A missed opportunity

Toby Basey-Fisher, chief executive of Entia, discusses the missed opportunity to transform cancer through home monitoring technologies.

© Entia

© Entia

Cancer care is at a crossroads. Despite significant advancements in treatment, we are still falling short when it comes to delivering timely, effective care for patients. Recent statistics from Cancer Research UK reveal 55,000 patients in the UK missed the NHS's critical 62-day target for treatment over a six-year period, which is a profound missed opportunity to save lives.

Health tech innovations such as at-home patient monitoring offer a proven way to alleviate the pressures on healthcare systems, enhance patient outcomes and revolutionise the cancer care landscape. So why has the UK lagged behind in adopting these technologies?

In healthcare, remote patient monitoring (RPM) has seen rapid growth across a variety of conditions and spans digital solutions through to advanced blood monitoring solutions. The use of RPM tools in diabetes care has been widely embraced for decades. Glucometers allow patients to monitor their blood sugar levels in real time, reducing the need for frequent hospital visits while enabling timely interventions from healthcare providers. In a wealth of conditions, digital patient-facing applications that allow for tracking of symptoms and quality of life have been adopted to further personalise care pathways and enable the delivery of proactive care. It's estimated that by 2025, 70.6m US patients—about 26.2% of the population—will be using remote patient monitoring tools.

Unfortunately, cancer care in the UK lags woefully behind. This is despite the fact that real-time health data could provide continuous insights into a patient's condition, allowing for more personalised and 

proactive interventions that would reduce hospital visits, improve quality of life and reduce complications and emergency admissions. For instance, neutropenic sepsis is considered a medical emergency and it accounts for approximately 20,000 emergency admissions annually in the UK.

Several barriers have prevented RPM from widespread adoption in cancer care. One issue is the comparative complexity of both the health condition and the technology required. For diabetes care, glucometers have existed for over a century, allowing the transition from lab-based to home-based testing to happen incrementally. Until recently, however, the technology needed to support home monitoring for cancer wasn't available.

Advances in sensor technology now make it possible to monitor a range of relevant vital signs and biomarkers from a patient's home. From blood tests to tracking vital signs like blood pressure and oxygen levels, these tools make home monitoring for cancer viable and affordable. 

Another barrier is the fragmented nature of the UK's healthcare system. Unlike France's resilience digital oncology solution, which has a centralised commissioning system that supports the widespread adoption of patient-facing applications and home monitoring, the UK relies on a decentralised approach. Where that has been a centralised decision as with the investment in virtual wards, these were focused heavily on respiratory and frailty issues. This has resulted in uneven uptake of oncology RPM technologies across NHS trusts, with local decision-makers determining whether to invest in new solutions. As a result, life-saving innovations like remote blood monitoring systems and patient-facing applications remain on the periphery of cancer care due to red tape and commissioning procedures.

The potential for home monitoring technologies is to trigger a shift from a reactive model of care—where we wait for patients to present with complications—to a proactive model that prevents them from occurring in the first place. Febrile neutropenia, a common complication of chemotherapy, often leads to emergency hospital admissions and extended hospital stays. With continuous home monitoring, patients at risk of these complications could be identified and managed earlier, reducing the need for costly and distressing hospital visits.

In cancer care, studies demonstrate that proactive monitoring, particularly through remote methods, can significantly reduce the need for emergency hospital admissions by providing earlier intervention and more responsive care. This would mean freeing up valuable NHS resources, allowing healthcare providers to focus on delivering timely treatments. It would also reduce waiting times for cancer patients, who are currently being failed by a system that is overwhelmed by demand.

Beyond improving patient outcomes, RPM technologies have the potential to generate significant operational efficiencies. In the UK, the backlog of cancer treatments has reached critical levels, with thousands of patients waiting longer than they should for diagnosis and treatment. By adopting a more automated, home-based approach to monitoring, we could free up healthcare professionals to focus on getting patients treated faster.

Remote monitoring would also alleviate the pressure on hospital beds, allowing patients to recover in the comfort of their own homes. This not only improves the patient experience but also delivers substantial cost savings to the NHS. For example, managing complications like neutropenic fever in a hospital setting costs around £5,000 per patient. If home monitoring could prevent even a fraction of these admissions, the savings would be significant.

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