At HTN Now: Citizen Transformation, we were joined by Paul Landau, Founder and CEO of Careology, for a discussion on how Careology is building effective digital cancer care through empowering patients and equipping healthcare professionals with real-time, relevant information.
Here’s what Paul had to share with the health tech community…
Introducing Careology
Careology launched in 2019 with the aim of better equipping and seamlessly connecting patients, caregivers and healthcare teams throughout the entire cancer care pathway.
Our digital cancer care technology focuses on truly joining the dots and connecting all the key players in the cancer pathway, in a way that is both empowering for the patient, and has real clinical rigour. Bringing digital transformation to the health sector, and specifically the cancer care space, is extremely complex. In order to add value, it is critical that the patient’s needs are put right at the centre of how our technology is developed.
On empowering patients through digital tools
Digital offers enormous benefits for somebody going through a cancer diagnosis. If you look at a traditional cancer pathway, it can be an incredibly isolating and daunting journey. There’s a huge amount that people need to learn about their diagnosis and there’s an enormous amount that people need to manage day to day. Often people can feel isolated and alone.
One of the things that really struck me when I first came up with the idea for Careology is that cancer is almost the inverse of other conditions, in that people go to hospital for treatment when they are well and come home when they are unwell. It’s at home that you have to deal with all the toxicities and the nasty side effects of treatment, especially chemotherapy. From home, patients are often asked to make quite clinical judgement calls in terms of when they should pick up the phone and let somebody know about a particular side effect that they are experiencing.
So digital has a real capability to help that person at home feel far better supported and less isolated. What we’ve built at Careology is a platform that supports that person with a toolkit and helps them keep on top of all those things that need day-to-day management. It really empowers that person to know when to make that judgement call. It gives the patient better permission to pick up the phone, to feel that they aren’t being a nuisance and it’s the right thing to do.
Also, through Careology Professional, which is the enterprise side to Careology, it’s allowing the healthcare teams to have more insight than they have ever had available before. Instead of always fire-fighting and having to work reactively, often when things have become more advanced and more complex than they needed to be, the healthcare team is now able to work proactively and get in touch with that person if they can see that there is a problem.
How Careology equips healthcare professionals with real-time data and information
Careology has two main sides to the platform: the patient side, which allows patient and caregiver to make better, more informed decisions, and Careology Professional.
Careology Professional has been designed to provide a virtual ward. It’s a virtual cancer ward, if you like, which provides remote patient monitoring capabilities.
If I was a triage nurse, at the moment, I might be managing a triage helpline where I’m waiting for the patient to call me from home to tell me about a particular side effect and ask me what to do about it. Using the insight that Careology Professional provides, we are able to extend the reach of the healthcare team beyond the four walls of the clinic, and be able to see current status for all of the patients that we are looking after.
We use a RAG status – red, amber, green. It makes it easy for the team to see what’s happening – for example, they would be able to say, ‘Here’s Paul, he was green this morning, we can see he’s turned amber, we might want to get in touch and intervene now’. If you see somebody turn to red, you can prioritise them. They can step in earlier and stop side effects becoming far more acute, complex and expensive with all the knock-on effects that then happen.
The impact of digital cancer care on cancer treatment over the next five years
When we look at the breadth of the capability that we have now delivered, there is a huge amount of impact. You’ve got different impacts for the different stakeholders in the pathway.
It’s easy to see from a patient experience perspective already, from the things that we have discussed, that the platform is helping patients feel more in control, better supported, more confident. That’s really important, even at just a basic level. As we start to look further forward, there are more areas in which Careology and digital cancer care can support patients – for example, supporting patients with self-care or helping caregivers provide more direct care for the patient. You can really use it to increase the level of patient experience.
Another key thing is that you can reduce the need to always have to travel for appointments. Under a traditional cancer care model, patients always have to travel to the hospital, sit in a waiting room, wait their turn for treatment – overall that’s quite a simple task but it can actually end up with people having to give up half a day of their time. With this, you are really increasing the ability for the patient to feel that their time has been freed up. You are enhancing their experience, but also that area of self-care has a knock-on effect for the healthcare system at large. If you think about how many tasks are currently undertaken by members of the clinical team that perhaps the patient could be doing for themselves at home, you can suddenly free up so many appointments.
We all know that in the aftermath of COVID there are enormous challenges in terms of the cancer backlog – we just can’t get enough throughput in the system. We’re getting people who have been diagnosed later with more complex diagnoses and actually capacity is probably the number one challenge that we are facing as a sector at the moment. So more self-care offers so much opportunity to build capacity whilst improving patient experience.
Another key area is the dataset that we are generating, and the kinds of insight that we will be able to use five years from now around prioritising, personalising and predicting. We will be able to do more with the data to transform and use resources more effectively and more sensibly.
