A paradigm shift

A traditional health system understands acute and emergency care. If a bone breaks, it needs mending. However, when patients face complex management of chronic diseases, the system falls short. Examples of the shortfall include: the coordination of care partners, community support, and consideration for a person’s entire life.

A diagnosis’ social, emotional, spiritual, cultural, and financial effects are not woven into the patient experience, even though these are known to be critical quality-of-life determinants. As more and more patients are expressing the need for a well-rounded treatment approach, the old models of care are coming into question.

This is especially true in the realm of oncology. “In our current healthcare system, cancer care delivery is often fragmented. Patients and caregivers face many challenges, including providers who do not communicate effectively; disjointed, uncoordinated services that do not address all of their issues; and fragmented, costly systems of care.”¹ This fragmentation leads to a decreased quality of life for many patients as they navigate their treatment.

In reality, battling a disease like cancer is a whole human problem. It engulfs the body and mind, and we must consider this when designing treatments.

An emerging treatment approach

Whole person care in oncology is an emerging treatment approach that shifts the focus from curing to healing. When a person receives a cancer diagnosis, its effect on their life can be devastating, from managing family obligations to losing relationships, job insecurity, financial burden, and depression. The list goes on.

Patients often feel unsupported during this journey, which can significantly affect their health outcomes (both mental and physical). “Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs.”²

Some innovative approaches, like the CaLM method, have responded to this growing need for cancer care innovation. The model reimagines cancer care by expanding the care team to include psychiatrists, dieticians, and even financial advisors. This approach is rooted in empathy, putting the individual’s lived experiences and needs at the center.

What has spurred this movement? The answer is multi-faceted and combines changing patient demographics and the resulting demand for complementary and alternative medicine (CAM) products and services. Recent advances in medical science and technology, and increased patient access to information, also play a role.

The patient of the future is informed. They demand better care. The prescriptive care model that has dominated healthcare must adapt to accommodate these emerging trends. A more human approach is needed.

Whole person care and the shift to home care

The COVID-19 pandemic has accelerated digital innovation in healthcare. Virtual care has been adopted very quickly in a short period. A nationwide survey conducted by the Canadian Medical Association in May 2020 showed 42% of those who had had the opportunity to use virtual care since the pandemic began would prefer a virtual method as the first point of contact with their physician.³

When we factor in tools like remote home monitoring, social support, and home modifications, we see an opportunity to revolutionize cancer treatment.

Let’s take a look at a common intervention like chemotherapy. Oncologists at the University of Pennsylvania created the Cancer Care at Home program after being forced to shift to home care during the pandemic. They found treatments safe, effective, and less costly for their patients. 95% of the patients asked preferred chemotherapy at home, and there were no statistically significant differences in overall adverse effects.⁴

This is a prime example of considering the whole person when administering care. Most people want to be in a comfortable environment. They want to be at home. The combination of the whole human approach and recent technological advancements spurred by the pandemic shows us a path forward. We can develop some exciting solutions if we apply good service design to these capabilities to improve patient satisfaction significantly.

Designing for the future of care

The movement towards patient-centricity and a more collaborative approach to care is here to stay. The challenge is how to make this happen. We are dealing with a complex, multi-faceted system with entrenched and habitual operating methods. For healthcare leaders, this can seem like an impossible task.

Effective service design and delivery begins with listening to the needs of stakeholders and moving towards a solution based on those needs. Solutions can emerge by flipping the focus from assumed desired outcomes (cure) to actual patient needs (healing).

Through empathy-driven conversations with patients and caregivers in learning labs, we can map the gaps and pain points in existing patient journeys and identify an ideal experience journey. These spark insights for healthcare and pharmaceutical organizations and enable us to prototype a designed vision for a future-state service blueprint. Co-creation workshops with all stakeholders generate how services could ideally be delivered in holistic care and treatment.

In the case of whole-person care, a deep understanding of the lived experiences of patients will unlock the pathway to meaningful and effective service design.

References

1 —Schear RM, et al. Cancer Life reiMagined: The CaLM Model of Whole-Person Cancer Care. Association of Community Cancer Centers. 2020 July-August. https://www.accc-cancer.org/docs/documents/oncology-issues/articles/2020/ja20/ja20-cancer-life-reimagined.pdf?sfvrsn=54770615_9
2 —Polley MJ, et al. Using a Whole Person Approach to Support People With Cancer: A Longitudinal, Mixed-Methods Service Evaluation. Integrative Cancer Therapies. 2016 April 9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5739159/
3 —Abacus Data. Canadian Medical Association. What Canadians Think About Virtual Health Care: Nationwide Survey Results. 2020 May. https://www.cma.ca/sites/default/files/pdf/virtual-care/cma-virtual-care-public-poll-june-2020-e.pdf
4 —Medscape. News & Perspective. Advantages and Disadvantages of At-Home Chemotherapy Administration. https://www.medscape.com/resource/oncology-cancer-treatment-at-home