© Santiago Esteban / City Cancer Challenge
Reducing fragmentation in cancer care services is key to enhancing the quality of diagnosis, treatment and care, especially in low-resource settings. It is still common for patients to lack the support to navigate the care ecosystem precisely when they are most vulnerable.
At the same time, health professionals are left to manage interrupted patient information flows. This problem is exacerbated by the lack of data exchange and limited interoperability between existing healthcare information systems, facilities and providers, often resulting in inaccurate diagnoses, inadequate follow-up with patients, and ultimately, poor patient outcomes.
The solution is to break down data silos so that healthcare professionals can share patient information, allowing them to provide timely and accurate clinical decisions, reduce duplication of efforts and help patients navigate the cancer care system more easily.
The importance of a multi-stakeholder approach
Experience shows that the setup and implementation of innovative health solutions are more likely to be successful when a broad range of stakeholders and decision-makers from the public and private sectors are part of the process.
Involving medical, technical and legal experts to ensure that all aspects of a new initiative are covered from the outset creates ownership and contributes to the long-term success of a project.
A great example of this is the World Bank's new Digital Development Partnership which brings together public and private sector partners, such as Google, Microsoft and the Global System for Mobile Communications, to catalyse support for developing countries when creating and implementing digital development strategies, combining expertise from digital innovation and development financing in the process.
This collaborative approach is reinforced in the way cities in the City Cancer Challenge (C/Can) global network are addressing interoperability. In Kigali, a partnership between the Rwanda Biomedical Centre, Rwanda's central health implementation agency, and Allm, a Japanese medical ICT company, will support the exchange of medical information and coordination of healthcare service delivery including for oncology. By integrating an innovative digital platform, the aim is to provide more equitable, integrated and continuous health services for people in Kigali.
Digital solutions in a time of crisis
In parallel, investments are required to increase health workforce capacity. Equipping and training community health workers in digital data collection will help to ensure the generation of real-time data for disease surveillance and monitoring, including cancer surveillance.
In the World Bank's Uganda Economic Update, Digital Solutions in a Time of Crisis, one of the key recommendations to keep pace with technological innovation and support a more inclusive digital economy is the development of a national digital skills framework.
These conclusions align with the ongoing digital transformation process in Rwanda, where supporting the training and coordination of healthcare professionals to deliver improved outcomes for patients will be critical to the integration of new digital tools.
As Allison Ekberg Dvaladze, Health Policy Advisor for Health System Strengthening, WHO EURO, explained at C/Can’s recent Digital Health Discovery Forum:
"Digital health tools will continue to play a growing role in providing health care globally. Building and maintaining trust in their application through transparency, partnerships, public and end-user engagement and by placing patient needs at the forefront is essential to driving successful interventions and achieving meaningful outcomes."
In other cities, C/Can is supporting local stakeholders to develop networks of integrated care providers with the training, guidelines, infrastructure and data to meet the needs of patients and their families across the cancer care continuum.
In Cali, Colombia, two institutional cancer registries have been created at the Fundación Valle de Lili and the Hospital Universitario del Valle, with local technical assistance from the population-based cancer registry. Building on this effort, the municipal health secretariat is now collaborating with the Universidad del Valle to create a Cali cancer observatory.
This platform brings together data from different sources in Cali to generate a comprehensive analysis of the cancer situation in the city using a cross-institutional and multi-stakeholder approach.
Throughout 2020, C/Can cities have demonstrated their capacity to respond with agility to challenging environments and deliver tangible actions rapidly and effectively that previously would have taken months or years of planning.
We need to harness this mindset to bring the right stakeholders together and connect healthcare providers, patients and information systems in a way that is scalable and sustainable. And we must remain grounded in our purpose of delivering quality, patient-centered care and the delivery of better outcomes for patients.
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