Aims
Digital health approaches, including electronic medical records, decision support, wearables and electronic education platforms, promise to improve access and personalisation in cancer care but little is known about consumer preferences regarding digital health applications in cancer and their implementation. This study therefore sought to develop the Australian Digital Health in Cancer Roadmap, a consumer-driven strategic framework for implementation of digital health applications in cancer care.
Methods
A systematic literature meta-review (Jan 2013-June 2018) was combined with stakeholder consultations (consumers, health care providers, researchers, policy representatives, and technology developers) to identify barriers, enablers, needs and opportunities for implementation of digital health in cancer care in Australia. Thematic analysis by two independent researchers was then undertaken with resulting themes assessed by an expert reference group to identify corresponding needs and actions for a preliminary framework. Finally, stakeholders rated action items via a Delphi consensus process, to determine inclusion and level of importance/priority in the Roadmap.
Results
Ninety-three published reviews and focus groups/interviews with 51 stakeholders were analysed. Barriers, enablers, needs and opportunities for implementation were identified in a total of 23 themes, impacting from initial design and development through to implementation in clinical practice. Priorities included higher quality evidence and more translational research, increasing user access and engagement (including tailoring to individual characteristics/circumstances), ensuring validity, safety, and data security, and developing a coordinated approach with infrastructure and investment for effective integration within and across health services.
Conclusions
This study identified priorities for broader inclusion of digital health in cancer care. The Roadmap resulting from this work will enable effective implementation to maximise benefit to health systems and consumers.