CancerX Launches Core Competencies To Drive Equity in Access and Reduce Patient Financial Toxicity

In 2023, there will be an estimated 1,958,310 new cancer cases in the United States and, if past is precedent, over 50% will experience cancer-related financial toxicity. Financial toxicity, is the cumulative impact of the economic, health, and psychosocial harm caused by the direct and indirect expenses that accrue to patients and their families as a result of their cancer diagnosis (adapted from Shankaran et al, 2022; Yabroff et al, 2019; Hassan et al., 2022; Zafar et al., 2013) Cancer survivors who experience financial toxicity are more likely to also experience poorer quality of life, less satisfaction with cancer care, higher symptom burden, and increased risk of all-cause mortality.

Digital health solutions have enormous potential to transform how these patients navigate the costs and complexities of a cancer diagnosis. Solutions such as telemedicine platforms, artificial intelligence, machine learning algorithms, and electronic health record-embedded applications are valuable tools in health system strategies for connecting patients with comprehensive, high-value oncology care. They can also support health systems in connecting patients with needed financial resources while lowering the administrative burden of support services delivery for their providers and staff, a critical challenge to care delivery in an era of low staff levels and workforce burnout.

Going forward, the ability of health systems to address patient financial toxicity and deliver equitable access, cost, and health outcomes for all cancer patients will depend in part on their scaled use of digital health solutions to meet patient and provider needs. Systems can look to current applications of digital health solutions across the cancer care continuum for promising approaches to improve patient access and reduce out-of-pocket costs.

Digital solutions are helping health systems to:

• Engage cancer patients who live farther from the clinic
• Meet cancer patient preferences for hybrid care
• Connect eligible patients with cancer clinical trial opportunities as standard of care
• Support cancer care navigation, with fewer staff resources, for better patient financial outcomes

CancerX has developed a set of freely available health system resources to support the scaled implementation of digital health solutions in a way that improves patient access to cancer treatment and reduces financial toxicity associated with that treatment.

The resources developed by CancerX include:

• A core competencies guide to help healthcare leaders design a digital strategy to improve equity in access to cancer care and reduce out-of-pocket costs for patients.
• A financial navigation guide to support patient navigators in designing and implementing digitally-enabled financial navigation programs to reduce out-of-pocket costs for patients across their cancer journey.
• A solutions catalog featuring 14 fit-for-purpose digital solutions available on the market to support the implementation of a digital strategy to improve equity and reduce financial toxicity

These resources are designed to support health systems in digitizing components of their overarching strategies to provide equitable access and reduce patient cost. The resources can be used by health system oncology service line leadership and digital health division leadership to design and measure successful implementation of a digital strategy for equitable, high-value care and to choose fit-for-purpose digital solutions from the market to implement this strategy.

For example, health systems can use these resources to develop a strategy for implementing EHR-embedded health-related social needs screening and, subsequently, automated processes for connecting patients to available support services to improve their care.

The resources can also be used by patient service divisions, cancer care navigators, and social work leadership in the design and implementation of digitally-enabled financial navigation programming to reduce out-of-pocket costs for patients across their cancer journey.

The CancerX resources contain recommendations for the use of digital health solutions across multiple dimensions of cancer care delivery, including the use of digital solutions to expedite time to treatment initiation and to automate patient connections to financial support services.The resources also provide in-depth case studies demonstrating the real-world value of digital health tools for improving cancer care access and reducing patient financial toxicity.

About CancerX

The resources were developed by the project team supporting CancerX’s inaugural evidence generation project which is comprised of 24 member organizations and focused on the creation of precompetitive solutions to improve equity and reduce financial toxicity for patients, and the families of patients, diagnosed with cancer. The health system core competencies guide, and corresponding patient financial navigation guide, supports digitally-enabled patient access to cancer care and reduced patient financial toxicity.

These resources are the first in a suite of resources being developed by the CancerX project team to achieve CancerX moonshot goals. CancerX is a public-private partnership co-hosted by The Digital Medicine Society (DiMe) and Moffitt Cancer Center, alongside the Office for the National Coordinator for Health Information Technology (ONC) and Office of the Assistant Secretary for Health (OASH). The initiative was established in 2023 as a national accelerator to boost innovation in the fight against cancer within the reignited Cancer Moonshot program.

Conclusions

The rising burden of financial toxicity in cancer care demands a proactive response. There is a need for the deployment of support services at scale across health systems with differing infrastructure and resource specifications. Digital health solutions present a promising avenue for improving equitable access and reducing out-of-pockets costs for patients. The freely available CancerX resources provide a vital toolkit for health systems to navigate this quickly evolving landscape. By embracing these resources and implementing digital strategies, clinical decision-makers can enhance the quality of cancer care and alleviate financial toxicity faced by their patients, ultimately working towards a more equitable and patient-centered healthcare ecosystem.

Sarah Sheehan, M.P.A., is program lead, Digital Medicine Society (DiMe). Corrine Leach, Ph.D., M.P.H., is director of digital innovation services at the Moffitt Cancer Center in Tampa, Florida.