The Current Landscape

The oncology outpatient journey begins with a two-week urgent referral pathway, followed by a series of investigations and triage by a multidisciplinary team. Depending on the need for surgery patients must undergo a histological examination before meeting with a medical oncologist. Medical oncologist appointments last anywhere from 20 to 50 minutes depending on whether it's a new or follow-up consultation. 

The clinical workflow then varies depending on if the patient is a therapy or non-therapy patient. Therapy patients will have multiple appointments per week for 3-6 months with different teams and often in different locations. Non-therapy patients tend to have less frequent appointments. Clinicians highlighted therapy patients as having the greatest need for digital support.

Oncology patient management is fraught with challenges:

• Communication Breakdown: Poor coordination within and between hospital systems leads to delays and inefficiencies.
• Technological Fragmentation: Multiple, often non-digitised systems for different activities such as blood work, pathology, and imaging create bottlenecks in patient care.
• Complex Treatment Management: Adjuvant therapies involving various drug combinations and side effects require meticulous oversight and toxicity tracking.
• Demographic Hurdles: An urgent need for treatment, combined with a predominantly elderly patient population with generally low digital literacy, coupled with language barriers for non-English speakers, presents unique challenges.

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The Ripple effect

These issues cascade into the delivery of patient care:

• Appointment Chaos: Paper appointment capture, lost referral letters, increasingly overburdened outpatient clinics, and the complex need to consider multiple teams (surgery, pathology, radiology and medical oncology) in scheduling patient appointments creates a logistical nightmare. 
• Triage Troubles: Current systems lack the flexibility to effectively triage patients for different consultation types meaning opportunities for teleconsultations are missed.
• Follow-Up Clinics: Long-term follow-ups and survivorship clinics, especially for breast cancer patients, involve a complex web of treatments and check-ups (SQ injections, echos, ovarian suppression, blood tests etc) that hospitals must manage due to insufficient primary care resources.

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A Vision for Improved Efficiency

Improving efficiency in oncology outpatient management requires a multifaceted approach. Despite these challenges, the oncology experts we spoke to see huge potential for improvement through digital innovation:

• Appointment digitisation and automation: Allowing for digital scheduling and management of patient appointments would provide greater flexibility to adjust patient schedules. Digitisation would also allow for easier communication with patients of key appointment details (e.g. clinic location, appointment type) and any subsequent changes.
• Remote Monitoring: Implementing systems for tracking symptoms, treatment side effects (e.g. CTCAE), patient-reported outcomes, and objective patient information could improve triaging and treatment adjustment. Particularly for pre-surgery breast cancer patients, this could help monitor treatment responses and enable adjustment of surgical plans accordingly.
• Maximise appointment time: Using PVQs and other data captured remotely which can then be reviewed and validated by clinicians to maximise the use of time in-clinic touchpoints e.g. patient capturing their weight/height measurements at home via an app.
• Enhanced Nurse-Led Assessments: Through the availability of helpful patient information, nurses and advanced nurse practitioners can be empowered to manage stable patient cohorts thus reducing the clinical burden on consultants.
• Streamlined Workflows: Digitising patient tracking, room allocation, and clinician-patient interactions could significantly reduce wait times and late clinic finishes.

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This is where Avegen's customisable outpatient management solution comes into play. Our solution offers end-to-end digitisation of each step of the care pathway, enabling better resource prioritisation, reducing paperwork, and ultimately lowering costs.

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The Road Ahead

While the potential benefits of these improvements are clear, implementation will require careful consideration of:

• Digital and Health Literacy: Any solution must be accessible to the older oncology patient population and seamlessly integrate with existing clinical workflows.
• Adaptability: Any new technology must be flexible enough to adapt to different tumour types, cancer stage, treatment combinations and different patient preferences
• Customisation: Given the wide variation in oncology department practices, solutions must be tailored to each unit's specific needs, ways of working and culture.

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By addressing these challenges head-on and leveraging tried and tested solutions like ours, we can create a more efficient and compassionate system for cancer care delivery. The focus must remain on enhancing patient outcomes while easing the burden on healthcare providers.

If interested in partnering together with us to solve your oncology outpatient management challenges, please get in touch with us via our contact us page.

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