A commentary published in JCO Clinical Cancer Informatics addresses the rise of a digital burden and advocates for the development of tools to balance the benefits and burdens of digital technologies in patient-centered oncology care.

Caroline Chung, MD, vice president and chief data officer of The University of Texas MD Anderson Cancer Center, and colleagues defined “digital toxicity” as “the increasing requirement for patients to interact with different technologies to arrange and manage their care, [which] may cause additional burden.” Factors that contribute to digital toxicity, they argued, include a general lack of user experience testing of platforms across the cancer care continuum, as well as the difficulty of interfacing with programs designed as standalone services.

“This lack of human factors testing may increase stress, confusion, or feelings of being overwhelmed, especially in a population that may be less digitally literate than younger populations,” Chung and colleagues wrote.

The absence of programs that seek to integrate digital platforms may result in frustrating user experiences for patients. Errors such as repeated notifications and duplicate requests for information, as well as the need for multiple password-protected accounts, can distract patients from scheduling and accessing the multi-platformed care they seek.

The electronic patient-reported outcome assessment has emerged as a source of potential digital toxicity. “Although such tools have been shown to improve patient communication, quality of life, and survival, the usefulness of an electronic patient-reported outcome intervention relies on a patient’s willingness to provide frequent reports on their symptoms even while they are experiencing unpleasant side effects,” Chung and colleagues wrote.

Because it often seems unclear how data will be used to coordinate care across the cancer spectrum, patients may find it burdensome to report data—especially in the midst of an acute episode. Disengaging from digital platforms because of a perceived lack of usefulness can also cause a patient to miss important communications from their care team.

In the articles, the authors proposed strategies for curbing digital toxicity, beginning with the development of user-friendly and human-centered platforms that are easy to use and make their goals clear. The ability to securely share information across platforms to reduce redundancy should be prioritized.

“Providers and systems should search for redundancies within their current offerings and ensure that any information collected can be re-used to reduce the risk of multiple requests made to the patient for the same or similar information,” they wrote. “Effort should be given to working with patients to find optimal notification settings and other preferences for digital engagement.”

“The digitalization of cancer care has great potential to improve patient care and outcomes, including the potential to introduce new conveniences, efficiencies, and improve access to care,” they concluded. “As we continue to rely on technology in the delivery of cancer care, developers, health care providers, and policymakers should seek to collaboratively work toward creating intuitive, patient-centered digital tools.”

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Reference:

https://ascopubs.org/doi/abs/10.1200/CCI.23.00105?md5=42583588d76f06a6fc1d9834541105ca&cid=DM18042&bid=403355005

Disclosures: Chung declared financial ties to drugmakers. See full study for details.

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