So I think where things will change, going forward, is the old gold standard of going to hospital for every appointment and seeing somebody face-to-face. I think there is real recognition today that it isn’t always the best route, it isn’t always better for the patient, and it isn’t always better for the provider.
Working with Guys’ and St Thomas’ NHS Foundation Trust
Careology formed the partnership with Guys’ and St Thomas’ (GSTT) over the summer of 2022. GSTT is one of the leading cancer centres in the UK with national and international reach, with a large and sophisticated cancer centre; it’s an incredibly exciting relationship.
The key way that the relationship has been set up to work is that we will now be co-developing in partnership with GSTT. It means that they become almost an extension of our team and we are collaborating with them really closely to look at our current capability and feature set, and to understand how in the short-term we can refine and tweak that to make sure we are delivering on our promising to deliver the best care that we can for patients.
Looking at it from the bigger picture, it’s incredible to now be able to get the input of a large complex cancer centre, to help us understand entirely new capabilities we haven’t even thought of yet that would be beneficial to the NHS. We’re not just looking at things in terms of what is beneficial for GSTT as a single trust or a single cancer centre, it’s looking at the cancer care needs for the NHS and beyond, even internationally.
The aspiration from both sides is to build the world’s leading digital cancer care platform, leveraging our ability to innovate, develop quickly, design great user experiences, whilst also leveraging that sophistication and clinical and operational insight from a leading cancer centre. It really is a groundbreaking partnership.
Working with Macmillan
Macmillan is a relationship that we entered into around this time last year. At the time, we had lots of ideas in terms of things that we could do together, but over the course of this year we’ve really been able to nail some of the low-hanging fruit and opportunities to collaborate to really start using digital to benefit both parties.
One of the things we have been working on in the last few months is an API, which now allows us to surface Macmillan content in the Careology app to help patients get the right information at the right time. Under the traditional model, patients would receive their diagnosis, be given lots of leaflets and pamphlets from their provider, and go home with lots of paper. No-one can consume that and memorise it all and what typically happens is that all of that paper ends up in someone’s bedside drawer, and at the point of need, you can’t remember where you put it or find the information.
Going back to our partnership with GSTT, we’ve heard that they often get feedback from patients that they don’t feel they are given enough information. As a trust, they know that they actually give the patient lots of information, but ultimately it’s information overload and patients aren’t taking it in.
So with the Macmillan API, the whole idea is that you can surface the right information that is personalised to the patient’s needs as those needs are changing. So depending on the patient’s diagnosis, treatment regime, symptoms and side effects, we can make sure that the right content is surfaced. If, for example, I reported that I’m feeling really nauseous and I want ways to alleviate it, I’d see articles, recipes, tips and so on – holistic information that is useful to me at that point in time.
Then there’s the environmental agenda too – when you think about how much paper is printed to be given to patients who then leave it in their bedside drawers, that’s not particularly healthy from an environment. So it helps in that area as well as helping trusts get the right information to the right person at the right time.
Evaluations into the tech
We do a lot of work on an ongoing basis, looking at the impacts that we are making. We spent a lot of time working with our partners to look at the ideal surface design for this sort of technology to make sure that you are getting engagement both with patients and caregivers, and the clinical teams. Typically, we’re seeing over 70 percent engagement rate with patients, and well into the high 90s with the clinical teams. So we are seeing the technology being used in a really rigorous way when we deploy it.
There was a study published in the last couple of weeks in the International Journal of Medical Informatics, written by three different authors – a systematic review, totally independent, looking at all of the apps in app stores that have relevance to cancer. Globally, there were just over 400 apps claiming to be useful for a cancer diagnosis. The study whittled that down to the apps which really are directing impacting cancer from a broad perspective; apps which would be useful for tracking toxicities and patient-reported outcomes, along with providing data back to the healthcare provider.
Following this systematic review, we were delighted that Careology came out on top. From a feature perspective, we were ranked the number one technology available in the marketplace today, which is incredibly exciting and rewarding to the whole team.
Final thoughts
It’s such an important space. When the ideation for Careology came about, it was very much based around personal experience and understanding the unmet need to create something that could better support and connect patients and healthcare teams.
That was before COVID; the pandemic has been a real accelerant to this sort of technology. The healthcare space has never been the fastest adopter of new technologies, but I think today everyone understands that digital can make a huge amount of difference to the problems and challenges that the sector is facing. It’s a very important time for the category; it’s emerging really strongly. We’re seeing real opportunities across the pathway, from the point of diagnosis through treatment and then beyond, into survivorship and end of life care. Digital has such an important role to play to help people going through such a difficult diagnosis, but critically we need to also support the clinical team to work smarter, more efficiently and more effectively, which is ultimately better for everyone involved.
The last couple of years have been transformative, we’ve seen a huge amount of development, and I hope that acceleration continues to happen. We’re normalising digital now; five years from now, I think everyone in a cancer pathway will be using digital as a key part of their care plan.
