Cancer patients spend a lot of time on their care. Meeting with doctors and other members of their health care team, getting labs and other tests, picking up prescriptions, and undergoing treatment all take time. So does getting to and from each appointment, sitting in the waiting room between each appointment, and so on.
In recent years, cancer researchers have worked to quantify the level of “time toxicity” or time spent commuting to, waiting for, and receiving cancer treatment. Now, for the first time, a pilot study has shown it’s possible to use digital technology to safely reduce the amount of time some patients spend receiving care. With a simple text-messaging system, patients saved more than an hour at each visit captured by the study, which was led by researchers from the Perelman School of Medicine and Penn Medicine’s Abramson Cancer Center, and published in NEJM Catalyst.
“Patients with cancer spend an enormous amount of time engaging with the health care system, and for patients with advanced cancer in particular, that time is precious,” says senior author Ronac Mamtani, section chief of genitourinary cancers. “We developed a safe and effective platform that—for certain patients—could really challenge the status quo and give them quality time back.”
Inspired by the efficiency of the TSA pre-check line to bypass long lines at the airport, Mamtani and former Penn oncology fellow and lead author Erin M. Bange, now an assistant professor at Memorial Sloan Kettering Cancer Center, developed a text message-based platform using the Center for Health Care Transformation and Innovation’s Way to Health platform to obtain patient reported-symptoms and make sure patients are ready for immunotherapy treatment. Patients receiving immunotherapy for cancer treatment are currently required to complete bloodwork and meet with their health care team in the office before every infusion to confirm they have not developed any concerning symptoms that might signal a reaction to the immunotherapy and a need to pause treatment. The pre-treatment symptom check is a necessary safety measure that many patients treated with immunotherapy pass with flying colors, given the relatively low rate of side effects for immunotherapy compared to traditional chemotherapy.
In this pilot clinical trial, patients receiving single-agent immunotherapy for solid tumor cancers at Penn Medicine’s Abramson Cancer Center were enrolled and randomized to either an in-person pre-infusion symptom check in the office with their provider, or to complete a 16-question symptom check, estimated to take less than five minutes, via the text message platform. If their labs were normal and no symptoms were reported, patients were given the option to fast-track and bypass the in-person visit, proceeding directly to their immunotherapy infusion. The 16 patients who were fast-tracked saved more than 60 minutes per visit, including 30 minutes less wait time, than the 15 patients who were randomized to continue with the usual in-person visit.
Read more at Penn Medicine News.
