a challenge for providers: How do you find the right treatment for each patient, while considering the patient’s lifestyle, goals, financial situation and insurance? And how can you tell if the first-line treatment is working?

Quality and availability of remote patient monitoring (RPM): Not all patients live close to leading cancer treatment centers, which makes RPM incredibly important in cancer care. Many common treatments require regular monitoring for side effects after outpatient treatment. Yet many current RPM solutions leave a lot to be desired, both in terms of ease of use and quality of data capture.

For patients

The complexity of managing cancer treatment: For both patients and their caregivers, navigating a cancer diagnosis and treatment is complicated and emotional. Yet positive outcomes require strong adherence to the treatment plan and a solid support system, especially between appointments.
Unequal access to specialty care: Getting treatment when you live far from a top-rated cancer hospital adds another layer of complexity. In cancer care, multiple drugs and treatments are used, with overlapping providers. Side effects from treatment are common, and patients need open lines of communication with their care team to help triage potential complications.

Wearables can enable active communication between the patient and the care team, helping the patient feel connected. That connection can make for a better patient experience, which in turn can improve outcomes."

– Oncology executive at a leading life sciences company

4 Press release. Global Cancer Therapies Market Report 2022: Market to Reach $209.2 Billion by 2026 - Industry Focuses on New Approaches to Treat Cancer. Research and Markets. August 3, 2022.

Opportunities

These challenges frustrate providers and patients alike, and bleed value from the healthcare system. Well-designed digital solutions can address these shortcomings, enhancing the patient experience by connecting healthcare stakeholders and giving them tools to excel.

Successful digital solutions restore value in three important ways:

Keep patients engaged
Successful disease management depends on patient engagement and adherence. Multiple factors contribute to poor adherence and persistence among cancer patients, including the emotional burden of a diagnosis, complex treatment regimens, caregiver challenges, concerns over side effects and insurance reimbursement worries.

Whether it’s a patient app with a personalized drug dosing algorithm, medication reminders, a companion solution that assists patients with a challenging therapy administration or symptom tracking that can be done anytime, anywhere, digital solutions can provide comprehensive support between appointments. Connected digital devices, companion apps and wearable tech give patients and their caregivers the real-time insights they need to better manage their cancer treatment.

Engaged patients often see better outcomes. A study at Memorial Sloan Kettering Cancer Center found that patients who used a digital ePRO tool to track symptoms improved survival by more than five months and reported better quality of life. One potential reason for the dramatic improvement: nurses had a 77% response rate to alerts and offered patients symptom management counseling, supportive medications, chemotherapy dose modifications and referrals.⁵

Improve provider tools and communication
Providing clinicians with tools that enable them to have data-driven discussions with their patients about disease progression and treatment options can empower patients to make the right treatment decisions for their unique situations.

Secure, compliant communication tools can connect providers to both patients and other care team members, improving collaboration and streamlining care decisions. Well-designed digital health solutions can enable patient outreach, educational opportunities, telehealth, mental health support, remote patient monitoring, dose titration and more.

Algorithms hosted on a digital solution can integrate multiple data sources into powerful tools to enhance clinician decision support and detect risk. In one study, researchers used natural language processing (NLP) software algorithms to automatically extract mammographic and pathologic findings from free text mammogram and pathology reports and processed the data 30% faster than humans with 99% accuracy.⁶ Likewise, deep learning AI tools can help clinicians identify lung nodules that are too small to be detected by the human eye, which could reduce the 35% of nodules missed during initial screenings.⁷

Generate invaluable real-world data
Biopharma increasingly relies on insights from real-world data to optimize both R&D and commercialization. Real-world data (RWD) can inform clinical development strategies, improve access and enable outcomes-based contracts with payers, enhance sales and marketing strategies and substantiate the value proposition of your therapy.

But it can be challenging and expensive to acquire high-quality, longitudinal RWD. Common data sources, like claims data, often lack the level of detail needed for clinical and commercial use cases. When useful data sets do exist, they can often cost upwards of $1M per year. The best digital health solutions in disease management generate and utilize a wealth of data at both the individual patient and population levels.

We should be growing faster, acquiring more patients. Marketing budget is not enough to solve upstream challenges. Relying on TV ads is a brute-force approach, but what is required is a surgical approach: How do we get patients paired with the right doctor, healthcare system and drug? It takes time and resources, but the brand lifecycle is finite. How do you get more patients on your brand? Digital."

– Data science & artificial intelligence lead at a top 10 biopharma company

5  Basch E, Allison MD, Dueck AC, et al. Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment. JAMA. July 11, 2017.
6  Press release. Artificial intelligence expedites breast cancer risk prediction. August 29, 2016.
7  Svoboda E. Artificial intelligence is improving the detection of lung cancer. Nature. Nov. 18, 2020.

