There’s an app for almost anything these days—even cancer care, thanks to a new treatment option now offered through University of Minnesota Health.
Experts from University of Minnesota Health and Fairview Health Services recently partnered with a company called Proteus Digital Health to bring a pioneering technology and a new category of pharmaceuticals called digital medicine to cancer care for the first time.
University of Minnesota Health Hematologist/Oncologist Edward Greeno, MD, has helped implement the digital medicines for cancer patients. We asked him for more information about the new advancement.
Digital medicines are currently used in the treatment of conditions like diabetes and hypertension. Until now, however, no health system has been able to offer digital medicines to cancer patients.
Here’s how the technology, called Proteus Discover, works: A small pill with an ingestible, FDA-approved sensor and prescribed medicine are put into a capsule by a pharmacist. In this case, the medicine is oral chemotherapy for patients with colorectal cancer. A patient wears a patch on their torso that syncs to a secure app. When the digital chemotherapy is taken and reaches the patient's stomach fluid, the sensor sends a signal that patch. The patch records the time the patient ingested the medicine, as well as the patient’s heart rate and activity patterns. This information is sent to the app on the patient’s mobile device.
Each patient can view health information on the app, get reminders to take medication and choose to share health data with a support network of caregivers. The patient's healthcare team can also access the patient’s data from the mobile app.
We deliver great care to our patients now, but we also must embrace opportunities to make it better. Over the years, we’ve put a lot of time and thought into creating safeguards for chemotherapy. But those safety measures are attached to the clinic, meaning they’re most effective when patients are receiving chemotherapy at our clinic under the supervision of our trained staff. Now that many cancer patients can take chemotherapy at home using oral medication, we’ve lost some of those safeguards. Digital medicine gives us the chance to provide safety oversight when a cancer patient takes oral chemotherapy from home, which leads to better outcomes for the people under our care.
Taking oral chemotherapy medicine at home can be challenging for cancer patients. If a patient doesn’t feel well, for example, that person might intentionally decide to skip a pill or take an extra dose. The can be problematic when taking oncology drugs. It’s also possible for a patient to misunderstand the instructions for their drugs and accidentally take them incorrectly.
We can avoid some of these problems with digital medicine. Using Proteus Discover, patients can see the history of when they took their medication and get reminders on their app when they need to take their next dose. They can also report and send any problems directly to me, their doctor, through this app. It gives patients more control and allows them to feel confident in their medication regimen.
Digital medicine provides me with a more direct connection to my patients. It is an additional tool I can use to keep my patients as healthy as possible and avoid potential problems. For example, if I can see that a patient isn’t taking their chemotherapy appropriately, I can intervene quickly to provide help. This could help prevent a patient from getting too sick on their own and ending up in the emergency room.
I can also use the information on steps or physical activity to have a conversation about exercise during chemotherapy with my patients. This is insight I haven’t had before, and it’s been a useful way to help facilitate broader conversations about their health. My patients have been very open to it.
First of all, using digital medicine is a choice my patients make. If one of my patients is interested in the program, I tell them it is a great way to stay more connected to me as their oncologist, and other members of the care team, without the need to travel and schedule time for an in-person visit. Of course I am still seeing my patients for our needed appointments. But the use of digital medicine allows us to have a touch point in between those visits, and we can make better use of our time during our appointments because we have data right there to discuss.
Patients taking oral chemotherapy at home or outside of a clinical setting won’t have a nurse and pharmacist evaluating them and their chemotherapy dose before each treatment. The patient needs to look in the mirror and do that evaluation. This responsibility can be both empowering and terrifying to the patient. This technology can turn that mirror into a window that gives us better visibility and access to help that person.