Head of Global Commercial Innovation at Genmab

Chris Leggett

Image Credit: Natee Meepian | stock.adobe.com | AdobeStock_620910592

Cancer is a life-altering disease, and the pursuit of quality care can be daunting for those affected. However, oncology care is undergoing a significant transformation that brings hope to millions living with cancer — a shift towards home healthcare. In 2022, 1,918,030 new cancer cases and 609,360 cancer deaths were projected to occur in the United States.

 In the short years ahead, the numbers will continue to increase significantly, but with advances in technology combined with healthcare system changes to evolve areas like access and reimbursement, oncology home care will become an integrated part of the continuum of cancer care. 

The numbers are staggering and yet we’re immune to hearing them — sounding like a broken record. The good news is that more patients are living with cancer longer than ever before

, thanks to exciting innovations and advancements in technology. One ripple effect of these breakthroughs is the emerging shift towards value-based care and improved patient experiences at home. Embracing this new model could revolutionize how we deliver better and more patient-centered cancer care, providing improved patient outcomes, enhanced quality of life, and reduced strain on resources. While there are still hurdles to overcome along the way, home healthcare holds great promise for the future of oncology care and is undergoing significant transformation. The shift towards homecare is undoubtedly poised to be at the forefront of this paradigm shift.

From acute disease management to living longer and better

Thanks to innovative treatments, the focus of oncology care is and will continue to transition from acute disease management to chronic disease management. Patients are increasingly demanding the ability and access to receive quality cancer care in the comfort of their own homes. Not only is that a huge benefit to patients, but such a shift can address gaps in other areas, such as a shortage of healthcare professionals and geographical challenges faced by patients in reaching the right treatment centers. The healthcare system still lags in its ability to make the right tools and resources available to bridge this gap, but it’s never too late to start preparing for what we already know is coming.

Healthcare professionals now have the opportunity to manage patients outside of acute care settings. With the increasing adoption of remote patient monitoring and an understanding of how specific technologies work with individual patients, cancer care can finally be managed as a chronic condition rather than an acute one. Best of all, this type of care can be highly personalized to each patient's journey. Everyone living with cancer (and their caregivers) has unique circumstances; no two are the same. Quality home care is a way for patients and their families to have an improved quality of life, carrying out daily activities we often take for granted, without the hindrance of prolonged hospital stays or frequent visits to infusion suites. This shift not only changes the way providers manage the disease but also reflects how patients can play a major role in incorporating their care into their daily lives.

The demand for home care is already evident and growing. Look at Mayo Clinic's investment in Medically Home

, as well as the involvement of payers and retail pharmacies like CVS and Walgreens in home healthcare services. These moves suggest a shift towards expanding care well beyond traditional brick-and-mortar clinics and hospitals. The COVID-19 pandemic only further accelerated this trend, as more Americans lost their skepticism about taking part in virtual healthcare services and embraced home healthcare as an efficient, viable alternative. Most of us know all too well the frustrating experiences of the current healthcare system. It’s rife with inefficiencies and high costs; many of these are still persistent issues in the virtual space. The path forward will require far tighter integration of telehealth and digital health solutions, as well as loosening of cumbersome restrictions.

Easier said than done, but we are already seeing a constituency for change among the many Americans who have experienced the benefits of in-home care. As they are finding out, there are a wide range of benefits to home care, particularly for cancer patients:

First and foremost, it offers significant cost savings. By moving lower acuity services outside of hospitals and health systems and managing them remotely at home, resources such as hospital beds and infusion chairs are made available to patients in need, while providing more cost-effective care for others. Mayo Clinic has even explored the option of managing patients in nearby hotels for a brief period before sending them home, resulting in better access and substantial cost savings. Additionally, technology plays a vital role in enabling this trend, with advancements in remote patient monitoring and real-time alerts helping healthcare providers detect when additional services or emergency interventions may be required.

Another advantage of home care is the ability to gain insights into a patient's complete environment. By entering a patient's home, healthcare professionals can observe their nutrition, living conditions, and other factors that contribute to their overall health outcomes. This comprehensive understanding of the patient's life allows for better management and improved results. Moreover, home care reduces exposure to hospitals or clinics, which is particularly important for patients with weakened immune systems. It enables patients to maintain their regular daily routines and alleviates the burden on caregivers, who often face challenges related to transportation and scheduling.

But to fully accommodate home healthcare, there are two primary areas that need to evolve within the healthcare system.

First, stakeholder alignment and reimbursement policies need to be addressed, along with changes in regulations.

 We currently see far too many barriers at the state level that restrict telehealth consultations and second opinions. My own mother-in-law experienced the frustration of being unable to consult or have a telehealth appointment with specialists that could have potentially provided her additional treatment options because of onerous regulations in her state. To fully integrate telehealth and digital health solutions, federal regulations must be adjusted to overcome the burdensome state-level restrictions.

Second, there is a need for the evolution of value-based care models to support home healthcare.

 Reimbursement structures should align with the shift towards chronic disease management and incentivize providers to embrace oncology home care. 

While the advantages of home care are significant, let’s recognize that it is not a one-size-fits-all solution. The decision to provide care at home or in a healthcare facility must be based on individual patient needs and potential risks. Adequate training and upskilling of staff are crucial to ensuring that home care is effectively implemented and managed. Additionally, expanding access to reliable internet and cellular capabilities in rural areas is essential; as hard as it can be to believe in 2023, some patients currently must rely on public Wi-Fi access points at local fast-food restaurants to connect with their care teams.

Above all, the future of oncology care promises hope, providing new options for millions battling cancer. With cancer projected to grow globally to 26 million new cancer cases and 17 million cancer deaths per year by 2030

, this necessary shift from acute to chronic disease management models, coupled with advancements in technology, will enable patients to receive cancer care in the comfort of their own homes. There will no doubt be technical, organizational, and cultural hurdles to overcome along the way. By embracing oncology home care, healthcare systems can improve patient outcomes, enhance quality of life, and alleviate the strain on resources, ultimately delivering better and more patient-centered care for those living with cancer.

Chris Leggett is the Head of Global Commercial Innovation at Genmab

https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21708

https://www.health.com/news/cancer-survivor-rates-increase

https://homehealthcarenews.com/2022/01/medically-home-looks-to-expand-business-model-after-landing-110m-strategic-investment/#:~:text=The%20Mayo%20Clinic%20and%20Kaiser,Clinic%20and%20Kaiser%20again%20contributing

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802672/

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While there are still hurdles to overcome along the way, home healthcare could deliver better patient-centered cancer care, providing improved patient outcomes, enhanced quality of life, and reduced strain on resources.