BrightInsight’s Disease Management Solution

In order to ease these disease management challenges and take advantage of the wide range of opportunities, it’s important to take a strategic approach. Here are some benefits our Disease Management Solution can deliver:

Configurable, flexible functionality

Applications that are configurable to meet your unique needs are core to both accelerating speed-to-market and expanding your product portfolio over time. Our solution supports:

Connected devices
Custom clinical surveys to capture electronic Patient Reported Outcomes (ePRO) and Quality of Life (QoL) tracking
Configurable notifications, reminders and alerts to prompt health interventions
Configurable care plans and educational resources to personalize the patient experience
Configurable user and administration controls and alerts to meet data privacy requirements
Robust clinician interfaces that integrate with the EHR

It’s also important to build on a platform that’s compliant with even the most highly regulated digital health SaMD classifications. This allows you to maintain compliance across geographies and over time, even as the product scales and evolves.

I would access [BrightInsight's clinician portal] prior to the patient appointment for preparation to understand what's happened, and during the consultation to highlight areas of concern for the patient and show improvement or decline. I like the user-friendliness of this—I feel better equipped to use this to inform payers."

– Nurse practitioner, hematology/oncology

HEALTHCARE PROVIDER INTERFACES

Our Healthcare Provider Interfaces enable clinicians to see trend data directly within their EHR workflow to track how patients are responding to therapy and where any changes to the care plan may be needed.

Comprehensive, patient-centered tools

A patient app with tools that support patients throughout their disease management journey is a key differentiator. A great patient app solution helps patients recognize the impact of their actions through features like symptom tracking, patient-care team communication, automated medication and refill reminders and integration with connected devices.

The best patient tools include personalized drug dosing algorithms to drive adherence and persistence, plus personalized education tools designed to empower patients.

DAILY SYMPTOM LOGS

Patients can track the frequency of symptoms they are experiencing with tools like daily symptom logs and quality of life surveys help track the impact on daily living.

MEDICATION AND APPOINTMENT REMINDERS

Hematological oncology med appt reminders

The patient app automatically imports prescriptions directly from the EHR and medication reminders support treatment adherence. Connected devices, such as an integrated Smart Pill Box, which captures each date, time and dose of therapy administration, can help patients manage their condition.

Right now, I'm writing all this down. Every time I go in, every three months, the doctors are asking for this information. If I could record between scheduled visits, which days I'm having nausea, lipidemia, that would be great because the doctor was repeatedly adjusting my doses and medications based on my side effects."

– Tanya, breast cancer patient

A real-world data engine with actionable insights

The most powerful digital health solutions allow for the secure, compliant capture and use of patient- and population-level data. On an individual level, analytics dashboards with usage and usability metrics, combined with algorithm hosting, aid clinical decision-making, increasing patient adoption and engagement. On a broader level, data powers reimbursement management tools, demonstrating therapy value to payers and increasing therapy access.

A PLATFORM FOR COMPANION DIAGNOSTICS

Personalized, or precision medicine, has revolutionized cancer care. These therapies rely on biomarker tests to identify the right therapy for the right patients at the right time. Due to these advances, more and more cancer treatments require a companion diagnostic to identify eligible patient populations or those at increased risk for adverse reactions.

A digital Connected Diagnostic Platform can complement disease management tools to optimize device performance and enhance the patient experience while maintaining global regulatory compliance and best-in-class security.

BrightInsight’s Connected Diagnostics Platform leverages real-time data to streamline workflows, accelerate revenue growth and drive portfolio innovation.

ANALYTICS DASHBOARDS

Commercial and brand leaders leverage our Analytics Dashboards to harness unique data to drive product strategy and marketing tactics.

Learn more about BrightInsight's Disease Management Solution with our Solid Tumor Oncology demo.

Deliver better disease management with BrightInsight

Go with the proven partner that top biopharma companies trust. When you team up with BrightInsight, you can accelerate time to market while future-proofing your disease management solutions for regulatory, security and privacy compliance.

By building their disease management solutions on top of the BrightInsight® Platform, top biopharma and medtech companies can address patient and provider pain points and unlock a better path to adherence and persistence across a wide range of therapy areas and treatments.

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The BrightInsight Disease Management Solution (DMS) is not a cleared or approved medical device. The use cases presented within this article are hypothetical use cases and do not make reference to a specific product, product claims or product branding. The Nubexrin interface that is illustrated is for example purposes only and does not represent a real product or product branding.

How digital solutions ease challenges and deliver value

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