As the CEO of a health care technology company, I want to state for the record that technology does not heal. Caregivers heal. And the oncologist, in particular, blends the skills of scientist and clergy to heal patients and their families during the most challenging of times.
Oncologists want patient-centered care and want patients and families to share in the treatment decision process. The challenge lies in facilitating the simple and sacred moment of discussion. Clinical oncology science is exploding, and oncologists themselves struggle to keep current with the same information that their patients can readily access. With larger patient loads, less time and resources, and ever-expanding medical literature, discussions between oncologists and patients may be overshadowed by competing tasks and concerns.
Oncologists do not yet have access to real-world data on the comparative benefits and risks across available treatment options to provide precise guidance. Limited time and energy for counseling may lead to decisions that avoid lengthy and difficult discussions about goals of care.
New outcomes-focused reimbursement models reward oncologists who offer better value for the care they deliver. Many oncologists are supportive of the concept of value-based care, realizing that costs are unsustainable at a system level and increasingly unsustainable for those who are bankrupted by their own cancer treatment. At times of distress, patients may overestimate the benefits of treatments, which might sometimes extend life by just weeks. Oncologists do not yet have access to real-world data on the comparative benefits and risks across available treatment options to provide precise guidance. Limited time and energy for counseling could lead to decisions that avoid lengthy and difficult discussions about the goals of care.
The oncologist’s counseling on and documentation of patient/family understanding of curative versus palliative intent of treatment is a small but important first step. A patient’s clear comprehension of these terms is a good way to help him or her and their families become better-educated health care consumers. But this is just the start. We must integrate the patient’s values and goals into treatment decision-making. Knowledge from genomics/proteomics and molecular testing can help us understand which patients are likely to best tolerate and respond to treatment so that meaningful shared decisions can be informed from both the patient’s and the oncologist’s points of view.
Technology certainly does not heal, but it offers critically needed tools at the adept fingertips of the true healers.
By 2019, 90% of Medicare payments are anticipated to be tied to value.* The health care technology market is rapidly mobilizing to help address the value gaps. Carevive is building oncology clinical decision support, patient engagement, and data analytic tools to better support cancer teams at the point of care. Reimbursement models rewarding patient engagement and improved clinical outcomes will drive quicker adoption of such technology by the health systems. Clinicians require better-quality technology that presents them with more precise and helpful insights. Without that information and data, undoubtedly, the confluence of an exploding science and a value-based reimbursement system will result in an unfair burden on the health care team.
We are passionate about our mission to support cancer care teams and patients. And we are grateful for the burgeoning contributions to the Carevive platform from the oncology clinical community so that we may all be part of the solution. Technology certainly does not heal, but it offers critically needed tools at the adept fingertips of the true healers.
*Burwell SM. Setting value-based payment goals—HHS efforts to improve U.S. health care. N Engl J Med 2015;372(10): 897-899.
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