Article

Remote Monitoring: Challenges and Opportunities in Cancer Care

Patients no longer need to rely only on in-person visits to help manage their cancer care. Remote monitoring technology allows health care providers to track how their patients are doing with phone and tablet apps, wearable tech like smart watches and wristbands, and Bluetooth-enabled medical devices such as weight scales and blood pressure cuffs.1

These remote monitoring devices track valuable patient information that doctors can review and use to make treatment changes and updates. Blood pressure, oxygen or glucose levels, body weight, body fat—all of this vital data can be captured and sent to a care team as data over a secure connection.1

New studies support the benefits of remote monitoring

Remote monitoring can even be used to track quality of life data, such as sleep patterns and activity level. In 2018, researchers at Memorial Sloan Kettering Cancer Center did just that. Researchers studying quality of life in multiple myeloma patients used Fitbits to gather data on eating, sleeping, and activity levels. Doctors treating these patients were able to use Fitbit data to determine whether chemotherapy would be an unsafe treatment choice based on patient health. More importantly, patients who were found to not be healthy enough for chemotherapy were able to be coached through the program to achieve better overall health. Some patients who were not ideal chemotherapy candidates at the start of the study were able to improve their health and increase their treatment options.2

Researchers at Cedars-Sinai Medical Center in Los Angeles, California, and Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, studied a small population of patients with different cancer diagnoses. The study focused on patients in relatively poor health, with high levels of fatigue and low levels of mobility. Researchers used Fitbits and related health monitoring products to track vital information such as step and stair counts, resting and active heart rates, calories expended, and sleep patterns. Using real-time data and interactions between health care providers and patients, the study showed that remote monitoring could demonstrate a clear connection between patient activity levels and patient health and quality of life. The more active the patients were, the more effective their treatment was.

What this research means

For example, patients who were coached to increase their total steps taken per day by 1,000 saw significantly lower risk for hospitalizations, reduced complications and adverse effects, and increased survival rates. The study found that patients who walked fewer than 1,000 steps per day survived an average of 2 months, while patients who walked between 1,000 and 2,000 steps per day survived an average of 5.5 months. An increase in stairs climbed correlated to a reduced number of hospitalizations and other complications. Conversely, patients who reported higher levels of fatigue showed decreased step counts, shorter walks, and fewer stairs climbed. And more generally, researchers found that patients who stuck to a consistent, healthy sleep schedule had a higher overall rate of survival.3

UT Southwestern's Simmons Cancer Center have shown pilot study of older cancer patients found that they were willing to wear physical activity monitors (PAMs) for 10 weeks or more and used them correctly. Data from the PAMs correlated well with clinician assessment of patient status, the researchers found. Twenty-four patients being treated for a variety of cancers including breast, lung, and gastrointestinal cancers, participated in the study, and 23 of the participants met the goal set for feasibility for using the devices.

The future of wearable tech in oncology care

Evaluation of a patient's functional status is a key part of clinical encounters and affects treatment decisions. Cancer patients often are older and subtle differences in functional status can be particularly important in evaluating elderly patients. Adding objective data from PAMs can sharpen oncologist's assessments of their patients, the researchers said.

"We found that patients could successfully use the wearable devices over a prolonged period. Measured steps per day differentiated performance status with great sensitivity, and correlated well with multiple quality-of-life surveys," said Dr. Arjun Gupta, Instructor of Internal Medicine and first author of the study. "Importantly, the attrition rate was low, and patients reported a positive experience with using the device, indicating that these new-generation wearables are adoptable even in cancer patients, who may be elderly and less technologically literate.4

Remote monitoring through wearable technology can provide doctors with current, accurate vital data. Patients can benefit by wearing these devices not only to establish or support treatment decisions, but also to support recovery and general quality of life. 

References

  1. "ASCO 2018: Remotely Monitoring Patients Decreases Symptom Severity in Head and Neck Cancer" https://www.rdmag.com/article/2018/06/asco-2018-remotely-monitoring-patients-decreases-symptom-severity-head-and-neck-cancer. Accessed March 16, 2019.
  2. "Cedars-Sinai uses Fitbits better monitor cancer patients and improve care" https://healthtechmagazine.net/article/2018/09/cedars-sinai-uses-fitbits-better-monitor-cancer-patients-and-improve-care. Accessed March 16, 2019.
  3. "Fitness Wearables Are Finding a Place in Oncology Care" https://www.oncologynurseadvisor.com/home/cancer-types/general-oncology/fitness-wearables-are-finding-a-place-in-oncology-care/. Accessed March 17, 2019.
  4. "Wearable fitness monitors useful in cancer treatment, study finds" https://www.sciencedaily.com/releases/2018/05/180501130856.htm. Accessed March 17, 2019.
  5. "Exploring the Benefits of Wearable Technology" https://www.huffingtonpost.com/jonha-revesencio/exploring-the-benefits-of_b_7910662.html. Accessed March 17, 20198.