Digital monitoring can provide significant support to this patient-centred follow-up, or remote cancer surveillance. Within the NHS Long Term Plan (2019) there is recognition that implementation of self-management services tailored to individual needs offers huge benefits to patients and providers. It will improve the quality of life for people following treatment for cancer through addressing their needs, and help them to return to living their lives as positively, healthily and quickly as possible. (NHS England, 2019).
beetrootONCOLOGY is an exciting new service specifically designed for remote cancer surveillance pathways, but based on the tried and tested beetrootDMARD service. It utilises the beetrootPROMS approach to collect quality of life data from patients and will enable better communication between patients and their clinicians.
As patients receive ever better care for cancer diagnoses their life expectancy improves. They can return to living normal lives. However there is always a risk that their cancer may return. Should it do so they need the earliest possible intervention. While they’re away from the hospital environment living independent lives its easy for those earlier signs to be missed.
Additionally there is an increased risk that newly referred patients whose investigations have been deferred due to capacity issues caused by Covid-19 may be ‘lost’ to the system as it gets back to normal. Delays can prove life-threatening as shown in this article.
Collect a range of data from patients using beetrootPROMS, and, by combing that data with previously collected clinical data use patient-specific surveillance templates to identify patients of concern. Surveillance templates are similar to the monitoring profiles used in beetrootDMARD, the monitoring rules for which which are based on diagnosis and medication. In beetrootCANCER the templates’ rules are based more on tumour site and treatment regime.
Also use beetrootPROMS to:
- collect remote data from patients such as quality of life questionnaires and some vital signs and use those data to identify early onset of problems
- provide regular ‘nudge’ education and advice
- enable two-way communication between patients and their clinicians.
beetrootCANCER case study
At the end of 2019 the MSE Group Cancer Directorate, initiated a tender process to procure a new open access cancer surveillance digital health service. The intention was, at that time, to provide faster and more effective remote surveillance and monitoring of cancer patients treated at any of the Trust’s three hospitals (covering a population of 1.2 million). The competitive process started just before Christmas 2019, and responses were received by early February, 2020.
And then the coronavirus pandemic gathered pace.
The selection process revealed THERAPYAUDIT to be the preferred bidder, with a proposal to offer beetrootCANCER as the digital health service of choice. beetrootCANCER is unashamedly based on beetrootDMARD, a service which has been successfully deployed to the Trust to benefit clinicians and patients who required remote Disease Modifying Rheumatic Drugs (DMARDs), such as methotrexate. While beetrootCANCER wasn’t presented as an off-the-shelf solution for cancer surveillance, it had a sound basis to work with, and the additional benefit of a two-level beetrootPROMS service to enable effective communication with patients.
Michael Catling, former MSE Group Director, Cancer
This beetrootCANCER deployment is at an early stage, but work has started with breast cancer units to identify patients and connect to the various data sources that will provide important patient data. The plan is to extend the service to colo-rectal and prostate cancer patients, and also introduce the web-portal version of beetrootPROMS over the coming months. Although the necessary use of video-consult is a vital tool in maintaining ongoing communication between THERAPYAUDIT and MSE team members, a deployment devoid of physical contact from the outset will be an interesting challenge. Human beings, after all, are exactly that, human and social, and even a single in-person kick-off meeting is worth a number of crackly video calls.