ACCC President-Led Forum Addresses RPM Technologies + Health Equity

On November 10, 2022, ACCC President Dr. David R. Penberthy, MBA, held his third in a series of four Tech Talks, where invited subject matter experts and ACCC members discussed remote patient monitoring (RPM) in cancer care. Through shared experiences and challenges to implementing these technologies in oncology, speakers and members also shared how RPM has impacted health equity among their respective patient populations. The question posed to attendees: does RPM bridge the health equity gap without creating further inequities?

When asked to describe where their cancer program or practice was in its use of remote patient monitoring technology prior to the Tech Talk, most registrants (61 percent) indicated that they currently do not use but are actively researching this technology. Twenty percent identified their program or practice as “new users” to RPM technology, with an additional 11 percent identifying themselves as “experienced users” of this technology. This Tech Talk was driven by the ACCC Digital Tools in Cancer Care education program, with three members of the project’s Advisory Committee serving as the day’s speakers.

A Brief History

Amanda Dean Martin, DNP, CNEP, ACNP-BC, RNFA, chief of the Division of Advanced Practice and Clinical Integration at Banner MD Anderson Cancer Center, kicked off the Tech Talk with a brief history of RPM and its transition from only capturing objective data like blood pressure to eventually including subjective data, such as the information being collected through electronic patient-reported outcomes (ePROs). Dean Martin discussed the growing use of medical devices to capture these data and how oncology is using these technologies to successfully manage patients’ symptoms and monitor treatment compliance.

RPM Best Practices

Cardinale B. Smith, MD, PhD, chief quality officer of Cancer Services and vice president of Cancer Clinical Services at Mount Sinai Health System & Tisch Cancer Institute, shared how COVID-19 changed RPM in oncology. “Telehealth and virtual care are here to stay,” she said. “We now have the opportunity to envision how we want this care to be delivered going forward.” For those looking to select an RPM technology partner, Dr. Smith suggested that participants focus on six key areas: 

1. Patient vitals you want to track
2. Access to video visits, including the use of tablets to collect ePROs and facilitate provider-patient communication
3. User web interface—the technology must be easy for clinical staff and patients to use
4. Connectivity, including solutions for patients without broadband access
5. Home set-up and orientation
6. Tech support, as vendors must be available to troubleshoot any issues with patients.

The use of tablets to perform remote patient monitoring “opens up the opportunity to collect ePROs and push out surveys to at-risk and underserved patients,” Dr. Smith suggested, concluding that “there is no roadmap for this type of care. Engaging patients is challenging, and it took us some time to develop the right patient education.” The other challenge is cost. While Mount Sinai Health System used a grant from the Federal Communications Commission to fund a pilot RPM program aimed at improving the care of Black and Latinx patients with cancer, questions regarding how to pay for this technology and bill for these services going forward remain.

Yet “technology, itself, is not the number one cost. There are a lot of technology platforms available at different price points,” said Adam Dicker, MD, PhD, FASTRO, FASCO, senior vice president of Radiation Oncology at Thomas Jefferson University Hospitals, Bodine Center for Cancer Treatment. He suggested that cancer programs and practices figure out how to use their own human capital “because that is the costliest asset.”

While Dr. Penberthy posed a question at the start of his Tech Talk (Do RPM technologies help or hinder health equity?), Dr. Dicker offered an answer. “The healthcare community was prepared for the COVID-19 pandemic,” he said. “[But] not all of our patients were prepared.” 

There is still work that needs to be done to ensure all patients with cancer (regardless of race, ethnicity, and socio-economic status) benefit equitably from remote patient monitoring (RPM) technology and programs.

Access the Tech Talk in its entirety online. For more information, including tools and resources, on leveraging technology to transform cancer care delivery and the patient experience, visit the ACCC website.

The ACCC Digital Tools in Cancer Care education program is supported by AstraZeneca.