When deciding on the value of a certain treatment for cancer, the current “value paradigm” considers factors such as improvements in clinical outcomes, side effects, and quality of life (QoL). One factor that is not taken into account – as discussed in an opinion article recently published by JAMA Oncology¹ – is the impact of treatment on patients’ time. 

For the patient, pursuing cancer treatment comes at the expense of time and energy that could be devoted elsewhere. By omitting patient time as an endpoint of interest, the patient’s opportunity to prioritize their time and opt for a shorter or less time-intensive treatment route is taken away. It is for this reason that developing methods and tools to quantify patients’ time consumed by healthcare – in this case, the amount of time patients commit to a certain cancer treatment in hospital – would be valuable.

Consumption of patient time can be considered as an additional element of healthcare resource utilization (HRU). Currently, a range of methods are used to capture data and estimate HRU. These include analysis of routinely collected data on care episodes, such as electronic health records and medico-administrative datasets, as well as designed-for-purpose data collection, including surveys of patients or healthcare professionals. These methods could all potentially be used to derive estimates of patients’ time. 

An option for directly measuring it is the use of geofencing with personal mobile devices, such as smartphones. Geofencing technology can capture data on the frequency, pattern, and duration of patient visits to healthcare locations. Additional information on the nature of treatment received and the patient’s experience can be gathered via a survey instrument, distributed to their smartphone following a geofencing alert. This approach is relevant and valid for use across a wide range of diseases and conditions.

Vitaccess is an innovative research organization, focused on patient-centric real-world evidence generation and the development of digital research methods in health. We are developing a new digital composite HRU-measurement instrument, using geofencing technology, as an improvement on existing methods for estimating HRU. This new

instrument has the potential to quantify HRU from the perspective of a traditional health system as well as the patient, for example, hospital procedures conducted versus patient time expended on the procedures.

Geofencing allows survey data to be collected from patients at an optimal time during or following a visit to a healthcare location, when their responses are most relevant and recall is expected to be at its best. Patient-reported data can be collected quickly, flexibly, and inexpensively via surveys, while minimizing inaccuracy and bias arising from challenges of recall. The HRU-measurement instrument could be used not only to measure patients’ time in hospital, but also to capture more detailed data on their experience and QoL during the period of treatment.

The opportunity for collecting data on patients’ time and experience of treatment in this way would be particularly significant for those with advanced disease who are navigating end-of-life treatment decisions. Development of the geofencing-enabled HRU instrument is being led by Vitaccess – to learn more about this initiative, or to find out how we can work together, contact us at info@vitaccess.com. 

¹Fundytus A et al. Has the Current Oncology Value Paradigm Forgotten Patients’ Time? Too Little of a Good Thing. JAMA Oncol. Published online August 26, 2021. DOI:10.1001/jamaoncol.2021.3600


By Fatemeh Amini & Giles Monnickendam

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