Based in North Wales, clinical oncologists and medical researchers, Dr Pasquale Innominato and Dr Nick Wreglesworth tell us about the work they’re undertaking to improve the experience and well-being of people with cancer – making use of the small scale, portable digital technology we find inside the smartphones in our pockets and increasingly strapped around our wrists. 

Can digital solutions be used to predict patient decline? Can they facilitate better symptom control? Will they also allow for less face-to-face contact between patients and clinicians – reducing patient travel and transport costs and relieving over-booked clinics? With the very generous support of Cancer Research Wales (CRW) we are investigating the role of digital health technology in Ysbyty Gwynedd, North Wales.

Thanks to the CRW Innovation Grant, we have started on a multi-phase research journey, aiming to improve the well-being and safety of patients with cancer.

A combination of newer treatments, better diagnostic capabilities and earlier interventions mean that more people are living with, and being treated for cancer in Wales than ever before.

Whilst in terms of medical science breakthrough this is clearly positive, the pathways and the systems in place to deliver these treatments haven’t much changed for 20 years. Embracing technology must be part of the solution to improving clinical practice, in order to safely deliver treatment and improve the patient’s cancer care experience.

Our ‘vision’ for our department is for each consenting cancer patient undergoing anti-cancer treatment of any sort to be offered a device to monitor 24/7 specific health measures over the course of their cancer care.

We are undertaking a three-phase project, and recently published the results of our first phase in JCO health Informatics. Forty-eight randomly-selected cancer patients were issued with a Garmin Vívosmart® 4 wearable device connected to a bespoke phone-based application (both Apple and Android smartphone compatible) designed by the Welsh MedTech company Aparito.

The application “Nitrogen by Aparito” was also supported by NHSx Techforce 19 as part of their COVID response fund.

Although the results are preliminary, we demonstrated an appetite from cancer patients to be involved in monitoring and measuring their health. It also gave us some key learning points for future phases of the study, particularly on which wearable and what clinical infrastructure we will need. There was also a real ‘buy-in’ from colleagues within the department who agree that an efficient digital solution has endless potential benefits.

The next two phases will consider sick, acute cancer patients; by measuring and monitoring their health data can they avoid unnecessary hospital admissions?

We are counting on our ongoing collaboration with Warwick University to develop a more predictive algorithm (using Artificial Intelligence) before testing with cancer patients.

The big supermarket chains spend huge sums of money capturing and monitoring our digital footprint in order to tailor our shopping but our health care remains reliant on subjective measures.  Yet, we are beginning to adapt for a digital age – the need and ability to adapt was demonstrated during the COVID pandemic where almost all consultations became virtual.

From government policy to local delivery, digital technology will become a mainstay of NHS care. There needs to be attention and focus on rural areas – like North Wales, and we are keen to ensure any intervention is tested to high research standards to ensure that cancer patients are the ultimate beneficiaries.